Selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors for menopausal vasomotor symptoms

2015 ◽  
Vol 5 (6) ◽  
pp. 260-264
Author(s):  
Kathryn M. Holt ◽  
Amy N. Thompson
Keyword(s):  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Hormone Replacement ◽  
Medical Intervention ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Vasomotor Symptoms ◽  
Serious Adverse Events ◽  
Hormonal Therapies ◽  
Norepinephrine Reuptake

Abstract Introduction Some of the most bothersome symptoms associated with menopause are the vasomotor symptoms (VMS), characterized by transient elevations in body temperature associated with a narrowing of the thermoneutral zone and an abnormal firing rate of thermosensitive neurons in the hypothalamus. These VMS have traditionally been treated with hormone replacement therapy (HRT); however, after a trial suggesting an association between HRT and a number of serious adverse events, alternative therapies for VMS are being studied. The purpose of this review is to evaluate the available literature regarding the use of selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) for the alleviation of VMS associated with menopause. Methods PubMed and Ovid/MEDLINE keyword searches were conducted. Literature was reviewed for inclusion if it included any SSRI or SNRI for menopausal symptoms published prior to August 31, 2014. Results Seven studies were included in this review article. No articles were found directly comparing HRT to either SSRIs or SNRIs. Multiple agents within these two classes have been studied for VMS in menopausal and postmenopausal women. Discussion Vasomotor symptoms related to the perimenopausal and postmenopausal period can lead to significant physical distress, often requiring medical intervention. Traditional therapies for VMS of menopause have been dominated by the use of HRT. There are conflicting data regarding the use of SSRIs and SNRIs for patients with vasomotor symptoms related to menopause, and these agents may not be ideal for all patients. These agents may be considered as an alternative in patients who have a contraindication or are concerned about using hormonal therapies.

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

2018 ◽  
Vol 30 (5) ◽  
pp. 251-265 ◽  
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).

Antidepressants

2018 ◽  
Author(s):  
Shadi Doroudgar ◽  
Baovy Dang
Keyword(s):  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Patient Specific ◽  
Therapeutic Effects ◽  
Patient Counseling ◽  
Compulsive Disorder ◽  
Full Relief ◽  
Norepinephrine Reuptake

Antidepressant medications have numerous clinical uses in the field of psychiatry. There are many antidepressant classes, with the selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors being commonly used in clinical practice for depression and anxiety. Although these medications are effective, complete clinical effect is not rapid and full relief of symptoms can take more than a month. However, side effects with antidepressants can be expected to occur upon initiation of treatment and may lead to patient nonadherence. Education and appropriate patient counseling are necessary to assure that the therapeutic effects of medications are maximized. Treatment with antidepressants should be tailored to patient-specific criteria. This review contains 1 figure, 4 tables and 43 references Key Words: antidepressants, FDA-approved, obsessive-compulsive disorder, monoamine oxidase, MAOIs, selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, tricyclic antidepressants.

scholarly journals Multiple possible inaccuracies cast doubt on a recent report suggesting selective serotonin reuptake inhibitors to be toxic and ineffective

2017 ◽  
Vol 30 (5) ◽  
pp. 244-250 ◽  
Author(s):  
Fredrik Hieronymus ◽  
Alexander Lisinski ◽  
Jakob Näslund ◽  
Elias Eriksson
Keyword(s):  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Serious Adverse Events ◽  
Efficacy Parameter ◽  
Cast Doubt ◽  
Antidepressant Efficacy ◽  
The Many ◽  
Definition Of

According to a systematic review on the use of selective serotonin reuptake inhibitors (SSRIs) in adult depression that was recently published in BMC Psychiatry, the results of which have been widely disseminated in lay media, these drugs increase the risk for serious adverse events (SAEs) while exerting poor antidepressant efficacy. A cursory analysis, however, suggests the analysis of SAEs conducted by the authors to be marred by both methodological inaccuracies and blatant errors. After having corrected for these apparent mistakes, we conducted a sensitivity analysis in which we also accounted for a possible moderating effect of age; while this suggests SSRIs to be safe drugs in the non-elderly, they do confirm what is already known, that is, that they may enhance the risk for SAEs in the old. Given the loose definition of SAE, including also innocuous phenomena, the possible clinical significance of the latter observation, however, remains unclear until the nature and actual impact of the SAEs in question have been clarified. Moreover, with respect to efficacy, we find the paper in BMC Psychiatry misleading: first, the authors seem unaware of the well-established shortcomings associated with the conventional efficacy parameter on which their analysis is based, second, they have included suboptimal SSRI doses and third, they have missed some pivotal trials. Unless there are explanations for the many peculiarities in this paper that have escaped us, and which may be satisfactorily clarified by the authors, it seems important that the conclusions presented in this paper be publicly rectified.

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