Editor: Steven R. Daviss, M.D.
drdaviss@psychopharminfo.com
www.psychopharmINFO.com
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Number 3
Monday, February 17, 2003
PPI Index: *89.6 (+0.1%)

Copyright 2003 by Steven R. Daviss

Hi, folks.  I think I've got the spacing right on the newsletter so that it all fits without scrolling left and right.  Your screen resolution should be set to 800x600 or higher.  This should also allow you to print in portrait, rather than landscape, mode.  You may still want to reduce the "Text size" in the VIEW menu to get more on a page.   • • •    The monthly website is now up to date for January, but of course, Newsletter subscribers are getting their up-to-date information every week.  We don't have enough to start our subscribers-only discussion list yet, but I'll keep you posted.  If each of you could get 3 or 4 people to subscribe, there would be enough of a core group to make it work.  I have the software picked out:  it is Movable Type.  Articles of interest can be discussed in detail, allowing for a more educational forum.    • • •   This will likely be the last newsletter to get posted to the website.  The rest will be email only.  If you miss a copy, let me know and I'll shoot another one out to you.   =Steve.

TOP 10 GOOGLE NEWS ANTIDEPRESSANTS
(by number of hits; (#)=position last week)

             Hits   #
 1. Prozac    318  (1)
 2. Paxil     242  (2)
 3. Effexor    91  (4)
 4. Zoloft     70  (3)
 5. Wellbutrin 44  (6)
 6. Strattera  38  (5)
 7. Remeron    24  (9)
 8. Celexa     17  (8)
 9. Cymbalta   16  (7)
10. Serzone     4 (10)

TOP 10 SEARCHES FOR ANTIDEPRESSANTS
(by search hits; %=change from last week, as per WordTracker)

               Hits   %
 1. Lexapro    7899  +2
 2. Paxil      7100  -1
 3. Wellbutrin 5514  -1
 4. Zoloft     5487  +1
 5. Effexor    5280  -2
 6. Celexa     4656  -3
 7. Prozac     3405  -1
 8. Remeron    1605  +1
 9. Strattera  1247 +23
10. Serzone     657  -8

SIDE EFFECTS & INTERACTIONS
• Sexual
-citalopram
• Numbness
-paroxetine
• Review
-bupropion
• Interactions
-fluoxetine- haloperidol/Haldol
-fluvoxamine- haloperidol/Haldol
-nefazodone- haloperidol/Haldol
MEDICATION UPDATES FROM LAST WEEK

Go To: | CELEXA | CYMBALTA | EFFEXOR | LEXAPRO | LUVOX | PAXIL | PROZAC | REMERON | SARAFEM | SERZONE | STRATTERA | WELLBUTRIN | ZOLOFT | ZYBAN
ATOMOXETINE   (Strattera)


                 GOOGLE   SEARCH
         PUBMED   NEWS  ENGINE HITS  GOOGLE AD
        ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO   0      49       593        $0.16
2 WKS AGO   1      47       776        $0.16
LAST WEEK   5      51      1013        $0.14 
THIS WEEK   0      38      1247        $0.06
None.

Go to TOP
BUPROPION  (Wellbutrin, Wellbutrin SR, generic)


                 GOOGLE   SEARCH
         PUBMED   NEWS  ENGINE HITS  GOOGLE AD
        ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO   4      24      5656        $1.61
2 WKS AGO   5      23      5588        $1.50
LAST WEEK   1      36      5547        $1.71 
THIS WEEK   3      44      5514        $1.52
Vaillancourt R, Wagenaar H, Fisher C, Conway RD, Plemel J.
A retrospective survey of the use of bupropion slow release by members of the Canadian Armed Forces.
Can J Clin Pharmacol. 2002 Winter;9(4):205-13.   [PubMed]

Curry SJ, Ludman EJ, McClure J.
Self-administered treatment for smoking cessation.
J Clin Psychol. 2003 Mar;59(3):305-19.   [PubMed]

Go to TOP
CITALOPRAM  (Celexa)


