Long-term treatment with antidepressants in primary care

A postal survey of 222 patients receiving long-term antidepressants in a training general practice showed that the majority were GHQ-12 cases and 62% of respondents reported moderate or severe depressive symptoms on the BDI-13. Although these patients received significantly higher doses than those reporting few or no symptoms, only 40% were prescribed at least a therapeutic antidepressant dose. All patients reporting mild, moderate or severe depressive symptoms consulted their general practitioner significantly more frequently than those without symptoms and the content of these consultations suggested that the general practitioners were aware of these patients' psychological morbidity. Monitoring and appropriate management of patients receiving long-term antidepressants could lead to reduction in morbidity and consultation rate.

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The burden of depressive symptoms in the long-term treatment of patients with schizophrenia

Schizophrenia Research ◽

10.1016/j.schres.2006.09.027 ◽

2007 ◽

Vol 90 (1-3) ◽

pp. 186-197 ◽

Cited By ~ 122

Author(s):

R CONLEY ◽

H ASCHERSVANUM ◽

B ZHU ◽

D FARIES ◽

B KINON

Keyword(s):

Depressive Symptoms ◽

Term Treatment ◽

Long Term Treatment

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Reducing the Toxicity of Long-Term Glucocorticoid Treatment in Large Vessel Vasculitis

Current Rheumatology Reports ◽

10.1007/s11926-020-00961-0 ◽

2020 ◽

Vol 22 (12) ◽

Author(s):

Andriko Palmowski ◽

Frank Buttgereit

Keyword(s):

Adverse Events ◽

Takayasu Arteritis ◽

Term Treatment ◽

Large Vessel Vasculitis ◽

Large Vessel ◽

Serious Adverse Events ◽

Glucocorticoid Treatment ◽

Long Term Treatment ◽

Higher Doses

Abstract Purpose While glucocorticoids (GCs) are effective in large vessel vasculitis (LVV), they may cause serious adverse events (AEs), especially if taken for longer durations and at higher doses. Unfortunately, patients suffering from LVV often need long-term treatment with GCs; therefore, toxicity needs to be expected and countered. Recent Findings GCs remain the mainstay of therapy for both giant cell arteritis and Takayasu arteritis. In order to minimize their toxicity, the following strategies should be considered: GC tapering, administration of conventional synthetic (e.g., methotrexate) or biologic (e.g., tocilizumab) GC-sparing agents, as well as monitoring, prophylaxis, and treatment of GC-related AEs. Several drugs are currently under investigation to expand the armamentarium for the treatment of LVV. Summary GC treatment in LVV is effective but associated with toxicity. Strategies to minimize this toxicity should be applied when treating patients suffering from LVV.

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Orlistat in the Long-term Treatment of Obesity in Primary Care Settings.

Journal of Cardiopulmonary Rehabilitation ◽

10.1097/00008483-200101000-00017 ◽

2001 ◽

Vol 21 (1) ◽

pp. 53

Author(s):

J Hauptman ◽

C Lucas ◽

M N Boldrin ◽

H Collins ◽

K R Segal

Keyword(s):

Primary Care ◽

Term Treatment ◽

Primary Care Settings ◽

Long Term Treatment ◽

Treatment Of Obesity

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Long-term antidepressant treatment in general practice: changes in body mass index

BJPsych Bulletin ◽

10.1192/pb.bp.115.052472 ◽

2016 ◽

Vol 40 (6) ◽

pp. 310-314 ◽

Cited By ~ 1

Author(s):

Laura Chiwanda ◽

Matthew Cordiner ◽

Anne T. Thompson ◽

Polash Shajahan

Keyword(s):

