Adherence to antidepressant therapy for major depressive patients in a psychiatric hospital in Thailand

AbstractObjectiveTo analyze the interface between borderline personality disorder (BPD) and bipolarity in depressed patients comorbid with BPD.MethodsAs part of National Multi-site Study of 493 consecutive DSM-IV major depressive patients evaluated in at least two semi-structured interviews 1 month apart, 19 (3.9%) had comorbid BPD (BPD+), whereas 474 (96.1%) did not manifest this comorbidity (BPD−).ResultsCompared to BPD (−), BPD (+) patients displayed higher rates of bipolar (BP) disorders and temperaments, an earlier age at onset with a family history of affective illness, more comorbidity, more stressors before the first episode which was more often depressive or mixed, as well as a greater number and severity of affective episodes.ConclusionsThe hypothesis which fitted at best our findings was to consider BPD as a contributory factor in the development of BP disorder, which could have favoured the progression from unipolar major depression to BP disorder. We could not however exclude that some features of BP disorder may have contributed to the development of BPD.

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Gender differences in the clinical effects of fluvoxamine and milnacipran in Japanese major depressive patients

International Clinical Psychopharmacology ◽

10.1097/00004850-200505000-00058 ◽

2005 ◽

Vol 20 (3) ◽

pp. A16

Author(s):

Shingo Naito ◽

Kazuhiro Sato ◽

Hisashi Higuchi ◽

Keizo Yoshida ◽

Hitoshi Takahashi ◽

...

Keyword(s):

Gender Differences ◽

Clinical Effects ◽

Major Depressive ◽

Depressive Patients

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Erratum: CYP2D6 ultrarapid metabolism and early dropout from fluoxetine or amitriptyline monotherapy treatment in major depressive patients

Molecular Psychiatry ◽

10.1038/mp.2012.108 ◽

2012 ◽

Vol 18 (2) ◽

pp. 266-266 ◽

Cited By ~ 2

Author(s):

E M Peñas-LLedó ◽

H D Trejo ◽

P Dorado ◽

A Ortega ◽

H Jung ◽

...

Keyword(s):

Major Depressive ◽

Early Dropout ◽

Depressive Patients

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Repeated use of SSRIs potentially associated with an increase on serum CK and CK-MB in patients with major depressive disorder: a retrospective study

Scientific Reports ◽

10.1038/s41598-021-92807-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Shengwei Wu ◽

Yufang Zhou ◽

Zhengzheng Xuan ◽

Linghui Xiong ◽

Xinyu Ge ◽

...

Keyword(s):

Creatine Kinase ◽

Major Depressive Disorder ◽

Retrospective Study ◽

Depressive Disorder ◽

Selective Serotonin Reuptake Inhibitors ◽

Cardiac Injury ◽

First Episode ◽

Cardiovascular Risks ◽

Major Depressive ◽

Depressive Patients

AbstractThere is a large amount of evidence that selective serotonin reuptake inhibitors (SSRIs) are related to cardiovascular toxicity, which has aroused concern regarding their safety. However, few studies have evaluated the effects of SSRIs on cardiac injury biomarkers, such as creatine kinase (CK) and creatine kinase isoenzyme (CK-MB). The purpose of our study was to determine whether SSRIs elevated CK and CK-MB levels of prior medicated depressive patients (PMDP) compared to first-episode drug-naïve depressive patients (FDDPs). We performed an observational and retrospective study involving 128 patients with major depressive disorder. Patients who had never used any type of antidepressant were designated FDDP; patients who had used only one type of SSRI but were not treated after a recent relapse were designated PMDP. Serum CK and CK-MB levels were measured before and after using SSRIs for a period of time. The duration of current treatment in the FDDP and PMDP groups was 16.200 ± 16.726 weeks and 15.618 ± 16.902 weeks, respectively. After SSRI treatment, levels of serum CK in the PMDP group were significantly higher than in the FDDP group. Univariate ANCOVA results revealed that PMDP was 22.313 times more likely to elevate CK (OR 22.313, 95% CI 9.605–35.022) and 2.615 times more likely to elevate CK-MB (OR 2.615, 95% CI 1.287–3.943) than FDDP. Multivariate ANCOVA revealed an interaction between the group and sex of CK and CK-MB. Further pairwise analysis of the interaction results showed that in female patients, the mean difference (MD) of CK and CK-MB in PMDP was significantly greater than that in FDDP (MD = 33.410, P = 0.000, 95% CI 15.935–50.886; MD = 4.613, P = 0.000, 95% CI 2.846–6.381). Our findings suggest that patients, especially females, who had previously used SSRI antidepressants were more likely to have elevated CK and CK-MB, indicators of myocardial muscle injury. Use of SSRIs should not be assumed to be completely safe and without any cardiovascular risks.

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Antidepressant therapy

Drug and Therapeutics Bulletin ◽

10.1136/dtb.3.11.41 ◽

1965 ◽

Vol 3 (11) ◽

pp. 41-43

Keyword(s):

General Practice ◽

Experimental Evidence ◽

Psychiatric Hospital ◽

Specific Treatment ◽

Antidepressant Therapy ◽

Short Article ◽

Commit Suicide ◽

Consistent Approach

In diagnosing depression, the most important maxim is to remember its existence. Depression may present overtly or covertly; it may be associated with suicide, alcoholism, or addiction to amphetamines. Perhaps half the depressions seen in general practice require specific treatment, of which a quarter may need referral to a psychiatrist or a psychiatric hospital. If left untreated about 1 in 7 severe depressives die, commit suicide, or become chronic invalids. About these observations there is general agreement. Unfortunately, views about treatment are more diverse, and it is impossible to discuss all of them in a short article, especially if the conclusions are to be firm enough for general use. What follows, therefore, does not represent a consensus of psychiatric opinion, for this does not exist. It is an account of a consistent approach to therapy well supported by experimental evidence and found useful in practice.

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