scholarly journals A Review Article on Selective Serotonin Reuptake Inhibitors (SSRIS)

2019 ◽  
Vol 7 (6) ◽  
pp. 72-75
Author(s):  
Devi Meena ◽  
Subhash Subhash Chand ◽  
Deovrat Kumar
Keyword(s):  
Adverse Reaction ◽  
Half Life ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Serotonin Syndrome ◽  
Meta Analysis ◽  
Fold Increase ◽  
Serum Concentrations ◽  
Prescribing Trends ◽  
Life Threatening ◽  
Anxiety Depression

Depression, tension and mental health have been ignored as a serious issue since ages. Depression can be fatal or life-threatening, if not treated to this problem. Antidepressants are also regularly used to treat many other conditions, such as social phobia, fibromyalgia, panic disorder, anxiety/anxiety depression, PTSD, OCD, PMDD, and menopause. The major antidepressant used in the study followed oral prescribing trends. A “serious adverse reaction means an adverse reaction which is fatal, life-threatening, disabling, incapacitating, or which results in or prolongs hospitalization.” Material method collect from Google, Wikipedia, Elsevier, PubMed, Google scholar, Sci-Hub etc. This is a meta-analysis study. Fluoxetine have the longest half-life, but Fluvoxamine have short half-life. SSRIs increase the serum concentrations of the latter two drugs, potentiating their effects and increasing the risk of toxicity. Fluoxetine and Paroxetine specifically, are known to cause a 5-fold increase in serum TCA concentration upon co-administration. By in the addition of combination therapy SSRIs associated many types of adverse drug reaction and some time it can cause serotonin syndrome also.  

scholarly journals Serotonin Toxicity: Implications for Clinical Practice

2016 ◽  
Vol 13 (3) ◽  
Author(s):  
Auston Rotheram ◽  
Wayne Harris ◽  
Colin Curtain ◽  
David Nihill
Keyword(s):  
Adverse Reaction ◽  
Prescription Drugs ◽  
Serotonin Syndrome ◽  
Management Strategies ◽  
Clinical Information ◽  
Over The Counter ◽  
Life Threatening ◽  
Serotonergic Drugs ◽  
High Index Of Suspicion ◽  
Serotonin Toxicity

Serotonin toxicity, or serotonin syndrome, is a potentially life threatening adverse reaction to the use of one or more serotonergic drugs. Patients presenting with low level obscure symptoms may have pathophysiology rooted in adverse dopamine and serotonergic poly-pharmacy reactions involving illegal, over-the-counter and/or prescription drugs. In this clinical information paper an overview of serotonin toxicity, diagnostic criteria, and management strategies will be offered. Cultivating a high index of suspicion for serotonin toxicity across a broad patient demographic is recommended

Drug-Induced Serotonin Syndrome

2017 ◽  
Vol 37 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Dana Bartlett
Keyword(s):  
Monoamine Oxidase ◽  
Serotonin Receptor ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Serotonin Syndrome ◽  
Serotonin Metabolism ◽  
Drug Induced ◽  
Confirmatory Tests ◽  
Life Threatening ◽  
Serotonin Receptor Agonists ◽  
Norepinephrine Reuptake

Serotonin syndrome is a potentially fatal condition caused by drugs that affect serotonin metabolism or act as serotonin receptor agonists. Monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, and serotonin-norepinephrine reuptake inhibitors are the medications most commonly associated with serotonin syndrome. Serotonin syndrome can be mild and of short duration, but a prolonged course, life-threatening complications, and death are possible. Detection of serotonin syndrome is not difficult if the diagnostic criteria are understood and properly used, but the syndrome has no confirmatory tests and other drug-induced syndromes can, to a degree, mimic serotonin syndrome. The treatment is symptomatic and supportive. Antidotal therapies are available, but the evidence for their effectiveness is limited. If serotonin syndrome is promptly identified and aggressively treated, the patient should fully recover.

