• Title/Summary/Keyword: Selective serotonin reuptake inhibitors

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Augmentation Strategies in Obsessive Compulsive Disorder (강박장애의 약물효과 증대 전략)

  • Lee, Chul
    • Korean Journal of Biological Psychiatry
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    • v.5 no.2
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    • pp.162-165
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    • 1998
  • The serotonin reuptake inhibitors(SRIs) and the serotonin selective reuptake inhibitors(SSRIs) are considered the first choice agents for pharmacologic treatment of obsessive-compulsive disordr(OCD). However, many patients with OCD experience little or no improvement in their symptoms when treated with SRIs or SSRIs. Patients who have experienced a partial or no response to an SRI/SSRI at 10 to 12 weeks are often considered for augmentation strategies. Nearly every class of psychotropic medications has been tried in an open fashion, though augmentation strategies have been somewhat disappointing.

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The Role of Serotonin in Pathology and Treatment of the Mood Disorders (기분장애의 병리와 치료에 있어 세로토닌의 역할)

  • Jung, In Kwa;Kim, Jin Se
    • Korean Journal of Biological Psychiatry
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    • v.4 no.2
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    • pp.168-178
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    • 1997
  • The serotonin has been known to play important roles in pathology of the mood disorders. We summerize the evidences of serotonin in pathology of the mood disroders in a view of neuroanatomical and neurochemical aspects. Nowaday, the selective serotonin reuptake inhibitors(SSRIs) may be practically the first line of antidepressants with traditional tricyclic antidepressants(TCAs). Authors review the role of serotonin in the treatment of the mood disorders, in a view of the general considerations in selecting antidepressants, pharmacology, therapeutic indications, side effects, doses of medication, drug-discontinuation syndrome, drug-to-drug interactions, and special therapeutic situations.

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Apathy syndrome in a patient previously treated with selective serotonin reuptake inhibitors for depression

  • Kim, Hye-Geum;Koo, Bon-Hoon;Lee, Seung Woo;Cheon, Eun-Jin
    • Journal of Yeungnam Medical Science
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    • v.36 no.3
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    • pp.249-253
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    • 2019
  • There is considerable overlap in the clinical presentations of apathy and depression. However, differential diagnosis between apathy and other psychiatric conditions, including depression and dementia, is important. In this report, we present the case of a 67-year-old woman with a history of receiving selective serotonin reuptake inhibitor (SSRI) treatment for depression. Differential diagnosis between treatment-resistant depression and SSRI-induced apathy syndrome was required. The symptoms of her apathy syndrome were relieved after the discontinuation of SSRIs and the addition of olanzapine, methylphenidate, and modafinil. Furthermore, we briefly review related literature in this article.

Antidepressants in Child and Adolescent Psychiatry (소아청소년정신과 영역에서의 항우울제)

  • Yang, Su-Jin;Kim, Jae-Min;Yoon, Jin-Sang;Kim, Sun-Young
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.19 no.2
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    • pp.83-88
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    • 2008
  • Antidepressants, in particular selective serotonin reuptake inhibitors (SSRIs), are one of the most commonly used classes of psychotropic drugs for treating children and adolescents. The US Food and Drug Administration has issued a black box warning concerning the increased risks of suicidal ideation and behavior associated with antidepressant treatment in children and adolescents. The aim of this review is to assess the risks and benefits of antidepressants in the treatment of child and adolescent psychiatric disorders.

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Comparison of Bleeding Tendency Between Selective Serotonin Reuptake Inhibitors and Serotonin Norepinephrine Reuptake Inhibitors Using Platelet Function Analyzer (혈소판기능분석기를 이용한 선택적 세로토닌 재흡수 억제제와 세로토닌 노르에피네프린 재흡수 억제제의 출혈 경향성 비교)

