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[PMID]:29235659
[Au] Autor:Mulvahill JS; Nicol GE; Dixon D; Lenze EJ; Karp JF; Reynolds CF; Blumberger DM; Mulsant BH
[Ad] Endereço:Healthy Mind Lab, Department of Psychiatry, School of Medicine, Washington University, St. Louis, Missouri.
[Ti] Título:Effect of Metabolic Syndrome on Late-Life Depression: Associations with Disease Severity and Treatment Resistance.
[So] Source:J Am Geriatr Soc;65(12):2651-2658, 2017 Dec.
[Is] ISSN:1532-5415
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND/OBJECTIVES: Metabolic syndrome (MetS) is the co-occurrence of obesity and metabolic derangements. Prior research implicates MetS in prolongation of the course of depression in older adults, but its effect on antidepressant response is unknown in this population. The objective was to determine whether MetS and related metabolic dyscrasias are associated with decreased rate of remission from depression in older adults treated pharmacologically for depression. DESIGN: Secondary analysis of a randomized controlled trial. SETTING: Three academic medical centers in North America. PARTICIPANTS: Adults aged 60 and older (mean age 69.1) with major depressive disorder (MDD) (N = 435). INTERVENTION: Open-label, protocolized treatment with extended-release venlafaxine for 12 or more weeks. MEASUREMENTS: Time to remission from depression, with remission defined as a Montgomery-Åsberg Depression Rating Scale (MADRS) score of 10 or less at last two visits. RESULTS: Two hundred twenty-two participants (51%) met criteria for MetS at baseline; MetS was associated with greater severity (MADRS score) and chronicity of depression at baseline. Remission was achieved in 182 participants (42%). In the unadjusted analysis, MetS was associated with prolonged time to remission (hazard ratio for remission = 0.71, 95% confidence interval = 0.52-0.95), but this relationship was not significant in the adjusted model; greater number of MetS components and lower high-density lipoprotein cholesterol had similar effects. Only diastolic blood pressure (DBP) was a significant predictor of time to remission before and after adjustment, with higher DBP predicting longer time to remission. Insulin sensitivity did not predict time to remission. CONCLUSION: The presence of MetS in older adults with depression was associated with greater symptom severity and chronicity of depression, which appears to have accounted for the poorer antidepressant response observed in those with MetS. Additionally, our preliminary finding of an association between higher DBP and poorer antidepressant response bears further examination and replication.
[Mh] Termos MeSH primário: Antidepressivos de Segunda Geração/uso terapêutico
Depressão/tratamento farmacológico
Depressão/etiologia
Síndrome Metabólica/complicações
Cloridrato de Venlafaxina/uso terapêutico
[Mh] Termos MeSH secundário: Fatores Etários
Idoso
Resistência a Medicamentos
Feminino
Seres Humanos
Masculino
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antidepressive Agents, Second-Generation); 7D7RX5A8MO (Venlafaxine Hydrochloride)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180203
[Lr] Data última revisão:
180203
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE
[do] DOI:10.1111/jgs.15129


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[PMID]:28982121
[Au] Autor:Li X; Zhu L; Su Y; Fang S
[Ad] Endereço:Department of Neurology, Neuroscience Centre, the First Teaching Hospital of Jilin University, Changchun, China.
[Ti] Título:Short-term efficacy and tolerability of venlafaxine extended release in adults with generalized anxiety disorder without depression: A meta-analysis.
