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At least 1,099 records · Page 61Linked to original sources
PubMed2000

Antidepressant-like effect of 7-nitroindazole in the forced swimming test in rats.

RATIONALE: There is some strong evidence about the role of nitric oxide (NO) as an intercellular messenger in central physiological mechanisms. NO is synthesized from L-arginine by nitric oxide synthase (NOS), as a response to activation of N-methyl-D-aspartate (NMDA) receptors by excitatory amino acids. NMDA receptor antagonists also produce antidepressant-like actions in preclinical models. OBJECTIVE: In the present study, the involvement of NO in the mechanism of depression was investigated. 7-Nitroindazole (7-NI) (15, 30, 60, 90 mg/kg IP), a selective inhibitor of neuronal NOS was examined. METHODS: The Porsolt forced swimming test (FST) has been used as a test for screening new antidepressant agents. RESULTS: 7-NI dose-dependently decreased the immobility time in FST, but produced no significant change in locomotor activity in naive rats. Neither L-arginine, nor D-arginine (100 mg/kg) affected the immobility time in the FST or revealed any effect on locomotion. L-Arginine but not D-arginine, given 10 min before 7-NI, reversed the 7-NI-induced effect on immobility time. CONCLUSIONS: Our findings suggest that NO might be an important modulator of depression in rats.

Animals↗
PubMed1981

[Amineptine and amotival syndrome (author's transl)].

Intellectual, affective and motor inhibition is part of the syndrome encountered in: drug withdrawal in addicts especially with opiates; hebephrenia. Amineptine a new antidepressant agent with psychoanaleptic properties has been studied in these patients. Considering this psychotonic activity was logical to test both the tolerance of this compound in drug addicts and the risk of delirious reactivation in schizophrenic patients. The open study in 19 patients shows an effect of amineptine: -on inhibition and loss of activity, apragmatism and deterioration of social behaviour; -a subjective improvement of intellectual performance. And moreover: without reactivation of preexisting delirious ideas in schizophrenic patients; without drug addiction in treated toxicomaniacs.

Adult↗
PubMed1996

The 5-HT1A receptor: signaling, desensitization, and gene transcription.

The hypothesis that antianxiety or antidepressant agents (e.g., 5-HT1A agonists, 5-HT uptake blockers) exert their clinical actions via enhancement of serotonergic neurotransmission due to desensitization of 5-HT1A autoreceptors predicts that regulation of this receptor plays a crucial role in the therapeutic actions of these agents. A multidisciplinary strategy is described for the characterization of the 5-HT1A receptor at the level of cellular signaling mechanisms and genetic regulation, using heterologous expression of the cloned receptor in cell lines, site-directed mutagenesis, isolation of receptor-positive neuronal cell lines, and promoter analysis of the 5-HT1A receptor gene. These analyses will yield new insights into the possible mechanisms down-regulation of 5-HT1A receptor signaling, and may suggest novel sites of inherent defect involved in anxiety syndromes or major depression.

Antidepressive Agents↗
PubMedDate not supplied

Neural-network applications for analysis of adverse drug reactions.

A neural-network analysis has been applied to predict adverse or side effects of drugs using a database of antidepressant agents with known effects as well as input from a database with both patient parameters and drug information. A NeuralWork software package was implemented on a Macintosh Quadra 700 and trained on a database of ten drugs with known adverse effects. Another agent (not in the database) was used to test the ability of the network to predict the relative incidence of its side effects. Despite the small number of drugs used for training, the adverse effects of some drugs, such as doxepin, were predicted with 90-100% accuracy. These results indicate that neural-network analysis can be used to predict adverse drug effects for drugs within a given class and ultimately can be extended to include patient parameters to predict the mechanisms of action of drugs from relatively large databases.

Adverse Drug Reaction Reporting Systems↗
PubMed1996

Chronic administration of imipramine and lithium changes the phase-angle relationship between the activity and core body temperature circadian rhythms in rats.