  • Koo, Seung Mo;Kim, Hyun;Lee, Kang Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.153-161
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    • 2021
  • Objectives : The purpose of this study is to compare bleeding tendency of selective serotonin reuptake inhibitor (SSRI) and serotonin norepinephrine reuptake inhibitors (SNRI) using platelet function analyzer (PFA-100) in patients with major depressive disorder. Methods : This study is a prospective open-label study conducted by a single institution. A total of 41 subjects diagnosed with major depressive disorder under the DSM-5 diagnostic criteria participated in this study. The subjects were classified into SSRI (escitalopram) groups and SNRI (duloxetine) groups, respectively, according to random assignments. The closure time (CT) was measured using a platelet function analyzer (PFA-100) before each antidepressant was administered and after 6 weeks. Paired-sample t-test was conducted within each group to determine whether a specific antidepressant had an effect on closure time. In order to confirm the relative change in platelet function between the two groups, an independent sample t-test was conducted to compare and analyze the change in closure time between the two groups. Results : There was no significant changes in closure time (CEPI-CT, CADP-CT) before and 6 weeks after drug administration in the SSRI and SNRI groups, and there was no difference in the amount of changes in closure time between the two groups. Conclusions : Our results showed no difference in bleeding tendency between SSRI and SNRI. This study suggests that further large-scale studies on bleeding tendency for various antidepressants are needed in the future.

Novel Pharmacological Treatment for Depression (새로운 우울증 치료 약물)

  • Jeong, Hee Jeong;Moon, Eunsoo
    • Korean Journal of Biological Psychiatry
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    • v.23 no.1
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    • pp.1-11
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    • 2016
  • Development of various antidepressants such as monoamine oxidase inhibitors, tricyclic antidepressants, selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, and noradrenergic and specific serotonergic antidepressant has led to a tremendous progression of pharmaceutical treatment for depression, but still there are some limitations of current antidepressants, such as treatment-resistant depression and delayed onset of antidepressants. The pathogenesis of depression is unclear because depression is a heterogeneous disease state, and the mechanisms of antidepressants remain uncertain as well. Nevertheless, in an attempt to develop novel antidepressants, some trials have been conducted based on the potential biological mechanism discovered in the numerous research results. This review will provide information about the potential novel antidepressants and the current states of clinical studies using them. In particular, some potential novel antidepressants anti-inflammatory agents, antioxidants, anticholinergics, modulators of Hypothalamic Pituitary Adrenal Axis, glutamate, and opioid systems, as well as some neuropeptides such as susbstance P, neuropeptide Y, and galanin will be discussed.

Usage of Antidepressants and Weight (항우울제의 사용과 체중)

  • Lee, Ung;Cho, Sung Joon
    • Korean Journal of Biological Psychiatry
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    • v.27 no.2
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    • pp.58-63
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    • 2020
  • Depressive disorder is a very common disease, clinical manifestations vary, and the mechanism is not clear. Therefore, a pharmacotherapy is very important to achieve sufficient therapeutic effect, but the choice of drug is not easy due to the occurrence of side effects of treatment and confusion with clinical features. It is easy to overlook the side effects of weight gain with antidepressants compared with antipsychotics, but they are frequently observed in clinical settings. The first-generation antidepressants have higher weight gains than selective serotonin reuptake inhibitors. Serotonin norepinephrine reuptake inhibitors are observed to have less weight gain, and dopamine norepinephrine reuptake inhibitors have weight loss effect due to decreased appetite. Mirtazapine, an atypical antidepressant, has a strong histamine H1 blockade, and gains weight gain from short-term use. The effects of desvenlafaxine, vortioxetine, and agomelatin on weight, which have recently been increasing in use, have not been largely identified. For better compliance, studies on weight gain due to the use of antidepressants are needed.