[So] Source:PLoS One;12(10):e0185865, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Although efficacy of venlafaxine extended release (XR) for generalized anxiety disorder (GAD) has been reported in previous analyses in 2002 and 2004, the sample size was rather small and estimate of safety or tolerability was not clear. The present analysis had the advantage of large sample size and provided evidence for tolerability. METHODS: Literature databases were searched, including Pubmed, Embase, Cochrane Central Register of Controlled Trials, Web of science and clinical trials. 10 eligible articles were finally selected and data was extracted and logged into the Review Manager 5.3 by two independent authors. The risk of bias was evaluated by the Cochrane Collaboration's Risk of Bias Tool and the stability of the results was assessed by sensitivity analysis. The publication bias was assessed by funnel plot and Egger's/Begg's test using Stata Version 12.0 software. RESULTS: In the current meta-analysis, 10 articles (14 studies) satisfying the inclusion criteria were analyzed. As efficacy outcomes, our findings indicated venlafaxine XR was significantly more effective than placebo according to mean change of the Hamilton Rating Scale for Anxiety total scores [mean difference = 3.31, 95% confidence interval(CI) 1.44-5.18, P = 0.0005], response [odds ratio(OR) = 1.83, 95%CI 1.58-2.12, P<0.00001], and remission (OR = 2.55, 95%CI 1.36-4.78, P = 0.003). In terms of tolerability, the most frequently reported treatment-emergent adverse events were nausea, dry mouth, dizziness, insomnia, somnolence, and headache. In addition, discontinuation due to all-cause (OR = 1.17, 95%CI 0.92-1.49, P = 0.19) was not significantly different between the two groups, whereas discontinuation due to adverse events was statistically higher in the venlafaxine XR group compared with the placebo treatment (OR = 2.80, 95%CI 2.21-3.54, P<0.00001) and discontinuation due to inefficacy was lower in venlafaxine than placebo treatment (OR = 0.26, 95%CI 0.17-0.40, P<0.00001). There was no significant publication bias and sensitivity analysis showed that our analysis exhibited high stability. CONCLUSION: We concluded that venlafaxine XR (75-225 mg/day) is an effective and well-tolerated pharmacological treatment option for adult patients with GAD.
[Mh] Termos MeSH primário: Antidepressivos de Segunda Geração/administração & dosagem
Transtornos de Ansiedade/tratamento farmacológico
Cloridrato de Venlafaxina/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Antidepressivos de Segunda Geração/uso terapêutico
Preparações de Ação Retardada
Seres Humanos
Cloridrato de Venlafaxina/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Nm] Nome de substância:
0 (Antidepressive Agents, Second-Generation); 0 (Delayed-Action Preparations); 7D7RX5A8MO (Venlafaxine Hydrochloride)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171006
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185865


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[PMID]:28708853
[Au] Autor:Westin AA; Brekke M; Molden E; Skogvoll E; Spigset O
[Ad] Endereço:Department of Clinical Pharmacology, St Olav University Hospital, Trondheim, Norway.
[Ti] Título:Selective serotonin reuptake inhibitors and venlafaxine in pregnancy: Changes in drug disposition.
[So] Source:PLoS One;12(7):e0181082, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pregnancy may cause changes in drug disposition. The clinical consequences may be profound and even counterintuitive; in some cases pregnant women may need more than twice their usual drug dose in order to maintain therapeutic drug levels. For antidepressants, evidence on drug disposition in pregnancy is scarce. The aim of this study was to determine the effects of pregnancy on serum levels of selective serotonin reuptake inhibitors (SSRIs) and venlafaxine in a large and naturalistic patient material, in order to provide tentative dose recommendations for pregnant women. METHODS: Using patient data from two routine therapeutic drug monitoring (TDM) services in Norway with linkage to the national birth registry, dose-adjusted serum drug concentrations of SSRIs and venlafaxine during pregnancy were compared to the women's own baseline (non-pregnant) values, using a linear mixed model. FINDINGS: Overall, the TDM databases contained 196,726 serum concentration measurements from 54,393 women. After data linkage and drug selection (SSRIs or venlafaxine only), we identified 367 analyses obtained from a total of 290 pregnancies in 281 women, and 420 baseline observations from the same women. Serum concentrations in the third trimester were significantly lower than baseline for paroxetine (-51%; 95% confidence interval [CI], -66%, -30%; p<0.001), fluvoxamine (-56%; CI, -75%, -23%; p = 0.004) and citalopram (-24%; CI, -38%, -7%; p = 0,007), and higher than baseline for sertraline (+68%; CI, +37%, +106%; p<0.001). For escitalopram, fluoxetine and venlafaxine concentrations did not change significantly. CONCLUSIONS: For paroxetine and fluvoxamine the pronounced decline in maternal drug serum concentrations in pregnancy may necessitate a dose increase of about 100% during the third trimester in order to maintain stable concentrations. For fluoxetine, venlafaxine, citalopram, escitalopram and sertraline, the present study indicates that dose adjustments are generally not necessary during pregnancy.
