Monoamine Agonists (“Antidepressants”), Including Dopamine Agonists (“Stimulants”)

2018 ◽  
pp. 85-100
Author(s):  
S. Nassir Ghaemi
Keyword(s):  
Clinical Pharmacology ◽  
Side Effects ◽  
Sexual Dysfunction ◽  
Drug Interactions ◽  
Psychotropic Drugs ◽  
Withdrawal Syndrome ◽  
Serotonin Reuptake ◽  
Dopamine Agonists ◽  
Serotonin Reuptake Inhibitors ◽  
Norepinephrine Reuptake

The drug class of monoamine agonists includes agents called antidepressants and stimulants. Monoamine agonists are the most widely used class of psychotropic drugs. There are three major monoamines, and thus three main types of monoamine agonists. We consider each in turn: the serotonin reuptake inhibitors (SRIs), norepinephrine reuptake inhibitors (NRIs), and dopaminergic agents. We also discuss the dopamine agonists—bupropion (Wellbutrin) and amphetamines (“stimulants”), as well as other new monoamine agonists. The clinical pharmacology of specific agents within each class, including their efficacy and side effects, is explored. Specific phenomena surveyed include SRI tolerance, sexual dysfunction, drug interactions, serotonin withdrawal syndrome, and suicide and akathisia.

Female Sexual Side Effects Associated with Selective Serotonin Reuptake Inhibitors: A Descriptive Clinical Study of 33 Patients

1995 ◽  
Vol 25 (3) ◽  
pp. 239-248 ◽  
Author(s):  
Winston W. Shen ◽  
Jeffrey H. Hsu
Keyword(s):  
Side Effects ◽  
Sexual Dysfunction ◽  
Adverse Effects ◽  
Serotonin Reuptake ◽  
Female Sexual Dysfunction ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Spontaneous Remission ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Sexual Side Effects

Objective: After the advent of selective serotonin reuptake inhibitors on the U.S. market in 1988, American psychiatrists have been faced with more choices of antidepressants for the treatment of depression. The prescribing of SSRIs has been increasing in popularity because they are easily titrated by the physicians and tolerated by patients. However, the SSRI use is frequently associated with female sexual dysfunction. The aim of this study was to describe these SSRI-associated female sexual side effects. Methods: In a retrospective series, clinic records of 110 female SSRI-treated outpatients were reviewed for loss of or decreased libido, orgasmic disturbances (anorgasmia or delayed orgasm), as well as clinical management patterns to alleviate sexual side effects. Results: Twenty-one fluoxetine-, nine paroxetine-, and five sertraline-treated cases with female sexual inhibition were identified. The fates of SSRI-associated sexual adverse effects and clinical managements of restoring these side effects were described. Conclusions: With some limitations in interpreting the data, the findings of this study suggest that SSRI-associated female sexual dysfunction occurs at a higher rate than we previously thought, equal potentials in implicating female sexual side effects among three SSRIs, and the absence or the low incidence of female sexual adverse effects from bupropion, and that these side effects can be managed by waiting for a spontaneous remission, dosage reduction of SSRIs, substitution with bupropion and other antidepressants, or the use of an antidote.

scholarly journals Sexual dysfunction in selective serotonin reuptake inhibitors (SSRIs) and potential solutions: A narrative literature review

2016 ◽  
Vol 6 (4) ◽  
pp. 191-196 ◽  
Author(s):  
Elizabeth Jing ◽  
Kristyn Straw-Wilson
Keyword(s):  
Side Effects ◽  
Sexual Dysfunction ◽  
Health Care Providers ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Treatment Strategies ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Care Providers ◽  
Sexual Side Effects