Postoperative Serotonin Syndrome Following Methylene Blue Administration for Vasoplegia After Cardiac Surgery: A Case Report and Review of the Literature

2020 ◽  
pp. 108925322096025
Author(s):  
Mafdy N. Basta
Keyword(s):  
Methylene Blue ◽  
Case Report ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Serotonin Syndrome ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Medical Emergency ◽  
Serotonergic Activity ◽  
Threatening Condition ◽  
Life Threatening

Serotonin syndrome is a potentially life-threatening condition associated with increased serotonergic activity in the central nervous system. The increasing incidence of this condition is thought to parallel the increasing use of serotonergic agents in medical practice. The selective serotonin reuptake inhibitors are perhaps the most commonly implicated group of medications associated with serotonin syndrome. This case report describes the occurrence of postoperative serotonin syndrome in a patient on long-term sertraline who underwent coronary artery bypass graft and was treated with methylene blue for perioperative vasoplegia. It delineates the various clinical features commonly encountered and illustrates the recommended management modalities, including prevention, for this potentially lethal medical emergency. With prompt diagnosis and expeditious treatment, the patient has had full recovery.

Phase I trial characterizing the pharmacokinetic profile and NK and CD8+ t cell expansion with n-803, a chimeric IL-15 superagonist, in healthy volunteers.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e15008-e15008
Author(s):  
John M. Wrangle ◽  
Mark P Rubinstein ◽  
Caroline Mart ◽  
Joseph H. Azar ◽  
Cameron Williams ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Nk Cells ◽  
Half Life ◽  
Immune Cell ◽  
Inflammatory Responses ◽  
Nk Cell ◽  
Subcutaneous Administration ◽  
Fold Increase ◽  
Cell Number ◽  
Serum Concentrations

e15008 Background: The oncotherapeutic promise of IL-15, a potent immune stimulant, is limited by short serum half-life. The fusion protein N-803 is an IL-15 superagonist complex that has > 20-fold longer half-life in vivo vs IL-15. This study characterized the pharmacokinetic (PK) profile, biological activity, and safety of N-803 after subcutaneous administration to healthy human volunteers. Methods: Volunteers were randomized 1:1 to receive 1 mg/mL or 2 mg/mL N-803. Each subject received 2 doses of N-803: 10 µg/kg followed 24 days later by 20 µg/kg. After each dose, PK and safety measures were assayed for 9 successive days. Primary endpoint was the PK profile of N-803; secondary was safety; and exploratory endpoints were cytokine levels, immune cell characterization, and immunogenicity. Results: N-803 resulted in no grade ≥3 or serious adverse events (AEs). Mild injection site reactions, chills, and pyrexia were the most common AEs. Serum N-803 concentrations peaked 10.3-15.4 hours after administration and declined with a half-life of 20.0-20.7 hours. Peak N-803 serum concentrations were dose-dependent, with a 1.5-fold increase in Cmax after administration of 20 µg/kg vs 10 µg/kg. In the peripheral blood, N-803 induced a transient decline, followed by a significant increase (3-fold) in NK cell number that persisted for ≥24 days. N-803 also caused a significant proliferation of NK (22-fold increase in Ki-67+ cells), CD8+ (27-fold) and CD4+ T (11-fold) cells; however, increased cell number occurred only in NK cells. N-803 administration also increased serum levels of interferon gamma, IL-10, and IL-6. One of 14 evaluable subjects had measureable anti-N-803 antibodies at the end-of-study visit. Conclusions: N-803 results in prolonged elevation of drug serum concentrations, contrasting with rapid clearance of recombinant human IL-15 (ie, half-life of ~20 vs < 1 hour). N-803 administration was well-tolerated in healthy volunteers, without evidence of adverse systemic inflammatory responses, and resulted in proliferation of NK cells and CD8+ T cells, as well as sustained increases in NK cell number. Findings in this study are consistent with published results from N-803 administration in treating liquid tumors and lung cancer. Our results demonstrate N-803 administration potentiates the proliferation and activity of lymphocytes with antitumor and antivirus properties, and suggest this investigational product holds promise in treatment of cancer as well as infectious disease such as HIV. Clinical trial information: NCT03381586 .

Neurobehavioral Consequences Associated with Long Term Tramadol Utilization and Pathological Mechanisms

2020 ◽  
Vol 18 (10) ◽  
pp. 758-768 ◽  
Author(s):  
Khadga Raj ◽  
Pooja Chawla ◽  
Shamsher Singh
Keyword(s):  
Alzheimer’S Disease ◽  
Parkinson’S Disease ◽  
Alzheimer's Disease ◽  
Parkinson's Disease ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Serotonin Syndrome ◽  
Dopamine Synthesis ◽  
Synthetic Analog

