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Harvey J Kliman, Sarah B Quaratella, Alessandra C Setaro, Erin C Siegman, Zarrin T Subha, Reshef Tal, Kristin M Milano, Theodore L Steck
Serotonin [5-hydroxytryptamine (5-HT)] is essential to intrauterine development, but its source is debated. We used immunocytochemistry to gauge 5-HT, its biosynthetic enzyme tryptophan hydroxylase 1 (TPH1); an importer (serotonin transporter, 5-HTT/SERT/SLC6A); other transporters [P-glycoprotein 1 (P-gp/ABCB1), OCT3/SLC22A3, and gap junction connexin-43]; and the 5-HT degradative enzyme monoamine oxidase A (MAOA) in sections of placentas. In humans, 5-HT was faintly stained only in first-trimester trophoblasts, whereas TPH1 was not seen at any stage...
April 1, 2018: Endocrinology
Chris Stubbs, Lisa Mattingly, Steven A Crawford, Elizabeth A Wickersham, Jessica L Brockhaus, Laine H McCarthy
CLINICAL QUESTION: In menopausal women who experience regular hot flashes, does treatment with selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) reduce the frequency and/or severity of hot flashes? ANSWER: Yes. Review of the literature suggests that treatment with SSRIs or SNRIs reduces the frequency and severity of hot flashes in menopausal and post-menopausal women. Studies demonstrated that paroxetine (Paxil), citalopram (Celexa) and escitolapram (Lexapro) were the most effective SSRIs, and venlafaxine (Effexor) was the most effective first line SNRI, with desvenlafaxine as a second option...
May 2017: Journal of the Oklahoma State Medical Association
Caitlyn T Solem, Ahmed Shelbaya, Yin Wan, Chinmay G Deshpande, Jose Alvir, Elizabeth Pappadopulos
BACKGROUND: In major depressive disorder (MDD), treatment persistence is critical to optimize symptom remission, functional recovery, and health care costs. Desvenlafaxine tends to have fewer drug interactions and better tolerability than other MDD drugs; however, its use has not been assessed in the real world. OBJECTIVE: The aim of the present study is to compare medication persistence and concomitant MDD drug use with branded desvenlafaxine (Pristiq(®)) compared with antidepressant drug groups classified as 1) branded selective serotonin reuptake inhibitors (SSRIs; ie, escitalopram [Lexapro™]) and selective serotonin-norepinephrine reuptake inhibitors (SNRIs; ie, venlafaxine [Effexor(®)], duloxetine [Cymbalta(®)]) and 2) generic SSRIs/SNRIs (ie, escitalopram, citalopram, venlafaxine, fluvoxamine, fluoxetine, sertraline, paroxetine, and duloxetine)...
2016: Neuropsychiatric Disease and Treatment
Jon N Jureidini, Jay D Amsterdam, Leemon B McHenry
OBJECTIVE: Deconstruction of a ghostwritten report of a randomized, double-blind, placebo-controlled efficacy and safety trial of citalopram in depressed children and adolescents conducted in the United States. METHODS: Approximately 750 documents from the Celexa and Lexapro Marketing and Sales Practices Litigation: Master Docket 09-MD-2067-(NMG) were deconstructed. RESULTS: The published article contained efficacy and safety data inconsistent with the protocol criteria...
March 16, 2016: International Journal of Risk & Safety in Medicine
Mark A Marzinke, Athena K Petrides, Kimberley Steele, Michael A Schweitzer, Thomas H Magnuson, Shauna P Reinblatt, Janelle W Coughlin, William Clarke
BACKGROUND: There is a high coincidence between obesity and psychiatric disorders including depression. Depressive disorders are commonly treated with antidepressants, including the selective serotonin reuptake inhibitor Lexapro (escitalopram). Although candidates for elective Roux-en-Y gastric bypass (RYGB) surgery may be treated with escitalopram, drug dosing strategies are typically not adjusted postoperatively. Therefore, studies are needed to better characterize escitalopram drug concentrations in a postsurgical setting...
June 2015: Therapeutic Drug Monitoring
Stefanie C Altieri, Hongyan Yang, Hannah J O'Brien, Hannah M Redwine, Damla Senturk, Julie G Hensler, Anne M Andrews
Large numbers of women undergo antidepressant treatment during pregnancy; however, long-term consequences for their offspring remain largely unknown. Rodents exposed to serotonin transporter (SERT)-inhibiting antidepressants during development show changes in adult emotion-like behavior. These changes have been equated with behavioral alterations arising from genetic reductions in SERT. Both models are highly relevant to humans yet they vary in their time frames of SERT disruption. We find that anxiety-related behavior and, importantly, underlying serotonin neurotransmission diverge between the two models...
