Review on Antidepressant Medication

Depression is a life-threatening, debilitating, and common disease affecting different segments of community. Chemical and synthetic drugs available to treat this disease cause many adverse effects and may lead to complete recovery in only 50% of patients. Antidepressants are effective and accessible treatment options that can reduce suffering and prevent relapse of symptoms. They are recommended as first line treatment options in moderate and severe depression or mild or sub threshold depression that has persisted despite other interventions All current antidepressants, with the exception of agomelatine, increase the transmission of the monoamines, particularly serotonin, nor adrenaline and dopamine. The antidepressants are crucial for the treatment of depressive episodes in the acute phase when untreated symptoms are at their worst. With long-term use, however, the brain sets to work compensating for the drug-induced changes with a process he calls oppositional tolerance. Antidepressant drugs are the mainstay for the treatment of depression. Usually, antidepressants are given in combination with some form of limited supportive psychotherapy.

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A review on antidepressant effect of medicinal plants

Bangladesh Journal of Pharmacology ◽

10.3329/bjp.v12i1.29184 ◽

2017 ◽

Vol 12 (1) ◽

pp. 1 ◽

Cited By ~ 7

Author(s):

Zahra Rabiei ◽

Sana Rabiei

Keyword(s):

Medicinal Plants ◽

Complete Recovery ◽

Antidepressant Effect ◽

Common Disease ◽

Pubmed Central ◽

Synaptic Regulation ◽

Synthetic Drugs ◽

Antidepressant Effects ◽

Life Threatening ◽

Anti Oxidant

Depression is a life-threatening, debilitating, and common disease affecting different segments of community. Chemical and synthetic drugs available to treat this disease cause many adverse effects and may lead to complete recovery in only 50% of patients. At the same time, medicinal plants have been reported to exert optimal pharmacological effects in treating depression in different models. In this review, the relevant articles indexed in the reliable databases PubMed, PubMed central, Scopus and Web of Science were review-ed. The review indicated that most medicinal plants exerted antidepressant effects through synaptic regulation of serotonin, noradrenaline, and dopamine, regulating activity of hypothalamic-pituitary-adrenal axis, reinfor-cing anti-oxidant defense system, and decreasing inflammatory mediators. The medicinal plants and their active compounds can relieve depression through different pathways and hence are considered a new source to produce antidepressants.

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An insight into the etiopathogenesis, clinical patterns, treatment outcome and repercussions of cutaneous small-vessel vasculitis

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20183169 ◽

2018 ◽

Vol 4 (3) ◽

pp. 419

Author(s):

Rajkumar Kannan ◽

Muthusubramanian Chandrasekar ◽

Sridhar Venu ◽

Jayakalyani Vijayananth

Keyword(s):

Systemic Disease ◽

Treatment Options ◽

Tertiary Care ◽

Clinical Manifestations ◽

Complete Recovery ◽

Small Vessel ◽

Small Vessel Vasculitis ◽

Tertiary Care Centre ◽

Drug Induced ◽

Etiological Factors

Background: Cutaneous small-vessel vasculitis (CSVV) is a group of disorder which is characterised by involvement of capillaries, arterioles and venules. CSVV can be idiopathic or primary, or secondary to infection, drugs or as a part and parcel of underlying systemic disease. The aim of our study is to find out the etiological factors, treatment options and their outcome in CSVV.Methods: We analysed 75 cases of CSVV out of patients who attended Dermatology OPD, in a tertiary care-centre from April 2017 to March 2018.The study design was descriptive study. A detailed history taking, thorough clinical examination and appropriate relevant investigations including biopsy were done for all the patients fulfilling the inclusion criteria and exclusion criteria.Results: A sample size of 75 patients (53 women and 22 men) were included in the study. Their mean age was found to be 25 years (range 18-40). The following etiological factors were made out in our study: Benign isolated (40) patients, (53%), infective etiology (14) patients, (19%), vasculitis in background of ANA/dsDNA/ANCA positivity (12) patients, (16%), drug induced (9), patients (12%). The main clinical manifestations of CSVV in our study were found to be the following viz, palpable purpura in all 75 patients (100%), fever & malaise in 30 patients, (40%), ulcers in 30 patients (40%) arthritis/arthralgia in 15 patients, (20%). After a median follow up of 6 months, complete recovery was observed in all patients, although relapses occurred in 8 patients (11%).Conclusions: CSVV is usually associated with other vasculitis and connective tissue disorders and patients turning ANCA positive somewhere in the course of the disease is of ominous sign and hence, it becomes mandatory to keep these patients on a long term vigil.