[Mh] Termos MeSH primário: Antidepressivos/sangue
Monitoramento de Medicamentos
Inibidores da Captação de Serotonina/sangue
Cloridrato de Venlafaxina/sangue
[Mh] Termos MeSH secundário: Adulto
Antidepressivos/uso terapêutico
Citalopram/sangue
Citalopram/uso terapêutico
Bases de Dados Factuais
Transtorno Depressivo/tratamento farmacológico
Feminino
Fluvoxamina/sangue
Fluvoxamina/uso terapêutico
Seres Humanos
Noruega
Paroxetina/sangue
Paroxetina/uso terapêutico
Gravidez
Terceiro Trimestre da Gravidez
Inibidores da Captação de Serotonina/uso terapêutico
Cloridrato de Venlafaxina/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antidepressive Agents); 0 (Serotonin Uptake Inhibitors); 0DHU5B8D6V (Citalopram); 41VRH5220H (Paroxetine); 7D7RX5A8MO (Venlafaxine Hydrochloride); O4L1XPO44W (Fluvoxamine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170927
[Lr] Data última revisão:
170927
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170715
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0181082


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[PMID]:28677828
[Au] Autor:Koesters M; Ostuzzi G; Guaiana G; Breilmann J; Barbui C
[Ad] Endereço:Department of Psychiatry II, Ulm University, Ludwig-Heilmeyer-Str. 2, Guenzburg, Germany, D-89312.
[Ti] Título:Vortioxetine for depression in adults.
[So] Source:Cochrane Database Syst Rev;7:CD011520, 2017 Jul 05.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Major depressive disorder is a common mental disorder affecting a person's mind, behaviour and body. It is expressed as a variety of symptoms and is associated with substantial impairment. Despite a range of pharmacological and non-pharmacological treatment options, there is still room for improvement of the pharmacological treatment of depression in terms of efficacy and tolerability. The latest available antidepressant is vortioxetine. It is assumed that vortioxetine's antidepressant action is related to a direct modulation of serotonergic receptor activity and inhibition of the serotonin transporter. The mechanism of action is not fully understood, but it is claimed to be novel. Vortioxetine was placed in the category of "Other" antidepressants and may therefore provide an alternative to existing antidepressant drugs. OBJECTIVES: To assess the efficacy and acceptability of vortioxetine compared with placebo and other antidepressant drugs in the treatment of acute depression in adults. SEARCH METHODS: We searched Cochrane's Depression, Anxiety and Neurosis Review Group's Specialised Register to May 2016 without applying any restrictions to date, language or publication status. We checked reference lists of relevant studies and reviews, regulatory agency reports and trial databases. SELECTION CRITERIA: We included randomised controlled trials comparing the efficacy, tolerability, or both of vortioxetine versus placebo or any other antidepressant agent in the treatment of acute depression in adults. DATA COLLECTION AND ANALYSIS: Two review authors independently selected the studies and extracted data. We extracted data on study characteristics, participant characteristics, intervention details and outcome measures in terms of efficacy, acceptability and tolerability. We analysed intention-to-treat (ITT) data only and used risk ratios (RR) as effect sizes for dichotomous data and mean differences (MD) for continuous data with 95% confidence intervals (CI). Meta-analyses used random-effects models. MAIN RESULTS: We included 15 studies (7746 participants) in this review. Seven studies were placebo controlled; eight studies compared vortioxetine to serotonin-norepinephrine reuptake inhibitors (SNRIs). We were unable to identify any study that compared vortioxetine to antidepressant drugs from other classes, such as selective serotonin reuptake inhibitors (SSRIs).Vortioxetine may be more effective than placebo across the three efficacy outcomes: response (Mantel-Haenszel RR 1.35, 95% CI 1.22 to 1.49; 14 studies, 6220 participants), remission (RR 1.32, 95% CI 1.15 to 1.53; 14 studies, 6220 participants) and depressive symptoms measured using the Montgomery-Åsberg Depression Scale (MADRS) (score range: 0 to 34; higher score means worse outcome: MD -2.94, 95% CI -4.07 to -1.80; 14 studies, 5566 participants). The quality of the evidence was low for response and remission and very low for depressive symptoms. We found no evidence of a difference in total dropout rates (RR 1.05, 95% CI 0.93 to 1.19; 14 studies, 6220 participants). More participants discontinued vortioxetine than placebo because of adverse effects (RR 1.41, 95% CI 