Abstract Sexual dysfunction is an underdiscussed adverse effect to selective serotonin reuptake inhibitors (SSRIs) and may increase the risk for discontinuation and nonadherence to antidepressant pharmacotherapy. Given the prevalence of depression, health care providers should educate patients about SSRI-associated sexual dysfunction in order to promote patient awareness and medication adherence. This study evaluated primary literature from 1997 to 2015 to identify SSRI-related sexual side effects, therapeutic alternatives, and treatment strategies. The results indicate that paroxetine is associated with the greatest rate of sexual dysfunction among the SSRIs. Potential alternatives to SSRI treatment include bupropion, mirtazapine, vilazodone, vortioxetine, and serotonin-norepinephrine reuptake inhibitors. In the event that a subject responds solely to SSRIs but experiences unwanted sexual side effects, bupropion may be added as an adjunctive medication. Some limited evidence also suggests that saffron may reduce some aspects of sexual dysfunction, excluding ability to reach orgasm.

scholarly journals Side effects of psychotropic drugs on eye

2021 ◽  
Vol 21 (1) ◽  
pp. 29-33
Author(s):  
A.A. Petukhova ◽  
◽  
A.A. Panov ◽  
Ya.V. Malygin ◽  
M.A. Kazanfarova ◽  
...  
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Psychotropic Drugs ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Tricyclic Antidepressants ◽  
Vision Loss ◽  
Acute Angle ◽  
Serotonin Reuptake Inhibitors ◽  
Angle Closure

Any antipsychotics provoke more or less ocular complications. Some of them are relatively harmless (i.e., dark eyelids, conjunctival and corneal pigmentation, mydriasis, nystagmus, dry eye etc.). These adverse effects are resolved spontaneously after treatment discontinuation, drug switching, or prescribing additional therapy. However, the intake of both typical and atypical neuroleptics, lithium salts, some anticonvulsants (e.g., topiramate) is associated with high risks of vision loss. Moreover, in some patients these medications may result in blindness. The use of psychotropic drugs (e.g., tricyclic antidepressants or serotonin reuptake inhibitors) in patients with higher risk of acute angle closure is of particular concern. The association between phenothiazines and anticonvulsants and retinopathy, chlorpromazine and cataract, anticonvulsants and poor color vision and reduced contrast sensitivity is also important. Psychiatrists and ophthalmologists should consider potential ocular side effects in patients receiving psychotropic drugs. Knowing management algorithm for these conditions is also important. The number of recent publications on this issue is limited. Therefore, articles older than 10 years are sometimes used. Keywords: eye, visual organ, adverse effects, psychotropic drugs, neuroleptics, tricyclic antidepressants, selective serotonin reuptake inhibitors, glaucoma, retinopathy, cataract. For citation: Petukhova A.A., Panov A.A., Malygin Ya.V., Kazanfarova M.A. Side effects of psychotropic drugs on eye. Russian Journal of Clinical Ophthalmology. 2021;21(1):29–33. DOI: 10.32364/2311-7729-2021-21-1-29-33.

Selective serotonin reuptake inhibitors in the treatment of affective disorders—III. Tolerability, safety and pharmacoeconomics

1998 ◽  
Vol 12 (4_suppl) ◽  
pp. 55-S87 ◽  
Author(s):  
Burton J. Goldstein ◽  
Paul J Goodnick
Keyword(s):  
Side Effects ◽  
Drug Interactions ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Safety Margin ◽  
Antidepressant Drugs ◽  
Healthcare Services ◽  
Serotonin Reuptake Inhibitors ◽  
Antidepressant Therapy ◽  
Selective Serotonin

