The Antidepressant Effects of 5-HT Uptake Inhibitors

1989 ◽  
Vol 155 (S8) ◽  
pp. 32-40 ◽  
Author(s):  
Anna Åberg-Wistedt

The functional roles of monaminergic transmitters in depression have been widely studied during the past decade. Data from that research suggest that lower levels of the 5-HT metabolite, 5-HIAA, in the cerebrospinal fluid; 5-HT uptake in human platelets; and platelets [3H]-imipramine binding sites occur in depressed patients. In recent years several potent and selective 5-HT uptake inhibitors have become available for clinical studies. The first shown to have antidepressant effects, zimelidine, was followed by similar compounds such as femoxetine, fluvoxamine, Citalopram, indalpine, fluoxetine, paroxetine, and sertraline. The effectiveness of serotonin inhibitors in treating other disorders, such as obsessive–compulsive disorder, anxiety, and panic disorder, has also been demonstrated. This review reports the data from clinical studies with these agents. The 5-HT uptake inhibitors are devoid of anticholinergic properties and have not produced weight gain or sedative side-effects, but may have another profile of side-effects. Headache, nausea, and vomiting have been reported, however.

1989 ◽  
Vol 155 (S8) ◽  
pp. 15-24 ◽  
Author(s):  
D. L. Murphy ◽  
J. Zohar ◽  
C. Benkelfat ◽  
M. T. Pato ◽  
T. A. Pigott ◽  
...  

Involvement of the brain serotonin (5-HT) neurotransmitter system in obsessive-compulsive disorder (OCD) was originally suggested on the basis of therapeutic effects found with the semi-selective serotonin uptake inhibitor, clomipramine. More recent studies directly comparing clomipramine with non-selective or norepinephrine-selective uptake inhibitors, such as desipramine or nortriptyline, as well as studies with new, more selective serotonin uptake inhibitors, including fluvoxamine and fluoxetine, have supported that hypothesis. Clomipramine's antiobsessional effect has been augmented with the serotonin precursor, L-tryptophan, or with lithium, which has prominent serotonergic effects. Patients whose OCD symptoms improved on clomipramine worsened when the drug was discontinued (regardless of duration of therapy) and improved when clomipramine was reinstituted. OCD symptoms also worsened when metergoline, a 5-HT antagonist, was given to patients who had improved with clomipramine. Metergoline given alone had no effect. Administration of m-chlorophenylpiperazine (m-CPP), a 5-HT receptor agonist, to untreated OCD patients increased their anxiety, depression, and dysphoria, and exacerbated their OC symptoms. After 4 months of clomipramine therapy, m-CPP failed to produce the same behavioural effects, suggesting an alteration of a 5-HT subsystem (possibly downregulation of some 5-HT receptors). The data reviewed suggest an important role for an abnormal brain 5-HT subsystem in patients with OCD.


Author(s):  
V. V. Freize ◽  
L. V. Malyshko ◽  
G. I. Grachev ◽  
V. B. Dutov ◽  
N. V. Semenova ◽  
...  

The purpose of the study was to summarize data from foreign studies about the use of virtual reality (VR) technology in the treatment of patients with various mental disorders.Materials and methods: we selected and analyzed articles from MEDLINE / PubMed databases during the period from 2000 till 2020, as well as relevant references in the bibliography of the analyzed articles. 45 articles were included in further analysis from 575 English-language articles.Results: The use of VR technologies in the treatment of mental disorders appears to be one of the promising directions in psychiatry. The successfulness of these methods in patients with eating disorders, anxiety-phobic disorders, and obsessive-compulsive disorder is supported to be evidentiary information. There is evidence of the effectiveness of such methods in patients with schizophrenia, particularly, one of the most significant results is an increase in social functioning. The absence of side effects data makes it possible to consider t VR therapy as a safe method. It is needed to make further study the areas of application of VR therapy and conduct research to identify possible side effects of this method.Conclusion: The obtained results are important for drawing attention to the prospect of using VR technologies in Russian psychiatry and demonstrate the need for further study of this method.