1.09 to 1.81; 14 studies, 6220 participants) but fewer discontinued due to inefficacy (RR 0.56, 95% CI 0.34 to 0.90, P = 0.02; 14 studies, 6220 participants). The quality of the evidence for dropouts was moderate.The subgroup and sensitivity analyses did not reveal factors that significantly influenced the results.In comparison with other antidepressants, very low-quality evidence from eight studies showed no clinically significant difference between vortioxetine and SNRIs as a class for response (RR 0.91, 95% CI 0.82 to 1.00; 3159 participants) or remission (RR 0.89, 95% CI 0.77 to 1.03; 3155 participants). There was a small difference favouring SNRIs for depressive symptom scores on the MADRS (MD 1.52, 95% CI 0.50 to 2.53; 8 studies, 2807 participants). Very low quality evidence from eight studies (3159 participants) showed no significant differences between vortioxetine and the SNRIs as a class for total dropout rates (RR 0.89, 95% CI 0.73 to 1.08), dropouts due to adverse events (RR 0.74, 95% CI 0.51 to 1.08) and dropouts due to inefficacy (RR 1.52, 95% CI 0.70 to 3.30).Against individual antidepressants, analyses suggested that vortioxetine may be less effective than duloxetine in terms of response rates (RR 0.86, 95% CI 0.79 to 0.94; 6 studies, 2392 participants) and depressive symptoms scores on the MADRS scale (MD 1.99, 95% CI 1.15 to 2.83; 6 studies; 2106 participants). Against venlafaxine, meta-analysis of two studies found no statistically significant differences (response: RR 1.03, 95% CI 0.85 to 1.25; 767 participants; depressive symptom scores: MD 0.02, 95% CI -2.49 to 2.54; 701 participants). In terms of number of participants reporting at least one adverse effect (tolerability), vortioxetine was better than the SNRIs as a class (RR 0.90, 95% CI 0.86 to 0.94; 8 studies, 3134 participants) and duloxetine (RR 0.89, 95% CI 0.84 to 0.95; 6 studies; 2376 participants). However, the sensitivity analysis casts some doubts on this result, as only two studies used comparable dosing.We judged none of the studies to have a high risk of bias for any domain, but we rated all studies to have an unclear risk of bias of selective reporting and other biases. AUTHORS' CONCLUSIONS: The place of vortioxetine in the treatment of acute depression is unclear. Our analyses showed vortioxetine may be more effective than placebo in terms of response, remission and depressive symptoms, but the clinical relevance of these effects is uncertain. Furthermore, the quality of evidence to support these findings was generally low. In comparison to SNRIs, we found no advantage for vortioxetine. Vortioxetine was less effective than duloxetine, but fewer people reported adverse effects when treated with vortioxetine compared to duloxetine. However, these findings are uncertain and not well supported by evidence. A major limitation of the current evidence is the lack of comparisons with the SSRIs, which are usually recommended as first-line treatments for acute depression. Studies with direct comparisons to SSRIs are needed to address this gap and may be supplemented by network meta-analyses to define the role of vortioxetine in the treatment of depression.
[Mh] Termos MeSH primário: Antidepressivos/uso terapêutico
Transtorno Depressivo Maior/tratamento farmacológico
Piperazinas/uso terapêutico
Sulfetos/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Cloridrato de Duloxetina/uso terapêutico
Seres Humanos
Pacientes Desistentes do Tratamento/estatística & dados numéricos
Placebos/uso terapêutico
Ensaios Clínicos Controlados Aleatórios como Assunto
Indução de Remissão
Inibidores da Recaptação de Serotonina e Norepinefrina/uso terapêutico
Cloridrato de Venlafaxina/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Antidepressive Agents); 0 (Piperazines); 0 (Placebos); 0 (Serotonin and Noradrenaline Reuptake Inhibitors); 0 (Sulfides); 3O2K1S3WQV (vortioxetine); 7D7RX5A8MO (Venlafaxine Hydrochloride); 9044SC542W (Duloxetine Hydrochloride)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170908
[Lr] Data última revisão:
170908
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170706
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD011520.pub2


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[PMID]:28555718
[Au] Autor:Rawson KS; Dixon D; Civitelli R; Peterson TR; Mulsant BH; Reynolds CF; Lenze EJ
[Ad] Endereço:Department of Psychiatry, School of Medicine, Washington University, St. Louis, Missouri.
[Ti] Título:Bone Turnover with Venlafaxine Treatment in Older Adults with Depression.
[So] Source:J Am Geriatr Soc;65(9):2057-2063, 2017 Sep.
