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[PMID]:29345153
[Au] Autor:Ornoy A; Koren G
[Ad] Endereço:a Laboratory of Teratology, Department of Medical Neurobiology , Hebrew University Hadassah Medical School , Jerusalem , Israel.
[Ti] Título:Selective serotonin reuptake inhibitor use in pregnant women; pharmacogenetics, drug-drug interactions and adverse effects.
[So] Source:Expert Opin Drug Metab Toxicol;14(3):247-259, 2018 Mar.
[Is] ISSN:1744-7607
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Possible negative effects of selective serotonin reuptake inhibitors (SSRIs) in pregnancy relate to congenital anomalies, negative perinatal events and neurodevelopmental outcome. Many studies are confounded by the underlying maternal disease and by pharmacogenetic and pharmacokinetic differences of these drugs. Areas covered: The possible interactions of SSRIs and serotonin and norepinephrine reuptake inhibitors with other drugs and the known effects of SSRIs on congenital anomalies, perinatal and neurodevelopmental outcome. Expert opinion: SSRIs should be given with caution when combined with other drugs that are metabolized by cytochrome P450 enzymes. SSRIs apparently increase the rate of severe cardiac malformations, induce neonatal adaptation problems in up to 30% of the offspring, increase the rate of persistent pulmonary hypertension of the newborn and possibly slightly increase the rate of prematurity and low birth weight. Most neurodevelopmental follow up studies did not find significant cognitive impairments except some transient gross motor delay, slight impairment of language abilities and possibly behavioral changes. The literature on the possible association of SSRIs with autism spectrum disorder is inconsistent; if an association exists, it is apparently throughout pregnancy. The risk associated with treatment discontinuation seems to outweigh the risk of treatment, as severe maternal depression may negatively affect the child's development. If needed, treatment should continue in pregnancy with the minimal effective dose.
[Mh] Termos MeSH primário: Depressão/tratamento farmacológico
Complicações na Gravidez/tratamento farmacológico
Inibidores da Captação de Serotonina/administração & dosagem
[Mh] Termos MeSH secundário: Animais
Interações Medicamentosas
Feminino
Seres Humanos
Recém-Nascido
Farmacogenética
Gravidez
Efeitos Tardios da Exposição Pré-Natal/epidemiologia
Inibidores da Captação de Serotonina/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Serotonin Uptake Inhibitors)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180119
[St] Status:MEDLINE
[do] DOI:10.1080/17425255.2018.1430139


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[PMID]:28452902
[Au] Autor:Fan KY; Liu HC
[Ad] Endereço:*Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital; and †Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan.
[Ti] Título:Delirium Associated With Fluoxetine Discontinuation: A Case Report.
[So] Source:Clin Neuropharmacol;40(3):152-153, 2017 May/Jun.
[Is] ISSN:1537-162X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Withdrawal symptoms on selective serotonin reuptake inhibitor (SSRI) discontinuation have raised clinical attention increasingly. However, delirium is rarely reported in the SSRI discontinuation syndrome. CASE: We report a case of delirium developing after fluoxetine discontinuation in a 65-year-old female patient with major depressive disorder. She experienced psychotic depression with limited response to treatment of fluoxetine 40 mg/d and quetiapine 100 mg/d for 3 months. After admission, we tapered fluoxetine gradually in 5 days because of its limited effect. However, delirious pictures developed 2 days after we stopped fluoxetine. Three days later, we added back fluoxetine 10 mg/d. Her delirious features gradually improved, and the clinical presentation turned into previous psychotic depression state. We gradually increased the medication to fluoxetine 60 mg/d and olanzapine 20 mg/d in the following 3 weeks. Her psychotic symptoms decreased, and there has been no delirious picture noted thereafter. CONCLUSIONS: Delirium associated with fluoxetine discontinuation is a much rarer complication in SSRI discontinuation syndrome. The symptoms of SSRI discontinuation syndrome may be attributable to a rapid decrease in serotonin availability. In general, the shorter the half-life of any medication, the greater the likelihood patients will experience discontinuation symptoms. Genetic vulnerability might be a potential factor to explain that SSRI discontinuation syndrome also occurred rapidly in people taking long-half-life fluoxetine. The genetic polymorphisms of both pharmacokinetic and pharmacodynamic pathways might be potentially associated with SSRI discontinuation syndrome.
