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]
This review attempts to present the current status of these add-on/combination approaches with particular focus on the medicinal chemistry aspects. [doi.org]
Entire Body System
- 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]
Jaw & Teeth
- 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]
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]
- Periodontitis
Xianxian Li, Xiangnan Wu, Yuanyuan Ma, Zhichao Hao, Shenyuan Chen, Taozi Fu, Helin Chen and Hang Wang, Oral administration of 5-hydroxytryptophan aggravated periodontitis-induced alveolar bone loss in rats, Archives of Oral Biology, 10.1016/j.archoralbio [doi.org]
Musculoskeletal
- Restless Legs Syndrome
OBJECTIVE/BACKGROUND: Because restless legs syndrome (RLS) is a problematic syndrome, demonstrating an association between use of selective serotonin reuptake inhibitors (SSRIs)/serotonin-norepinephrine reuptake inhibitors (SNRIs) and RLS may help direct [ncbi.nlm.nih.gov]
Suspected diagnoses in the other 212 patients included restless legs syndrome (n = 109), periodic limb movement disorder of sleep diagnosed by polysomnography (n = 47), akathisia attributed to dopaminergic drugs (n = 7), dystonia (n = 4), tremor (n = [doi.org]
legs syndrome (RLS) / Delayed / Incidence not known petechiae / Delayed / Incidence not known DRUG INTERACTIONS Abciximab: (Moderate) Platelet aggregation may be impaired by selective serotonin reuptake inhibitors (SSRIs) due to platelet serotonin depletion [pdr.net]
Skin
- Chronic Urticaria
There is increasing evidence of platelet activation and systemic inflammation in chronic spontaneous urticaria and delayed pressure urticaria (DPU). [ncbi.nlm.nih.gov]
Eyes
- 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]
Neurologic
- 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]
- Seizure
The incidence of seizures was 1.9% and coma was 2.4%. Serotonin syndrome occurred in 14% of overdoses. [ncbi.nlm.nih.gov]
- Homonymous 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]
Workup
Serum
- Klüver-Bucy Syndrome
These cases support the benefit of SSRIs in treating associated Klüver-Bucy syndrome. [ncbi.nlm.nih.gov]
Microbiology
- Helicobacter Pylori
Both reductions may be explained by better selection of patients over the years, an increasing use of proton pump inhibitors (from 2.3% in controls in the previous study to 7.9% in the present study), and declining cohort prevalence of Helicobacter pylori [doi.org]
Treatment
Withdraw treatment plus preventive medication may lead to a better outcome. [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]
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]
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]
Etiology
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]
Use of over-the-counter medications or dietary supplements in addition to prescribed serotonergic medications is also an important etiology. [emedicine.medscape.com]
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]
Pathophysiology
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]
Prevention
SSRIs prevent serotonin from being removed from the space between brain cells. [sharecare.com]
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]
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]
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]
Withdraw treatment plus preventive medication may lead to a better outcome. [ncbi.nlm.nih.gov]