drdaviss@psychopharminfo.com
www.psychopharmINFO.com
Newsletter
Number 12
Monday, April 28, 2003
PPI Index: 88.2 (+1.2%)
Copyright 2003 by Steven R. Daviss
There was no issue last week, so this one is bigger, catching you up on the last two weeks of new journal articles and news. /// Lots of items in the SIDE EFFECTS & INTERACTIONS section. /// A record number of HIGHLIGHTS articles, including a detailed discussion of liver CYtochrome P450 (CYP450) enzyme drug interactions, as well as effects of Wellbutrin on neurotransmitters, treating post-stroke depression, Prozac in pregnancy and lactation, Remeron side effects, a head-to-head study of Remeron and Paxil, overdose data, Effexor for neuropathy, and even something about what happens to all that Prozac that people flush down the toilet. /// In the TOP 10 SEARCHES, Strattera has passed Celexa in number of searches to rank #6 now, but its ascent may be starting to slow down. /// In the TOP 10 NEWS, there was a huge increase in news items mentioning many of the medications. I think this is primarily due to the release of quarterly earnings statements from the drug companies, as many of these articles are financial. Cymbalta and Strattera are new entries in the TOP 10, pushing out Wellbutrin and Serzone. /// Finally, Janssen just released a "Dear Doctor" letter about Risperdal and strokes. In elderly folks getting risperidone for dementia-related psychosis, there was a significantly higher incidence of strokes and transient ischemic attacks (TIAs) in those getting the drug versus those getting placebo. The actual numbers are pretty small, but I've asked Janssen to send me the actual data so I can provide more specific information. As always, discuss any concerns with your personal physician before making any changes to your medications.
See you next week. =Steve
(by number of hits; (#)=position last week)
Hits #
1. Prozac 403 (1)
2. Paxil 221 (2)
3. Zoloft 101 (4)
4. Strattera 61 (-)
5. Celexa 60 (7)
6. Effexor 59 (10)
7. Lexapro 57 (9)
8. Emend 36 (3)
9. Remeron 20 (8)
10. Cymbalta 20 (-)
*Only meds tracked by PsychopharmINFO
TOP 10 SEARCHES FOR MEDICATIONS*
(by search hits; %=change from last week, as per WordTracker**)
Hits %
1. Lexapro 7469 -3
2. Paxil 5804 -4
3. Effexor 4940 -2
4. Zoloft 4522 -6
5. Wellbutrin 4512 -20
6. Strattera 3449 +1
7. Celexa 3266 -5
8. Prozac 2849 -2
9. Remeron 1486 -4
10. Serzone 597 -6
*Only meds tracked by PsychopharmINFO- SIDE EFFECTS & INTERACTIONS
- • CARDIAC
- -bupropion
- citalopram
- -venlafaxine
- • LOW SODIUM/HYPONATREMIA
- -citalopram
- • SEIZURES
- -citalopram
- -venlafaxine
- • RESPIRATORY
- -citalopram
- • KIDNEY
- -citalopram
- • ELDERLY
- -citalopram
- • NAUSEA/DIARRHEA
- -citalopram
- • SWEATING
- -citalopram
- • HEADACHE
- -citalopram
- • PREGNANCY
- -fluoxetine
- • REVIEW
- -mirtazapine
- • LIVER/PANCREAS
- -nefazodone
- • BLOOD COUNTS
- -paroxetine
- • NERVOUS SYSTEM
- -sertraline
- • COGNITION
- -sertraline
- • SEROTONIN SYNDROME
- -venlafaxine/SSRIs
- • INTERACTIONS
- -CYP2D6+SSRIs
- -CYP2D6
- -FLUOXETINE+MOTHER NATURE
- -FLUVOXAMINE+ALPRAZOLAM/XANAX
- -FLUVOXAMINE+2C19
Go To: | CELEXA | CYMBALTA | EFFEXOR | EMEND | LEXAPRO | LUVOX | PAXIL | PROZAC | REMERON | SARAFEM | SERZONE | STRATTERA | WELLBUTRIN | ZOLOFT | ZYBAN
APREPITANT (Emend)
GOOGLE SEARCH
PUBMED NEWS ENGINE HITS GOOGLE AD
ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO 0 87 10 $0.05
2 WKS AGO 0 86 36 $0.05
LAST WEEK 1 87 37 $0.05
THIS WEEK 1 36 43 $0.05
Chawla SP, Grunberg SM, Gralla RJ, Hesketh PJ, Rittenberg C, Elmer ME, Schmidt C, Taylor A, Carides AD, Evans JK, Horgan KJ.Establishing the dose of the oral NK1 antagonist aprepitant for the prevention of chemotherapy-induced nausea and vomiting.