May 2015: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
Yimin Yu, Huafang Li, Biao Wang, Keqing Li, Xiufeng Xu, Jianguo Shi, Chengge Gao, Qingrong Tan
BACKGROUND: Depression is an increasingly important public health problem in China, but only a small minority of patients with this condition receive treatment. One of the reasons for low treatment rates is the relatively high cost of imported antidepressant medications. AIM: Compare the efficacy and safety of the generic form of the selective serotonin re-uptake inhibitory (SSRI) antidepressant escitalopram to the proprietary form of escitalopram (Lexapro) in the treatment of major depression...
April 2013: Shanghai Archives of Psychiatry
Cassandra M Pugh, Joseph T Sweeney, Christopher P Bloch, Justine A Lee, Justine A Johnson, Lynn R Hovda
OBJECTIVE: To evaluate a population of cats with selective-serotonin reuptake inhibitor (SSRI) toxicosis and characterize the population affected, list products ingested, the clinical signs observed, treatments performed, length of hospitalization, patient outcome, and overall prognosis. DESIGN: Retrospective study from 2004 to 2010. SETTING: Referral veterinary center. ANIMALS: Thirty-three witnessed cat SSRI ingestions...
September 2013: Journal of Veterinary Emergency and Critical Care
Kevin M Wood, Parastoo Hashemi
The treatment of depression with selective serotonin reuptake inhibitors, SSRIs, is important to study on a neurochemical level because of the therapeutic variability experienced by many depressed patients. We employed the rapid temporal capabilities of fast scan cyclic voltammetry at carbon fiber microelectrodes to study the effects of a popular SSRI, escitalopram (ESCIT), marketed as Lexapro, on serotonin in mice. We report novel, dynamic serotonin behavior after acute ESCIT doses, characterized by a rapid increase in stimulated serotonin release and a gradual rise in serotonin clearance over 120 min...
May 15, 2013: ACS Chemical Neuroscience
Eiji Kirino
Escitalopram (escitalopram oxalate; Cipralex(®), Lexapro(®)) is a selective serotonin reuptake inhibitor (SSRI) used for the treatment of major depressive disorder (MDD) and anxiety disorder. This drug exerts a highly selective, potent, and dose-dependent inhibitory effect on the human serotonin transport. By inhibiting the reuptake of serotonin into presynaptic nerve endings, this drug enhances the activity of serotonin in the central nervous system. Escitalopram also has allosteric activity. Moreover, the possibility of interacting with other drugs is considered low...
2012: Patient Preference and Adherence
Michael J Fellner
Two new cases are presented with delusions of parasitosis. Both were women, one middle-aged and one elderly, and exhibited classic symptoms of parasites and "strings" in the skin indicative of Morgellons disease. Each had an additional psychiatric disorder: drug addiction to cocaine and senile dementia. They also illustrate the difficulty encountered by the dermatologist in providing adequate therapy because of resistance to psychiatric referral as well as to standard accepted medication. Newer psychotropics, such as risperdal and lexapro, show promise in helping these patients and add to the therapeutic armamentarium of pimozide...
March 2012: Skinmed
Robert H Howland
Previous reviews have focused on the potential cardiac toxicity of the racemic drug citalopram (Celexa(®)). Evaluating the safety of escitalopram (Lexapro(®)) is an important issue to consider, since it is the S-enantiomer of citalopram. Escitalopram has a small effect on the QTc interval. A prolonged QTc was seen in 2% to 14% of escitalopram overdose cases, without serious cardiac sequelae. The QTc prolongation effect of citalopram in beagle dogs has been attributed to the minor metabolite racemic didemethylcitalopram (DDCT)...
April 2012: Journal of Psychosocial Nursing and Mental Health Services
Eric Q Wu, Andrew P Yu, Veronique Lauzon, Karthik Ramakrishnan, Maryna Marynchenko, Rym Ben-Hamadi, Steven Blum, M Haim Erder
BACKGROUND: To reduce pharmacy costs, managed care organizations encourage therapeutic substitution from brand to a generic product. However, little is known about whether these cost-containment strategies can also potentially lower total expenditures for payers in treatment of major depressive disorder (MDD). OBJECTIVE: To compare economic outcomes of patients with MDD who were switched from a brand selective serotonin reuptake inhibitor (SSRI) to an alternative generic SSRI for nonmedical reasons versus patients who continued on the brand SSRI...