[Mh] Termos MeSH primário: Antidepressivos de Segunda Geração/efeitos adversos
Delírio/etiologia
Fluoxetina/efeitos adversos
Inibidores da Captação de Serotonina/efeitos adversos
Síndrome de Abstinência a Substâncias/etiologia
[Mh] Termos MeSH secundário: Idoso
Antipsicóticos/uso terapêutico
Benzodiazepinas/uso terapêutico
Delírio/prevenção & controle
Transtorno Depressivo Maior/tratamento farmacológico
Monitoramento de Medicamentos
Resistência a Múltiplos Medicamentos
Quimioterapia Combinada
Feminino
Fluoxetina/uso terapêutico
Seres Humanos
Inibidores da Captação de Serotonina/uso terapêutico
Síndrome de Abstinência a Substâncias/fisiopatologia
Síndrome de Abstinência a Substâncias/prevenção & controle
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antidepressive Agents, Second-Generation); 0 (Antipsychotic Agents); 0 (Serotonin Uptake Inhibitors); 01K63SUP8D (Fluoxetine); 12794-10-4 (Benzodiazepines); N7U69T4SZR (olanzapine)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1097/WNF.0000000000000214


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[PMID]:29355886
[Au] Autor:Eshun-Wilson I; Siegfried N; Akena DH; Stein DJ; Obuku EA; Joska JA
[Ad] Endereço:Centre for Evidence Based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zyl Drive, Tygerberg, 7505, Parow, Cape Town, Western Cape, South Africa, 7505.
[Ti] Título:Antidepressants for depression in adults with HIV infection.
[So] Source:Cochrane Database Syst Rev;1:CD008525, 2018 01 22.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Rates of major depression among people living with HIV (PLWH) are substantially higher than those seen in the general population and this may adversely affect antiretroviral treatment outcomes. Several unique clinical and psychosocial factors may contribute to the development and persistence of depression in PLWH. Given these influences, it is unclear if antidepressant therapy is as effective for PLWH as the general population. OBJECTIVES: To assess the efficacy of antidepressant therapy for treatment of depression in PLWH. SEARCH METHODS: We searched The Cochrane Common Mental Disorders Group's specialised register (CCMD-CTR), the Cochrane Library, PubMed, Embase and ran a cited reference search on the Web of Science for reports of all included studies. We conducted additional searches of the international trial registers including; ClinicalTrials.gov, World Health Organization Trials Portal (ICTRP), and the HIV and AIDS - Clinical trials register. We searched grey literature and reference lists to identify additional studies and contacted authors to obtain missing data. We applied no restrictions on date, language or publication status to the searches, which included studies conducted between 1 January 1980 and 18 April 2017. SELECTION CRITERIA: We included randomized controlled trials of antidepressant drug therapy compared to placebo or another antidepressant drug class. Participants eligible for inclusion had to be aged 18 years and older, from any setting, and have both HIV and depression. Depression was defined according to Diagnostic and Statistical Manual of Mental Disorders or International Statistical Classification of Diseases criteria. DATA COLLECTION AND ANALYSIS: Two review authors independently applied the inclusion criteria and extracted data. We presented categorical outcomes as risk ratios (RR) with 95% confidence intervals (CIs). Continuous outcomes were presented mean (MD) or standardized mean differences (SMD) with standard deviations (SD). We assessed quality of evidence using the GRADE approach. MAIN RESULTS: We included 10 studies with 709 participants in this review. Of the 10 studies, eight were conducted in high income countries (USA and Italy), seven were conducted prior to 2000 and seven had predominantly men. Seven studies assessed antidepressants versus placebo, two compared