Remarkable effect of milnacipran, a serotonin–noradrenalin reuptake inhibitor (SNRI), on depressive symptoms in patients with Parkinson's disease who have insufficient response to selective serotonin reuptake inhibitors (SSRIs): two case reports

2005 ◽  
Vol 29 (2) ◽  
pp. 351-353 ◽  
Author(s):  
Hitoshi Takahashi ◽  
Mitsuhiro Kamata ◽  
Keizo Yoshida ◽  
Hisashi Higuchi ◽  
Tetsuo Shimizu
Keyword(s):  
Parkinson’S Disease ◽  
Depressive Symptoms ◽  
Reuptake Inhibitor ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Case Reports ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Remarkable Effect ◽  
Insufficient Response

Extrapyramidal Reactions and the Selective Serotonin-Reuptake Inhibitors

1997 ◽  
Vol 31 (12) ◽  
pp. 1481-1489 ◽  
Author(s):  
Charles F Caley
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Medical Literature ◽  
Case Reports ◽  
Hospital Readmissions ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Contributing Factors

OBJECTIVE: To review the known published reports of extrapyramidal reactions (EPRs) associated with the use of selective serotonin-reuptake inhibitors (SSRIs). DATA SOURCES: Information was selected from a MEDLINE search (January 1990 to January 1996) of English-language medical literature. Manual searches of pertinent journal article bibliographies were also performed. DATA EXTRACTION: Appropriate information from all reports obtained was included, with specific attention directed toward patient age, gender, primary psychiatric diagnosis, total daily SSRI dosage, dosage escalation strategy, and concurrent psychotropic medications. DATA SYNTHESIS: Reports of EPRs associated with SSRI use have been accumulating in the medical literature for several years. More commonly associated with high-potency antipsychotics, EPRs can have an adverse impact on medication compliance and hospital readmissions. The proposed hypothesis for EPRs occurring with SSRI use involves serotonin's inhibitory actions on extrapyramidal dopamine activity. Other possible contributing factors include pharmacokinetic interactions or drug—disease interactions. EPRs may include dystonias, dyskinesias, akathisia, parkinsonism, exacerbations of Parkinson's disease, and possibly the neuroleptic malignant syndrome. The majority of SSRI-related reactions appear to occur within the first month of treatment. Information from available case reports does not strongly support any consistent risk factor, although some worth considering may include total SSRI daily dose, rapid dose escalation strategies, increased age, female gender, concurrent psychotropics known to also precipitate EPRs, and concurrent disease states such as Parkinson's disease. Since SSRI-related EPRs have occurred in different situations with different possible contributing factors, clinical pharmacy practitioners and other healthcare providers should remain aware of these reactions and carefully consider educating and monitoring their patients accordingly. CONCLUSIONS: The use of SSRIs may be associated with the development of EPRs; therefore, appropriate monitoring should be considered for patients so that optimal pharmaceutical care may be provided.

Hyponatremia associated with selective serotonin-reuptake inhibitors

2017 ◽  
Vol 41 (S1) ◽  
pp. S758-S758
Author(s):  
S. Petrykiv ◽  
L. De Jonge ◽  
M. Arts
Keyword(s):  
Risk Factors ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Current Knowledge ◽  
Case Reports ◽  
Serotonin Reuptake Inhibitors ◽  
Older Age ◽  
Selective Serotonin ◽  
Cochrane Library ◽  
Baseline Serum