[Is] ISSN:1532-5415
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Epidemiologic data suggest older adults receiving serotonergic antidepressants may have accelerated bone loss. We examined bone turnover marker changes and patient-level variables associated with these changes in older adults receiving protocolized antidepressant treatment. DESIGN: Open-label, protocolized treatment study. SETTING: Medical centers in Pittsburgh, St Louis, and Toronto. PARTICIPANTS: Older adults with major depression (N = 168). MEASUREMENTS: Serum levels of the bone resorption marker C-terminal cross-linking telopeptide of type 1 collagen (CTX) and the bone formation marker procollagen type 1 N propeptide (P1NP) were assayed before and after 12 weeks of treatment with venlafaxine. Whether CTX and P1NP changes were associated with depression remission and duration of depression and genetic polymorphisms in the serotonin transporter (5HTTLPR) and 1B receptor (HTR1B) were also examined. RESULTS: CTX increased and P1NP decreased during venlafaxine treatment, a profile consistent with accelerated bone loss. Two individual-level clinical variables were correlated with bone turnover; participants whose depression did not go into remission had higher CTX levels, and those with chronic depression had lower P1NP levels. HTR1B genotype predicted P1NP change, whereas 5HTTLPR genotype was unrelated to either biomarker. CONCLUSION: Bone turnover markers change with antidepressant treatment in a pattern that suggests accelerated bone loss, although the clinical significance of these changes is unclear. These data are preliminary and argue for a larger, controlled study to confirm whether antidepressants are harmful to bone metabolism and whether certain individuals might be at increased risk.
[Mh] Termos MeSH primário: Remodelação Óssea/efeitos dos fármacos
Transtorno Depressivo Maior/tratamento farmacológico
Inibidores da Recaptação de Serotonina e Norepinefrina/uso terapêutico
Cloridrato de Venlafaxina/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Biomarcadores/sangue
Colágeno Tipo I/sangue
Feminino
Seres Humanos
Masculino
Pró-Colágeno/sangue
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Collagen Type I); 0 (Procollagen); 0 (Serotonin and Noradrenaline Reuptake Inhibitors); 7D7RX5A8MO (Venlafaxine Hydrochloride)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171005
[Lr] Data última revisão:
171005
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170531
[St] Status:MEDLINE
[do] DOI:10.1111/jgs.14936


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[PMID]:28443381
[Au] Autor:Kallweit U; Bassetti CL
[Ad] Endereço:a Department of Neurology , Bern University Hospital and University of Bern , Bern , Switzerland.
[Ti] Título:Pharmacological management of narcolepsy with and without cataplexy.
[So] Source:Expert Opin Pharmacother;18(8):809-817, 2017 Jun.
[Is] ISSN:1744-7666
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Narcolepsy is an orphan neurological disease and presents with sleep-wake, motoric, neuropsychiatric and metabolic symptoms. Narcolepsy with cataplexy is most commonly caused by an immune-mediated process including genetic and environmental factors, resulting in the selective loss of hypocretin-producing neurons. Narcolepsy has a major impact on workableness and quality of life. Areas covered: This review provides an overview of the temporal available treatment options for narcolepsy (type 1 and 2) in adults, including authorization status by regulatory agencies. First- and second-line options are discussed as well as combination therapies. In addition, treatment options for frequent coexisting co-morbidities and different phenotypes of narcolepsy are presented. Finally, this review considers potential future management strategies. Non-pharmacological approaches are important in the management of narcolepsy but will not be covered in this review. Expert opinion: Concise evaluation of symptoms and type of narcolepsy, coexisting co-morbidities and patients´ distinct needs is mandatory in order to identify a suitable, individual pharmacological treatment. First-line options include Modafinil/Armodafinil (for excessive daytime sleepiness, EDS), Sodium Oxybate (for EDS and/with cataplexy), Pitolisant (for EDS and cataplexy) and Venlafaxine (for cataplexy (off-label) and co-morbid depression). New symptomatic and causal treatment most probably will be completed by hypocretin-replacement and immune-modifying strategies.