different antidepressant classes and one had three arms comparing two antidepressant classes with placebo.Antidepressant therapy may result in a greater improvement in depression compared to placebo. There was a moderate improvement in depression when assessed with the Hamilton Depression Rating Scale (HAM-D) score as a continuous outcome (SMD 0.59, 95% CI 0.21 to 0.96; participants = 357; studies = 6; I = 62%, low quality evidence). However, there was no evidence of improvement when this was assessed with HAM-D score as a dichotomized outcome (RR 1.10, 95% CI 0.89 to 1.35; participants = 434; studies = 5; I = 0%, low quality evidence) or Clinical Global Impression of Improvement (CGI-I) score (RR 1.28, 95% CI 0.93 to 1.77; participants = 346; studies = 4; I = 29%, low quality evidence). There was little to no difference in the proportion of study dropouts between study arms (RR 1.28, 95% CI 0.91 to 1.80; participants = 306; studies = 4; I = 0%, moderate quality evidence).The methods of reporting adverse events varied substantially between studies, this resulted in very low quality evidence contributing to a pooled estimate (RR 0.88, 95% CI 0.64 to 1.21; participants = 167; studies = 2; I = 34%; very low quality evidence). Based on this, we were unable to determine if there was a difference in the proportion of participants experiencing adverse events in the antidepressant versus placebo arms. However, sexual dysfunction was reported commonly in people receiving selective serotonin reuptake inhibitors (SSRIs). People receiving tricyclic antidepressants (TCAs) frequently reported anticholinergic adverse effects such as dry mouth and constipation. There were no reported grade 3 or 4 adverse events in any study group.There was no evidence of a difference in follow-up CD4 count at study termination (MD -6.31 cells/mm , 95% CI -72.76 to 60.14; participants = 176; studies = 3; I = 0%; low quality evidence). Only one study evaluated quality of life score (MD 3.60, 95% CI -0.38 to 7.58; participants = 87; studies = 1; very low quality evidence), due to the poor quality evidence we could not draw conclusions for this outcome.There were few studies comparing different antidepressant classes. We are uncertain if SSRIs differ from TCAs with regard to improvement in depression as evaluated by HAM-D score (MD -3.20, 95% CI -10.87 to 4.47; participants = 14; studies = 1; very low quality evidence). There was some evidence that mirtazapine resulted in a greater improvement in depression compared to an SSRI (MD 9.00, 95% CI 3.61 to 14.39; participants = 70; studies = 1; low quality evidence); however, this finding was not consistent for all measures of improvement in depression for this comparison.No studies reported on virological suppression or any other HIV specific outcomes.The studies included in this review had an overall unclear or high risk of bias due to under-reporting of study methods, high risk of attrition bias and inadequate sequence generation methods. Heterogeneity between studies and the limited number of participants, and events lead to downgrading of the quality of the evidence for several outcomes. AUTHORS' CONCLUSIONS: This review demonstrates that antidepressant therapy may be more beneficial than placebo for the treatment of depression in PLWH. The low quality of the evidence contributing to this assessment and the lack of studies representing PLWH from generalized epidemics in low- to middle-income countries make the relevance of these finding in today's context limited. Future studies that evaluate the effectiveness of antidepressant therapy should be designed and conducted rigorously. Such studies should incorporate evaluation of stepped care models and health system strengthening interventions in the study design. In addition, outcomes related to HIV care and antiretroviral therapy should be reported.
