» Posts in the Antidepressants Category:

Switching Psychopharmacological Drugs: SwitchWiki

Walter van den Broek
April 4, 2011
The most useful wiki for physicians, this SwitchWiki. In this wiki you can find detailed information about switching from one antidepressant to the other, the same for antipsychotics and how to combine mood stabilizers. You can also calculate the conversion from a benzodiazepine to diazepam equivalents. Both for the antidepressants and anti psychotics switch tables are made. Clicking on the appropriate switch continues to an explanation and switch schedule with links to Medscape, Pubmed, PubChem, Wikipedia and several other websites for more information. The benzodiazepines calculator can help you switch from one to another benzodiazepine. This SwitchWiki is made by Walter .....read more »

FDA Antidepressant Warning has Unintended Consequences

Dr Shock
July 1, 2009
We discussed a prior publication in the Archives of General Psychiatry about the decline of antidepressants use after the FDA black box warning. In a more recent study published in the same journal this prior study was criticized because it had some serious limitations. The study used prevalent use instead of incidence use. This means, used all cases instead of the new cases that started using antidepressants and they included all use instead of the use for depression. Antidepressant indications range from major depression to smoking cessation and weight loss, with varied suicidality risk. The warning for heightened suicidality .....read more »

Predictors of nonadherence to antidepressants in depressed patients

Dr Shock
February 25, 2009
Why is maintenance antidepressant therapy important? Of patients with a depressive disorder 50% will have further episodes The recurrence rate of depression is 80 to 90% after 3 episodes Poor adherence to treatment of chronic conditions such as depressive disorder is a large problem Nonadherence rates in recurrent depressed patients range from 39.7% to 52.7% with a mean of 46,5% over 2 years Suboptimal dosing and duration of antidepressants increases the risk of relapse and recurrence. Clinicians are only 50% accurate in their identification of potentially nonadherent patients. What are the potential risk factors for nonadherence in patients with recurrent depressive disorder? This question was recently researched .....read more »

Use of Antidepressants Increases more in Canada than Australia

Dr Shock
September 6, 2008
Provocative title, no? The observed increases over the time period 2000-2003 were 49 (53%) and 21 (22%) DDD/1000 beneficiaries/day inNova Scotia and Australia, respectively. Defined Daily Doses (DDDs) This standard measure is set at the average maintenance dose per day of a drug when used for its major indication. It overcomes difficulties in comparing prescriptions of different price, pack size, duration and dose. Use is expressed as the number of DDDs per 1000 concession beneficiaries per day (DDD/1000 beneficiaries/day), which allows comparisons over time and place. This may be due to prescribing antidepressants for conditions other than depression in Novia Scotia. It could .....read more »

We can’t blame the serotonin transporter gene for everything.

Dr Shock
August 8, 2008
Our prospective study does not support the assumption that paroxetine can cause a prolonged PFA-closure (bleeding) time during paroxetine therapy due to a serotonin transporter polymorphism. Old age, use of platelet inhibitors and a history of gastrointestinal bleeding remain the focus for SSRI-induced bleeding complications. Selective Serotonin Reuptake Inhibitors (SSRIs) are the most commonly used antidepressants. From case reports and observational studies it has become clear that treatment with SSRIs can leadto bleeding mostly from the upper gastrointestinal tract (gullet and stomach). But also bruising is frequently complained of. The most likely mechanism is the prevention of serotonin uptake in blood .....read more »

Antidepressants have Limited Efficacy in Juvenile Depression

Dr Shock
July 15, 2008
A recent systematic review and meta-analysis shows that at worse antidepressants are not effective for juvenile depression and at best better research might proof this conclusion wrong.Juvenile meaning depression among children and adolescents.The figure above is the forest plot of this systematic review:Forest plot of rate ratios (RR, with 95% CI) of responses to drug or placebo in 30 randomised double-blind placebo-controlled comparisons of rates of ‘response’ to antidepressants v. placebo, with overall pooled RR (1.22; 95% CI 1.15–1.31; blue diamond).Antidepressants of all types showed limited efficacy in juvenile depression, but fluoxetine might be more effective, especially in adolescents. Studies .....read more »

Carefull with the combination SSRIs and NSAIDs

Dr Shock
July 9, 2008
When both SSRIs and NSAIDs are concomitantly used, it would be sufficient to treat 250 patients per year for 1 case of upper gastrointestinal (GI) tract bleeding to be attributed to such combination, and 500 patients per year if SRIs are concomitantly used with antiplatelet drugs.SRIs: SSRIs, including sertraline hydrochloride, fluoxetine hydrochloride, fluvoxamine maleate, paroxetine hydrochloride, citalopram hydrobromide, and escitalopram oxalate; selective serotonin and norepinephrine reuptake inhibitors (SNRIs), including venlafaxine and duloxetine hydrochloride.NSAIDs: ibuprofen, and naproxen.The authors of this study were the first to point out the dangers of combining SSRIs with NSAIDs in 1999. In the present study they .....read more »

Elderly Refuse Clinical Trials

Dr Shock
May 7, 2008
A failed randomized controlled trial of Fluoxetine versus placebo in elderly stroke survivors due to reluctance and subsequent informal discussions by their treating physicians. Also due in part to high community prescribing rates of antidepressants by general practitioners. In a recent research showed that 15% of adults aged over 75 years are in receipt of an antidepressant prescription from their general practitioner, half of them for more than 2 years and many without formal review. So adolescents your not alone. Elderly are not alone as well, in The Netherlands it was hard to find elderly for a study that .....read more »

On the Antidepressant-Suicide link

Dr Shock
July 11, 2007
In the last couple of years antidepressants were accused of causing suicide in patients using them. More recently a subgroup of patients, adolescents were assumed to be of increased risk for suicide when using antidepressants. This is a reference to an article on The Corpus Callosum, a scienceblog.This blog has already dedicated a number of posts about this subject. This recent post discusses: Suicide Attempts Among Patients Starting Depression Treatment With Medications or Psychotherapy and an editorial Antidepressants and Suicidal Behavior: Cause or Cure? in the latest (July 2007) issue of the American Journal of Psychiatry. The main finding .....read more »

Direct To Consumer Advertising of prescription drugs, a threat to Europe?

Dr Shock
July 7, 2007
The European Committee supports the request of the pharmaceutical companies for "direct-to-consumer-advertising". The International Society of Drug Bulletins warns against this legislation. It is wrong to confuse information with advertising.The dangers of "direct-to-consumer-advertising" are:1. advertisements from drug companies are mostly limited to those drugs with the highest profit2. efficacy is often exaggerated3. risks are usually obscured4. it confuses patients when suggested another drug by their physicians5. it forces physicians to use the advertised drug6. advertisements by drug companies lack comparison with drugs from other companies or other treatments, making it hard for consumers to compare different drugs or other treatment .....read more »