                 GOOGLE   SEARCH
         PUBMED   NEWS  ENGINE HITS  GOOGLE AD
        ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO   1      21      5187        $0.96
2 WKS AGO   4      14      5015        $0.81
LAST WEEK   1      18      4818        $0.70 
THIS WEEK   7      17      4656        $0.21
Atmaca M, Kuloglu M, Tezcan E, Ustundag B, Semercioz A.
Serum leptin levels in patients with premature ejaculation before and after citalopram treatment.
BJU Int. 2003 Feb;91(3):252-4.   [PubMed]

Varty GB, Cohen-Williams ME, Hunter JC.
The antidepressant-like effects of neurokinin NK1 receptor antagonists in a gerbil tail suspension test.
Behav Pharmacol. 2003 Feb;14(1):87-95.   [PubMed]

Anderer P, Saletu B, Semlitsch HV, Pascual-Marqui RD.
Perceptual and cognitive event-related potentials in neuropsychopharmacology: methodological aspects and clinical applications (pharmaco-ERP topography and tomography).
Methods Find Exp Clin Pharmacol. 2002;24 Suppl C:121-37.   [PubMed]

Saletu B, Anderer P, Saletu-Zyhlarz GM, Arnold O, Pascual-Marqui RD.
Classification and evaluation of the pharmacodynamics of psychotropic drugs by single-lead pharmaco-EEG, EEG mapping and tomography (LORETA).
Methods Find Exp Clin Pharmacol. 2002;24 Suppl C:97-120.   [PubMed]

Anderer P, Saletu B, Semlitsch HV, Pascual-Marqui RD.
Structural and energetic processes related to P300: LORETA findings in depression and effects of antidepressant drugs.
Methods Find Exp Clin Pharmacol. 2002;24 Suppl D:85-91.[PubMed]

Go to TOP
DULOXETINE  (Cymbalta) (not yet released)


                 GOOGLE   SEARCH
         PUBMED   NEWS  ENGINE HITS  GOOGLE AD
        ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO   0      30       106        $0.05
2 WKS AGO   1      30       105        $0.05
LAST WEEK   0      32       109        $0.05 
THIS WEEK   0      16       117        $0.05
None.

Go to TOP
ESCITALOPRAM  (Lexapro)


                 GOOGLE   SEARCH
         PUBMED   NEWS  ENGINE HITS  GOOGLE AD
        ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO   1      15      7203        $0.16
2 WKS AGO   0      10      7519        $0.13
LAST WEEK   0      14      7754        $0.15 
THIS WEEK   0       6      7899        $0.13
None.

Go to TOP
FLUOXETINE  (Prozac, Prozac Weekly, Sarafem, generic)


                 GOOGLE   SEARCH
         PUBMED   NEWS  ENGINE HITS  GOOGLE AD
        ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO   9     479      3503        $3.08
2 WKS AGO   4     355      3460        $3.00
LAST WEEK   8     374      3429        $3.22 
THIS WEEK   5     318      3405        $3.18
Kalgutkar AS, Taylor TJ, Venkatakrishnan K, Isin EM.
Assessment of the Contributions of CYP3A4 and CYP3A5 in the Metabolism of the Antipsychotic Agent Haloperidol to Its Potentially Neurotoxic Pyridinium Metabolite and Effect of Antidepressants on the Bioactivation Pathway.
Drug Metab Dispos. 2003 Mar 1;31(3):243-249.   [PubMed]

Varty GB, Cohen-Williams ME, Hunter JC.
The antidepressant-like effects of neurokinin NK1 receptor antagonists in a gerbil tail suspension test.
Behav Pharmacol. 2003 Feb;14(1):87-95.   [PubMed]

Go to TOP
FLUVOXAMINE  (Luvox, generic)


                 GOOGLE   SEARCH
         PUBMED   NEWS  ENGINE HITS  GOOGLE AD
        ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO   1       6       537        $0.08
2 WKS AGO   1       4       519        $0.07
LAST WEEK   1      29       486        $0.08 
THIS WEEK   1      29       480        $0.15
Kalgutkar AS, Taylor TJ, Venkatakrishnan K, Isin EM.
Assessment of the Contributions of CYP3A4 and CYP3A5 in the Metabolism of the Antipsychotic Agent Haloperidol to Its Potentially Neurotoxic Pyridinium Metabolite and Effect of Antidepressants on the Bioactivation Pathway.
Drug Metab Dispos. 2003 Mar 1;31(3):243-249.   [PubMed]

Go to TOP
MIRTAZAPINE  (Remeron, Remeron Soltabs, generic)


                 GOOGLE   SEARCH
         PUBMED   NEWS  ENGINE HITS  GOOGLE AD
        ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO   0       9      1612        $0.10
2 WKS AGO   4      11      1593        $0.06
LAST WEEK   3      13      1593        $0.12 
THIS WEEK   0      24      1605        $0.11
None.