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Pharmacotherapy, drug-drug interactions and potentially inappropriate medication in depressive disorders.

10.1101/2021.03.31.21254518 ◽

2021 ◽

Author(s):

Jan Wolff ◽

Pamel Reissner ◽

Gudrun Hefner ◽

Claus Normann ◽

Klaus Kaier ◽

...

Keyword(s):

Drug Interactions ◽

Psychotropic Drugs ◽

Odds Ratio ◽

Depressive Disorders ◽

Inappropriate Medication ◽

Antidepressant Drugs ◽

Severe Depression ◽

Potentially Inappropriate Medication ◽

Main Diagnosis ◽

Depressive Episodes

Introduction: The aim of this study was to analyse prescription patterns and the determinants of drug-drug interactions (DDI) and potentially inappropriate medication (PIM) in pharmacotherapy of depressive disorders. Methods: Our study was part of a larger pharmacovigilance project funded by the German Innovation Funds. It included all inpatients with a main diagnosis in the group of depressive episodes (F32, ICD-10) or recurrent depressive disorders (F33) discharged from eight psychiatric hospitals in Germany between 1 October 2017 and 30 September 2018 or between 1 January and 31 December 2019. Results: The study included 14,418 inpatient cases. The mean number of drugs per day was 3.7 (psychotropic drugs = 1.7; others = 2.0). Thirty-one percent of cases received at least five drugs simultaneously (polypharmacy). Almost one half of all cases received a combination of multiple antidepressant drugs (24.8%, 95% CI 24.1% - 25.5%) or a treatment with antidepressant drugs augmented by antipsychotic drugs (21.9%, 95% CI 21.3% - 22.6%). The most frequently used antidepressants were selective serotonin reuptake inhibitors, followed by serotonin and norepinephrine reuptake inhibitors and tetracyclic antidepressants. In multivariate analyses, cases with recurrent depressive disorders and cases with severe depression were more likely to receive a combination of multiple antidepressant drugs (Odds ratio recurrent depressive disorder: 1.56, 95% CI 1.41 - 1.70, severe depression 1.33, 95% CI 1.18 - 1.48). The risk of any DDI and PIM in elderly patients increased substantially with each additional drug (Odds Ratio: DDI 1.32, 95% CI: 1.27 - 1.38, PIM 1.18, 95% CI: 1.14 - 1.22) and severity of disease (Odds Ratio per point on CGI-Scale: DDI 1.29, 95% CI: 1.11 - 1.46, PIM 1.27, 95% CI: 1.11 - 1.44), respectively. Conclusion: This study identified potential sources and determinants of safety risks in pharmacotherapy of depressive disorders and provided additional data which were previously unavailable. Most inpatients with depressive disorders receive multiple psychotropic and non-psychotropic drugs and DDI and PIM are relatively frequent. Patients with a high number of different drugs must be intensively monitored in the management of their individual drug-related risk-benefit profiles.

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Potential Role of Ketamine in the treatment of Schizoaffective Disorder, Depressive Type

International Journal of Psychiatry ◽

10.33140/ijp/02/02/00007 ◽

2017 ◽

Vol 2 (2) ◽

Keyword(s):