Evidence suggests that there is an association between the pathophysiology of depression and a disturbance of circadian rhythms. Accordingly, attention has focused on the possible effects of antidepressants on circadian rhythms. In the present study, we examined the effects of chronic administration of two clinically effective antidepressant agents, imipramine and lithium, on several circadian rhythms in the rat. Activity, core body temperature, and drinking rhythms were assessed in constant darkness (DD) and light-dark (LD) conditions. In DD, lithium significantly lengthened the circadian period of the activity, temperature, and drinking rhythms, while imipramine had no effect. In LD, both drugs significantly delayed the phase of the activity rhythm, but did not change that of the other two rhythms. As a result, the phase-angle differences between the activity and temperature rhythms significantly increased. Neither lithium nor imipramine produced any effect on the resynchronization of these rhythms after an 8-h delay in the LD cycle. These results indicate that although both drugs produced different effects on the circadian period of individual rhythms, both caused a relative phase advance of the temperature rhythm as compared to the activity rhythm, and this effect may be related to the similarity in their antidepressant effects.

Animals↗
PubMed2004

Fluoxetine-induced memory impairment in four family members.

OBJECTIVE: Fluoxetine, a selective serotonin reuptake inhibitor antidepressant agent, has been implicated in learning and memory. Here, we report four cases from the same family of fluoxetine-related memory-impairment. RESULTS: Memory-impairment resulted after fluoxetine treatment and disappeared after changing to another selective serotonin reuptake inhibitor. CONCLUSIONS: There may be a relationship between fluoxetine-related memory impairment and genetic factors, and this side-effect appears to be specific to fluoxetine treatment. Possible mechanisms underlying this effect may be the drug's influence on the central serotonergic system or brain-derived neurotrophic factor.

Adult↗
PubMed2006

A meta-analysis of clinical trials comparing milnacipran, a serotonin--norepinephrine reuptake inhibitor, with a selective serotonin reuptake inhibitor for the treatment of major depressive disorder.

CONTEXT: Over the past few years, a number of studies have emerged suggesting that the treatment of major depressive disorder (MDD) with antidepressants which enhance both noradrenergic as well as serotonergic neurotransmission may result in higher response or remission rates than treatment with antidepressants which selectively enhance serotonergic neurotransmission. OBJECTIVE: The objective of this paper was to compare response rates among patients with MDD treated with either milnacipran, an antidepressant thought to simultaneously enhance both noradrenergic and serotonergic neurotransmission, or a selective serotonin reuptake inhibitor (SSRI). DATA SOURCES: Medline/Pubmed were searched. No year of publication or language limits were used. STUDY SELECTION: Double-blind, randomized clinical trials comparing milnacipran with an SSRI for the treatment of MDD. DATA EXTRACTION: Data were extracted with the use of a pre-coded form. DATA SYNTHESIS: Analyses were performed comparing response rates between the two antidepressant agents. Data from 6 reports involving a total of 1082 outpatients with MDD were identified and combined using a random-effects model. Patients randomized to treatment with milnacipran were as likely to experience clinical response as patients randomized to treatment with an SSRI according to the MADRS (RR = 1.04, 95% CI: 0.88-1.23, p = 0.533) or the HDRS (RR = 1.06, 95% CI: 0.90-1.24, p = 0.456) for the random effects model. Simply pooling MADRS-based response rates between the two agents revealed a 58.9% response rate for milnacipran and a 58.3% response rate for the SSRIs. Similarly, HDRS-based response rates were 59.7% and 57.5%. There was also no difference in overall discontinuation rates (RR = 0.93; 95% CI: 0.76-1.14; p = 0.506), the rate of discontinuation due to adverse events (RR = 0.77; 95% CI: 0.55-1.1; p = 0.157), or the rate of discontinuation due to inefficacy (RR = 0.98; 95% CI: 0.7-1.38; p = 0.95) between the two groups. CONCLUSIONS: These results suggest that milnacipran and the SSRIs do not differ with respect to their overall efficacy in the treatment of MDD.