Cancer. 2003 May 1;97(9):2290-300. [PubMed]
ATOMOXETINE (Strattera)
GOOGLE SEARCH
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ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO 0 5 2665 $0.78
2 WKS AGO 4 3 3258 $0.77
LAST WEEK 0 2 3422 $0.17
THIS WEEK 0 61 3449 $0.14
None.
BUPROPION (Wellbutrin, Wellbutrin SR, generic)
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ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO 3 17 4940 $1.69
2 WKS AGO 3 20 4590 $0.81
LAST WEEK 7 20 5673 $1.07
THIS WEEK 2 17 4512 $0.97
Cryan JF, Bruijnzeel AW, Skjei KL, Markou A.Bupropion enhances brain reward function and reverses the affective and somatic aspects of nicotine withdrawal in the rat.
Psychopharmacology (Berl). 2003 Apr 16 [epub ahead of print] [PubMed]
Sutherland G.
Smoking: can we really make a difference?
Heart. 2003 May;89 Suppl 2:ii25-7. [PubMed]
Piacentini MF, Clinckers R, Meeusen R, Sarre S, Ebinger G, Michotte Y.
Effect of Bupropion on hippocampal dopamine, serotonin and noradrenaline and on peripheral hormonal concentrations in the rat: an in vivo study.
J Appl Physiol. 2003 Apr 11 [epub ahead of print] [PubMed]
Inoue T, Kitaichi Y, Koyama T.
[Treatment strategy of refractory depression and its presynaptic mechanism of action]
Nihon Shinkei Seishin Yakurigaku Zasshi. 2003 Feb;23(1):11-20. Japanese. [PubMed]
Jack LM, Swan GE, Thompson E, Curry SJ, McAfee T, Dacey S, Bergman K.
Bupropion SR and smoking cessation in actual practice: methods for recruitment, screening, and exclusion for a field trial in a managed-care setting.
Prev Med. 2003 May;36(5):585-93. [PubMed]
Wagena E, Zeegers M, Van Schayck C, Wouters E.
Benefits and risks of pharmacological smoking cessation therapies in chronic obstructive pulmonary disease.
Drug Saf. 2003;26(6):381-403. [PubMed]
Yatham LN, Calabrese JR, Kusumakar V.
Bipolar depression: criteria for treatment selection, definition of refractoriness, and treatment options.
Bipolar Disord. 2003 Apr;5(2):85-97. [PubMed]
Cremers B, Schmidt KI, Maack C, Schafers HJ, Bohm M.
Catecholamine release in human heart by bupropion.
Eur J Pharmacol. 2003 Apr 25;467(1-3):169-71. [PubMed]
CITALOPRAM (Celexa)
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ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO 4 14 3731 $0.64
2 WKS AGO 1 11 3380 $0.57
LAST WEEK 6 11 3438 $1.70
THIS WEEK 0 60 3266 $1.87
Holland S, Townley S, Summerfield R.Citalopram - a risk factor for postoperative hyponatraemia.
Anaesthesia. 2003 May;58(5):491-2. No abstract available. [PubMed]
Kelly CA, Upex A, Spencer EP, Flanagan RJ, Bateman DN.
Adult respiratory distress syndrome and renal failure associated with citalopram overdose.
Hum Exp Toxicol. 2003 Feb;22(2):103-5. [PubMed]
Vandel P.
Antidepressant Drugs in the Elderly - Role of the cytochrome P450 2D6.
World J Biol Psychiatry. 2003 Apr;4(2):74-80. [PubMed]
Namerow LB, Thomas P, Bostic JQ, Prince J, Monuteaux MC.
Use of Citalopram in Pervasive Developmental Disorders.
J Dev Behav Pediatr. 2003 Apr;24(2):104-108. [PubMed]
Barak Y, Swartz M, Levy D, Weizman R.
Age-related differences in the side effect profile of citalopram.
Prog Neuropsychopharmacol Biol Psychiatry. 2003 May;27(3):545-8. [PubMed]
DULOXETINE (Cymbalta) (not yet released)
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PUBMED NEWS ENGINE HITS GOOGLE AD
ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO 0 1 126 $0.05
2 WKS AGO 0 2 111 $0.05
LAST WEEK 1 2 117 $0.05
THIS WEEK 1 20 105 $0.05
Fraser MO, Chancellor MB.Neural control of the urethra and development of pharmacotherapy for stress urinary incontinence.
