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Serotonin Reuptake Inhibitor

Inhibitors 5 Ht Uptake


Presentation

  • We present an 81-year-old male patient treated with sertraline and furosemide who presented with a recent-onset symptomatic hyponatremia. Low sodium levels persisted for more than 1 week after furosemide had been discontinued.[ncbi.nlm.nih.gov]
  • Three months later she presented to the emergency department with complaints of lethargy, muscle weakness, nausea, altered mental status, and a serum sodium level of 129 mEq/L. SIADH was diagnosed and attributed to duloxetine therapy.[ncbi.nlm.nih.gov]
  • (Case 2) A 27-year-old man presented to the emergency department with altered mental status, rigidity in his lower extremities, myoclonus, and hyperreflexia.[ncbi.nlm.nih.gov]
  • This review attempts to present the current status of these add-on/combination approaches with particular focus on the medicinal chemistry aspects.[doi.org]
  • Two case reports are presented demonstrating that SSRI-treatment may induce or aggravate pathological skin-picking behaviour. Possible mechanisms of SSRI-induced pathological skin-picking and implications for clinical care are discussed.[ncbi.nlm.nih.gov]
High-Pitched Cry
  • The most frequent symptoms observed in the newborns in our study were tremor, gastrointestinal or sleep disturbance, hypertonicity, and high-pitched cry.[archpedi.ama-assn.org]
Streptococcal Infection
  • A 14-year-old boy with Down syndrome (DS) showed a gradual decline in his daily activities and feeding capacities, and a marked deterioration triggered by a streptococcal infection was observed at the age of 15 years.[ncbi.nlm.nih.gov]
Non-Cardiac Chest Pain
  • ., 1996 Fluvoxamine 1 hospitalisation (non-cardiac chest pain) 1 out of 22 1 hospitalisation, 1 ruptured ectopic pregnancy, 1 hernia repair 2 out of 19 Feighner et al., 1999 Citalopram 3 suicide attempts, 1 miscarriage, 1 intestinal flu symptoms, 1 chest[dx.doi.org]
Bruxism
  • Ten isolated cases of bruxism were identified. Ten additional reports could not be classified.[ncbi.nlm.nih.gov]
  • A review by Lane provides a table listing all forms of EPS associated with SSRI administration prior to 1988, and they have included primarily bruxism, akathisia, dyskinesias, and dystonias, many of which appeared in patients not on any potentially confounding[doi.org]
  • ., Adler DA, Bungay KM ( 1996 ) Possible paroxetine-induced bruxism.[doi.org]
  • Early / 1.0-3.0 palpitations / Early / 2.0-3.0 dysuria / Early / 0.1-3.0 amnesia / Delayed / 0.1-2.0 memory impairment / Delayed / 2.0-2.0 hypertension / Early / 1.0-2.0 sinus tachycardia / Rapid / 1.0-2.0 myopathy / Delayed / 0-2.0 teeth grinding (bruxism[pdr.net]
Chronic Urticaria
  • Inflammation may be central to understanding the high comorbidity of depression and anxiety in patients with chronic urticaria (CU).[ncbi.nlm.nih.gov]
  • In contrast to antidepressants such as doxepin, which have previously been found to be effective in the treatment of chronic urticaria, the newer selective serotonin reuptake inhibitor antidepressants are only weakly antihistaminic and anticholinergic[ncbi.nlm.nih.gov]
Hemianopsia
  • Homonymous hemianopsia (HH) is a common adverse outcome after stroke. Spontaneous improvement more than 6 months poststroke is thought to be unlikely, and traditional visual rehabilitation techniques lack clear evidence of efficacy.[ncbi.nlm.nih.gov]
Indecisiveness
  • The question is about 'Work and activities'; score of 0 No difficulty; 1 Incapacity, fatique or weakness related to activites, work or hobbies; 2 Loss of interest in activites, hobbies or work-reported by patient or listlessness, indecision and vacillation[ncbi.nlm.nih.gov]
Agitation
  • Symptoms of serotonin syndrome can include: confusion agitation muscle twitching sweating shivering diarrhoea If you experience these symptoms, you should stop taking the medication and seek immediate advice from your GP or specialist.[nhs.uk]
  • Prominent features of the delirium, which lasted for nearly 2 days, included agitation, confusion, uncontrolled limb movements, abnormal ocular function, hypertension, pyrexia, brisk reflexes, ankle clonus and raised creatine kinase.[ncbi.nlm.nih.gov]
  • These ADEs include sexual dysfunction, hypertension, cardiac conduction risks, hyperglycemia, decreased bone density, sweating, withdrawal symptoms, and agitation.[ncbi.nlm.nih.gov]
  • Search terms included drug-induced akathisia, psychomotor agitation, drug-induced side effect, movement disorders, and extrapyramidal symptoms.[ncbi.nlm.nih.gov]
  • No increased rate of self-harm and suicidal thoughts compared with placebo Rate of events including agitation, anorexia, insomnia and suicidal thoughts and self harm increased compared with placebo Increased rate of self-harm compared with placebo in[web.archive.org]
Seizure
  • The incidence of seizures was 1.9% and coma was 2.4%. Serotonin syndrome occurred in 14% of overdoses.[ncbi.nlm.nih.gov]
  • It has been approved by the Food and Drug Administration for partial seizures in adults as both adjunctive and monotherapy, and as adjunctive therapy in children aged from 2 to 16 years ().[ncbi.nlm.nih.gov]
  • Symptoms of severe serotonin syndrome include: a high temperature of 38C or above seizures (fits) irregular heartbeat (arrhythmia) loss of consciousness If you or someone you know experience symptoms of severe serotonin syndrome, seek emergency medical[nhs.uk]