[Mh] Termos MeSH primário: Narcolepsia/tratamento farmacológico
Sono/efeitos dos fármacos
Promotores da Vigília/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Compostos Benzidrílicos/administração & dosagem
Compostos Benzidrílicos/uso terapêutico
Cataplexia/complicações
Cataplexia/diagnóstico
Cataplexia/tratamento farmacológico
Quimioterapia Combinada
Seres Humanos
Narcolepsia/complicações
Narcolepsia/diagnóstico
Neuropeptídeos/metabolismo
Uso Off-Label
Orexinas/metabolismo
Piperidinas/administração & dosagem
Piperidinas/uso terapêutico
Qualidade de Vida
Oxibato de Sódio/administração & dosagem
Oxibato de Sódio/uso terapêutico
Cloridrato de Venlafaxina/administração & dosagem
Cloridrato de Venlafaxina/uso terapêutico
Promotores da Vigília/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Benzhydryl Compounds); 0 (Neuropeptides); 0 (Orexins); 0 (Piperidines); 0 (Wakefulness-Promoting Agents); 4BC83L4PIY (1-(3-(3-(4-chlorophenyl)propoxy)propyl)piperidine); 7D7RX5A8MO (Venlafaxine Hydrochloride); 7G33012534 (Sodium Oxybate); R3UK8X3U3D (modafinil); V63XWA605I (armodafinil)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170427
[St] Status:MEDLINE
[do] DOI:10.1080/14656566.2017.1323877


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[PMID]:28407764
[Au] Autor:Lin HW; Simonavice CA; Lu CR; Lin WL; Wu PL; Chou CY; Liao CH; Lane HY
[Ad] Endereço:School of Pharmacy and Graduate Institute, College of Pharmacy, China Medical University, No. 91 Hsueh-Shih Road, Taichung, 40402, Taiwan. hsiangwl@gmail.com.
[Ti] Título:Severe hypertriglyceridemia secondary to venlafaxine use in an older adult on dialysis -case report.
[So] Source:BMC Health Serv Res;17(1):272, 2017 Apr 13.
[Is] ISSN:1472-6963
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Although the prescribing information for Venlafaxine extended release includes a discussion about possible increases in total cholesterol and triglycerides (TG) seen in healthier adult patients during premarketing clinical trials, no post-marketing studies or case reports, that discuss the effects of venlafaxine on TG in elderly patients with chronic kidney disease. CASE PRESENTATION: We report a 71 year-old male patient with end-stage renal disease on hemodialysis, with a history of coronary artery disease, mild hyperlipidemia, and hypertension. This patient twice demonstrated the severe rises in triglycerides while taking the antidepressant, i.e., venlafaxine, and discontinuing the long-term use of fenofirate. The adverse drug reaction sub-committee at the hospital rated the second event as a "probable reaction" using the Naranjo nomogram, accordingly. CONCLUSIONS: This case demonstrates the risk of changes in lipid profiles while taking venlafaxine and receiving on and off fenofibrate therapy in the older adult patient with chronic kidney disease and under hemodialysis. Regular monitoring for lipid changes after starting venlafaxine is strongly advised for patients with existing risk factors.
[Mh] Termos MeSH primário: Antidepressivos/efeitos adversos
Hipertrigliceridemia/induzido quimicamente
Falência Renal Crônica/terapia
Cloridrato de Venlafaxina/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Antidepressivos/uso terapêutico
Interações Medicamentosas
Seres Humanos
Falência Renal Crônica/complicações
Falência Renal Crônica/psicologia
Masculino
Diálise Renal
Fatores de Risco
Cloridrato de Venlafaxina/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antidepressive Agents); 7D7RX5A8MO (Venlafaxine Hydrochloride)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170529
[Lr] Data última revisão:
170529
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170415
[St] Status:MEDLINE
[do] DOI:10.1186/s12913-017-2195-2


  8 / 2306 MEDLINE  
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[PMID]:28364695
[Au] Autor:Szkutnik-Fiedler D; Grabowski T; Balcerkiewicz M; Michalak M; Pilipczuk I; Wyrowski L; Urjasz H; Grzeskowiak E
[Ad] Endereço:Department of Clinical Pharmacy and Biopharmacy, Poznan University of Medical Sciences, Poznan, Poland. Electronic address: d.szkutnik@wp.pl.
[Ti] Título:The influence of a single and chronic administration of venlafaxine on tramadol pharmacokinetics in a rabbit model.
[So] Source:Pharmacol Rep;69(3):555-559, 2017 Jun.
[Is] ISSN:1734-1140
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The combined use of tramadol with selective serotonin and norepinephrine reuptake inhibitors e.g. venlafaxine may be associated with serotonin syndrome. No previous studies exist examining the influence of a weak CYP2D6 inhibitor venlafaxine on the pharmacokinetics of tramadol. Therefore, the aim of this study was to determine the effect of a single and chronic administration of venlafaxine on the pharmacokinetics of tramadol using a rabbit model. METHODS: Adult New Zealand white rabbits of both sexes (n=21) were used. Animals received 100mg of tramadol per os (one slow release tablet) and 75mg of venlafaxine (one prolonged release capsule), and were divided into four groups: control group - a single dose of tramadol alone, 1day group - a single dose of tramadol and venlafaxine, 7 and 14days groups - seven and fourteen days administration of venlafaxine once daily plus a single dose of tramadol on the last day of the study. RESULTS: Venlafaxine administration over a period of 7 and 14days resulted in faster elimination of tramadol compared to the control group: significantly higher values of k , and lower values of t and MRT for the 7 and 14days group were observed. Although no differences in bioavailability of tramadol were obtained. CONCLUSION: Using a rabbit model, there is no evidence that the combined administration of tramadol and venlafaxine may increase the plasma exposure of tramadol and therefore increase the risk of serotonin syndrome.