BJU Int. 2003 May;91(8):743-8. [PubMed]
ESCITALOPRAM (Lexapro)
GOOGLE SEARCH
PUBMED NEWS ENGINE HITS GOOGLE AD
ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO 1 7 7777 $0.12
2 WKS AGO 0 9 7502 $0.37
LAST WEEK 0 10 7675 $2.11
THIS WEEK 0 57 7469 $1.32
None.
FLUOXETINE (Prozac, Prozac Weekly, Sarafem, generic)
GOOGLE SEARCH
PUBMED NEWS ENGINE HITS GOOGLE AD
ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO 6 160 3038 $2.68
2 WKS AGO 3 160 2886 $2.82
LAST WEEK 10 305 2917 $1.62
THIS WEEK 4 403 2849 $2.74
Spalletta G, Guida G, Caltagirone C.Is left stroke a risk-factor for selective serotonin reuptake inhibitor antidepressant treatment resistance?
J Neurol. 2003 Apr;250(4):449-55. [PubMed]
Yu YW, Chen TJ, Hong CJ, Chen HM, Tsai SJ.
Association Study of the Interleukin-1beta (C-511T) Genetic Polymorphism with Major Depressive Disorder, Associated Symptomatology, and Antidepressant Response.
Neuropsychopharmacology. 2003 Apr 2 [epub ahead of print] [PubMed]
Miklya I, Knoll J.
Analysis of the effect of (-)-BPAP, a selective enhancer of the impulse propagation mediated release of catecholamines and serotonin in the brain.
Life Sci. 2003 May 9;72(25):2915-21. [PubMed]
Margolis JM, Obach RS.
Impact of Nonspecific Binding to Microsomes and Phospholipid on the Inhibition of Cytochrome P4502D6: Implications for Relating in Vitro Inhibition Data to in Vivo Drug Interactions.
Drug Metab Dispos. 2003 May;31(5):606-11. [PubMed]
Liappas IA, Malitas PN, Dimopoulos NP, Gitsa OE, Liappas AI, Nikolaou CK, Christodoulou GN.
Three cases of zolpidem dependence treated with fluoxetine: the serotonin hypothesis.
World J Biol Psychiatry. 2003 Apr;4(2):93-6. [PubMed]
Vandel P.
Antidepressant Drugs in the Elderly - Role of the cytochrome P450 2D6.
World J Biol Psychiatry. 2003 Apr;4(2):74-80. [PubMed]
Ruggiero GM, Mauri MC, Omboni AC, Volonteri LS, Dipasquale S, Malvini L, Redaelli G, Pasqualinotto L, Cavagnini F.
Nutritional management of anorexic patients with and without fluoxetine: 1-year follow-up.
Prog Neuropsychopharmacol Biol Psychiatry. 2003 May;27(3):425-30. [PubMed]
Brooks BW, Foran CM, Richards SM, Weston J, Turner PK, Stanley JK, Solomon KR, Slattery M, La Point TW.
Aquatic ecotoxicology of fluoxetine.
Toxicol Lett. 2003 May 15;142(3):169-83. [PubMed]
Sheffield RE, Lo Sasso AT, Young CH, Way K.
Selective serotonin reuptake inhibitor usage patterns as risk factors for hospitalization.
Adm Policy Ment Health. 2002 Nov;30(2):121-39. [PubMed]
Pearlstein T, Joliat MJ, Brown EB, Miner CM.
Recurrence of symptoms of premenstrual dysphoric disorder after the cessation of luteal-phase fluoxetine treatment.
Am J Obstet Gynecol. 2003 Apr;188(4):887-95. [PubMed]
Heikkinen T, Ekblad U, Palo P, Laine K.
Pharmacokinetics of fluoxetine and norfluoxetine in pregnancy and lactation.
Clin Pharmacol Ther. 2003 Apr;73(4):330-7. [PubMed]
[No authors listed]
Treatment for Adolescents With Depression Study (TADS): Rationale, Design, and Methods.
J Am Acad Child Adolesc Psychiatry. 2003 May;42(5):531-542. [PubMed]
Silva RC, Santos NR, Brandao ML.
Influence of housing conditions on the effects of serotonergic drugs on feeding behavior in non-deprived rats.