IntroductionPsychotropic agents have been implicated in the cause of hyponatremia, including the majority of selective serotonin reuptake inhibitors (SSRIs). The reported incidence of hyponatremia caused by SSRIs varies widely up to 40%. Important risk factors are older age and concomitant use of diuretics. Though there are numerous retrospective studies available, an update of current knowledge SSRI induced hyponatremia is warranted.Objectives and aimsTo review the incidence, risk factors, mechanism, times of onset and resolution, and treatment of hyponatremia associated with selective serotonin-reuptake inhibitors (SSRIs).MethodsAn English language literature search was conducted using Pubmed, EMBASE and Cochrane library (December 1980–December 2015) using the search terms selective serotonin-reuptake inhibitor, hyponatremia, syndrome of inappropriate secretion of antidiuretic hormone, citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline.ResultsNumerous case reports, observational studies, and case-controlled studies, as well as one prospective clinical trial, have reported hyponatremia associated with SSRI use, with an incidence of 15%. Risk factors for the development of hyponatremia with SSRIs include older age, female gender, and concomitant use of diuretics, low body weight, and lower baseline serum sodium concentration. Predisposing factors, such as volume status, diuretic use, or concomitant use of other agents known to cause SIADH, may predispose to the development of hyponatremia. In published reports, hyponatremia developed within the first few weeks of treatment and resolved within 2 weeks after therapy was discontinued.ConclusionPractitioners should be on the alert for this potentially life-threatening adverse event, especially in older adults.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Sex differences in depressive symptoms and tolerability after treatment with selective serotonin reuptake inhibitor antidepressants: Secondary analyses of the GENPOD trial

2021 ◽  
pp. 026988112098641
Author(s):  
Marilia Gougoulaki ◽  
Glyn Lewis ◽  
David J Nutt ◽  
Tim J Peters ◽  
Nicola J Wiles ◽  
...  
Keyword(s):  
Sex Differences ◽  
Depressive Symptoms ◽  
Reuptake Inhibitor ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Menopausal Status ◽  
Physical Symptoms ◽  
Treatment Discontinuation ◽  
Selective Serotonin ◽  
Secondary Analyses

Background: Differences in serotonergic neurotransmission could lead to sex differences in depressive symptoms and tolerability after treatment with selective serotonin reuptake inhibitors (SSRIs). Aims: We investigated whether women have greater reductions in depressive symptoms than men after treatment with an SSRI (citalopram) compared with a noradrenaline reuptake inhibitor (reboxetine) control, and after antidepressant treatment irrespective of class. We also investigated tolerability and the influence of menopausal status. Methods: Secondary analyses of the GENPOD (GENetic and clinical Predictors Of treatment response in Depression) trial. Six hundred and one people with depression were recruited from UK primary care and randomized to citalopram or reboxetine. Beck Depression Inventory (BDI-II) score at 6 weeks was the primary outcome. Secondary outcomes included BDI-II score at 12 weeks, and physical symptoms and treatment discontinuation. We calculated main effects and interaction terms using linear and logistic regression models. Results: There was no evidence that women experienced greater reductions in depressive symptoms than men when treated with citalopram compared with reboxetine. We also found no evidence of sex differences at six or 12 weeks (irrespective of antidepressant class): men scored −0.31 (95% confidence interval (CI) −2.23 to 1.62) BDI-II points lower than women at six weeks and −0.44 (95% CI −2.62 to 1.74) points lower at 12 weeks. There was no evidence of sex differences in physical symptoms or treatment discontinuation and no evidence for an influence of menopausal status. Conclusion: Citalopram was not more effective in women compared with men and there was no difference in tolerability. Women and men had similar prognosis after SSRI treatment and similar prognosis regardless of antidepressant class. Findings were unaltered by menopausal status.

Extrapyramidal Symptoms with Selective Serotonin Reuptake Inhibitors

1994 ◽  
Vol 165 (6) ◽  
pp. 728-733 ◽  
Author(s):  
Dinesh K. Arya
Keyword(s):  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Case Reports ◽  
Serotonin Reuptake Inhibitors ◽  
Extrapyramidal Symptoms ◽  
Selective Serotonin ◽  
Neurotransmitter System ◽  
Literature Searches ◽  
Dopaminergic Neurotransmitter ◽  
Preclinical And Clinical Studies

BackgroundSeveral case reports in the literature suggest that selective serotonin reuptake inhibitors can produce extrapyramidal symptoms.MethodComputerised literature searches were used to identify reports on extrapyramidal symptoms and serotonin reuptake inhibitors. Subsequently, manual searches were made for articles in which there was any indication of the mechanisms responsible for these extrapyramidal symptoms.ResultsOnly a few reports could be identified in which serotonin reuptake inhibitors were implicated in extrapyramidal symptoms in some patients.ConclusionsEvidence is discussed from preclinical and clinical studies suggesting the interaction between serotoninergic and dopaminergic neurotransmitter system, as a possible mechanism for production of extrapyramidal symptoms.