April 2011: Annals of Pharmacotherapy
Karly P Garnock-Jones, Paul L McCormack
Escitalopram (escitalopram oxalate; Cipralex, Lexapro), a selective serotonin reuptake inhibitor (SSRI) indicated for the treatment of major depressive disorder (MDD), demonstrates a highly selective and potent, dose-dependent inhibition of the human serotonin transporter, inhibiting serotonin reuptake into presynaptic nerve terminals and thus increasing serotonergic activity in the CNS. With regard to primary endpoints (such as improved scores on the Montgomery-Asberg Depression Rating Scale [MADRS] and the Hamilton Depression Rating Scale [HAM-D]), escitalopram was generally more effective than placebo, at least as effective as citalopram, and generally at least as effective as other comparator drugs, including the SSRIs fluoxetine, paroxetine and sertraline, the serotonin-noradrenaline (norepinephrine) reuptake inhibitors (SNRIs) venlafaxine extended release and duloxetine, and the aminoketone bupropion in adult patients with MDD in short-term, well designed trials...
September 2010: CNS Drugs
G D Mendes, T Babadopulos, F R Bau, L S Chen, G De Nucci
OBJECTIVE: To assess the bioequivalence of two escitalopram formulations (Test formulation: escitalopram (10 mg tablet) manufactured by Apsen Farmacêutica S.A.) Reference formulation: escitalopram (Lexapro; 10 mg tablet) from Lundbeck Brasil Ltda) in healthy volunteers of both sexes. METHODS: The study was conducted using an open, randomized, two-period crossover design with at least a 21-day washout interval. Plasma samples were obtained over a 168 h period. Plasma escitalopram concentrations were analyzed by liquid chromatography coupled to tandem mass spectrometry (LC-MS-MS) with positive ion electrospray ionization using multiple reaction monitoring (MRM)...
August 2010: International Journal of Clinical Pharmacology and Therapeutics
Michael J Fellner, Muhammad Hassan Majeed
Delusions of parasitosis are usually a monosymptomatic dermatopsychiatric disorder manifested by the fixed false belief that insects are crawling over the body producing an intractable itch. Also known as parasitophobia, this disease can also be associated with other psychiatric disorders, such as schizophrenia or obsessive compulsive disorders. In most cases, the delusion is encapsulated and other mental functions remain intact. Parasitophobia is usually seen in middle-aged women and has proven a vexing problem for dermatologists to treat because patients are often reluctant to obtain a psychiatric consultation and wary of taking antipsychotic or antidepressant medication...
January 2009: Clinics in Dermatology
Luke T Day, Rebecca K Jeanmonod
The serotonin syndrome is a rare toxicological emergency increasingly seen in emergency practice, secondary to increased use of proserotinergic drugs. In this case report, the condition is described in a patient taking the selective serotonin reuptake inhibitor Lexapro and the muscle-relaxant Flexeril. Based on this case, Cyclobenzaprine should be considered on the growing list of medications that can precipitate the serotonin syndrome. With the increasing prevalence of proserotinergic polypharmacy, this uncommon toxidrome should be considered by the alert emergency medicine physician...
November 2008: American Journal of Emergency Medicine
Victor Serebruany, Alex Malinin, Vadim Dragan, Dan Atar, Louis van Zyl, Anatoly Dragan
BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) in general, and citalopram/escitalopram in particular, are widely used to treat clinical depression. However, SSRI bioavailability and non-compliance represent major issues, especially in the clinical trials setting. In this context, frequent drug-level measurements for compliance monitoring would be a desirable tool to improve clinical outcomes with SSRIs. However, the liquid chromatography techniques available are expensive, requiring excessive sample preparation, and suffer from high complexity...
2007: Clinical Chemistry and Laboratory Medicine: CCLM
Sohita Dhillon, Lesley J Scott, Greg L Plosker
Escitalopram (Cipralex, Lexapro, Seroplex, Sipralexa), the therapeutically active S-enantiomer of racemic citalopram (RS-citalopram), is a potent and highly selective serotonin reuptake inhibitor. It is effective and generally well tolerated in the treatment of moderate to severe generalised anxiety disorder (GAD) or social anxiety disorder (SAD), panic disorder (with or without agoraphobia) as well as obsessive-compulsive disorder (OCD). Moreover, escitalopram is at least as effective as paroxetine for the treatment of GAD, SAD or OCD and appears to achieve a more rapid response than racemic citalopram in the management of panic disorder...
2006: CNS Drugs
David Murdoch, Susan J Keam
Escitalopram (Cipralex), Lexapro), the active S-enantiomer of the racemic SSRI citalopram (RS-citalopram), is a highly selective inhibitor of the serotonin transporter protein. It possesses a rapid onset of antidepressant activity, and is an effective and generally well tolerated treatment for moderate-to-severe major depressive disorder (MDD). Pooled analyses from an extensive clinical trial database suggest that escitalopram is consistently more effective than citalopram in moderate-to-severe MDD. Preliminary studies suggest that escitalopram is as effective as other SSRIs and the extended-release (XR) formulation of the serotonin/noradrenaline (norepinephrine) reuptake inhibitor venlafaxine, and may have cost-effectiveness and cost-utility advantages...
2006: CNS Drugs
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