[Mh] Termos MeSH primário: Antidepressivos/uso terapêutico
Infecções por HIV/psicologia
[Mh] Termos MeSH secundário: Adulto
Antidepressivos/efeitos adversos
Intervalos de Confiança
Depressão/tratamento farmacológico
Feminino
Seres Humanos
Masculino
Pacientes Desistentes do Tratamento/estatística & dados numéricos
Placebos/uso terapêutico
Qualidade de Vida
Ensaios Clínicos Controlados Aleatórios como Assunto
Risco
Inibidores da Captação de Serotonina/efeitos adversos
Inibidores da Captação de Serotonina/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Antidepressive Agents); 0 (Placebos); 0 (Serotonin Uptake Inhibitors)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180123
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD008525.pub3


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[PMID]:29291438
[Au] Autor:Gu ZS; Zhou AN; Xiao Y; Zhang QW; Li JQ
[Ad] Endereço:Novel Technology Center of Pharmaceutical Chemistry, Shanghai Institute of Pharmaceutical Industry, China State Institute of Pharmaceutical Industry, 285 Gebaini Road, Shanghai 201203, PR China.
[Ti] Título:Synthesis and antidepressant-like activity of novel aralkyl piperazine derivatives targeting SSRI/5-HT /5-HT .
[So] Source:Eur J Med Chem;144:701-715, 2018 Jan 20.
[Is] ISSN:1768-3254
[Cp] País de publicação:France
[La] Idioma:eng
[Ab] Resumo:A series of novel aralkyl piperazine derivatives were synthesized, and evaluated for their serotonin reuptake inhibitory and 5-HT /5-HT receptors affinities activity. Antidepressant activities in vivo of the compounds were screened using the forced swimming test (FST) and tail suspension test (TST). The results indicated that compounds 21k (RUI, IC = 31 nM; 5-HT , 5-HT , k = 62, 12 nM) and 21n (RUI, IC = 25 nM; 5-HT , 5-HT , k = 28, 3.3 nM) exhibited high affinities for the 5-HT /5-HT receptors coupled with potent serotonin reuptake inhibition. Specifically, the most promising compound 21n possessed a good oral pharmacokinetic properties and an acceptable hERG profile, and showed potent antidepressant-like effect in the FST and TST models.
[Mh] Termos MeSH primário: Antidepressivos/farmacologia
Piperazinas/farmacologia
Receptor 5-HT1A de Serotonina/metabolismo
Receptores de Serotonina/metabolismo
Inibidores da Captação de Serotonina/farmacologia
[Mh] Termos MeSH secundário: Animais
Antidepressivos/síntese química
Antidepressivos/química
Relação Dose-Resposta a Droga
Seres Humanos
Masculino
Estrutura Molecular
Piperazinas/síntese química
Piperazinas/química
Ratos
Ratos Sprague-Dawley
Inibidores da Captação de Serotonina/síntese química
Inibidores da Captação de Serotonina/química
Relação Estrutura-Atividade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antidepressive Agents); 0 (Piperazines); 0 (Receptors, Serotonin); 0 (Serotonin Uptake Inhibitors); 0 (serotonin 7 receptor); 112692-38-3 (Receptor, Serotonin, 5-HT1A); 1RTM4PAL0V (piperazine)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180102
[St] Status:MEDLINE


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[PMID]:29206826
[Au] Autor:Ontiveros-Sánchez de la Barquera JA
[Ad] Endereço:Departamento de Psiquiatría, Hospital Universitario, Universidad Autónoma de Nuevo León; Instituto de Información e Investigación en Salud Mental A.C., Monterrey, N.L., México.
[Ti] Título:[Response to serotonergic and noradrenergic antidepressants: a crossover study of fluoxetine and desipramine in patients with first major depression episode].
[Ti] Título:Respuesta a antidepresivos serotoninérgicos y noradrenérgicos: estudio cruzado con fluoxetina y desipramina en pacientes con un primer episodio depresivo mayor..
[So] Source:Gac Med Mex;153(6):688-694, 2017 Nov-Dec.
