scholarly journals Trends and Advances in Separation and Detection of SSRIs and SNRIs in Biological Matrices

2013 ◽  
Vol 2013 ◽  
pp. 1-15 ◽  
Author(s):  
Ruchita Das ◽  
Y. K. Agrawal
Keyword(s):  
Reuptake Inhibitor ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Date Rape ◽  
Antidepressant Drugs ◽  
Selective Serotonin ◽  
Biological Matrices ◽  
First Choice ◽  
Analytical Approaches ◽  
Norepinephrine Reuptake

Nowadays antidepressant drugs like selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs) represent the first choice in the treatment of moderate to severe depressive illness, various phobias, and personality disorders. In spite of the therapeutic aspects, they often produce very severe and toxic effects in deliberate and accidental cases of poisoning. These are also considered as date-rape drugs used for drugged victims for raping or robbing. Therefore, in recent years, their analyses in different biological matrices for clinical and toxicological analysis purposes has been a target worthy of interest. Thus, the review focuses on recent advancements of various separation techniques like chromatography and electrophoresis that are concernd with the determination of selective serotonin reuptake inhibitor and selective norepinephrine reuptake inhibitor drugs and their metabolites in various biological matrices. In addition to this, a critical discussion on analytical approaches has also been incorporated, suggesting their applicability and limitations for further implementations. Thus, this paper will definitely help in the selection and development of proper analytical methodologies to achieve satisfactory results, better scientific understanding, and test interpretation.

scholarly journals Strategies for Managing Depression Refractory to Selective Serotonin Reuptake Inhibitor Treatment: A Survey of Clinicians

2000 ◽  
Vol 45 (5) ◽  
pp. 476-481 ◽  
Author(s):  
David Mischoulon ◽  
Andrew A Nierenberg ◽  
Leena Kizilbash ◽  
Jerrold F Rosenbaum ◽  
Maurizio Fava
Keyword(s):  
Reuptake Inhibitor ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Monoamine Oxidase Inhibitor ◽  
Oxidase Inhibitor ◽  
Tricyclic Antidepressant ◽  
Selective Serotonin ◽  
Treatment Practices ◽  
Group Settings ◽  
First Choice

Objective: To examine treatment practices in cases where selective serotonin reuptake inhibitors (SSRIs) are ineffective. Methods: We surveyed 801 clinicians (including 630 psychiatrists) attending the Massachusetts General Hospital's annual psychopharmacology review course. Clinicians were presented with a vignette about a patient with depression who had responded partially to an SSRI and were asked to choose among various strategies available to manage this patient. Results: Of those surveyed, 466 clinicians had been in practice a mean of 16.6 years (SD 10.7). Not all clinicians chose to answer every question. Among 455 respondents, 84% (n = 382) chose to increase the dose of the SSRI, 10% (n = 47) chose augmentation or combination, and 7%(n = 31) opted for switching agents. When asked to switch to another agent, 448 responded, of whom 52% (n = 235) chose a newer antidepressant, 34% (n = 152) chose another SSRI, 10%(n = 44) chose a tricyclic antidepressant (TCA), 2%(n = 8) chose a serotonin norepinephrine reuptake inhibitor (SNRI), 1% (n = 5) chose a monoamine oxidase inhibitor (MAOI), and 1% (n = 4) chose an undefined “other” agent. Among 445 respondents, bupropion was the most widely chosen augmenting agent (30%, n = 134), followed by lithium (22%, n = 98). West coast and Canadian clinicians preferred to switch to another SSRI rather than to a newer antidepressant. Canadian clinicians preferred lithium to bupropion as their first-choice augmenting agent, as did clinicians from academic settings. Clinicians from community, individual practice, or group settings favoured bupropion. More experienced clinicians preferred bupropion as a first-choice augmenter, whereas less experienced ones showed a slight preference for lithium. Canadian clinicians were more likely to use MAOIs as second-line agents. Conclusions: Clinicians in this sample often followed strategies different from those recommended in the literature. Bupropion may have an important role in augmentating treatment with SSRIs.