Antidepressive Agents↗
PubMed1996

The management of treatment-resistant depression in the medically ill.

There are a few well-designed studies to systematically assess treatment-resistant depression in the medically ill patient. Psychiatrists, however, do have extensive clinical experience in treating depression in the medical patient. This experience can be useful in helping to determine treatment resistance and in selecting consequent treatment choices. A decision tree is offered in Table 1 to clarify the questions the clinician must answer. The first step is to evaluate the role of the medical illness and to decide whether or not treating that effectively will also clear the depression. Physicians may find it helpful to use a decision tree in initiating treatment of patients with depression and physical illness. Once it has been clarified that the diagnosis of depression is a correct one and that an antidepressant medication is in order, consideration of safety, side effects, and other current prescriptions used by the patient must occur. Drug-drug interactions as well as changes in the clearance of medications are critical to the effectiveness of the choice and tolerability for the patient. An antidepressant agent needs to be given for an adequate time with optimization of dosing. Augmenting a medication to increase its therapeutic action could be tried if one agent alone is not effective. An alternative approach is that the second drug selected might affect different neurotransmitters, and the combination of mechanisms would result in resolution of symptoms. Adding psychotherapy, especially when social supports are lacking, can be particularly helpful. ECT is an important consideration for severe depression when suicidal concerns are imminent or the patient has not responded to pharmacotherapy trials. While we await further studies of treatment-resistant depression in large enough numbers of patients with particular illnesses, we can use these guidelines to direct our decisions to switch or augment our initial choices to provide the safest, most effective care possible.

Antidepressive Agents↗
PubMed1982

[Myoclonus of toxic origin].

EEG, EMG and clinical correlates of myoclonus due to poisoning are reviewed. The authors propose a classification into two groups. I. Sporadic diffuse asynchronous asymmetrical myoclonic jerks, responding to treatment. These states are encountered essentially in acute intoxication by vegetal poisons (strychnine), rodenticide (chloralose) and various medications (isoniazide, tricyclic antidepressant agent, lithium). These transitory manifestations are functional and prognosis is favourable. II. Subintrant generalized synchronous symmetrical myoclonus, uncontrolled by therapeutics. These myoclonus states observed over weeks or months are frequently consecutive to organic injuries due to direct toxicity (methylbromide) or after anoxia (toxic cardiac arrest). EEG and EMG correlations are very inconstant in both groups. EEG abnormalities are a sign of cortical and/or subcortical dysfunction. Normal EEG suggests a disease of the lower central nervous structure (brain stem, medulla). Chronic bismuth and dialysis encephalopathies are also related. Withdrawal syndrome with myoclonus jerks after sudden cessation of barbiturate or benzodiazepine long-term treatment is mentioned.

Aluminum↗
PubMed2003

Venlafaxine: a 2003 update.

BACKGROUND: venlafaxine has been available for use as an antidepressant in the United States for a decade. OBJECTIVE: Comprehensive reviews of venlafaxine have been published elsewhere; thus, this update focuses on newer issues of treatment remission in depression, treatment-resistant depression, and extended-release venlafaxine for generalized anxiety disorder (GAD). METHODS: Relevant clinical literature from 1993 through 2003 was identified from database searches of MEDLINE and International Pharmaceutical Abstracts, and from manual searches of reference lists of the identified papers. Search terms included venlafaxine extended-release, venlafaxine XR, treatment-resistant depression, depressive disorders, anxiety disorders, generalized anxiety disorder, and antidepressive agents second generation. RESULTS: With its dual action of serotonin and noradrenergic reuptake inhibition, venlafaxine has been shown to be superior in efficacy to selective serotonin reuptake inhibitors for severe major depressive disorder, treatment-resistant depression, and depressive symptom remission. Its demonstrated efficacy for both short- and long-term treatment of GAD has led to its use for obsessive-compulsive disorder and chronic pain syndromes, although inadequate clinical literature currently exists to support these latter 2 uses. In the past decade, no new or unexpected adverse events have been identified with venlafaxine therapy, except a possibly greater risk of fatal overdose compared with other serotonergic drugs, suggesting the need for caution in patients with suicidal ideation. Because venlafaxine is a potent serotonin agonist, caution must also be exercised to prevent the possibility of serotonin syndrome when used with other serotonin agonists, and its dose should be tapered very gradually to minimize the risk of a serotonin withdrawal reaction. CONCLUSION: Venlafaxine has emerged as a successful post-SSRI-era antidepressant with an expanded range of uses since it was first marketed.