Body Mass Index ◽

General Practice ◽

Body Mass ◽

Antidepressant Treatment ◽

Term Treatment ◽

Metabolic Effects ◽

Practice Population ◽

Long Term Treatment ◽

Patients With Diabetes

Aims and methodTo discern changes in body mass index (BMI) in patients on long-term antidepressant treatment in a general practice population and establish BMI changes in patients with and without a diagnosis of diabetes. We used a retrospective observational method and identified patients on four antidepressants of interest. We excluded those who did not have start and current BMI readings within the past 3 years and noted whether or not patients had a diagnosis of diabetes.ResultsLong-term treatment with citalopram, fluoxetine, mirtazapine and sertraline was associated with increased BMI in two-thirds of patients. There was reduction in BMI in patients with diabetes and an increase in BMI for patients who did not have diabetes.Clinical implicationsAwareness of environmental factors and their impact on individuals is important. Medication is not the only cause of abnormal metabolic effects. Overall monitoring of physical health is important in all groups of patients.

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Long-Term Treatment of Insomnia with Zolpidem: A Multicentre General Practitioner Study of 107 Patients

Journal of International Medical Research ◽

10.1177/030006059101900313 ◽

1991 ◽

Vol 19 (3) ◽

pp. 271-279 ◽

Cited By ~ 51

Author(s):

D. Schlich ◽

C. L'Heritier ◽

J.P. Coquelin ◽

P. Attali

Keyword(s):

General Practitioner ◽

Term Treatment ◽

Long Term Treatment

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The effect of monoamine oxidase-B inhibitors on the alleviation of depressive symptoms in Parkinson’s disease: meta-analysis of randomized controlled trials

Therapeutic Advances in Psychopharmacology ◽

10.1177/2045125320985993 ◽

2021 ◽

Vol 11 ◽

pp. 204512532098599

Author(s):

Yao Hsien Huang ◽

Jia Hung Chen ◽

El Wui Loh ◽

Lung Chan ◽

Chien Tai Hong

Keyword(s):

Depressive Symptoms ◽

Early Stage ◽

Meta Analysis ◽

Term Treatment ◽

Monoamine Oxidase B ◽

Controlled Trials ◽

Short Term ◽

Randomized Controlled ◽

Long Term Treatment

Background: Depression is a major nonmotor symptom of Parkinson’s disease (PD). However, few treatments exist for PD depression. Monoamine oxidase-B inhibitors (MAOB-Is) provide symptomatic relief for the motor symptoms of PD and exert antidepressive effects. The present meta-analysis of randomized controlled trials (RCTs) investigated the effects of MAOB-Is on depressive symptoms in patients with PD. Methods: Articles on PD-management-related RCTs using one of three MAOB-Is approved by the US Food and Drug Administration, that is, selegiline, rasagiline, and safinamide, were identified. The primary outcomes were the benefits of MAOB-Is for depressive symptoms. Subgroup analysis included the effects of MAOB-Is on patients in the early versus middle-to-late stages of PD and the effect of short-term versus long-term treatment. Results: Overall, six studies were included, four of which were conducted on patients with early stage PD. Overall, MAOB-Is significantly reduced the severity of depressive symptoms [standardized mean difference (SMD): −0.14, 95% confidence interval (CI): −0.21 to −0.06, p < 0.001]. Subgroup analysis indicated that the positive effect of MAOB-Is was significant in patients with early stage PD (SMD: −0.20, 95% CI: −0.31 to −0.09, p < 0.001), but not in those with middle-to-late-stage PD (SMD: −0.07, 95% CI: −0.17 to 0.03, p = 0.18). The antidepressive effect was significant for short-term treatment, that is, 90–120 days (SMD: −0.23, 95% CI: −0.35 to −0.10, p < 0.001), but not long-term treatment, that is, 24 weeks to 18 months (SMD: −0.08, 95% CI: −0.18 to 0.01, p = 0.09). Conclusion: In addition to the treatment of PD motor symptoms, MAOB-Is may help reduce the severity of depressive symptoms in PD, especially in patients with early stage PD. Considering the tolerability and simultaneous benefits of MAOB-Is, further RCTs are warranted to confirm their therapeutic effects in moderate-to-severe PD depression.

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