: Tramadol is a synthetic analog of codeine used to treat pain of moderate to severe intensity and is reported to have neurotoxic potential. At therapeutic dose, tramadol does not cause major side effects in comparison to other opioid analgesics, and is useful for the management of neurological problems like anxiety and depression. Long term utilization of tramadol is associated with various neurological disorders like seizures, serotonin syndrome, Alzheimer’s disease and Parkinson’s disease. Tramadol produces seizures through inhibition of nitric oxide, serotonin reuptake and inhibitory effects on GABA receptors. Extensive tramadol intake alters redox balance through elevating lipid peroxidation and free radical leading to neurotoxicity and produces neurobehavioral deficits. During Alzheimer’s disease progression, low level of intracellular signalling molecules like cGMP, cAMP, PKC and PKA affect both learning and memory. Pharmacologically tramadol produces actions similar to Selective Serotonin Reuptake Inhibitors (SSRIs), increasing the concentration of serotonin, which causes serotonin syndrome. In addition, tramadol also inhibits GABAA receptors in the CNS has been evidenced to interfere with dopamine synthesis and release, responsible for motor symptoms. The reduced level of dopamine may produce bradykinesia and tremors which are chief motor abnormalities in Parkinson’s Disease (PD).

Prevalence of anxiety, depression and suicidal behaviors among Brazilian undergraduate students: A systematic review and meta-analysis

2021 ◽  
Vol 282 ◽  
pp. 147-159
Author(s):  
Lauro Miranda Demenech ◽  
Adriano Trassantes Oliveira ◽  
Lucas Neiva-Silva ◽  
Samuel C. Dumith
Keyword(s):  
Systematic Review ◽  
Undergraduate Students ◽  
Meta Analysis ◽  
Suicidal Behaviors ◽  
Anxiety Depression

scholarly journals Psychological and Behavioral Impact of Lockdown and Quarantine Measures for COVID-19 Pandemic on Children, Adolescents and Caregivers: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Prateek Kumar Panda ◽  
Juhi Gupta ◽  
Sayoni Roy Chowdhury ◽  
Rishi Kumar ◽  
Ankit Kumar Meena ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sleep Disturbance ◽  
Behavioral Problems ◽  
Meta Analysis ◽  
Random Effect ◽  
Psychological Problems ◽  
Psychological State ◽  
Eligibility Criteria ◽  
Behavioral Abnormalities ◽  
Anxiety Depression

Abstract Background During the current ongoing COVID-19 pandemic, psychological problems like anxiety, depression, irritability, mood swings, inattention and sleep disturbance are fairly common among quarantined children in several studies. A systematic review of these publications to provide an accurate burden of these psychiatric/behavioral problems is needed for planning mitigating measures by the health authorities. Methods Different electronic databases (MEDLINE, EMBASE, Web of Science, CENTRAL, medRxiv and bioRxiv) were searched for articles describing psychological/behavioral complications in children/adolescents with/without pre-existing behavioral abnormalities and their caregivers related to the COVID-19 pandemic. Only original articles with/without comparator arms and a minimum sample size of 50 were included in the analysis. The pooled estimate of various psychological/behavioral problems was calculated using a random-effect meta-analysis. Results Fifteen studies describing 22 996 children/adolescents fulfilled the eligibility criteria from a total of 219 records. Overall, 34.5%, 41.7%, 42.3% and 30.8% of children were found to be suffering from anxiety, depression, irritability and inattention. Although the behavior/psychological state of a total of 79.4% of children was affected negatively by the pandemic and quarantine, at least 22.5% of children had a significant fear of COVID-19, and 35.2% and 21.3% of children had boredom and sleep disturbance. Similarly, 52.3% and 27.4% of caregivers developed anxiety and depression, respectively, while being in isolation with children. Conclusion Anxiety, depression, irritability, boredom, inattention and fear of COVID-19 are predominant new-onset psychological problems in children during the COVID-19 pandemic. Children with pre-existing behavioral problems like autism and attention deficit hyperactivity disorder have a high probability of worsening of their behavioral symptoms.