Treatment

  • METHODS: We examined whether the reactions to drug treatment in treatment-naive patients with MDD could be predicted by NIRS outcomes at the initial investigation.[ncbi.nlm.nih.gov]
  • Whether ERPs reflect the pharmacological effects of OCD treatment, particularly in treatment-naïve pediatric patients, remains unknown.[ncbi.nlm.nih.gov]
  • The acupuncture group had significantly lower SERS scores at weeks 1, 2, 4, and 6 after treatment compared with the medicine group (P 0.01).[ncbi.nlm.nih.gov]
  • OBJECTIVE: In adults there is growing evidence that antidepressant (AD) treatment results in a decline in inflammatory cytokines.[ncbi.nlm.nih.gov]
  • Multiple regression analyses were performed to compare the treatment outcomes.[ncbi.nlm.nih.gov]

Prognosis

  • The prognosis in animals that receive treatment is excellent. In one retrospective study, there were no deaths in 313 SSRI-poisoned dogs. No characteristic or classic histopathologic lesions result from SSRI toxicosis.[ncbi.nlm.nih.gov]
  • Gender, depression, and one-year prognosis after myocardial infarction. Psychosom Med. 1999; 61 :26–37. [ PubMed ] Rovner BW. Depression and increased risk of mortality in the nursing home patient.[ncbi.nlm.nih.gov]
  • Depression and 18-month prognosis after myocardial infarction. Circulation. 1995; 91 : 999–1005. Crossref Medline Google Scholar 4 Musselman DL, Evans DL, Nemeroff CB.[circ.ahajournals.org]
  • 9.1.1 Ingestion 9.1.2 Inhalation 9.1.3 Skin exposure 9.1.4 Eye contact 9.1.5 Parenteral exposure 9.1.6 Other 9.2 Chronic poisoning 9.2.1 Ingestion 9.2.2 Inhalation 9.2.3 Skin exposure 9.2.4 Eye contact 9.2.5 Parenteral exposure 9.2.6 Other 9.3 Course, prognosis[inchem.org]

Etiology

  • Use of over-the-counter medications or dietary supplements in addition to prescribed serotonergic medications is also an important etiology.[emedicine.medscape.com]
  • Understanding of the etiology of depression has been hampered by the absence of direct measurements of monoamines in humans.[ncbi.nlm.nih.gov]
  • […] access through Ovid Abstract There is some evidence that major depression-in particular, treatment-resistant depression (TRD)-is accompanied by activation of the inflammatory response system and that proinflammatory cytokines may play a role in the etiology[dx.doi.org]
  • It is further questionable whether the complexities of treating bipolar disorder (with its unknown etiology and well-known heterogeneity in response to treatment) are accurately portrayed as a reliable, mechanical thermostat.[ncbi.nlm.nih.gov]

Epidemiology

  • The first epidemiological study was published in 1999 and since then, 34 epidemiological studies from different areas, most of them including elderly patients in their study populations, have been published with a variety of results.[ncbi.nlm.nih.gov]
  • KEYWORDS: Congenital anomaly; Depression; Epidemiology; Medication; Registry; SSRI[ncbi.nlm.nih.gov]
  • METHODS: setting: Olmsted County, Minnesota. patient population: Eligible patients were county residents in the Rochester Epidemiology Project.[ncbi.nlm.nih.gov]
  • This paper reviews the relevant literature addressing the epidemiological data of Western populations and the data accumulated from clinical trial databases in several countries.[ncbi.nlm.nih.gov]
  • We synthesized the epidemiologic evidence concerning selective serotonin reuptake inhibitor (SSRI) exposure and the risk of CNS hemorrhage.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • Dysfunction of glutamatergic neurotransmission has been implicated in the pathophysiology of obsessive-compulsive disorder (OCD) and recent clinical reports suggest that some glutamate modulating agents are efficacious in the treatment of this disorder[ncbi.nlm.nih.gov]
  • Following a comprehensive overview of the clinical evidence, we will discuss the underlying pathophysiology of the SSRI discontinuation syndrome and comment on the use of animal models to better understand this condition.[ncbi.nlm.nih.gov]
  • Abstract The monoamine hypothesis of depression predicts that the underlying pathophysiologic basis of depression is a depletion in the levels of serotonin, norepinephrine, and/or dopamine in the central nervous system.[ncbi.nlm.nih.gov]
  • Accumulating evidence suggests that sigma-1 receptors play a role in the pathophysiology of neuropsychiatric diseases, as well as in the mechanisms of some selective serotonin reuptake inhibitors (SSRIs).[ncbi.nlm.nih.gov]
  • According to this new classification there are different pathophysiologies and treatments of PE, dependent on the underlying PE syndrome.[ncbi.nlm.nih.gov]

Prevention

  • Preventive Services Task Force. Screening for osteoporosis: US preventive services task force recommendation statement. Ann. Intern. Med. 154(5), 356–364 ( 2011 ). Crossref, Medline, Google Scholar 25 Eom C-S, Lee H-K, Ye S, Park SM, Cho K-H.[dx.doi.org]
  • Elderly patients commonly receive statin drugs for the primary or secondary prevention of cardiovascular and cerebrovascular events.[ncbi.nlm.nih.gov]
  • Authors' conclusions: Since the last version of this review, the new included studies have not added high quality evidence to support the use of SSRIs or venlafaxine as preventive drugs for migraine.[cochrane.org]
  • SSRIs prevent serotonin from being removed from the space between brain cells.[sharecare.com]
  • It is unclear whether antidepressants can prevent suicides or suicide attempts, particularly during long-term use. The Authors carried out a comprehensive review of long-term studies of antidepressants (relapse prevention).[prn.fm]

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