Neuropsychobiology. 2003;47(2):98-101. [PubMed]
FLUVOXAMINE (Luvox, generic)
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ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO 5 1 436 $0.12
2 WKS AGO 0 2 433 $0.06
LAST WEEK 4 3 434 $0.12
THIS WEEK 2 5 407 $0.12
Suzuki Y, Shioiri T, Muratake T, Kawashima Y, Sato S, Hagiwara M, Inoue Y, Shimoda K, Someya T.Effects of concomitant fluvoxamine on the metabolism of alprazolam in Japanese psychiatric patients: interaction with CYP2C19 mutated alleles.
Eur J Clin Pharmacol. 2003 Apr;58(12):829-33. [PubMed]
Yao C, Kunze KL, Trager WF, Kharasch ED, Levy RH.
Comparison of In Vitro and In Vivo Inhibition Potencies of Fluvoxamine toward CYP2C19.
Drug Metab Dispos. 2003 May;31(5):565-71. [PubMed]
Suhara T, Takano A, Sudo Y, Ichimiya T, Inoue M, Yasuno F, Ikoma Y, Okubo Y.
High levels of serotonin transporter occupancy with low-dose clomipramine in comparative occupancy study with fluvoxamine using positron emission tomography.
Arch Gen Psychiatry. 2003 Apr;60(4):386-91. [PubMed]
Vandel P.
Antidepressant Drugs in the Elderly - Role of the cytochrome P450 2D6.
World J Biol Psychiatry. 2003 Apr;4(2):74-80. [PubMed]
Martin A, Koenig K, Anderson GM, Scahill L.
Low-dose fluvoxamine treatment of children and adolescents with pervasive developmental disorders: a prospective, open-label study.
J Autism Dev Disord. 2003 Feb;33(1):77-85. [PubMed]
Katayama Y, Usuda K, Nishiyama Y, Katsura K.
[Post-stroke depression]
Nippon Ronen Igakkai Zasshi. 2003 Mar;40(2):127-9. Japanese. [PubMed]
MIRTAZAPINE (Remeron, Remeron Soltabs, generic)
GOOGLE SEARCH
PUBMED NEWS ENGINE HITS GOOGLE AD
ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO 2 10 1519 $0.16
2 WKS AGO 0 11 1502 $0.06
LAST WEEK 1 21 1544 $0.18
THIS WEEK 1 20 1486 $0.09
Biswas PN, Wilton LV, Shakir SA.The pharmacovigilance of mirtazapine: results of a prescription event monitoring study on 13554 patients in England.
J Psychopharmacol. 2003 Mar;17(1):121-6. [PubMed]
Wade A, Crawford GM, Angus M, Wilson R, Hamilton L.
A randomized, double-blind, 24-week study comparing the efficacy and tolerability of mirtazapine and paroxetine in depressed patients in primary care.
Int Clin Psychopharmacol. 2003 May;18(3):133-41. [PubMed]
NEFAZODONE (Serzone, generic)
GOOGLE SEARCH
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ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO 0 30 650 $4.60
2 WKS AGO 1 26 616 $4.80
LAST WEEK 1 1 637 $4.12
THIS WEEK 1 1 597 $4.20
Edwards IR.Withdrawing drugs: nefazodone, the start of the latest saga.
Lancet. 2003 Apr 12;361(9365):1240. No abstract available. [PubMed]
Spigset O, Hagg S, Bate A.
Hepatic injury and pancreatitis during treatment with serotonin reuptake inhibitors: data from the World Health Organization (WHO) database of adverse drug reactions.
Int Clin Psychopharmacol. 2003 May;18(3):157-61. [PubMed]
PAROXETINE (Paxil, Paxil CR)
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ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO 6 74 6232 $0.70
2 WKS AGO 1 60 5954 $2.07
LAST WEEK 2 208 6074 $1.52
THIS WEEK 3 221 5804 $1.95
Sheffield RE, Lo Sasso AT, Young CH, Way K.
Selective serotonin reuptake inhibitor usage patterns as risk factors for hospitalization.
Adm Policy Ment Health. 2002 Nov;30(2):121-39. [PubMed]
Wade A, Crawford GM, Angus M, Wilson R, Hamilton L.
A randomized, double-blind, 24-week study comparing the efficacy and tolerability of mirtazapine and paroxetine in depressed patients in primary care.
Int Clin Psychopharmacol. 2003 May;18(3):133-41. [PubMed]
Lederbogen F, Horer E, Hellweg R, Heuser I, Deuschle M.
Platelet counts in depressed patients treated with amitriptyline or paroxetine.