Treatment Option ◽

Schizoaffective Disorder ◽

Rating Scale ◽

Financial Burden ◽

Treatment Options ◽

Total Duration ◽

Severe Depression ◽

Area Of Interest ◽

Initial Score ◽

Depressive Episodes

Ketamine use for patients with severe treatment-resistant depression continues to be an area of interest due to the relatively limited number of treatment options for those patients. Although its use as a treatment option for patients with schizophrenia and schizoaffective disorder may seem counterintuitive, in this case report, we explore the efficacy of ketamine for depressive episodes in schizoaffective disorder. This patient who carried a diagnosis of schizoaffective disorder was given 300 mg of intramuscular ketamine for agitation. However, over the course of four days of inpatient stay, her depression drastically improved. She met criteria for remission with the Hamilton Rating Scale for Depression (HAM-D) score of 4, down from an initial score of 21. We advocate for a better understanding of the pros and cons of using ketamine for depression in schizoaffective disorders considering the controversy over the diagnosis of schizoaffective disorder, especially in African American population. At the urging of reducing the risk of suicide among this group and improving their quality of life as well as reducing financial burden by shortening total duration of hospitalization, it may be worthwhile to explore the feasibility of ketamine as a treatment option for severe depression in these patients, possibly as a last resort.

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Neuromodulation approaches for the treatment of major depression: challenges and recommendations from a working group meeting

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2010000300021 ◽

2010 ◽

Vol 68 (3) ◽

pp. 433-451 ◽

Cited By ~ 44

Author(s):

André Russowsky Brunoni ◽

Chei Tung Teng ◽

Claudio Correa ◽

Marta Imamura ◽

Joaquim P Brasil-Neto ◽

...

Keyword(s):

Working Group ◽

Treatment Options ◽

Antidepressant Drugs ◽

Severe Depression ◽

Comprehensive Overview ◽

Non Invasive ◽

High Prevalence ◽

Psychiatric Conditions ◽

Working Group Meeting

The use of neuromodulation as a treatment for major depressive disorder (MDD) has recently attracted renewed interest due to development of other non-pharmacological therapies besides electroconvulsive therapy (ECT) such as transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), deep brain stimulation (DBS), and vagus nerve stimulation (VNS). METHOD: We convened a working group of researchers to discuss the updates and key challenges of neuromodulation use for the treatment of MDD. RESULTS: The state-of-art of neuromodulation techniques was reviewed and discussed in four sections: [1] epidemiology and pathophysiology of MDD; [2] a comprehensive overview of the neuromodulation techniques; [3] using neuromodulation techniques in MDD associated with non-psychiatric conditions; [4] the main challenges of neuromodulation research and alternatives to overcome them. DISCUSSION: ECT is the first-line treatment for severe depression. TMS and tDCS are strategies with a relative benign profile of side effects; however, while TMS effects are comparable to antidepressant drugs for treating MDD; further research is needed to establish the role of tDCS. DBS and VNS are invasive strategies with a possible role in treatment-resistant depression. In summary, MDD is a chronic and incapacitating condition with a high prevalence; therefore clinicians should consider all the treatment options including invasive and non-invasive neuromodulation approaches.

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Pharmacotherapy, drug-drug interactions and potentially inappropriate medication in depressive disorders

PLoS ONE ◽

10.1371/journal.pone.0255192 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0255192

Author(s):

Jan Wolff ◽

Pamela Reißner ◽

Gudrun Hefner ◽

Claus Normann ◽

Klaus Kaier ◽

...

Keyword(s):