scholarly journals Antidepressant Drugs Effects on Blood Pressure

2021 ◽  
Vol 8 ◽  
Author(s):  
Anna Calvi ◽  
Ilaria Fischetti ◽  
Ignazio Verzicco ◽  
Martino Belvederi Murri ◽  
Stamatula Zanetidou ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Orthostatic Hypotension ◽  
Reuptake Inhibitor ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Hypertensive Crisis ◽  
Antidepressant Drug ◽  
Antidepressant Drugs ◽  
Norepinephrine Reuptake Inhibitor ◽  
Norepinephrine Reuptake

Individuals suffering from depressive disorders display a greater incidence of hypertension compared with the general population, despite reports of the association between depression and hypotension. This phenomenon may depend, at least in part, on the use of antidepressant drugs, which may influence blood pressure through different effects on adrenergic and serotoninergic pathways, as well as on histaminergic, dopaminergic, and cholinergic systems. This review summarizes extant literature on the effect of antidepressant drugs on blood pressure. Selective serotonin reuptake inhibitors are characterized by limited effects on autonomic system activity and a lower impact on blood pressure. Thus, they represent the safest class—particularly among elderly and cardiovascular patients. Serotonin–norepinephrine reuptake inhibitors, particularly venlafaxine, carry a greater risk of hypertension, possibly related to greater effects on the sympathetic nervous system. The norepinephrine reuptake inhibitor reboxetine is considered a safe option because of its neutral effects on blood pressure in long-term studies, even if both hypotensive and hypertensive effects are reported. The dopamine–norepinephrine reuptake inhibitor bupropion can lead to blood pressure increases, usually at high doses, but may also cause orthostatic hypotension, especially in patients with cardiovascular diseases. The norepinephrine–serotonin modulators, mirtazapine and mianserin, have minimal effects on blood pressure but may rarely lead to orthostatic hypotension and falls. These adverse effects are also observed with the serotonin-reuptake modulators, nefazodone and trazodone, but seldomly with vortioxetine and vilazodone. Agomelatine, the only melatonergic antidepressant drug, may also have limited effects on blood pressure. Tricyclic antidepressants have been associated with increases in blood pressure, as well as orthostatic hypotension, particularly imipramine. Oral monoamine–oxidase inhibitors, less frequently skin patch formulations, have been associated with orthostatic hypotension or, conversely, with hypertensive crisis due to ingestion of tyramine-containing food (i.e., cheese reaction). Lastly, a hypertensive crisis may complicate antidepressant treatment as a part of the serotonin syndrome, also including neuromuscular, cognitive, and autonomic dysfunctions. Clinicians treating depressive patients should carefully consider their blood pressure status and cardiovascular comorbidities because of the effects of antidepressant drugs on blood pressure profiles and potential interactions with antihypertensive treatments.

scholarly journals Use of Antidepressants among Patients Diagnosed with Depression: A Scoping Review

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Nirmal Raj Marasine ◽  
Sabina Sankhi ◽  
Rajendra Lamichhane ◽  
Nabin Raj Marasini ◽  
Nim Bahadur Dangi
Keyword(s):  
Reuptake Inhibitor ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Antidepressant Drugs ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Tolerability Profile ◽  
Highly Educated ◽  
Treatment Of Depression ◽  
Antidepressant Use

Introduction. Depression is a major global health problem with a relatively high lifetime prevalence and significant disability. Antidepressants are the most effective medications used for the treatment of depression. Hence, this study is aimed at summarizing the studies on antidepressant use among patients diagnosed with depression. Method. PubMed, Embase, Web of Science, Scopus, and Google Scholar were searched for literature (2000-2019) using keywords such as depression, drug utilization, antidepressants, prescription, serotonin reuptake inhibitor, serotonin and norepinephrine reuptake inhibitor, tricyclic antidepressants, and atypical antidepressants. Results. Antidepressant users were mostly females, married people, housewives, lower-income people, employees, and highly educated people, as they were found to be more prone to develop depression than their counterparts. Selective serotonin reuptake inhibitors (SSRIs), such as sertraline, were most commonly prescribed among depressive patients. Conclusion. Our study suggested that out of five major antidepressant drugs available for the treatment of depression, selective serotonin reuptake inhibitors are preferred over others because of their better side effects and tolerability profile.

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.

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