Simultaneous Analysis of Tricyclic, Tetracyclic and Other Antidepressant Drugs Using the Bio-Rad Benzodiazepines and Tricyclic Antidepressants by HPLC Test

Antiepileptics and antidepressants are two categories of drugs frequently used as adjuvant analgesics. They interfere with the pain pathways at different levels through complex and not always well-defined molecular mechanisms. Although only a few have been licensed for use in the treatment of certain types of pain, anticonvulsants and antidepressants are widely prescribed off-label for pain associated with a variety of conditions. Most solid data come from experience with their use for postherpetic neuralgia, pain associated with diabetic neuropathy, and fibromyalgia. Anticonvulsants and antidepressant drugs are frequently used as first-line therapy in the treatment of pain, especially neuropathic type. Key words: antidepressant drugs, antiepileptic drugs, carbamazepine, gabapentinoids, neuropathic pain, off-label use, serotonin-norepinephrine reuptake inhibitors, serotonin syndrome, tricyclic antidepressants, use in specific populations

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Antidepressants in Cancer Pain

Journal of Palliative Care ◽

10.1177/082585979100700411 ◽

1991 ◽

Vol 7 (4) ◽

pp. 42-44 ◽

Cited By ~ 15

Author(s):

Alberto E. Panerai ◽

Mauro Bianchi ◽

Paola Sacerdote ◽

Carla Ripamonti ◽

Vittorio Ventafridda ◽

...

Keyword(s):

Neuropathic Pain ◽

Cancer Pain ◽

Beneficial Effect ◽

Nerve Injury ◽

Analgesic Effect ◽

Tricyclic Antidepressants ◽

Antidepressant Drugs ◽

Depressive Illness ◽

Morphine Analgesia

Studies conducted in recent years have helped define the role of antidepressant drugs in the management of cancer pain. The anti-nociceptive action of these agents seems to be independent of beneficial effect on depression or mood. Among antidepressant drugs, those of the tricyclic class are preferred when an analgesic effect is sought. Their primary application is for pain due to nerve injury, so-called “neuropathic pain”. Although the co-administration of tricyclic antidepressants may increase plasma morphine concentrations, any potentiation of morphine analgesia is thought not to be due to an increased bioavailability of the opiate, but to an intrinsic analgesic effect of antidepressants. On this basis, the use of antidepressants in combination with opioids for the treatment of cancer pain is suitable when a component of deafferentation is present or when there is concomitant depressive illness.

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Antidepressants: uses and attitudes among consultant psychiatrists – A questionnaire study

Irish Journal of Psychological Medicine ◽

10.1017/s0790966700015184 ◽

1991 ◽

Vol 8 (2) ◽

pp. 167-170 ◽

Cited By ~ 2

Author(s):

Brian O'Shea

Keyword(s):

Cognitive Therapy ◽

Electroconvulsive Therapy ◽

Tricyclic Antidepressants ◽

Antidepressant Drugs ◽

Questionnaire Study ◽

Environmental Manipulation ◽

Novel Treatment

AbstractAn audit of Consultant Psychiatrists' views on and uses of antidepressant drugs is reported. At present senior prescribers largely opt for the older tricyclic antidepressants despite a knowledge of their shortcomings. MAOIs are less popular and newer drugs are viewed cautiously and apprehensively. Lofepramine is largely viewed as an alternative to dothiepin and amitriptyline. Non-drug strategies in the management of depression consist largely of support, environmental manipulation and electroconvulsive therapy. The relatively novel treatment, cognitive therapy, has a strong minority following.

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Column deactivation in analysis for underivatized tricyclic antidepressants by gas chromatography with use of a nitrogen detector.

Clinical Chemistry ◽

10.1093/clinchem/29.3.452 ◽

1983 ◽

Vol 29 (3) ◽

pp. 452-455 ◽

Cited By ~ 3

Author(s):

B Vinet

Keyword(s):

Tricyclic Antidepressants ◽

Antidepressant Drugs ◽

Glass Tube ◽

Solid Support ◽

Tricyclic Antidepressant ◽

Low Flow ◽

Sensitive Detector ◽

Linear Calibration ◽

Deactivation Process ◽

Nanogram Level

Abstract I describe deactivation treatment of the OV-17 chromatographic column to minimize adsorption of tricyclic antidepressant drugs on the solid support of the column. The procedure involves heat treatment at 399 degrees C under a low flow of nitrogen, with bleeding of OV-17 liquid phase from the injector tube into the column. The column is then conditioned with vapors of phenyldiethanolamine succinate, added to the carrier gas stream by bleeding from a coated injector glass tube. This deactivation process much improves the chromatographic performance of the column, allowing a sensitivity at the nanogram level with a nitrogen-sensitive detector. Determinations of tricyclic antidepressants in plasma with such a deactivated column results in a low CV and a linear calibration curve, reflecting the effectiveness of the deactivation.