[Mh] Termos MeSH primário: Analgésicos Opioides/farmacocinética
Inibidores da Recaptação de Serotonina e Norepinefrina/farmacologia
Tramadol/farmacocinética
Cloridrato de Venlafaxina/farmacologia
[Mh] Termos MeSH secundário: Administração Oral
Animais
Disponibilidade Biológica
Cápsulas
Preparações de Ação Retardada
Esquema de Medicação
Interações Medicamentosas
Feminino
Meia-Vida
Masculino
Coelhos
Inibidores da Recaptação de Serotonina e Norepinefrina/administração & dosagem
Comprimidos
Cloridrato de Venlafaxina/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Capsules); 0 (Delayed-Action Preparations); 0 (Serotonin and Noradrenaline Reuptake Inhibitors); 0 (Tablets); 39J1LGJ30J (Tramadol); 7D7RX5A8MO (Venlafaxine Hydrochloride)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170402
[St] Status:MEDLINE


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[PMID]:28291300
[Au] Autor:Çevik MÖ; Çelik M; Bucak IH; Han Almis B; Turgut M
[Ti] Título:[Possible Relation Between Antenatal Venlafaxine Use and VACTERL Association in a Newborn: A Case Report].
[Ti] Título:Antenatal Venlafaksin Kullanimi ve VACTERL Asosiasyonunun Olasi Iliskisi: Bir Olgu Sunumu..
[So] Source:Turk Psikiyatri Derg;28(1):67-70, 2017.
[Is] ISSN:1300-2163
[Cp] País de publicação:Turkey
[La] Idioma:tur
[Ab] Resumo:Major depressive disorder is common during antenatal period and many women are prescribed antidepressant drugs despite no antidepressant can be regarded as definitely safe in pregnancy. Previous studies have suggested links between gestational use of selective serotonin reuptake inhibitors (SSRI) or serotonin and norepinephrine reuptake inhibitors (SNRI) and certain birth defects. VACTERL association is a rare group of congenital malformations which were observed to occur together more often than would be expected by chance. Diagnosis requires coexistence of at least three congenital malformations from vertebral (V), anal (A), cardiac (C), tracheoesophageal (TE), renal (R), and limb (L) regions. Here, a case of a newborn female whose mother's gestational history revealed venlafaxine use before and during her pregnancy is reported. This newborn had anal atresia, patent ductus arteriosus, tracheoesophageal fistula, and upper limb anomalies. To the best of authors' knowledge this is the first report of VACTERL association possibly related to gestational use of SSRI or SNRI.
[Mh] Termos MeSH primário: Canal Anal/anormalidades
Antidepressivos/efeitos adversos
Esôfago/anormalidades
Cardiopatias Congênitas/diagnóstico
Rim/anormalidades
Deformidades Congênitas dos Membros/diagnóstico
Coluna Vertebral/anormalidades
Traqueia/anormalidades
Cloridrato de Venlafaxina/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Canal Anal/diagnóstico por imagem
Transtorno Depressivo/tratamento farmacológico
Diagnóstico Diferencial
Esôfago/diagnóstico por imagem
Evolução Fatal
Feminino
Cardiopatias Congênitas/diagnóstico por imagem
Seres Humanos
Recém-Nascido
Rim/diagnóstico por imagem
Deformidades Congênitas dos Membros/diagnóstico por imagem
Gravidez
Complicações na Gravidez/tratamento farmacológico
Coluna Vertebral/diagnóstico por imagem
Traqueia/diagnóstico por imagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antidepressive Agents); 7D7RX5A8MO (Venlafaxine Hydrochloride)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170828
[Lr] Data última revisão:
170828
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170315
[St] Status:MEDLINE


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[PMID]:28241180
[Au] Autor:Chekroud AM; Gueorguieva R; Krumholz HM; Trivedi MH; Krystal JH; McCarthy G
[Ad] Endereço:Department of Psychology, Yale University, New Haven, Connecticut2Spring Health, New York City, New York3Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.