Effect of Serotonin Uptake Inhibitors on Serotonin Metabolism in the Hypothalamus of Freely Moving Rats

  • Song, Yun-Seob;Yoon, Se-Na;Jung, Dong-Sik;Yoo, Sang-Hee;Ryu, Hyong-Kyun;Kim, Hyung-Gun
    • The Korean Journal of Physiology and Pharmacology
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    • v.4 no.6
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    • pp.439-444
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    • 2000
  • Tricyclic antidepressant clomipramine or selective serotonin reuptake inhibitors (SSRIs) have been commonly used for the treatment of premature ejaculation. In the present study, we analyzed the concentrations of serotonin and 5-hydroxyindoleacetic acid (5-HIAA) in the medial preoptic area (MPOA) of the hypothalamus by awakening animal microdialysis following administration of clomipramine and various SSRIs. We then compared the serotonin metabolism and clinical effects of clomipramine and SSRIs on premature ejaculation. Basal extracellular serotonin level in the MPOA was higher than other brain regions and it was significantly increased by clomipramine and the SSRIs. The rank order of the concentration of serotonin at the MPOA was clomipramine, sertraline, paroxetine and fluoxetine and the concentrations of 5-HIAA was vice versa. The changes in serotonin concentration at the MPOA appeared closely associated with the clinical effects of these drugs on premature ejaculation. These results suggest that the serotonergic neuronal activity in the MPOA may have an selective inhibitory influence on ejaculation, and the effects of clomipramine and SSRIs on erectile function are mainly mediated by MPOA of the hypothalamus.

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Early Interventions After Trauma (외상 후 초기중재)

  • Park, Joo-Eon;Lee, Boung-Chul;Jung, Young-Eun;Chae, Jeong-Ho
    • Anxiety and mood
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    • v.5 no.2
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    • pp.75-79
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    • 2009
  • In this article, we review the efficacy of early interventions after traumatic incidents and during acute stress disorder (ASD). There are some evidences that psychopharmacological medications such as propronolol, morphine, and hydrocortisone are effective in the prevention of posttraumatic stress disorder (PTSD). Considering the role of selective serotonin reuptake inhibitors in hippocampal neurogenesis and an animal model of PTSD, early administration of selective serotonin reuptake inhibitors is also fairly promising. Other pharmacological treatments including benzodiazepines did not treat ASD nor prevent PTSD. There are good evidences that cognitive behavioral therapy including cognitive therapy and prolonged exposure is a valuable intervention for ASD and the most effective prevention for PTSD. No contolled researches on eye movement desensitization&reprocessing, psychodynamic psychotherapy and hypnotherapy have performed. Recent randomized controlled studies using psychological debriefing did not prove as a useful intervention for the prevention of PTSD until now, although the efficacy of debriefing has been at the centre of controversy.

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Escitalopram, a selective serotonin reuptake inhibitor, inhibits voltage-dependent K+ channels in coronary arterial smooth muscle cells

  • Kim, Han Sol;Li, Hongliang;Kim, Hye Won;Shin, Sung Eun;Seo, Mi Seon;An, Jin Ryeol;Ha, Kwon-Soo;Han, Eun-Taek;Hong, Seok-Ho;Choi, Il-Whan;Choi, Grace;Lee, Dae-sung;Park, Won Sun
    • The Korean Journal of Physiology and Pharmacology
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    • v.21 no.4
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    • pp.415-421
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    • 2017
  • We investigated the inhibitory effect of escitalopram, a selective serotonin reuptake inhibitor (SSRI), on voltage-dependent $K^+$ (Kv) channels in freshly separated from rabbit coronary arterial smooth muscle cells. The application of escitalopram rapidly inhibited vascular Kv channels. Kv currents were progressively inhibited by an increase in the concentrations of escitalopram, suggesting that escitalopram inhibited vascular Kv currents in a concentration-dependent manner. The $IC_{50}$ value and Hill coefficient for escitalopram-induced inhibition of Kv channels were $9.54{\pm}1.33{\mu}M$ and $0.75{\pm}0.10$, respectively. Addition of escitalopram did not alter the steady-state activation and inactivation curves, suggesting that the voltage sensors of the channels were not affected. Pretreatment with inhibitors of Kv1.5 and/or Kv2.1 did not affect the inhibitory action of escitalopram on vascular Kv channels. From these results, we concluded that escitalopram decreased the vascular Kv current in a concentration-dependent manner, independent of serotonin reuptake inhibition.