scholarly journals Psychotropic drug-induced hyponatremia: results from a drug surveillance program–an update

2021 ◽  
Author(s):  
Johanna Seifert ◽  
Martin Letmaier ◽  
Timo Greiner ◽  
Michael Schneider ◽  
Maximilian Deest ◽  
...  
Keyword(s):  
Psychotropic Drugs ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Sodium Concentration ◽  
Electrolyte Imbalance ◽  
Selective Serotonin ◽  
Surveillance Program ◽  
Drug Surveillance ◽  
Angiotensin Ii Receptor ◽  
Drug Induced ◽  
Converting Enzyme Inhibitors

AbstractHyponatremia (HN) is the most common electrolyte imbalance (defined as a serum sodium concentration Na(S) of  < 130 mmol/l) and often induced by drugs including psychotropic drugs. AMSP (Arzneimittelsicherheit in der Psychiatrie) is a multicenter drug surveillance program that assesses severe or unusual adverse drug reactions (ADRs) occurring during treatment with psychotropic drugs. This study presents data from 462,661 psychiatric inpatients treated in participating hospitals between 1993 and 2016 and serves as an update of a previous contribution by Letmaier et al. (JAMA 15(6):739–748, 2012). A total of 210 cases of HN were observed affecting 0.05% of patients. 57.1% of cases presented symptomatically; 19.0% presented with severe symptoms (e.g., seizures, vomiting). HN occurred after a median of 7 days following the first dose or dose increase. Incidence of HN was highest among the two antiepileptic drugs oxcarbazepine (1.661% of patients treated) and carbamazepine (0.169%), followed by selective serotonin-norepinephrine reuptake inhibitors (SSNRIs, 0.088%) and selective serotonin reuptake inhibitors (0.071%). Antipsychotic drugs, tricyclic antidepressants, and mirtazapine exhibited a significantly lower incidence of HN. The risk of HN was 16–42 times higher among patients concomitantly treated with other potentially HN-inducing drugs such as diuretic drugs, angiotensin-converting-enzyme inhibitors, angiotensin II receptor blockers, and proton pump inhibitors. Female SSNRI-users aged  ≥ 65 years concomitantly using other HN-inducing drugs were the population subgroup with the highest risk of developing HN. The identification of high-risk drug combinations and vulnerable patient subgroups represents a significant step in the improvement of drug safety and facilitates the implementation of precautionary measures.

scholarly journals Syndrome of Inappropriate Secretion of Antidiuretic Hormone due to Selective Serotonin Reuptake Inhibitors After Pancreaticoduodenectomy for Carcinoma of the Ampulla of Vater: Case Report

2013 ◽  
Vol 98 (4) ◽  
pp. 289-291
Author(s):  
Ryota Iwase ◽  
Hiroaki Shiba ◽  
Takeshi Gocho ◽  
Yasuro Futagawa ◽  
Shigeki Wakiyama ◽  
...  
Keyword(s):  
Antidiuretic Hormone ◽  
Serum Sodium ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Plasma Osmolality ◽  
Sodium Concentration ◽  
Ampulla Of Vater ◽  
Serum Sodium Concentration ◽  
Selective Serotonin ◽  
Inappropriate Secretion

Abstract A 68-year-old man underwent pancreaticoduodenectomy with lymph nodes dissection for carcinoma of the ampulla of Vater. The patient had anxiety neurosis and had been treated with a selective serotonin reuptake inhibitor (SSRI). Postoperatively, SSRI was resumed on postoperative day 2. His serum sodium concentration gradually decreased, and the patient was given a sodium supplement. However, 11 days after the operation, laboratory findings included serum sodium concentration of 117 mEq/L, serum vasopressin of 2.0 pg/mL, plasma osmolality of 238 mOsm/kg, urine osmolality of 645 mOsm/kg, urine sodium concentration of 66 mEq/L, serum creatinine concentration of 0.54 mg/dL, and serum cortisol concentration of 29.1 μg/dL. With a diagnosis of syndrome of inappropriate secretion of antidiuretic hormone (SIADH), the antianxiety neurosis medication was changed from the SSRI to another type of drug. After switching the medication, the patient made a satisfactory recovery with normalization of serum sodium by postoperative day 20.

scholarly journals Ankle edema after administration of selective serotonin reuptake inhibitors

2018 ◽  
Vol 10 (1) ◽  
pp. 25-26
Author(s):  
Konstantinos Kontoangelos ◽  
Marina Ecomomou ◽  
Charalambos Papageorgiou
Keyword(s):  
Psychotropic Medication ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Clinical Manifestations ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Drug Induced ◽  
Skin Reactions ◽  
Wide Range ◽  
Life Threatening

Clinical manifestations of drug-induced skin reactions include a wide range of symptoms, from mild drug-induced exanthemas to dangerous and life-threatening generalized systematic reactions. Drug-induced skin reactions to psychotropic medication are usually associated with antiepileptic drugs. However, a significant role can be assigned to selective serotonin reuptake inhibitors. We report a case of a female patient, who after approximately one month therapy with escitalopram developed a bilateral ankle edema, which resolved completely within the first week following its discontinuation. Although serious complications are rare, clinicians should be aware of severe skin complications in patients treated with antidepressants, which necessitate careful clinical monitoring and management. Individualization of pharmacotherapy is crucial, together with regular evaluation of safety and tolerance of the treatment.