Drug Interactions ◽

Psychotropic Drugs ◽

Odds Ratio ◽

Depressive Disorders ◽

Inappropriate Medication ◽

Antidepressant Drugs ◽

Severe Depression ◽

Potentially Inappropriate Medication ◽

Main Diagnosis ◽

Depressive Episodes

Introduction The aim of this study was to describe the number and type of drugs used to treat depressive disorders in inpatient psychiatry and to analyse the determinants of potential drug-drug interactions (pDDI) and potentially inappropriate medication (PIM). Methods Our study was part of a larger pharmacovigilance project funded by the German Innovation Funds. It included all inpatients with a main diagnosis in the group of depressive episodes (F32, ICD-10) or recurrent depressive disorders (F33) discharged from eight psychiatric hospitals in Germany between 1 October 2017 and 30 September 2018 or between 1 January and 31 December 2019. Results The study included 14,418 inpatient cases. The mean number of drugs per day was 3.7 (psychotropic drugs = 1.7; others = 2.0). Thirty-one percent of cases received at least five drugs simultaneously (polypharmacy). Almost one half of all cases received a combination of multiple antidepressant drugs (24.8%, 95% CI 24.1%–25.5%) or a treatment with antidepressant drugs augmented by antipsychotic drugs (21.9%, 95% CI 21.3%–22.6%). The most frequently used antidepressants were selective serotonin reuptake inhibitors, followed by serotonin and norepinephrine reuptake inhibitors and tetracyclic antidepressants. In multivariate analyses, cases with recurrent depressive disorders and cases with severe depression were more likely to receive a combination of multiple antidepressant drugs (Odds ratio recurrent depressive disorder: 1.56, 95% CI 1.41–1.70, severe depression 1.33, 95% CI 1.18–1.48). The risk of any pDDI and PIM in elderly patients increased substantially with each additional drug (Odds Ratio: pDDI 1.32, 95% CI: 1.27–1.38, PIM 1.18, 95% CI: 1.14–1.22) and severity of disease (Odds Ratio per point on CGI-Scale: pDDI 1.29, 95% CI: 1.11–1.46, PIM 1.27, 95% CI: 1.11–1.44), respectively. Conclusion This study identified potential sources and determinants of safety risks in pharmacotherapy of depressive disorders and provided additional data which were previously unavailable. Most inpatients with depressive disorders receive multiple psychotropic and non-psychotropic drugs and pDDI and PIM are relatively frequent. Patients with a high number of different drugs must be intensively monitored in the management of their individual drug-related risk-benefit profiles.

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Frequency and characteristics of side effects associated with antidepressant drugs.

Bosnian Journal of Basic Medical Sciences ◽

10.17305/bjbms.2002.3575 ◽

2002 ◽

Vol 2 (1-2) ◽

pp. 5-11 ◽

Cited By ~ 1

Author(s):

Jasna Kusturica ◽

Irfan Zulić ◽

Svjetlana Loga-Zec ◽

Nedžad Mulabegović ◽

Slobodan Loga ◽

...

Keyword(s):

Side Effects ◽

Successful Treatment ◽

Antidepressant Drugs ◽

Antidepressant Medication ◽

Complete Recovery ◽

Dry Mouth ◽

Major Goal ◽

Blurred Vision ◽

Clinical Centre ◽

Chronic Health Problems

Depression is among the most common of chronic health problems. WHO report predicts that depression will be the leading cause of disability in the industrial world by the year 2020. To be successful, treatment for the patients suffering from depression must be continued until complete recovery, but most patients do not stay on their antidepressant medication long enough. One of the most frequent reasons for break down is appearance of unpleasant side effects. In this study we followed up dynamics of the characteristic side effects of antidepressant therapy, with the major goal to assess their frequency and characteristics. The sample was all female patients taking antidepressant drugs in the Department of Psychiatry of Clinical Centre of University in Sarajevo. The treatment with antidepressants was efficient in most of the patients. A major advantage of SSRI over TCA was less pronounced side effects. The most intensive side effects of TCA (amitriptyline) were dry mouth, tremor and tachycardia while the most frequent side effects included blurred vision, tachycardia, dry mouth, tremor and sedation. Side effects of SSRI (fluoxetine/fluvoxamine) were mild, and the most frequent were nausea, tachycardia, swelling, dry mouth.

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Oxidative Stress as a Possible Target in the Treatment of Toxoplasmosis: Perspectives and Ambiguities

International Journal of Molecular Sciences ◽

10.3390/ijms22115705 ◽

2021 ◽

Vol 22 (11) ◽

pp. 5705

Author(s):

Karolina Szewczyk-Golec ◽

Marta Pawłowska ◽

Roland Wesołowski ◽

Marcin Wróblewski ◽

Celestyna Mila-Kierzenkowska

Keyword(s):