[Is] ISSN:0016-3813
[Cp] País de publicação:Mexico
[La] Idioma:spa
[Ab] Resumo:BACKGROUND: Response rate data from studies with different kinds of antidepressant drugs help in the development of guidelines for the rational prescription of pharmacotherapy. However, there are still few comparative studies with selective reuptake inhibition on serotonin or norepinephrine in the same sample of major depression patients. METHODS: First episode major depression (DSM-III-R) outpatients who completed 6 weeks in two double-blind randomized trials with fluoxetine and desipramine were crossed over to treatment with the other drug under open conditions for 6 weeks. Response was considered if patient's final Hamilton depression scale score decreased 50% or more from baseline. RESULTS: No significant differences were found by drug treatment or sequence of treatment. Ten of the 18 patients (55.5%) were responders to both fluoxetine and desipramine, 3 (16.6%) were resistant to fluoxetine, 3 (16.6%) to desipramine and 2 (11.1%) to both drugs. DISCUSSION: These data suggest that among first major depressive episode outpatients fluoxetine and desipramine are equally effective. In patients who have been non-responders to one of the studied drugs, the other one is strikingly effective; this kind of treatment maneuver should be considered in such patients.
[Mh] Termos MeSH primário: Transtorno Depressivo Maior/tratamento farmacológico
Desipramina/uso terapêutico
Fluoxetina/uso terapêutico
[Mh] Termos MeSH secundário: Inibidores da Captação Adrenérgica/uso terapêutico
Adulto
Estudos Cross-Over
Transtorno Depressivo Maior/fisiopatologia
Desipramina/farmacologia
Método Duplo-Cego
Feminino
Fluoxetina/farmacologia
Seres Humanos
Masculino
Meia-Idade
Escalas de Graduação Psiquiátrica
Inibidores da Captação de Serotonina/uso terapêutico
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Adrenergic Uptake Inhibitors); 0 (Serotonin Uptake Inhibitors); 01K63SUP8D (Fluoxetine); TG537D343B (Desipramine)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.24875/GMM.17002671


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[PMID]:27770542
[Au] Autor:Shen ZQ; Gao SY; Li SX; Zhang TN; Liu CX; Lv HC; Zhang Y; Gong TT; Xu X; Ji C; Wu QJ; Li D
[Ad] Endereço:Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
[Ti] Título:Sertraline use in the first trimester and risk of congenital anomalies: a systemic review and meta-analysis of cohort studies.
[So] Source:Br J Clin Pharmacol;83(4):909-922, 2017 04.
[Is] ISSN:1365-2125
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIM: To perform a meta-analysis of available cohort studies on the association between sertraline use by pregnant women in the first trimester and the findings of congenital anomalies in infants. METHODS: A comprehensive search of articles published from the index date up to 31 December 2015 investigating the aforementioned associations was conducted on PubMed and Web of Science. Mesh headings used included the terms "serotonin reuptake inhibitor," "sertraline," "congenital anomalies" and "obstetrical outcome." RESULTS: Twelve cohort studies that involved 6 468 241 pregnant women were identified. We summarized odds ratios (ORs) and 95% confidence intervals (CIs) of congenital anomalies using the random-effects model. Pregnant women who used sertraline in the first trimester had a statistically significant increased risk of infant cardiovascular-related malformations (OR = 1.36; 95% CI = 1.06-1.74; I  = 64.4%; n = 12) as well as atrial and/or ventricular septal defects (OR = 1.36, 95% CI = 1.06-1.76; I  = 62.2%; n = 8). Additionally, positive but nonsignificant associations between sertraline use and congenital anomalies of the nervous system (OR = 1.39; 95% CI = 0.83-2.32; I  = 0%; n = 5), digestive system (OR = 1.23; 95% CI = 0.76-1.98; I  = 0%; n = 5), eye, ear, face and neck (OR = 1.08; 95% CI = 0.33-3.55; I  = 32.1%; n = 3), urogenital system (OR = 1.03; 95% CI = 0.73-1.46; I  = 0%; n = 5), and musculoskeletal system (OR = 0.97; 95% CI = 0.69-1.36; I  = 0%; n = 5) were observed. CONCLUSION: This meta-analysis suggested that the use of sertraline use by pregnant women in the first trimester had an increased risk of cardiovascular-related malformations as well as atrial and/or ventricular septal defects in infants. Meanwhile, nonsignificant associations between sertraline use and other congenital anomalies were found. More cohort studies are warranted to provide detailed results of other congenital anomalies.