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Serotonin Syndrome

Journal of Pharmacy Practice ◽

10.1177/0897190013504957 ◽

2013 ◽

Vol 27 (1) ◽

pp. 71-78 ◽

Cited By ~ 37

Author(s):

Susie H. Park ◽

Robin C. Wackernah ◽

Glen L. Stimmel

Keyword(s):

Drug Interaction ◽

Serotonin Syndrome ◽

Tricyclic Antidepressants ◽

Case Reports ◽

Antidepressant Drugs ◽

Cochrane Library ◽

Search Terms ◽

Potential Risk Factors ◽

Therapeutic Doses ◽

P450 2D6

Background: There is a warning associated with all serotonergic antidepressants and its concomitant use with tramadol due to the concern for a drug–drug interaction resulting in serotonin syndrome (SS). The prescribing of antidepressants with tramadol may be unnecessarily restricted due to fear of causing this syndrome. Objectives: There are 3 objectives of this review. To (1) review case reports of SS associated with the combination of tramadol and antidepressant drugs in recommended doses, (2) describe the mechanisms of the drug interaction, and (3) identify the potential risk factors for SS. Methods: Case reports of SS associated with tramadol and antidepressants were identified via Cochrane Library, PubMed, and Ovid (through October 2012) using search terms SS, tramadol, antidepressants, fluoxetine, sertraline, paroxetine, fluvoxamine, citalopram, escitalopram, venlafaxine, desvenlafaxine, duloxetine, mirtazapine, milnacipran, trazodone, vilazodone, and bupropion. Cases involving monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants were excluded. Results: Nine articles were identified describing 10 cases of suspected SS associated with therapeutic doses of tramadol combined with an antidepressant. Mechanisms of the drug–drug interactions involve pharmacodynamic, pharmacokinetic, and possible pharmacogenetic factors. Conclusions: Review of the available case reports of tramadol combined with antidepressant drugs in therapeutic doses indicates caution in regard to the potential for SS but does not constitute a contraindication to their use. Tramadol is only contraindicated in combination with MAOIs but not other antidepressants in common use today. These case reports do suggest several factors associated with a greater risk of SS, including increased age, higher dosages, and use of concomitant potent cytochrome P450 2D6 inhibitors. Tramadol can be safely combined with antidepressants; however, monitoring and counseling patients are prudent when starting a new serotonergic agent or when doses are increased.

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Therapeutic drug monitoring of non-tricyclic antidepressant drugs

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm.2004.243 ◽

2004 ◽

Vol 42 (11) ◽

Cited By ~ 22

Author(s):

Philip B. Mitchell

Keyword(s):

Therapeutic Drug Monitoring ◽

Drug Monitoring ◽

Selective Serotonin Reuptake Inhibitors ◽

Tricyclic Antidepressants ◽

Antidepressant Drugs ◽

Tricyclic Antidepressant ◽

Therapeutic Drug ◽

Cytochrome P450 Enzymes ◽

Clinical Value ◽

Major Benefit

AbstractTherapeutic drug monitoring (TDM) of many of the tricyclic antidepressants (TCAs) has been demonstrated to be of clear clinical value. This article reviews studies of TDM for the selective serotonin reuptake inhibitors (SSRIs) and other non-tricyclic antidepressants such as venlafaxine, nefazodone, trazodone, mianserin and bupropion. No definitive therapeutic concentrations have been demonstrated for these agents, nor have levels indicative of toxicity been reported. The major benefit of TDM for these agents would appear to be in the assessment of the apparently treatment-refractory depressed patient, to determine whether such lack of response is related to inadequate levels that would suggest either poor compliance, ultra-rapid metabolism, or drug interactions leading to induction of metabolising enzymes. Potential future applications of TDM, in conjunction with genotyping of cytochrome P450 enzymes and pharmacogenomic evaluations, are discussed.

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Development of Pharmacophore Model and Asymmetric Synthesis of Novel Tetrahydrofuran Derivatives Enroute to Triple Uptake Inhibitors As Anti-Depressant Agents

10.14293/p2199-8442.1.sop-chem.pe0ika.v1 ◽

2014 ◽

Author(s):

aloke dutta ◽

Horrick Sharma ◽

Soumava Santra ◽

Joy Debnath ◽

Maarten EA Reith

Keyword(s):