Oxidative Stress ◽

Animal Studies ◽

Treatment Options ◽

Natural Antioxidants ◽

Redox Status ◽

Host Cells ◽

Common Disease ◽

Parasite Viability

Toxoplasma gondii is an apicomplexan parasite causing toxoplasmosis, a common disease, which is most typically asymptomatic. However, toxoplasmosis can be severe and even fatal in immunocompromised patients and fetuses. Available treatment options are limited, so there is a strong impetus to develop novel therapeutics. This review focuses on the role of oxidative stress in the pathophysiology and treatment of T. gondii infection. Chemical compounds that modify redox status can reduce the parasite viability and thus be potential anti-Toxoplasma drugs. On the other hand, oxidative stress caused by the activation of the inflammatory response may have some deleterious consequences in host cells. In this respect, the potential use of natural antioxidants is worth considering, including melatonin and some vitamins, as possible novel anti-Toxoplasma therapeutics. Results of in vitro and animal studies are promising. However, supplementation with some antioxidants was found to promote the increase in parasitemia, and the disease was then characterized by a milder course. Undoubtedly, research in this area may have a significant impact on the future prospects of toxoplasmosis therapy.

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What are the reciprocal influences of randomized clinical trials and the patient–psychiatrist relationship?

European Psychiatry ◽

10.1016/s0924-9338(99)80724-x ◽

1999 ◽

Vol 14 (2) ◽

pp. 93-100

Author(s):

J. Catteau ◽

C. Cyran ◽

R. Bordet ◽

C.E. Thomas ◽

B.A. Dupuis

Keyword(s):

Clinical Trials ◽

Depressive Disorders ◽

Randomized Clinical Trials ◽

Antidepressant Drugs ◽

Antidepressant Medication ◽

Study Data ◽

Phase Iii ◽

Double Blind ◽

Phase Iii Clinical Trials ◽

Reciprocal Influences

SummaryThe goal of this prospective investigation was to study the course and the quality of patient-psychiatrist relationships during phase II / phase III clinical trials of antidepressant medication prescribed for depressive disorders. All patients who participated in the clinical trials (and subsequently in this survey) signed written informed consent statements and were subject to random double blind treatment assignment. Retrospective analysis of 118 investigations was carried out, and the patients involved were questioned concerning their experiences and impressions during and after the study. Data show that the outcome of clinical trials of antidepressant drugs are not a function of pre-existing good patient-psychiatrist relationships. On the other hand, no effects on the patient-psychiatrist relationship were found as a result of the experimental procedure, and it can be concluded that no detrimental effects on future patient-psychiatrist relationships were incurred.

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Drug Induced Pneumonitis Secondary to Treatment with Paritaprevir/Ritonavir/Ombitasvir and Dasabuvir (VIEKIRA PAK®) for Chronic Hepatitis C: Case Report of an Unexpected Life-Threatening Adverse Reaction

Case Reports in Medicine ◽

10.1155/2017/4895736 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Shih Yea Sylvia Wu ◽

Bridget Faire ◽

Edward Gane

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Kidney Injury ◽

Complete Recovery ◽

Final Diagnosis ◽

Community Acquired Pneumonia ◽

Drug Induced ◽

First Case ◽

Life Threatening

VIEKIRA PAK (ritonavir-boosted paritaprevir/ombitasvir and dasabuvir) is an approved treatment for compensated patients with genotype 1 (GT1) chronic hepatitis C virus (HCV) infection. This oral regimen has minimal adverse effects and is well tolerated. Cure rates are 97% in patients infected with HCV GT 1a and 99% in those with HCV GT 1b. We report the first case of life-threatening allergic pneumonitis associated with VIEKIRA PAK. This unexpected serious adverse event occurred in a 68-year-old Chinese female with genotype 1b chronic hepatitis C and Child-Pugh A cirrhosis. One week into treatment with VIEKIRA PAK without ribavirin, she was admitted to hospital with respiratory distress and acute kidney injury requiring intensive care input. She was initially diagnosed with community acquired pneumonia and improved promptly with intravenous antibiotics and supported care. No bacterial or viral pathogens were cultured. Following complete recovery, she recommenced VIEKIRA PAK but represented 5 days later with more rapidly progressive respiratory failure, requiring intubation and ventilation, inotropic support, and haemodialysis. The final diagnosis was drug induced pneumonitis.

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