Antidepressive Agents, Second-Generation↗
PubMed1996

Dose-response relationship with venlafaxine.

Considerations when selecting a first-line antidepressant agent include the potential for achieving greater response with increasing dosages, thereby allowing greater flexibility in dosing. The efficacy and dose-response of venlafaxine, a novel serotonin and norepinephrine reuptake inhibitor, was evaluated in two placebo-controlled studies. Both studies demonstrated that venlafaxine was efficacious (as determined by the Hamilton Rating Scale for Depression, the Montgomery-Asberg Depression Rating Scale, and the Clinical Global Impressions scale scores), as well as safe and tolerable when administered either twice or three times daily in the treatment of outpatients who had major depression. In addition, evidence of a dose-response relationship was shown in both studies.

Adolescent↗
PubMed1981

Central pre- and postsynaptic monoamine receptors in antidepressant therapy.

Activation of postsynaptic noradrenergic alpha 1-receptors may be involved in the mediation of psychomotor activating effects of tricyclic antidepressant (TCA) drugs. On the other hand, the pronounced sedative properties of some TCA drugs seem to be correlated with their alpha 1-receptor blocking capacity. The presynaptic alpha 2-receptors probably mediate the feed back inhibition of central NE neurons seen after administration of TCA drugs, particularly the secondary amines. Yet other antidepressants such as mianserin are potent antagonists at central alpha 2-receptors, a phenomenon which can even cause activation of brain NE neurons and form a basis for their therapeutic action. beta-Receptor activation in the brain is also suggested to participate in the therapeutic effect of several drugs, e.g. mianserin and the putative antidepressant agent salbutamol, a beta 2- receptor agonist. A reduced central beta-receptor activation may, accordingly, contribute to depressive symptoms associated with treatment with beta-adrenoceptor blocking drugs, both by their action per se as well as by secondary effects on the monoamine systems, which we recently have demonstrated. Facilitation of brain 5-HT neurotransmission seems to be achieved with several TCA drugs not only via inhibition of reuptake but also through sensitization of postsynaptic 5-HT receptors, developing during repeated treatment. In contrast the "presynaptic" 5-HT receptors do not show increased sensitivity during chronic TCA drug treatment, thus allowing for an enhanced synaptic effect of 5-HT induced by TCA drugs.

Animals↗
PubMed2001

Bupropion SR in the naturalistic treatment of elderly patients with major depression.