Go to TOP
NEFAZODONE  (Serzone, generic)


                 GOOGLE   SEARCH
         PUBMED   NEWS  ENGINE HITS  GOOGLE AD
        ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO   1      21       753        $3.84
2 WKS AGO   0      18       736        $4.22
LAST WEEK   1       5       710        $1.52 
THIS WEEK   2       4       657        $3.58
Kalgutkar AS, Taylor TJ, Venkatakrishnan K, Isin EM.
Assessment of the Contributions of CYP3A4 and CYP3A5 in the Metabolism of the Antipsychotic Agent Haloperidol to Its Potentially Neurotoxic Pyridinium Metabolite and Effect of Antidepressants on the Bioactivation Pathway.
Drug Metab Dispos. 2003 Mar 1;31(3):243-249.   [PubMed]

Varty GB, Cohen-Williams ME, Hunter JC.
The antidepressant-like effects of neurokinin NK1 receptor antagonists in a gerbil tail suspension test.
Behav Pharmacol. 2003 Feb;14(1):87-95.   [PubMed]

Go to TOP
PAROXETINE  (Paxil, Paxil CR)


                 GOOGLE   SEARCH
         PUBMED   NEWS  ENGINE HITS  GOOGLE AD
        ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO   5     258      7419        $1.72
2 WKS AGO   4     145      7272        $1.41
LAST WEEK   3     184      7170        $0.67 
THIS WEEK   6     242      7100        $0.70
Bertelsen KM, Venkatakrishnan K, Von Moltke LL, Obach RS, Greenblatt DJ.
Apparent Mechanism-based Inhibition of Human CYP2D6 in Vitro by Paroxetine: Comparison with Fluoxetine and Quinidine.
Drug Metab Dispos. 2003 Mar 1;31(3):289-293.   [PubMed]

Duggal HS.
Paroxetine-induced limb anesthesia.
Gen Hosp Psychiatry. 2003 Jan-Feb;25(1):51-2. No abstract available.   [PubMed]

Sullivan MD, Katon WJ, Russo JE, Frank E, Barrett JE, Oxman TE, Williams JW Jr.
Patient beliefs predict response to paroxetine among primary care patients with dysthymia and minor depression.
J Am Board Fam Pract. 2003 Jan-Feb;16(1):22-31.   [PubMed]

Fernandez F, Sarre S, Launay JM, Aguerre S, Guyonnet-Duperat V, Moisan MP, Ebinger G, Michotte Y, Mormede P, Chaouloff F.
Rat strain differences in peripheral and central serotonin transporter protein expression and function.
Eur J Neurosci. 2003 Feb;17(3):494-506.   [PubMed]

Varty GB, Cohen-Williams ME, Hunter JC.
The antidepressant-like effects of neurokinin NK1 receptor antagonists in a gerbil tail suspension test.
Behav Pharmacol. 2003 Feb;14(1):87-95.   [PubMed]

Melke J, Westberg L, Landen M, Sundblad C, Eriksson O, Baghei F, Rosmond R, Eriksson E, Ekman A.
Serotonin transporter gene polymorphisms and platelet [(3)H] paroxetine binding in premenstrual dysphoria.
Psychoneuroendocrinology. 2003 Apr;28(3):446-58.   [PubMed]

Go to TOP
SERTRALINE  (Zoloft)