The Impact of Trends in Psychotropic Prescribing on the Method of Suicide in the Elderly

2005 ◽  
Vol 45 (2) ◽  
pp. 115-120 ◽  
Author(s):  
Ajit Shah ◽  
Lubbaba Lodhi
Keyword(s):  
Psychotropic Drugs ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
The Elderly ◽  
Serotonin Reuptake Inhibitors ◽  
Prescribing Patterns ◽  
Selective Serotonin ◽  
Hypnotics And Sedatives ◽  
Suicide Rates ◽  
Elderly Suicide

Suicide rates in the elderly have declined in many countries in recent years. This decline has been reported to be associated with increased prescribing of antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), antipsychotics and antimanic drugs and reduced prescribing of barbiturates, hypnotics and sedatives. This study examined the relationship between prescribing patterns of individual psychotropic drugs and suicide rates by specific methods of elderly suicides. There was a negative correlation between the prescription of tricyclic antidepressants, selective serotonin reuptake inhibitors, antipsychotics, antimanic drugs and non-opiate analgesics and a decline in elderly suicide rates due to poisoning by solid and liquid substances, hanging, strangulation and suffocation, drowning, firearms and explosives, and jumping from high places. There was a positive correlation between the prescription of barbiturates, hypnotics and sedatives and elderly suicide rates due to poisoning by solid and liquid substances, hanging, strangulation and suffocation, drowning, firearms and explosives, and jumping from high places. This study demonstrated that changes in prescribing patterns of individual psychotropic drugs do influence elderly suicide rates of the commonly used methods of suicide and suggest that this may be due to more accurate diagnostic-specific prescribing of psychotropic drugs.

scholarly journals Drug-Induced Liver Injury during Antidepressant Treatment: Results of AMSP, a Drug Surveillance Program

2015 ◽  
Vol 19 (4) ◽  
pp. pyv126 ◽  
Author(s):  
Michaela-Elena Friedrich ◽  
Elena Akimova ◽  
Wolfgang Huf ◽  
Anastasios Konstantinidis ◽  
Konstantinos Papageorgiou ◽  
...  
Keyword(s):  
Liver Injury ◽  
Antidepressant Treatment ◽  
Surveillance Program ◽  
Drug Surveillance ◽  
Treatment Results ◽  
Drug Induced ◽  
Drug Induced Liver Injury

Drug-induced pancreatitis: focus on drugs used to treat cardiovascular disease

2021 ◽  
pp. 37-42
Author(s):  
A. V. Filippova ◽  
O. D. Ostroumova
Keyword(s):  
Adverse Reactions ◽  
Enzyme Inhibitors ◽  
Antihypertensive Drugs ◽  
Case Series ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Angiotensin Ii Receptor ◽  
Drug Induced ◽  
Converting Enzyme Inhibitors ◽  
Treatment And Prevention ◽  
Meta Analyses

Cardiovascular diseases (CVD) are the leading cause of death worldwide and in Russia. Therefore, the question of safe and rational drug therapy is acute. But, like most drugs, drugs for the treatment of CVD have a number of adverse reactions, in particular, the development of acute pancreatitis. This adverse reactions can be both dose-dependent and depend on the duration of administration of these groups of drugs. The purpose of this review is to analyze the literature data on drugs intended for the treatment of СVD that can lead to the development of drug-induced pancreatitis (LIP), on the mechanisms of development of this pathology against the background of taking specific drugs, diagnosis, treatment and prevention. The development of LIP is associated with the use of diuretics, both loop (furosemide, etacric acid, bumetamide), and thiazide/thiazide-like (chlorothiazide, hydrochlorothiazide and chlorthalidone), antihypertensive drugs of central action (methyldopa), angiotensin converting enzyme inhibitors and angiotensin II receptor blockers, statins, antiarrhythmic drugs (amiodarone, procainamide). Literature data on the development of LIP are presented in most publications with the description of clinical case/series of cases, however, in the case of LIP associated with the use of ACEI and statins, there are also data from cohort, retrospective observational, prospective case-control, randomized controlled trials, and meta-analyses. With timely diagnosis, and the cancellation of drugs that have caused the development of OP, the symptoms of the disease regress until they completely disappear and develop serious consequences.

