Past use of selective serotonin reuptake inhibitors and the risk of cerebrovascular events in the elderly

2005 ◽  
Vol 20 (3) ◽  
pp. 169-171 ◽  
Author(s):  
Corrado Barbui ◽  
Mauro Percudani ◽  
Ida Fortino ◽  
Michele Tansella ◽  
Lorenzo Petrovich
Keyword(s):  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
The Elderly ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Cerebrovascular Events

Clinical comparison of selective serotonin reuptake inhibitors in the treatment of geriatric depression: a review of literature

2000 ◽  
Vol 10 (4) ◽  
pp. 349-373 ◽  
Author(s):  
Richard Marc Patel
Keyword(s):  
Side Effect ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Relevant Literature ◽  
The Elderly ◽  
The United States ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Geriatric Depression ◽  
First Choice

IntroductionWith their ease of administration, relatively benign side-effect profile and safety in overdose, in the United States the selective serotonin reuptake inhibitors (SSRIs) have become de facto first choice in the treatment of geriatric depression, displacing tricyclic antidepressants (TCAs). In this paper, the relevant literature regarding neurochemistry, kinetics, dosing, efficacy and differential side-effect profiles of citalopram, fluvoxamine, fluoxetine, sertraline, and paroxetine, the five currently available SSRIs in the USA, will be reviewed with special emphasis on geriatric data. Of late, considerable controversy has been generated regarding whether SSRIs are as effective as TCAs in severe and melancholic depressive subtypes. This important issue will be explored and the relative utility of all the SSRIs in the elderly patient compared and contrasted. Finally, reasons for difficulties in comparing results across studies will be elucidated.

Abstract WP167: Effects of Selective Serotonin Reuptake Inhibitors versus Tricyclic Antidepressants on Cerebrovascular Events

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Jou Wei Lin ◽  
Chia-Hsuin Chang ◽  
Chin-Hsien Lin
Keyword(s):  
Confidence Interval ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Tricyclic Antidepressants ◽  
Hazard Ratio ◽  
Serotonin Reuptake Inhibitors ◽  
Adjusted Hazard Ratio ◽  
Selective Serotonin ◽  
Cerebrovascular Events ◽  
Reduced Risk

Background: The objective of this study was to examine the effects of selective serotonin reuptake inhibitors (SSRIs) versus tricyclic antidepressants (TCAs) on cerebrovascular events in patients with depression or anxiety. Methods: We performed a retrospective cohort study in a nationwide population. The patients who started to take SSRIs and TCAs with a diagnosis of depression or anxiety between January 1, 2001 and December 31, 2009 were identified from the Taiwan National Health Insurance claims database. We examined the association between the two types of antidepressants and incidence of stroke using a proportional hazard model adjusted for risk factors for stroke. Results: Among of the 24,662 SSRI and 14,736 TCA initiators, the crude incidence rate for stroke was 10.03 and 13.77 per 100 person-years respectively. SSRI use was associated with a significantly reduced risk as compared with TCAs with the adjusted hazard ratio of 0.67 (95% confidence interval 0.47 to 0.96) in a dose-dependent manner. No significant effect modification was found among subgroups, such as hypertension, diabetes, previous cardiovascular and cerebrovascular diseases. The adjusted hazard ratio was 1.09 (95% confidence interval 0.65 to 1.85) for those aged more than 65 years, suggesting only a potential trend for a higher risk of stroke with SSRIs in the geriatric group. Conclusions: As compared with TCAs, the use of SSRIs was associated with a reduced risk for cerebrovascular events in a clear dose-response manner. Further researches are needed to examine the potential risk and benefit of SSRI use for patients with high risk of stroke.

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.

Efficacy and Tolerability of Moclobemide in Comparison with Placebo, Tricyclic Antidepressants, and Selective Serotonin Reuptake Inhibitors in Elderly Depressed Patients: A Clinical Overview

1997 ◽  
Vol 42 (10) ◽  
pp. 1043-1050 ◽  
Author(s):  
Roman Amrein ◽  
Max Stabl ◽  
Stephan Henauer ◽  
Eva Affolter ◽  
Iris Jonkanski
Keyword(s):  
Adverse Events ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Safety Data ◽  
The Elderly ◽  
Similar Efficacy ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Depressed Patients ◽  
Tetracyclic Antidepressants

Objective: To review the efficacy and safety of moclobemide in comparison with TCAs(for our purposes, “TCAs” will represent tricyclic and tetracyclic antidepressants, including maprotilin and mianserin) and selective serotonin reuptake inhibitors (SSRIs) in elderly depressed patients. Methods: The efficacy data reviewed were obtained from the following sources: 1) results of published studies in the elderly; 2) data on patients aged ≥ 60 years extracted from all available controlled trials in adults (≥ 18 years) in which moclobemide was compared with TCAs or SSRIs; and 3) the adverse events were extracted for patients aged ≥ 60 years from the safety data base of all available comparative short-term studies with moclobemide versus TCAs, SSRIs, or placebo and of long-term studies with moclobemide. Results: The data show that moclobemide is an effective antidepressant in depressed patients aged ≥ 60 years. The response rate to moclobemide was 50% to 55% in this population. Moclobemide was more effective than placebo and was of similar efficacy to the TCAs and the more recently introduced SSRIs. The tolerability of moclobemide was rated as “very good” or “good” in almost 90% of these patients, which was better than the tolerability of TCAs and similar to that of SSRIs. Patients without any adverse events were more frequently found in the moclobemide group than in those treated with TCAs (P < 0.01) or SSRIs (P < 0.01). Adverse events of the anticholinergic type were more frequent with TCAs than with moclobemide (P < 0.001), and nausea was found 3 times more frequently with SSRIs than with moclobemide (P < 0.01). Conclusions: Moclobemide is an effective and well-tolerated antidepressant for the treatment of elderly depressed patients.

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