Eur Psychiatry. 2003 Mar;18(2):89-91. [PubMed]
Jureidini J, Tonkin A, Keller MB, Ryan ND, Strober M, Weller EB, McCafferty JP, Hagino OR, Birmaher B, Wagner KD.
Paroxetine in major depression.
J Am Acad Child Adolesc Psychiatry. 2003 May;42(5):514-5. No abstract available. [PubMed]
SERTRALINE (Zoloft)
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ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO 2 71 5006 $0.72
2 WKS AGO 2 57 4688 $0.92
LAST WEEK 5 77 4793 $1.17
THIS WEEK 1 101 4522 $1.09
Spalletta G, Guida G, Caltagirone C.Is left stroke a risk-factor for selective serotonin reuptake inhibitor antidepressant treatment resistance?
J Neurol. 2003 Apr;250(4):449-55. [PubMed]
Siepmann M, Grossmann J, Muck-Weymann M, Kirch W.
Effects of sertraline on autonomic and cognitive functions in healthy volunteers.
Psychopharmacology (Berl). 2003 Apr 12 [epub ahead of print] [PubMed]
Baca E, Gonzalez de Chavez M, Garci;a-Toro M, Perez-Arnau F, Porras-Chavarino A.
Sertraline is more effective than imipramine in the treatment of non-melancholic depression: Results from a multicentre, randomized study.
Prog Neuropsychopharmacol Biol Psychiatry. 2003 May;27(3):493-500. [PubMed]
Mulholland C, Lynch G, King DJ, Cooper SJ.
A double-blind, placebo-controlled trial of sertraline for depressive symptoms in patients with stable, chronic schizophrenia.
J Psychopharmacol. 2003 Mar;17(1):107-12. [PubMed]
Sheffield RE, Lo Sasso AT, Young CH, Way K.
Selective serotonin reuptake inhibitor usage patterns as risk factors for hospitalization.
Adm Policy Ment Health. 2002 Nov;30(2):121-39. [PubMed]
Khouzam HR, Emes R, Gill T, Raroque R.
The antidepressant sertraline: a review of its uses in a range of psychiatric and medical conditions.
Compr Ther. 2003 Spring;29(1):47-53. [PubMed]
VENLAFAXINE (Effexor, Effexor XR)
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ARTICLES ITEMS (WORDTRACKER) ($/CLICK)
3 WKS AGO 4 8 5073 $0.18
2 WKS AGO 0 7 4958 $0.15
LAST WEEK 0 8 5069 $0.35
THIS WEEK 5 59 4940 $0.32
Spigset O, Hagg S, Bate A.Hepatic injury and pancreatitis during treatment with serotonin reuptake inhibitors: data from the World Health Organization (WHO) database of adverse drug reactions.
Int Clin Psychopharmacol. 2003 May;18(3):157-61. [PubMed]
Whyte IM, Dawson AH, Buckley NA.
Relative toxicity of venlafaxine and selective serotonin reuptake inhibitors in overdose compared to tricyclic antidepressants.
QJM. 2003 May;96(5):369-374. [PubMed]
[No authors listed]
Venlafaxine: Not yet first in the antidepressant class.
Harv Ment Health Lett. 2003 Apr;19(10):5-7. No abstract available. [PubMed]
Malek-Ahmadi P.
Gabapentin and posttraumatic stress disorder.
Ann Pharmacother. 2003 May;37(5):664-6. [PubMed]
Sindrup SH, Bach FW, Madsen C, Gram LF, Jensen TS.
Venlafaxine versus imipramine in painful polyneuropathy: A randomized, controlled trial.
Neurology. 2003 Apr 22;60(8):1284-9. [PubMed]
- CYP450 DRUG INTERACTIONS IN THE ELDERLY
- Looks like a good review of this topic, using fluoxetine, fluvoxamine, and citalopram as examples.
- PREDICTING CYP450 DRUG INTERACTIONS FROM LAB STUDIES
- This may be rather esoteric for most, but it has implications for translating in vitro (in the lab) data into in vivo (real people) situations. This is how these liver enzyme drug interactions are determined: (1) make a bunch of tiny fat pellets ("microsomes") each containing one specific P450 enzyme (such as 2D6, 2C19, or 3A4); (2) add different concentrations of your study drug to each of the separate batches of P450 microsomes; (3) add a given concentration of a drug ("substrate") which is known to be broken down by that enzyme (eg, 2D6=dextromethorphan, 3A4=codeine; (4) measure the final concentrations of the substrate that are left after a given period of time. The more a study drug inhibits the enzyme, the more substrate that will be left at the end. The study drug concentration that inhibits 50% of the enzyme present is called the IC50. Well, this study shows that not only is the IC50 dependent on the degree of inhibition that the study drug has, it is also dependent on the microsome concentration. When empty microsomes (those containing no enzyme, just fat) are added, the IC50 was affected, because the study drug binds to the empty microsomes (so-called "nonspecific binding"). Therefore, many previous studies may need to be reinterpreted based on this new finding. In the end, in vivo experience is the ultimate test to see if there are P450 interactions between two drugs.