The clinical use of tricyclic antidepressants (TCAs) is often complicated by toxicity and safety problems due to their effects on multiple mechanisms of action, many of which are unnecessary for therapeutic effect. The development of the selective serotonin reuptake inhibitors (SSRIs), with their selective mode of action, has resulted in a class of antidepressant drugs possessing an improved side-effect profile, while retaining good clinical efficacy. Their introduction into clinical practice has led to enhanced patient compliance with antidepressant therapy and the ability to maintain treatment over longer periods of time at an adequate therapeutic dose. Although, as a result of their selective action, side-effects associated with SSRI therapy are minimised, distinct variations between individual SSRIs in terms of their tolerability profiles have been observed. The wealth of clinical data now available has revealed differences in their potential to cause psychiatric and neurological side-effects, dermatological reactions, anticholinergic side-effects, changes in body weight, sexual dysfunction, cognitive impairment, discontinuation reactions and drug-drug interactions. Patients who suffer from concomitant depression and physical illness may experience different tolerability profiles, in addition to the greater likelihood that they will be receiving concomitant medications with the potential for pharmacokinetic drug-drug interactions with coadministered SSRI therapy. In addition, the safety margin of SSRIs in overdose may vary within the group. Knowledge of the differences that exist among the SSRIs in respect of tolerability and safety will aid physicians in the selection of the most beneficial treatment strategy for their patients. A successful clinical outcome leads to a reduced economic burden for the patient, their family and the healthcare services. Thus, pharmacoeconomic considerations are also important in choosing antidepressant therapy. The SSRIs, despite relatively higher prescription costs, have been demonstrated to be a more cost-effective option than the TCAs. Furthermore, there is evidence that the emerging clinical differences between SSRIs may translate into significantly different economic outcomes within the group.

St. John's Wort (Hypericum Perforatum) as a Treatment for Premenstrual Dysphoric Disorder: Case Report

2003 ◽  
Vol 33 (3) ◽  
pp. 295-297 ◽  
Author(s):  
Kai-Lin Huang ◽  
Shih-Jen Tsai
Keyword(s):  
Side Effects ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Premenstrual Dysphoric Disorder ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
St John’S Wort ◽  
St John's Wort ◽  
Gastrointestinal Side Effects

Premenstrual dysphoric disorder (PMDD), a menstruous dysfunction, is characterized by profoundly depressed mood, and studies have shown that antidepressants are effective for PMDD. The authors describe a case of PMDD who was initially treated with selective serotonin reuptake inhibitors. Due to intolerable gastrointestinal side effects with selective serotonin reuptake inhibitors, St. John's wort (900 mg/day) was substituted and much improvement in PMDD symptoms was noted for at least five-month follow-up. The authors propose that St. John's wort could be an alternative medication for PMDD, especially for patients experiencing intolerable side effects with selective serotonin reuptake inhibitors.

Management of Depression, Part 2: Treatment Options

2018 ◽  
Author(s):  
Michael Banov
Keyword(s):  
Monoamine Oxidase ◽  
Mental Health Professionals ◽  
Serotonin Reuptake ◽  
Tricyclic Antidepressants ◽  
Antidepressant Medication ◽  
Monoamine Oxidase Inhibitors ◽  
Serotonin Reuptake Inhibitors ◽  
Clinical Depression ◽  
Depression Treatment ◽  
Norepinephrine Reuptake

Clinical depression is a commonly occurring and profoundly disabling condition that affects approximately 4%, or nearly 350 million people, worldwide according to the World Health Organization. Managing depression is challenging due to the marked variability in biological contributors, the heterogeneity of the illness, psychosocial history, current stresses exacerbating the condition, medical and psychiatric co-occurring conditions, lifestyle, and motivation and willingness to accept and engage in treatment recommendations. Mental health professionals such as master-level counselors, psychologists, or psychiatrists are specially trained to identify and treat depression; however, a significant amount of depression presents in primary care medical settings. This review covers treatment of depression with psychotherapy, complementary and alternative medicine (CAM), and antidepressant medication, as well as treatment course and long-term depression treatment. Tables list CAM depression treatments, nonnutraceutical CAM therapies, managing antidepressant side effects, tricyclic antidepressants, serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, norepinephrine dopamine reuptake inhibitor, alpha2 antagonists, serotonin-2 antagonist/reuptake inhibitors, monoamine oxidase inhibitors, food restrictions with monoamine oxidase inhibitors, managing partial response/treatment-resistant depression, and serotonin receptor modulators.   This review contains 15 tables and 98 references Key words: antidepressant medication, clinical depression, depression, monoamine oxidase inhibitors, nonpharmacologic depression treatment, omega-3 fatty acids, S-adenosylmethionine, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, St. John’s wort, tricyclic antidepressants

Sign in / Sign up

Export Citation Format

Share Document