Author(s):  
Daniel W. O’Connor ◽  
Christos Plakiotis ◽  
Peter Farnbach

Electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS) and deep brain stimulation (DBS) all entail the delivery of electrical impulses to the brain with the aim of relieving mental disorders. ECT is an effective treatment of depression, mania and catatonia and, to a lesser extent, of schizophrenia. Its side effects, principally cognitive impairment, are mitigated through the use of individually tailored, unilateral delivery. TMS is more convenient but of lesser effectiveness. DBS, while reversible and thus safer than lesional surgery, is a major undertaking that is reserved at present for profoundly disabling depression, obsessive-compulsive disorder (OCD), and Tourette’s syndrome.


CNS Spectrums ◽  
1999 ◽  
Vol 4 (6) ◽  
pp. 71-77 ◽  
Author(s):  
Mark Hyman Rapaport ◽  
Cathy G. McAllister

ABSTRACTThis article presents a rationale for the hypothesis that an autoimmune mechanism might be involved in the pathogenesis of some forms of obsessive-compulsive aborder (OCO). Existing clinical studies suggesting that some individuals with OCD may have an autoimmune-mediated disorder are briefly summarized. A case example where intravenous immunoglobulin G has been successfully used to treat an adult with OCD spectrum disorder is presented. Preclinical data demonstrating that fragments from the group Αβ hemolytic streptococcus cell wall M proteins can generate antibodies that bind to rat and human tissue are also presented.


1987 ◽  
Vol 151 (1) ◽  
pp. 107-112 ◽  
Author(s):  
W. O. Monteiro ◽  
H. F. Noshirvani ◽  
I. M. Marks ◽  
P.T. Lelliott

Forty-six patients with obsessive-compulsive disorder undergoing a double-blind controlled study of clomipramine and placebo were interviewed to assess changes in sexual function. Of 33 patients with previously normal orgasm, nearly all of the 24 on clomipramine developed total or partial anorgasmia; none of the 9 on placebo did so. Anorgasmia persisted with minimal tolerance over the five months that clomipramine was taken. Men and women were equally affected. Sexual side-effects are easily missed without a structured interview, and can detract from the value of drug treatment.


1993 ◽  
Vol 5 (1) ◽  
pp. 1-6 ◽  
Author(s):  
A.S. De Leeuw ◽  
J.A. Den Boer ◽  
H.G.M. Westenberg

SummaryIn this first part of a review on biological psychiatric aspects of obsessive-compulsive disorder (OCD), firstly a short introduction is given about historical, diagnostic and epidemiological issues concerning OCD. Subsequently pharmacologic treatment-studies are discussed. Only serotonin (5-HT) reuptake blockers are proven to be effective. There is accumulating evidence that this therapeutic effect is not due to antidepressant effects. The results of the treatment-studies strongly suggests that 5-HT is involved in OCD. CSF-studies seem to confirm this. Possibly the therapeutic effect is related with adaptive changes of 5-HT receptors. There is evidence that in a subgroup of O CD-patients the dopaminergic system is involved.


1998 ◽  
Vol 173 (S35) ◽  
pp. 79-90 ◽  
Author(s):  
M. A. Jenike

Background Case reports suggest that neurosurgical operations can improve symptoms in patients with severe treatment-refractory obsessive-compulsive disorder (OCD). However, it is unclear which procedure is best and which may produce the most side-effects.Method I review the literature on the efficacy and complications of four frequently used neurosurgical procedures (cingulotomy, capsulotomy, limbic leucotomy and subcaudate tractotomy) that are used to treat refractory OCD.Results Since the vast majority of patients who underwent surgery were severely and chronically disabled, it is likely that these procedures were of assistance in alleviating some of their symptoms. It is currently impossible to determine which surgical procedure is the best for a particular patient.Conclusions Despite a lack of controlled data and inconsistencies in the literature, it appears that when nonsurgical treatments have failed to improve OCD symptoms significantly in severely ill patients, at least partial relief can be obtained by some people with OCD by neurosurgery Results of cumulative studies strongly support the need for continued research in this area.


Sign in / Sign up

Export Citation Format

Share Document