[Ti] Título:Reevaluating the Efficacy and Predictability of Antidepressant Treatments: A Symptom Clustering Approach.
[So] Source:JAMA Psychiatry;74(4):370-378, 2017 Apr 01.
[Is] ISSN:2168-6238
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Depressive severity is typically measured according to total scores on questionnaires that include a diverse range of symptoms despite convincing evidence that depression is not a unitary construct. When evaluated according to aggregate measurements, treatment efficacy is generally modest and differences in efficacy between antidepressant therapies are small. Objectives: To determine the efficacy of antidepressant treatments on empirically defined groups of symptoms and examine the replicability of these groups. Design, Setting, and Participants: Patient-reported data on patients with depression from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial (n = 4039) were used to identify clusters of symptoms in a depressive symptom checklist. The findings were then replicated using the Combining Medications to Enhance Depression Outcomes (CO-MED) trial (n = 640). Mixed-effects regression analysis was then performed to determine whether observed symptom clusters have differential response trajectories using intent-to-treat data from both trials (n = 4706) along with 7 additional placebo and active-comparator phase 3 trials of duloxetine (n = 2515). Finally, outcomes for each cluster were estimated separately using machine-learning approaches. The study was conducted from October 28, 2014, to May 19, 2016. Main Outcomes and Measures: Twelve items from the self-reported Quick Inventory of Depressive Symptomatology (QIDS-SR) scale and 14 items from the clinician-rated Hamilton Depression (HAM-D) rating scale. Higher scores on the measures indicate greater severity of the symptoms. Results: Of the 4706 patients included in the first analysis, 1722 (36.6%) were male; mean (SD) age was 41.2 (13.3) years. Of the 2515 patients included in the second analysis, 855 (34.0%) were male; mean age was 42.65 (12.17) years. Three symptom clusters in the QIDS-SR scale were identified at baseline in STAR*D. This 3-cluster solution was replicated in CO-MED and was similar for the HAM-D scale. Antidepressants in general (8 of 9 treatments) were more effective for core emotional symptoms than for sleep or atypical symptoms. Differences in efficacy between drugs were often greater than the difference in efficacy between treatments and placebo. For example, high-dose duloxetine outperformed escitalopram in treating core emotional symptoms (effect size, 2.3 HAM-D points during 8 weeks, 95% CI, 1.6 to 3.1; P < .001), but escitalopram was not significantly different from placebo (effect size, 0.03 HAM-D points; 95% CI, -0.7 to 0.8; P = .94). Conclusions and Relevance: Two common checklists used to measure depressive severity can produce statistically reliable clusters of symptoms. These clusters differ in their responsiveness to treatment both within and across different antidepressant medications. Selecting the best drug for a given cluster may have a bigger benefit than that gained by use of an active compound vs a placebo.
[Mh] Termos MeSH primário: Antidepressivos/uso terapêutico
Transtorno Depressivo Maior/tratamento farmacológico
Transtorno Depressivo Maior/psicologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Afeto/efeitos dos fármacos
Idoso
Antidepressivos/efeitos adversos
Bupropiona/efeitos adversos
Bupropiona/uso terapêutico
Citalopram/efeitos adversos
Citalopram/uso terapêutico
Análise por Conglomerados
Transtorno Depressivo Maior/diagnóstico
Relação Dose-Resposta a Droga
Quimioterapia Combinada
Cloridrato de Duloxetina/efeitos adversos
Cloridrato de Duloxetina/uso terapêutico
Feminino
Seres Humanos
Masculino
Mianserina/efeitos adversos
Mianserina/análogos & derivados
Mianserina/uso terapêutico
Meia-Idade
Ensaios Clínicos Controlados Aleatórios como Assunto
Sono/efeitos dos fármacos
Síndrome
Resultado do Tratamento
Cloridrato de Venlafaxina/efeitos adversos
Cloridrato de Venlafaxina/uso terapêutico
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antidepressive Agents); 01ZG3TPX31 (Bupropion); 0DHU5B8D6V (Citalopram); 250PJI13LM (Mianserin); 7D7RX5A8MO (Venlafaxine Hydrochloride); 9044SC542W (Duloxetine Hydrochloride); A051Q2099Q (mirtazapine)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170518
[Lr] Data última revisão:
170518
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170228
[St] Status:MEDLINE
[do] DOI:10.1001/jamapsychiatry.2017.0025



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