The association between neutrophil-to-lymphocyte ratio and contrast-induced acute kidney injury in patients with carotid artery stenting

Vascular ◽  
2021 ◽  
pp. 170853812110125
Author(s):  
Altuğ Ösken ◽  
Ahmet Öz ◽  
Muhammed Keskin ◽  
Evliya Akdeniz ◽  
Hasan Şahan ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Kidney Injury ◽  
Fold Increase ◽  
Multivariate Regression Analysis ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Life Threatening ◽  
Prolonged Hospital

Objectives Contrast-induced acute kidney injury (CI-AKI) is a life-threatening complication that leads to comorbidities and prolonged hospital stay lengths in the setting of peripheral interventions. The presence of some CI-AKI risk factors has already been investigated. In this study, we evaluated the predictors of CI-AKI after carotid artery stenting. Methods A total of 389 patients with 50% to 99% carotid artery stenosis who underwent carotid artery stenting were included in this study. Patients were grouped according to CI-AKI status. Results CI-AKI developed in 26 (6.6%) patients. Age, baseline creatinine level, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were higher and estimated glomerular filtration rate, haemoglobin and lymphocyte count were lower in CI-AKI patients. In the multivariate regression analysis, the neutrophil-to-lymphocyte ratio triggered a 1.39- to 2.63-fold increase in the risk of CI-AKI onset ( p < 0.001). Conclusions The neutrophil-to-lymphocyte ratio may be a significant predictor of CI-AKI in patients with carotid artery stenting and higher neutrophil-to-lymphocyte ratio values may be independently associated with CI-AKI.

scholarly journals The Risk of Acute Pancreatitis and Selective Serotonin Reuptake Inhibitors Use: A Meta-Analysis of Case–Control Studies

Dose-Response ◽  
2020 ◽  
Vol 18 (1) ◽  
pp. 155932582090235
Author(s):  
Shih-Wei Lai ◽  
Cheng-Chan Yu ◽  
Cheng-Li Lin ◽  
Kuan-Fu Liao
Keyword(s):  
Acute Pancreatitis ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Case Series ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Statistical Association ◽  
Case Control Studies

Background/Objective: Some case series and case report have shown the association between the risk of acute pancreatitis and use of selective serotonin reuptake inhibitors. The results of systematic studies were not consistent. Methods: A meta-analysis was performed to investigate the risk of acute pancreatitis associated with use of selective serotonin reuptake inhibitors. Results: There was no statistical association between the risk of acute pancreatitis and selective serotonin reuptake inhibitors use (odds ratio: 1.19, 95% confidence interval: 0.93-1.51). Conclusions: Despite reaching no statistical significance, the possibility of the association between the risk of acute pancreatitis and selective serotonin reuptake inhibitors use cannot be totally excluded.

scholarly journals Antidepressants and Risk of Sudden Cardiac Death: A Network Meta-Analysis and Systematic Review

2021 ◽  
Vol 9 (2) ◽  
pp. 26
Author(s):  
Narut Prasitlumkum ◽  
Wisit Cheungpasitporn ◽  
Nithi Tokavanich ◽  
Kimberly R. Ding ◽  
Jakrin Kewcharoen ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Mental Disorders ◽  
Ventricular Arrhythmia ◽  
Cardiac Death ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Meta Analysis ◽  
Tricyclic Antidepressant ◽  
Systemic Review ◽  
Analysis Model ◽  
Antidepressant Use

Background: Antidepressants are one of the most prescribed medications, particularly for patients with mental disorders. Nevertheless, there are still limited data regarding the risk of ventricular arrhythmia (VA) and sudden cardiac death (SCD) associated with these medications. Thus, we performed systemic review and meta-analysis to characterize the risks of VA and SCD among patients who used common antidepressants. Methods: A literature search for studies that reported risk of ventricular arrhythmias and sudden cardiac death in antidepressant use from MEDLINE, EMBASE, and Cochrane Database from inception through September 2020. A random-effects model network meta-analysis model was used to analyze the relation between antidepressants and VA/SCD. Surface Under Cumulative Ranking Curve (SUCRA) was used to rank the treatment for each outcome. Results: The mean study sample size was 355,158 subjects. Tricyclic antidepressant (TCA) patients were the least likely to develop ventricular arrhythmia events/sudden cardiac deaths at OR 0.24, 0.028–1.2, OR 0.32 (95% CI 0.038–1.6) for serotonin and norepinephrine reuptake inhibitors (SNRI), and OR 0.36 (95% CI 0.043, 1.8) for selective serotonin reuptake inhibitors (SSRI), respectively. According to SUCRA analysis, TCA was on a higher rank compared to SNRI and SSRI considering the risk of VA/SCD. Conclusion: Our network meta-analysis demonstrated the low risk of VA/SCD among patients using antidepressants for SNRI, SSRI and especially, TCA. Despite the relatively lowest VA/SCD in TCA, drug efficacy and other adverse effects should be taken into account in patients with mental disorders.

Sign in / Sign up

Export Citation Format

Share Document