To Evaluate Synergetic Potential of Piperine with Citalopram on Chronic Unpredictable Mild Stress- Induced Depression in Wistar Rats

Depression is a neurological and mood disorder identified by a discouraged state of mind and low confidence, influencing the cognitive and social wellness of an individual. An imbalance in the monoamine neurotransmit¬ters leads to depression. Selective serotonin reuptake inhibitors drugs are the generally recommended anti-depressants as they enhance the levels of serotonin in the brain. The efficiency of selective serotonin reuptake inhibitors (SSRIs) in mild or moderate cases of depression has been disputed. In this study, co-administration of piperine, along with citalopram, was evaluated. Citalopram, in combination with piperine, possesses effective potency to improve the behavioral imperfections through forced swim test (FST), tail suspension test (TST), and acto-photometer behavioral tests. Thus, the results revealed that a combination of piperine with citalopram has excellent beneficial effects than an individual in the treatment of depression. This synergetic effect of piperine with citalopram may attribute to their inhibitory activity of the CYP450 enzymes.

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Great boast, small roast on effects of selective serotonin reuptake inhibitors: response to a critique of our systematic review

Acta Neuropsychiatrica ◽

10.1017/neu.2017.38 ◽

2018 ◽

Vol 30 (5) ◽

pp. 251-265 ◽

Cited By ~ 6

Author(s):

Kiran Kumar Katakam ◽

Naqash Javaid Sethi ◽

Janus Christian Jakobsen ◽

Christian Gluud

Keyword(s):

Systematic Review ◽

Serotonin Reuptake ◽

Selective Serotonin Reuptake Inhibitors ◽

Rating Scale ◽

Serotonin Reuptake Inhibitors ◽

Selective Serotonin ◽

Serious Adverse Events ◽

Hamilton Depression Rating Scale ◽

Beneficial Effects ◽

Post Hoc

Our systematic review inBMC Psychiatryconcluded that selective serotonin reuptake inhibitors (SSRIs) compared with placebo significantly increase the risk of serious adverse events (SAEs) in patients with major depression and the potential beneficial effects of SSRIs seem to be outweighed by the harms. Hieronymus et al. accused us of methodological inaccuracies and blatant errors. In theirpost-hocanalysis of our data, they reported that SSRIs only increase the risk of SAEs in elderly and seems safe for non-elderly patients. They also found our review misleading because our efficacy analyses were based on the 17-item Hamilton Depression Rating Scale; we included suboptimal SSRI doses; and we missed some ‘pivotal trials’. We do not agree with Hieronymus et al. regarding several of the ‘errors’ they claim that we have made. However, we acknowledge that they have identified minor errors and that we missed some trials. After rectifying the errors and inclusion of the missed trials by us and Hieronymus et al., we re-analysed the data. The updated analyses are even more robust and confirm our earlier conclusions. SSRIs significantly increase the risk of an SAE both in non-elderly (p=0.045) and elderly (p=0.01) patients [overall odds ratio 1.39; 95% confidence interval (CI) 1.13 to 1.73;p=0.002; I2=0%]. Moreover, SSRIs did not change noticeably the 17-item Hamilton Depression Rating Scale, the internationally accepted scale (mean difference −2.02 points; 95% CI −2.38 to −1.66;p<0.00001). We found no differential effect of dose (p=0.20).

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Pharmacotherapy of fibromyalgia – current knowledge

Ból ◽

10.5604/01.3001.0014.9019 ◽

2021 ◽

Vol 22 (1) ◽

pp. 36-45

Author(s):

Anna Julia Krupa ◽

Krzysztof Wojtasik Bakalarz ◽

Jarosław Woroń ◽

Marcin Siwek ◽

Jerzy Wordliczek

Keyword(s):

Serotonin Reuptake ◽

Selective Serotonin Reuptake Inhibitors ◽

Current Knowledge ◽

Pain Syndrome ◽

Serotonin Reuptake Inhibitors ◽

Selective Serotonin ◽

Beneficial Effects ◽

Knowledge Based ◽

Inflammatory Drugs ◽

Underlying Pathophysiology

Fibromyalgia is a chronic pain syndrome, which affects 2–4% of the general population. Despite its substantial prevalence in the community, the underlying pathophysiology of fibromyalgia remains largely unknown, and the diagnosis is made using symptom-based criteria. As a result, patients may be classified as suffering from fibromyalgia in spite of differing in the pathogenesis of their complaints. Therefore it is no surprise, that the efficacy of pharmacotherapy of fibromyalgia remains limited. This work aims to provide a summary of current knowledge based on trials which assessed the efficacy of fibromyalgia pharmacotherapy. The drugs with the highest amount of research proving their efficacy in reducing fibromyalgia symptoms are duloxetine, milnacipran, pregabalin and amitriptyline. Studies documenting the efficacy of venlafaxine, gabapentin and antidepressants other than serotonin and noradrenalin reuptake inhibitors are smaller in number. Data obtained in trials verifying the effects of selective serotonin reuptake inhibitors, tramadol or cannabinoids are too sparse to draw any clear conclusions. There are reports indicating that opioids (other than tramadol) are contradicted in fibromyalgia, the use of selective serotonin reuptake inhibitors seems disputable too, due to the risk of inducing a change in the pain phenotype. There is a lack of data suggesting the efficacy of nonsteroid anti-inflammatory drugs in fibromyalgia. Furthermore, there are individual studies showing beneficial effects of other drugs and dietary supplements or combinations thereof in patients with fibromyalgia. In summary, the obtained data show that the amount of medicines whose efficacy in fibromyalgia has been verified in numerous studies is limited. More studies exploring the pathophysiology of fibromyalgia and trials verifying the effects of pharmacotherapy are needed to achieve the optimal efficacy of fibromyalgia pharmacotherapy.

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