scholarly journals Antipsychotic discontinuation after the initiation of selective serotonin reuptake inhibitors therapy for the treatment of behavioral and psychological symptoms associated with dementia

2018 ◽  
Vol 8 (3) ◽  
pp. 122-126 ◽  
Author(s):  
Monica Mathys ◽  
Steven Fang ◽  
Jini John ◽  
Jasmine Carter

Abstract Introduction: Antipsychotics are used off label to treat behavioral and psychological symptoms of dementia (BPSD). Due to the emerging data of selective serotonin reuptake inhibitors (SSRIs) for treatment of BPSD, clinicians may choose to use this medication class instead of antipsychotics when pharmacologic therapy is necessary. The objective of this study was to evaluate the prevalence of antipsychotic discontinuation 6 months after SSRI initiation for the treatment of BPSD. Methods: Patients with Alzheimer dementia who were prescribed an antipsychotic and later prescribed an SSRI for BPSD during January 1, 2009, through December 30, 2014, were studied. Exclusion criteria included (1) a dementia diagnosis besides Alzheimer; (2) scheduled benzodiazepines, mood stabilizers, or non-SSRI antidepressant use during the study period; (3) diagnoses of bipolar or psychotic disorders; and (4) diagnosis of delirium during the study period. Patients' age, sex, race, and functional assessment of staging for Alzheimer disease scores were collected. The names, doses, and stop dates of SSRIs and antipsychotics were also recorded. Results: Thirty-six patients were included in the analyses. Overall, antipsychotic use was reduced in 11 patients (30.6%). Ten patients (27.8%) discontinued the antipsychotic, and 1 additional patient had a reduction in dose. When comparing specific SSRIs, 8 (72%) responders were prescribed citalopram, and 15 (60%) nonresponders were prescribed sertraline. Discussion: Approximately 30% of patients with Alzheimer dementia who were prescribed antipsychotics for BPSD were able to discontinue the medication or had a dose reduction after starting SSRI therapy. Most SSRI responders were prescribed citalopram.

2000 ◽  
Vol 12 (S1) ◽  
pp. 213-215 ◽  
Author(s):  
Dilip V. Jeste ◽  
Jonathan P. Lacro

When an ideal drug for any medical condition is sought, both its efficacy and safety need to be examined. For the treatment of the complex of symptoms that constitute the behavioral and psychological symptoms of dementia (BPSD), much of the literature has focused on antipsychotic agents, including both types of D2 blockers: the conventional neuroleptics and the newer atypical agents. Fewer studies have investigated other medications, such as anticonvulsants, benzodiazepines, betablockers, selective serotonin reuptake inhibitors, and cholinergics.


Medicina ◽  
2007 ◽  
Vol 43 (5) ◽  
pp. 412
Author(s):  
Mantas Jakimavičius ◽  
Audrius Sveikata ◽  
Paulius Vainauskas ◽  
Rimas Jankūnas ◽  
Loreta Mikučionytė ◽  
...  

Depression is one of the leading causes of disability worldwide, affecting 121 million people in whole world. In many developed countries, the number of prescriptions for antidepressants increased steeply during the 1990s. The objective of the present study was to evaluate the antidepressant prescribing patterns in all regions of Lithuania during 2003–2004, to analyze the use within different antidepressant groups, and to examine trends in age- and gender-specific antidepressant use. Antidepressants were classified into three groups according to Anatomic Therapeutic Chemical (ATC) Classification specifying the defined daily doses. The results of our study show an increase in the use of reimbursed antidepressants except tricyclic in 2004 when compared to 2003. Increase in the use of selective serotonin reuptake inhibitors and other nontricyclic antidepressants is probably related to their better tolerability, improved risk-benefit ratio, and less toxicity in overdose. There was no increase in the percentage of consumed selective serotonin reuptake inhibitors in elderly patients when compared with younger ones, despite elderly patients are most likely to benefit from reduced sedation, less antimuscarinic and less cardiac toxicity of selective serotonin reuptake inhibitors. The prevalence of the antidepressant use is the highest among middle-aged people (40–59 years), while the young (under 20) and elderly (older than 70) patients receive mostly selective serotonin reuptake inhibitors. Additional studies should be carried out in order to assess drug-prescribing patterns in accordance with the guidelines of depression treatment in Lithuania considering diagnosis, dosage, and duration of treatment.