[Mh] Termos MeSH primário: Anormalidades Induzidas por Medicamentos/etiologia
Inibidores da Captação de Serotonina/administração & dosagem
Sertralina/administração & dosagem
[Mh] Termos MeSH secundário: Anormalidades Induzidas por Medicamentos/epidemiologia
Estudos de Coortes
Feminino
Seres Humanos
Lactente
Gravidez
Primeiro Trimestre da Gravidez
Risco
Inibidores da Captação de Serotonina/efeitos adversos
Sertralina/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Serotonin Uptake Inhibitors); QUC7NX6WMB (Sertraline)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161023
[St] Status:MEDLINE
[do] DOI:10.1111/bcp.13161


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[PMID]:27776567
[Au] Autor:Roopan S; Larsen ER
[Ad] Endereço:1Psychiatric Department Kolding-Vejle,Region of Southern Denmark,Denmark.
[Ti] Título:Use of antidepressants in patients with depression and comorbid diabetes mellitus: a systematic review.
[So] Source:Acta Neuropsychiatr;29(3):127-139, 2017 Jun.
[Is] ISSN:1601-5215
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Depression may be difficult to treat and with comorbid diabetes mellitus (DM) it is an even bigger challenge. This article aims to evaluate antidepressants most suitable for patients with depression and comorbid DM. Design and methods Initially we searched for randomised, controlled double-blind trials of treatment with antidepressants in depressed with DM but there were only a few studies and many of them were small trials. Thus, we decided to include studies that were not only randomised-controlled trials. In total, we ended up with 18 articles for our purposes. RESULTS: The combination of depression and DM may be harmful as depression has a strong impact on psychosocial and medical outcomes in patients with DM. Almost all of the trials in this review showed a reduction in depressive symptoms after treatment with an antidepressant in the acute as well as during maintenance phase. It showed that depression improvement had a favourable effect on glycaemic control that was weight independent. Some studies included only subjects with minor depression or with suboptimal-controlled diabetes making it difficult to show an effect. CONCLUSION: From these data, we will recommend choosing an selective serotonin reuptake inhibitor (SSRI) if possible to treat a depression among patients with diabetes. If treatment with a tricyclic antidepressant is needed, closer glycaemic monitoring is recommended. Bear in mind that there is a possible risk of hypoglycemia when using SSRIs. Agomelatine and bupropion have shown promising results, but need to be investigated in more trials.
[Mh] Termos MeSH primário: Antidepressivos/uso terapêutico
Comorbidade
Depressão/tratamento farmacológico
Diabetes Mellitus/psicologia
[Mh] Termos MeSH secundário: Acetamidas/efeitos adversos
Acetamidas/uso terapêutico
Adulto
Idoso
Antidepressivos/efeitos adversos
Antidepressivos de Segunda Geração/administração & dosagem
Antidepressivos de Segunda Geração/uso terapêutico
Antidepressivos Tricíclicos/efeitos adversos
Antidepressivos Tricíclicos/uso terapêutico
Bupropiona/efeitos adversos
Bupropiona/uso terapêutico
Depressão/complicações
Diabetes Mellitus/tratamento farmacológico
Método Duplo-Cego
Feminino
Seres Humanos
Hiperglicemia/induzido quimicamente
Hiperglicemia/complicações
Hipnóticos e Sedativos/efeitos adversos
Hipnóticos e Sedativos/uso terapêutico
Hipoglicemia/induzido quimicamente
Hipoglicemia/complicações
Masculino
Meia-Idade
Ensaios Clínicos Controlados Aleatórios como Assunto
Inibidores da Captação de Serotonina/efeitos adversos
Inibidores da Captação de Serotonina/uso terapêutico
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Acetamides); 0 (Antidepressive Agents); 0 (Antidepressive Agents, Second-Generation); 0 (Antidepressive Agents, Tricyclic); 0 (Hypnotics and Sedatives); 0 (Serotonin Uptake Inhibitors); 01ZG3TPX31 (Bupropion); 138112-76-2 (S 20098)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1017/neu.2016.54


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[PMID]:28460603
[Au] Autor:Mars B; Heron J; Gunnell D; Martin RM; Thomas KH; Kessler D
[Ad] Endereço:School of Social and Community Medicine, University of Bristol, Bristol, UK.