Side Effects ◽

Selective Serotonin Reuptake Inhibitors ◽

Tricyclic Antidepressants ◽

Unmet Need ◽

Antidepressant Drugs ◽

Pharmacophore Model ◽

Unipolar Depression ◽

Current Treatment ◽

Monoamine Neurotransmitters ◽

Norepinephrine Reuptake

Unipolar depression, caused by an imbalance of monoamine neurotransmitters in brain, is ranked as the most prevalent of all somatic and psychiatric illness. It is estimated that about 40 % of patients remains refractory to treatment thereby limiting the use of current antidepressant drugs. Moreover, because of relapse and unwanted side effects of existing drugs there is an unmet need to discover novel agents for the treatment of this devastating mental disorder. Current treatment aims at alleviating extraneuronal concentration of serotonin (5-HT) and /or norepinephrine (NE) (Figure 1). Tricyclic antidepressants were among the first class to have been discovered but due to their nonspecific side effects they have limited use in clinics. They have been largely replaced by second-generation antidepressants including selective serotonin reuptake inhibitors (SSRI, e.g., fluoxetine, Figure 2), selective norepinephrine reuptake inhibitors (NRI, e.g. reboxetine, Figure 2), and serotonin and norepinephrine reuptake inhibitors (SNRI, venlafexine, Figure 2).

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Monitoring of adverse drug reactions to antidepressant drugs in a teaching hospital

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20171107 ◽

2017 ◽

Vol 6 (4) ◽

pp. 933 ◽

Cited By ~ 2

Author(s):

Swetha Munoli ◽

Soumya B. Patil

Keyword(s):

Adverse Events ◽

Adverse Drug Reactions ◽

Serotonin Reuptake ◽

Selective Serotonin Reuptake Inhibitors ◽

Tricyclic Antidepressants ◽

Antidepressant Drugs ◽

Serotonin Reuptake Inhibitors ◽

Selective Serotonin ◽

Drug Reactions ◽

Medical Sciences

Background: Adverse drug reactions (ADRs) are considered among the leading causes of morbidity and mortality. Adverse drug reactions are important determinants of non-adherence to antidepressant treatment, but their assessment is complicated by overlap with depressive symptoms and lack of reliable self-report measures The present study was therefore undertaken to monitor the ADRs of the antidepressant in the psychiatric outpatient unit of Raichur Institute of Medical Sciences, Raichur, Karnataka, IndiaMethods: Study was conducted from December 2012 to November 2013, the patients on antidepressant drugs from psychiatry out- patient department (OPD) of Raichur Institute of Medical Sciences were considered for analysis. The patients were diagnosed by consultant psychiatrist. Data was collected in standard questionnaire format. All patients diagnosed with psychiatric disorder as per ICD 10 criteria and receiving treatment with antidepressant were included. Assessment of causality and severity of recorded adverse events was done using WHO assessment scale and modified Siegel and Hartwig Scale respectively.Results: In our study 74 adverse drug reactions(ADRs) were seen among 52 cases, total 263 cases were screened.CNS and Anticholinergic side effects were most common adverse drug reactions noted. Tricyclic antidepressants (TCA) and Selective serotonin reuptake inhibitors (SSRIs) were the drugs causing maximum ADRs. Assessment of causality and severity of recorded adverse events showed possible to probable and mild to moderate severity respectively.Conclusions: CNS and Anticholinergic side effects were most common adverse drug reactions noted. Tricyclic antidepressants (TCA) were most commonly prescribed drugs followed by Selective serotonin reuptake inhibitors (SSRIs). Tricyclic antidepressants (TCA) and Selective serotonin reuptake inhibitors (SSRIs) accounted for most of ADRs (87.8%). Assessment of causality of recorded adverse events showed no certain cause and assessment of severity of recorded adverse events showed no severe cases.

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Sialorrhoea associated with sertraline use

Scottish Medical Journal ◽

10.1177/0036933019875051 ◽

2019 ◽

Vol 64 (4) ◽

pp. 159-161

Author(s):

Ebru Şahan ◽

Tezer Kılıçarslan ◽

İsmet Kırpınar

Keyword(s):

Male Patient ◽

Serotonin Reuptake ◽

Tricyclic Antidepressants ◽

Antidepressant Drugs ◽

Excessive Amount ◽

Psychoactive Drugs ◽

Dose Increase ◽

Case Presentation ◽

Saliva Secretion ◽

Falling Asleep

Introduction Sialorrhoea, which has been defined as excessive amount of saliva in the mouth, can be a debilitating symptom. Psychoactive drugs may cause an increase or decrease in saliva secretion. Antidepressant drugs, especially tricyclic antidepressants and less often serotonin reuptake inhibitors, are often associated with a decrease in salivation and the complaint of dry mouth. Case presentation A 46-year-old male patient with complaints of being depressed, lack of motivation, irritability and difficulty in falling asleep was started on sertraline treatment and had trouble with sialorrhoea after the dose increase, without other causes of hypersalivation. Discussion We could not find report of any case with antidepressant-associated sialorrhoea in the literature. Future cases may support a relationship between sertraline and sialorrhoea.

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