Use of buspirone in selective serotonin reuptake inhibitor-induced sleep bruxism

2017 ◽  
Vol 41 (S1) ◽  
pp. s855-s855
Author(s):  
V. Prisco ◽  
T. Iannaccone ◽  
G. Di Grezia
Keyword(s):  
Ventral Tegmental Area ◽  
Cortical Neurons ◽  
Serotonin Reuptake ◽  
Sleep Disturbances ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Myofascial Pain ◽  
Sleep Bruxism ◽  
Selective Serotonin ◽  
Drug Induced ◽  
Ventral Tegmental

Sleep bruxism is characterized by the involuntary clenching or grinding of the teeth during sleep and can cause severe health problems, including the destruction of tooth structure, temporo-mandibular joint dysfunction, myofascial pain, and severe sleep disturbances. Iatrogenic sleep bruxism may be common during treatment with psychotropic medications, such as anti-psychotics and antidepressants, especially selective serotonin reuptake inhibitors (SSRIs). Bruxism is a common movement disorder that affects 8–21% of the population. The majority of bruxism symptoms are mild or moderate, although rare but severe cases may lead to serious periodontal damage, temporo-mandibular dysfunction, sleep disturbances, jaw pain, and stiffness. As a result, such cases must be treated with medication. It has been hypothesized that the mechanism of SSRI-induced bruxism may involve excessive serotonergic action on the meso-cortical neurons arising from the ventral tegmental area. It has been argued that,the addition of buspirone, was necessitated by the high level of residual anxiety. As a result, these symptoms may have been prevented through the use of buspirone alone. Buspirone, is an agonist of the 5-HT1A receptor that increases dopaminergic neuron, firing in the ventral tegmental area and increases the synaptic release of dopamine in the prefrontal cortex. These effects ameliorate drug-induced bruxism. Buspirone can also ameliorate extrapyramidal side effects, such as akathisia and tardive dyskinesia, and this property may be an additional explanation for the bruxism-related effects of the drug. Furthermore, buspirone may be an effective treatment for the bruxism associated with the use of these medications.Disclosure of interestThe authors have not supplied their declaration of competing interest.

PRIAPISM AS A COMPLICATION OF PSYCHOPHARMACOTHERAPY

2020 ◽  
pp. 33-43
Author(s):  
Andrey V. Golenkov
Keyword(s):  
Psychotropic Drugs ◽  
Selective Serotonin Reuptake Inhibitors ◽  
First Generation ◽  
Selective Serotonin ◽  
Elderly Men ◽  
Stabilizing Agents ◽  
Daily Dose ◽  
Female Version ◽  
Almost All ◽  
Injectable Form

Priapism is a serious complication of psychopharmacotherapy, which can result in erectile dysfunction if there is no timely diagnosis and treatment. Purpose: to study cases of priapism in patients taking psychotropic drugs which were described in the literature. Articles were searched in the Medline database (1969-2020) in English by keywords – priapism and psychotropic drugs. 265 articles were found, most of which were devoted to the use of trazodone (81 articles) and resperidone (50) in patients with mental disorders with the development of priapism. There were cases of such complication associated with taking 12 antipsychotics (six – of the first generation and six – of the second; three – drugs of prolonged action) and 12 antidepressants (from the group of tricyclic, tetracyclic, selective serotonin and dopamine reuptake inhibitors, monoamine oxidase inhibitors, serotonin and norepinephrine reuptake antagonists/inhibitors, selective serotonin reuptake inhibitors), as well as four mood stabilizing agents. The prescribed doses of drugs varied widely. Often these medications were used in various combinations. Priapism most often occurred in the first days (month) of treatment with low doses of drugs. Cases of priapism against the background of psychopharmacotherapy are described not only in adults and elderly men, but also in children starting from the age of two, as well as in women who developed clitorism (female version of priapism). Although priapism is caused by many factors, caution should be exercised when adding other psychotropic drugs to treatment, when increasing their single (daily) dose, passing from the tablet to the injectable form, including appointment of depot drugs, and canceling treatment. Special attention should be paid to patients having episodes of prolonged erections and hematological pathology (hemoglobinopathies and thrombophilias) in their medical history. Priapism is a rare but dangerous complication that requires urgent urological care. This condition can develop when taking almost all psychotropic drugs that have serotoninergic, dopaminergic and alpha-adrenergic antagonistic properties.

Psychopharmacology in medical practice

2020 ◽  
pp. 6465-6470
Author(s):  
Philip J. Cowen
Keyword(s):  
Psychiatric Disorders ◽  
Medical Practice ◽  
Psychotropic Drugs ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Antipsychotic Drugs ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Medical Conditions ◽  
Antianxiety Drugs

Drugs intended to treat psychiatric disorders are referred to as psychotropic drugs. The main categories are antidepressants, mood stabilizing drugs, antipsychotic drugs, and antianxiety drugs. These drugs are widely used in medical practice and most clinicians are likely to have under their care several patients receiving treatment with them. Practitioners therefore need to have an understanding of both the uses and unwanted effects of psychotropic drugs, and particularly of (1) their interactions with drugs used to treat other medical conditions, (2) characteristic abstinence syndromes that can occur with sudden discontinuation of antidepressants (particularly selective serotonin reuptake inhibitors and venlafaxine) and anxiolytics.

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