[Ti] Título:Prevalence and patterns of antidepressant switching amongst primary care patients in the UK.
[So] Source:J Psychopharmacol;31(5):553-560, 2017 May.
[Is] ISSN:1461-7285
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Non-response to antidepressant treatment is a substantial problem in primary care, and many patients with depression require additional second-line treatments. This study aimed to examine the prevalence and patterns of antidepressant switching in the UK, and identify associated demographic and clinical factors. METHOD: Cohort analysis of antidepressant prescribing data from the Clinical Practice Research Datalink, a large, anonymised UK primary care database. The sample included 262,844 patients who initiated antidepressant therapy between 1 January 2005 and 31 June 2011. RESULTS: 9.3% of patients switched to a different antidepressant product, with most switches (60%) occurring within 8 weeks of the index date. The proportion switching was similar for selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants and other antidepressants (9.3%, 9.8% and 9.2%, respectively). Most switches were to an SSRI (64.5%), and this was the preferred option regardless of initial antidepressant class. Factors predictive of switching included male gender, age, and history of self-harm and psychiatric illness. CONCLUSION: Over one in every 11 patients who initiates antidepressant therapy will switch medication, suggesting that initial antidepressant treatment has been unsatisfactory. Evidence to guide choice of second-line treatment for individual patients is currently limited. Additional research comparing different pharmacological and psychological second-line treatment strategies is required in order to inform guidelines and improve patient outcomes.
[Mh] Termos MeSH primário: Antidepressivos/uso terapêutico
Depressão/dietoterapia
Transtorno Depressivo/tratamento farmacológico
[Mh] Termos MeSH secundário: Antidepressivos Tricíclicos/uso terapêutico
Estudos de Coortes
Bases de Dados Factuais
Feminino
Seres Humanos
Masculino
Meia-Idade
Prevalência
Atenção Primária à Saúde/métodos
Inibidores da Captação de Serotonina/uso terapêutico
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antidepressive Agents); 0 (Antidepressive Agents, Tricyclic); 0 (Serotonin Uptake Inhibitors)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1177/0269881117693748


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[PMID]:29357714
[Au] Autor:Quagliato LA; Freire RC; Nardi AE
[Ad] Endereço:a Laboratory of Panic & Respiration, Institute of Psychiatry , Federal University of Rio de Janeiro , Rio de Janeiro , Brazil.
[Ti] Título:Risks and benefits of medications for panic disorder: a comparison of SSRIs and benzodiazepines.
[So] Source:Expert Opin Drug Saf;17(3):315-324, 2018 Mar.
[Is] ISSN:1744-764X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Panic disorder (PD) is a prevalent and disabling anxiety disorder that can be treated effectively. Selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines are among the most frequently prescribed drugs for PD. In this article, the authors review the current evidence on efficacy, adverse events, and limitations of these two treatment options. Areas covered: MEDLINE/Pubmed and Web of Science databases were searched for open or placebo-controlled trials on SSRIs and/or benzodiazepines in PD treatment. Expert opinion: The literature search yielded 4,957 articles related to the theme. Of these, 24 articles were included in this review. Despite their usefulness in PD, SSRIs are associated with a delay of several weeks in onset of therapeutic effect and have the potential to exacerbate anxiety and panic early in the treatment course. Benzodiazepines present rapid onset of action, but can cause tolerance and dependence. Despite strong evidence of the effectiveness of SSRIs and benzodiazepines in the treatment of PD, few trials have performed head-to-head comparisons of these two drug classes. Future studies on the pharmacological treatment of PD should make direct comparisons of risks, benefits, and limitations of each group. This could help improve the evidence-based pharmacotherapy of PD.