                 GOOGLE   SEARCH
         PUBMED   NEWS  ENGINE HITS  GOOGLE AD
        ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO   2      82      5528        $1.44
2 WKS AGO   3      82      5478        $1.22
LAST WEEK   3      85      5443        $1.15 
THIS WEEK   1      70      5487        $2.48
Varty GB, Cohen-Williams ME, Hunter JC.
The antidepressant-like effects of neurokinin NK1 receptor antagonists in a gerbil tail suspension test.
Behav Pharmacol. 2003 Feb;14(1):87-95.   [PubMed]

Go to TOP
VENLAFAXINE  (Effexor, Effexor XR)


                 GOOGLE   SEARCH
         PUBMED   NEWS  ENGINE HITS  GOOGLE AD
        ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO   0       5      5441        $3.91
2 WKS AGO   9      61      5382        $3.97
LAST WEEK   2      64      5358        $0.23 
THIS WEEK   2      91      5280        $0.17
Varty GB, Cohen-Williams ME, Hunter JC.
The antidepressant-like effects of neurokinin NK1 receptor antagonists in a gerbil tail suspension test.
Behav Pharmacol. 2003 Feb;14(1):87-95.    [PubMed]

Go to TOP

COMMENTARY:   

   • • •  The interest in Strattera continues to climb, while Lexapro continues to be the number one searched antidepessant. Searches for Serzone continue to plummet, as folks decide the concerns about liver problems aren't worth it. Even the lawyers are losing interest, as Google has only 2 sponsored attorney links today (where it used to be 8 or more).

   • • •   Anxiety about terrorism is the latest national angst. Newsweek has a cover story on it this week.

   • • •   So far, the poll results (see below) indicate folks are primarily interested in side effects of medications. Once the meds are approved by the FDA, the assumption is that they work. Figuring out which ones have which side effects is a whole 'nother ball of wax. The package insert is a good starting point, but they list every side effect under the sun. The handout from the pharmacist is a briefer version. The PubMed articles can help, but aren't easily reviewed. What I have in mind is a side-by-side review of each of the medications, listed by side effect. Say, you don't want to take a chance of gaining weight. You look at the Weight Gain page and see the antidepressants listed in rank order of their risks of weight gain. Or, you want a med which makes you sleepy, so you look at the Sedation page for the drug which is most likely to make you sleepy. You get the idea. Let me know if you think this would be useful. The data would mostly come from package inserts and large studies, I think.


HIGHLIGHTS OF THE WEEK

NEW CLASS OF ANTIDEPRESSANT
Neurokinin (NK1, also referred to as Substance P) antagonists are among the latest chemicals to be identified with antidepressant properties. They also reduce nausea and vomiting. The usual animal models (rats and mice) don't work as well for these drugs because their receptors are too different from ours. This paper shows that gerbils work well in this regard, showing that the NK1 antagonists acted just like a number of known antidepressants. You may want to keep tabs on some of these drugs, which include aprepitant (MK-869); L-742,694; L-733,060; CP-99,994; and CP-122,721.
REVIEW OF ZYBAN SIDE EFFECTS
Surveyed 357 members of the Canadian Armed Forces who took bupropion for smoking cessation. 47% were smoke-free for an average of 6 months. 70% reported side effects, and 12% saw a doctor due to side effects. The abstract does not list the types of side effects.
CELEXA REDUCES LEPTIN IN SEXUAL DYSFUNCTION
I don't really get this, but it has some implications for weight gain. Leptin is a hormone that has many functions, including weight regulation and sexual function. This study showed that men with premature ejaculation treated with citalopram had lower leptin levels than those on placebo.
PAXIL RESPONSE TIED TO BELIEFS
333 people with dysthymia (chronic, minor depression) received either paroxetine or placebo. Folks who believed less in the biological basis of depression were more than 3 times more likely to achieve remission on Paxil than those who believed their depression was biological. These beliefs did not affect response to placebo.

LETTERS TO THE EDITOR

Selected letters to the editor will be published here. Selection factors include conciseness, broad appeal, and originality. Name will be included unless signed "Anonymous". Comments, questions, and observations on research articles, news items, top 10 lists, surveys, and other letters are preferred. Letters may be edited for clarity and brevity.

Send letters to: editor@psychopharminfo.com

10% of the proceeds from this newsletter are donated to the National Alliance for the Mentally Ill (NAMI).


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