INTRODUCTION: Bupropion immediate release (IR) and bupropion sustained release (SR) are frequently used to treat geriatric depression, as they have few cardiovascular, gastrointestinal and sexual adverse effects. We sought to examine the efficacy and dosing patterns of bupropion in a naturalistic cohort of elderly subjects with major depression (MD). METHODS: 31 elderly ( > 60 years) patients with unipolar MD (DSM-IV) who were enrolled in Duke's Mental Health Clinical Research Center for the Study of Depression in Later Life were prescribed bupropion SR or IR, alone or in combination with other antidepressant agents, for 12 weeks. Montgomery-Asberg depression rating scale (MADRS) scores and clinical global impression (CGI) severity scores were used to define response. RESULTS: 74% (23/31) of the sample were responders (MADRS < 15) and 53% (16/30) achieved a partial (CGI = 2) or complete (CGI = 1) remission of MD at week 12. Among patients treated with bupropion SR monotherapy, the mean (range) maximal daily dose achieved was 240 mg (150-400 mg). Among those treated with bupropion IR, the mean (range) maximum daily dose achieved was 258 mg (150-450 mg). In subjects on monotherapy, 67% (10/15) of MD subjects were responders (MADRS < 15) and 50% (7/14) achieved full or partial remission. Response rates did not differ statistically among those with high and low medical comorbidity. CONCLUSIONS: In this naturalistic 12-week study, geriatric MD patients with high and low medical comorbidity responded well to bupropion and bupropion SR. In elderly patients, four to eight week acute treatment periods may be insufficient. Our findings suggest that nearly 50% of elderly depressed subjects at a tertiary center may need combination therapy over the course of their illness. Controlled randomized studies to establish the long-term efficacy and optimal dose of the newer antidepressants in geriatric depression are urgently needed.

Administration, Oral↗
PubMed1975

[Cardiopulmonary effects after i.v. administration of maprotiline in the dog].

The cardiopulmonary effects of the antidepressive agent maprotiline were investigated in the dog. In ventilation experiments on dogs anaesthetized with chloralose, respiratory minute volume decreased by 5-10% shortly after intravenous injection of 1 and 3 mg/kg; acid-base-balance variables remained unchanged. After an intravenous dose of 10 mg/kg ineffective hyperventilation was observed, associated with a transient decrease of P-O2 and a slight increase in P-CO2 in the arterial blood. In cardiac-catheterization experiments on dogs anaesthetized with chloralose and morphine and receiving artificial respiration, an intravenous dose of 3 mg/kg maprotiline had no appreciable effect on the cardiovascular system, apart from a transient and slight, but statistically significant increase in pulmonary capillary pressure immediately after the injection. Anaesthesia was slightly deeper and more prolonged after the intravenous administration of maprotiline.

Animals↗
PubMed1976

Antidepressant treatment with maprotiline in the management of emotional disturbances in patients with acute myocardial infarction: a controlled study.

In coronary artery disease the patients usually manifest both anxiety and depression disturbances. A controlled clinical study was conducted to test the efficacy of a new antidepressant agent, maprotiline, in the early stages of acute myocardial infarction. The sample consisted of 126 patients, sixty-three receiving orally 25 mg of maprotiline twice daily and the remainder 5 mg of diazepam twice daily. Treatment lasted on an average two weeks (ten days to eight weeks). The depressive and/or anxiety conditions were rated on the basis of a questionnaire administered before and after treatment. Depression improved markedly in patients receiving maprotiline, while the two drugs developed a comparable anxiolytic action. Tolerability was good. No clinical or ECG evidence of cardiotoxic signs was detected. The importance of a drug with these characteristics in the management of emotional disturbances in the early stages of coronary artery disease is emphasized.

Acute Disease↗
PubMed2003

Voltammetric and HPLC techniques for the determination of paroxetine hydrochloride.

The antidepressant agent paroxetine hydrochloride (POT) was studied by cyclic voltammetry (CV), differential pulse voltammetry (DPV) and osteryoung square wave voltammetry (OSWV). A sensitive method is described for the determination of POT in its pure form and in human plasma. The linear relationship between concentration and peak current permits the quantification of POT by CV, DPV and OSWV in the concentration range of 2 x 10(-5) - 8 x 10(-4) M. Applicability to tablets and human plasma analysis has been illustrated. Furthermore, a HPLC method with diode array detection was developed. Linearity was established between 2 x 10(-7) - 6 x 10(-5) M for POT. The described methods were successfully employed with high degrees of precision and accuracy for the estimation of total drug content in human plasma and pharmaceutical dosage forms of POT.

Antidepressive Agents, Second-Generation↗