[Mh] Termos MeSH primário: Benzodiazepinas/uso terapêutico
Transtorno de Pânico/tratamento farmacológico
Inibidores da Captação de Serotonina/uso terapêutico
[Mh] Termos MeSH secundário: Benzodiazepinas/administração & dosagem
Benzodiazepinas/efeitos adversos
Tolerância a Medicamentos
Seres Humanos
Transtorno de Pânico/fisiopatologia
Inibidores da Captação de Serotonina/administração & dosagem
Inibidores da Captação de Serotonina/efeitos adversos
Transtornos Relacionados ao Uso de Substâncias/epidemiologia
Fatores de Tempo
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Serotonin Uptake Inhibitors); 12794-10-4 (Benzodiazepines)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE
[do] DOI:10.1080/14740338.2018.1429403


  10 / 17644 MEDLINE  
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[PMID]:27773594
[Au] Autor:Pelrine E; Pasik SD; Bayat L; Goldschmiedt D; Bauer EP
[Ad] Endereço:Biology Department, Barnard College, New York, NY 10027, United States.
[Ti] Título:5-HT2C receptors in the BNST are necessary for the enhancement of fear learning by selective serotonin reuptake inhibitors.
[So] Source:Neurobiol Learn Mem;136:189-195, 2016 Dec.
[Is] ISSN:1095-9564
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Selective serotonin reuptake inhibitors (SSRIs) are widely prescribed to treat anxiety and depression, yet they paradoxically increase anxiety during initial treatment. Acute administration of these drugs prior to learning can also enhance Pavlovian cued fear conditioning. This potentiation has been previously reported to depend upon the bed nucleus of the stria terminalis (BNST). Here, using temporary inactivation, we confirmed that the BNST is not necessary for the acquisition of cued or contextual fear memory. Systemic administration of the SSRI citalopram prior to fear conditioning led to an upregulation of the immediate early gene Arc (activity-regulated cytoskeleton-associated protein) in the oval nucleus of the BNST, and a majority of these neurons expressed the 5-HT2C receptor. Finally, local infusions of a 5-HT2C receptor antagonist directly into the oval nucleus of the BNST prevented the fear memory-enhancing effects of citalopram. These findings highlight the ability of the BNST circuitry to be recruited into gating fear and anxiety-like behaviors.
[Mh] Termos MeSH primário: Citalopram/farmacologia
Condicionamento Clássico/fisiologia
Medo/fisiologia
Aprendizagem/fisiologia
Receptor 5-HT2C de Serotonina/fisiologia
Núcleos Septais/fisiologia
Inibidores da Captação de Serotonina/farmacologia
[Mh] Termos MeSH secundário: Animais
Comportamento Animal/efeitos dos fármacos
Comportamento Animal/fisiologia
Citalopram/administração & dosagem
Condicionamento Clássico/efeitos dos fármacos
Sinais (Psicologia)
Medo/efeitos dos fármacos
Aprendizagem/efeitos dos fármacos
Masculino
Ratos
Ratos Sprague-Dawley
Receptor 5-HT2C de Serotonina/efeitos dos fármacos
Núcleos Septais/efeitos dos fármacos
Núcleos Septais/metabolismo
Antagonistas do Receptor 5-HT2 de Serotonina/administração & dosagem
Antagonistas do Receptor 5-HT2 de Serotonina/farmacologia
Inibidores da Captação de Serotonina/administração & dosagem
Regulação para Cima
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Receptor, Serotonin, 5-HT2C); 0 (Serotonin 5-HT2 Receptor Antagonists); 0 (Serotonin Uptake Inhibitors); 0DHU5B8D6V (Citalopram)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161105
[St] Status:MEDLINE



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