2014 ◽  
Vol 48 (6) ◽  
pp. 857-865 ◽  
Author(s):  
Antônio Ignácio de Loyola Filho ◽  
Érico Castro-Costa ◽  
Josélia Oliveira Araújo Firmo ◽  
Sérgio Viana Peixoto

OBJECTIVE To analyze the trends and factors associated with the antidepressant use among older adults. METHODS This population-based study evaluated older adults in 1997 (n = 351, baseline) and the survivors at the 15th follow-up year (n = 462, in 2012) among the aging cohort of Bambuí. The prevalence of antidepressant use was estimated, and the most commonly used antidepressants each year were identified. Prevalence ratios with 95% confidence intervals were estimated using Poisson regression with robust variance to investigate differences in the prevalence of use between 1997 and 2012. RESULTS The overall consumption of antidepressants (PR = 2.87, 95%CI 1.94;4.25) and of selective serotonin reuptake inhibitors (PR = 7.50, 95%CI 3.74;15.02) was significantly higher in 2012. However, no significant difference was observed in the use of tricyclic antidepressants between the two cohorts (PR = 0.89, 95%CI 0.49;1.62). In the 2012 cohort, antidepressant use was associated with females, increased age, increased income (≥ 4 minimum wages), self-assessment of health as reasonable, and attending ≥ 5 medical consultations in the last 12 months. CONCLUSIONS The increased consumption of antidepressants in the period due to increased use of selective serotonin reuptake inhibitors was consistent with results observed in international studies of different population groups and contexts. The positive correlation observed between antidepressant use and family income may be a warning of possible inequalities in access to mental health services.


2019 ◽  
Vol 12 (1) ◽  
pp. 40-46
Author(s):  
Rossitza K. Iakimova ◽  
Daniil C. Aptalidis ◽  
Milena S. Pandova ◽  
Maria B. Stoyanova ◽  
Maya Y. Stoimenova-Popova

Summary Premenstrual syndrome (PMS) is often co-morbid with panic disorder (PD). Selective serotonin reuptake inhibitors (SSRis) are the first-line treatment for both PMS and PD when they manifest separately, but their co-occurrence often complicates the treatment. Our objectives were to evaluate the clinical picture of PMS, co-morbid with PD and the way it changes under 6-month SSRI treatment course. For that purpose, we conducted a longitudinal interventional study. We examined 30 women suffering from PMS and a current episode of PD, verified through premenstrual screening tool (PSST) and Mini International Neuropsychiatric Interview (M.I.N.I.6.0.), respectively. Before treatment initiation, irritability, mood lability, anxiety, breast tension and tenderness, changes in appetite, headaches, palpitations, and abdominal bloating were most common. The somatic symptoms were more than twice as common as the psychological. After 6 months of treatment, most of the symptoms mentioned above were still present but less severe. Forty per cent of the women recovered completely. It seems that in cases of comorbidity between PMS and PD, though somatic symptoms are more common, SSRIs are an effective option for managing both somatic and psychological symptoms.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Nirmal Raj Marasine ◽  
Sabina Sankhi ◽  
Rajendra Lamichhane ◽  
Nabin Raj Marasini ◽  
Nim Bahadur Dangi

Introduction. Depression is a major global health problem with a relatively high lifetime prevalence and significant disability. Antidepressants are the most effective medications used for the treatment of depression. Hence, this study is aimed at summarizing the studies on antidepressant use among patients diagnosed with depression. Method. PubMed, Embase, Web of Science, Scopus, and Google Scholar were searched for literature (2000-2019) using keywords such as depression, drug utilization, antidepressants, prescription, serotonin reuptake inhibitor, serotonin and norepinephrine reuptake inhibitor, tricyclic antidepressants, and atypical antidepressants. Results. Antidepressant users were mostly females, married people, housewives, lower-income people, employees, and highly educated people, as they were found to be more prone to develop depression than their counterparts. Selective serotonin reuptake inhibitors (SSRIs), such as sertraline, were most commonly prescribed among depressive patients. Conclusion. Our study suggested that out of five major antidepressant drugs available for the treatment of depression, selective serotonin reuptake inhibitors are preferred over others because of their better side effects and tolerability profile.


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