- LUVOX + XANAX
- Found that fluvoxamine can more than double the blood level of alprazolam, and that this effect is partly related to one's CYP 2C19 genotype (yes, another one of those P450 enzymes).
- LUVOX 2C19 INHIBITION: IN VITRO vs IN VIVO
- As if on cue, this study appears to connect the above two articles. They compared the IC50 (actually, the Ki, which is pretty much the same thing) in vitro vs in vivo, taking into account the effect of nonspecific binding. They found that 2C19 inhibition was 40 times greater in real people than in the test tube. So, as you read about other P450 studies, look to see if it's in vivo and if they control for nonspecific binding.
- CELEXA SIDE EFFECTS IN ELDERLY
- Reviews the FDA database of 1344 people on citalopram for age-related side effects. There was one symptom which occured more in the elderly: slow heart beat (bradycardia); and 4 symptoms which occured less often: nausea, diarrhea, sweating, headache.
- POST-STROKE DEPRESSION
- We already know that a left-brain stroke is more likely to cause major depression than a right-sided one. This study of 45 people confirmed this finding (left=50% w/depression; right=16% w/depression). They suggest that a left-brain stroke is also more likely to be resistant to treatment with SSRIs (though, from the abstract, I don't see that they actually treated anyone other than a single dose of Prozac or Zoloft). Another study confirmed the finding about left-brain strokes being at higher risk for depression, but found that fluvoxamine/Luvox was effective for treatment.
- WELLBUTRIN INCREASES NEUROTRANSMITTERS
- Animal study where one dose of bupropion was given, and the brain (hippocampus) levels of dopamine, norepinephrine, and serotonin were measured over the course of 3 hours. All neurotransmitter levels increased. Prolactin also went down; anything which increases dopamine will decrease prolactin, confirming bupropion's effect on dopamine. Most human studies have not found an effect of bupropion on prolactin, but these small studies are 20+ years old.
- PROZAC-TAINTED LAKES, RIVERS & STREAMS
- Fluoxetine has been found in low levels in wastewater which is discharged into natural bodies of water. This article addresses the potential of damage to the organisms living there. While they did not find toxic effects in Japanese ricefish, they suggest further work is needed to determine if low-level exposure has any behavioral effects. Hmm, wonder what its effect on Japanese fighting fish would be?
- PROZAC IN PREGNANCY
- Looked at 11 women and measured blood levels of fluoxetine and its active metabolite, norfluoxetine, in them and their babies. The drug was metabolized faster than normal, and its concentration in the newborns at delivery was about two-thirds that of the mother. In breast milk, the babies would get 2-4% of the mothers' daily dose. There were no developmental abnormalities found in the babies.
- REMERON SIDE EFFECTS
- Surveyed primary care doctors in England using prescription data on over 13,000 people, asking them if they noticed any side effects possibly from mirtazapine. Sedation and fatigue were the most common side effects. Keep in mind, this is an uncontrolled, retrospective survey, so it is affected by "recall bias".
- REMERON VS PAXIL
- Double-blind trial in primary care depression comparing mirtazapine with paroxetine. Both were effective, but Remeron worked faster and caused more fatigue. Paxil caused more sweating, headache and nausea.
- SSRI AND EFFEXOR OVERDOSES
- Six years of Australian overdose data were reviewed, concluding that, after intentional overdoses: (1) tricyclics cause more coma; (2) venlafaxine causes more seizures (14% of cases); (3) SSRIs are less likely to prolong the QRS interval on EKG; (4) and that both SSRIs and venlafaxine are more likely to cause serotonin toxicity in overdose.
- EFFEXOR FOR NEUROPATHY
- Antidepressants are often used to treat painful neuropathy, the most common being amitriptyline/Elavil and imipramine/Tofranil. This is a well-controlled study in 40 people, finding that Effexor worked as well as imipramine for this condition.
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