Efficacy of Traditional Chinese Medicine Combined with Selective Serotonin Reuptake Inhibitors on the Treatment for Parkinson’s Disease with Depression: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 49 (03) ◽  
pp. 627-643
Author(s):  
Si-Tong Feng ◽  
Xiao-Le Wang ◽  
Ya-Ting Wang ◽  
Yu-He Yuan ◽  
Zhi-Peng Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin

Depression is a common neuropsychiatric symptom of Parkinson’s disease (PD), resulting in a lower quality of life and cognitive impairment in PD patients. Traditional Chinese medicine (TCM) formulas have been widely used in neurodegenerative disease and neuropsychic disorders to improve life quality of patients in ethnomedicine. TCM formulas combined with selective serotonin reuptake inhibitors (SSRIs) also have a positive effect on depressed PD compared with SSRIs as reported by several clinical studies. However, the results are discordant and failed to be conclusive. We aim to evaluate the efficacy of TCM formulas combined with SSRIs for depressed PD in this systematic review. We searched literatures from PubMed, Web of Science, Medline, Embase, Google Scholar, Chinese National Knowledge Infrastructure, Wanfang Database, and VIP Information Database before July 2020. We included randomized controlled trials investigating the efficacy of TCM formulas combined with SSRIs on depressed PD patients. This analysis was according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Eleven randomized clinical trials involving 861 subjects were enrolled in this analysis. The overall results showed that TCM formulas combined with SSRIs significantly improved the depression score [weighted mean difference (WMD): −4.920, 95% confidence interval (CI): (−5.999, −3.840); [Formula: see text]¡ 0.001] and had a statistical significance on Unified Parkinson’s Disease Rating Scale II score [WMD: −1.209, 95% CI: (−1.561, −0.857); [Formula: see text] < 0.001]. Furthermore, we observed that Chai-Hu-Shu-Gan Powder combined with SSRIs had a significant improvement on the depressive symptom in PD compared to the SSRIs alone [WMD: −5.390, 95% CI: (−7.66, −3.11); [Formula: see text] < 0.001]. No severe side events were reported in these included trials. This systematic review provided the evidences that TCM formulas combined with SSRIs might be helpful and safe in the treatment of depression of PD, including Chai-Hu-Shu-Gan Powder. Also, more randomized double-blinded trials with reliable design are required in the future.

scholarly journals Drug interaction between a selective serotonin reuptake inhibitor and a triptan leading to serotonin toxicity: a case report and review of the literature

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Gilbert Jin ◽  
Philip Stokes
Keyword(s):  
Drug Interaction ◽  
Selective Serotonin Reuptake Inhibitor ◽  
Reuptake Inhibitor ◽  
Lower Limb ◽  
Side Effect ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Serotonin Toxicity

Abstract Background Serotonin toxicity is a known side effect of selective serotonin reuptake inhibitors and has previously also been described as a possible side effect of 5-hydroxytryptamine receptor agonist (triptan) medications. However, the literature is conflicted about the risk of developing serotonin toxicity as a result of drug interaction between selective serotonin reuptake inhibitors and triptans. Case presentation A 30-year-old Caucasian woman with a history of depression on regular fluvoxamine presented to the emergency department with right-sided facial and lower limb twitching. The patient had recently been prescribed sumatriptan for migraines and had taken her first ever dose shortly prior to the onset of symptoms. She was tachycardic, diaphoretic, and hypertonic on initial assessment with bilateral lower limb and ocular clonus. Electrocardiogram showed sinus tachycardia with QT interval under the treatment interval, and pathology and imaging findings were unremarkable. Her symptoms improved with supportive management and cyproheptadine. Conclusions This patient’s presentation fulfilled both Sternbach and Hunter criteria for serotonin toxicity, illustrating a potential case of serotonin toxicity as a result of drug interaction between a selective serotonin reuptake inhibitor and a triptan.

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