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Silvia Scabini, Mattia Trunfio, Veronica Pirriatore, Daniele Imperiale, Sabrina Audagnotto, Roberto Bertucci, Valeria Ghisetti, Giacoma Cinnirella, Angelina Cistaro, Mariaelena Perna, Andrea Calcagno, Giovanni Di Perri
A case of progressive multifocal leukoencephalopathy (PML) is described in an HIV-negative patient with mixed connective-tissue disease (MCTD) on a minimally immunosuppressive treatment with hydroxychloroquine. The patient presented with right-sided weakness, episodes of disorientation and loss of short-term memory and of vision in her right eye. PML was diagnosed by JCV DNA on cerebrospinal fluid and radiological criteria. She was treated with off-label maraviroc and mirtazapine but died two months after hospital admission, despite a surprising decrease in the viral load of cerebrospinal fluid three weeks after starting therapy...
June 1, 2018: Le Infezioni in Medicina
Mario Gennaro Mazza, Aurora Rossetti, Eugenia Rossana Botti, Massimo Clerici
RATIONALE: Vortioxetine is a new multimodal antidepressant approved by the Food and Drug Administration for the treatment of Major Depressive Disorder and recently introduced in Europe. While antidepressant properties of vortioxetine and its tolerability have been demonstrated by preclinical and clinical studies data on the safety of vortioxetine after overdose are still lacking. PATIENT CONCERNS: A 50-year-old Caucasian man presenting a severe depressive episode that in a suicide attempt he took vortioxetine at 250 mg...
June 2018: Medicine (Baltimore)
Tomasz Zaprutko, Robert Göder, Krzysztof Kus, Wiktor Pałys, Filip Rybakowski, Elżbieta Nowakowska
Depression is a global health problem associated with a significant public health burden and costs. Although studies on costs of diseases are being considered as an increasingly important factor for health policies, information concerning costs of inpatient care of depression is still insufficient. Thus, the main aim of this study was to evaluate costs of hospitalization of patients treated in 2016 in psychiatric clinics in Poznan (Poland) and in Kiel (Germany) and to analyze treatment used in these centers...
2018: PloS One
Michael Y Guo, Mahyar Etminan, Ric M Procyshyn, David D Kim, Ali Samii, Abbas Kezouh, Bruce C Carleton
BACKGROUND: Antidepressants are one of the most prescribed classes of medications. A number of case reports have linked these drugs to extrapyramidal symptoms (EPSs), but no large epidemiologic study to date has examined this association. We sought to quantify the association of EPSs with different antidepressants by undertaking a large pharmacoepidemiologic study. METHODS: A nested case-control study was conducted using a large health claims database in the United States from June 2006 to December 2015...
June 12, 2018: Journal of Clinical Psychopharmacology
Zofia Rogóż, Agnieszka Wąsik, Elzbieta Lorenc-Koci
BACKGROUND: Atypical antipsychotic drugs have some efficacy in alleviating the negative and some cognitive symptoms of schizophrenia but those effects are small and mechanisms of this action are still unknown A few clinical reports have suggested that antidepressants (ADs), are able to augment the activity of atypical antipsychotic drugs. Thus, in the present study, we aimed to evaluate the effect of ADs, escitalopram (ESC) or mirtazapine (MIR) and aripiprazole (an atypical antipsychotic drug) given separately or jointly, on the MK-801-induced positive and cognitive symptoms of schizophrenia in mice...
February 24, 2018: Pharmacological Reports: PR
Shan Xing, Shiyun Kim, Glen T Schumock, Daniel R Touchette, Gregory S Calip, Alex D Leow, Todd A Lee
Objective: Use of second-generation antipsychotics (SGAs) for treatment of depression has increased, and patients with depression and comorbid diabetes or cardiovascular disease are more likely to use SGAs than those without these conditions. We compared SGA and non-SGA depression pharmacotherapies on the risk of diabetes hospitalization or treatment intensification in adults with depression and preexisting diabetes. Methods: This was a retrospective cohort study of US commercially insured adults (2009-2015 Truven MarketScan Commercial Claims and Encounters Database) aged 18-64 years old with type 2 diabetes mellitus and unipolar depression previously treated with a selective serotonin reuptake inhibitor or serotonin-norepinephrine reuptake inhibitor...
May 10, 2018: Primary Care Companion to CNS Disorders
Caroline Ratnam, Emeric Saguin, Symphonie Keou, Julie Plantamura, Coralie Mennessier, Bertrand Lahutte, Hervé Delacour
We report the case of a 40-year-old patient followed for post-traumatic stress disorder. A re-evaluation of its pharmacological treatment with the introduction of mirtazapine (30 mg/day) was associated with a rhabdomyolysis (CK> 20,000 IU/L at day 3). The diagnosis of mirtazapine induced rhabdomyolysis was made. After withdrawal of this drug combined with a symptomatic treatment (hydratation), the patient recovered well and was discharged without any nephrological sequelae. This article is intended to underline the diagnostic approach to elevated CK activity and the potential role of the "medical biologist" as a consultant for the relevant use of biological examinations...
June 1, 2018: Annales de Biologie Clinique
Andreina A Ottman, Carly B Warner, Jamie N Brown
Mirtazapine is commonly used to treat major depressive disorder. Due to its effects on multiple neurotransmitters, it has been investigated for possible benefits in patients with fibromyalgia. The objective of this systematic review is to assess the efficacy and safety of mirtazapine in the treatment of patients with fibromyalgia. Pubmed (1946-May 2018), Embase (1947-May 2018), CENTRAL, and were queried using the search term combination: fibromyalgia, pain, chronic pain, neuralgia, neuropathic pain, chronic widespread pain, or chronic pain syndrome and mirtazapine...
June 2, 2018: Rheumatology International
Pedro Vicente Ferreira Naves, Marcelo Calderaro, Luis Otavio Caboclo
Myoclonic status epilepticus (MSE) in patients without epilepsy, or de novo MSE, is a rare condition associated with several acute symptomatic etiologies, including drugs and toxins. We describe a 94-year-old woman with Alzheimer dementia and long use of mirtazapine 30 mg/d and alprazolam 1 mg/d who developed MSE approximately 24 hours after abrupt discontinuation of alprazolam. The patient was taking sulfamethoxazole/trimethoprim for urinary tract infection, diagnosed 2 weeks before admission. She had no history of seizures...
May 30, 2018: Clinical Neuropharmacology
Luke A Perry, Dhruvesh Ramson, Suzanne Stricklin
BACKGROUND: Many individuals who have a diagnosis of schizophrenia experience a range of distressing and debilitating symptoms. These can include positive symptoms (such as delusions, hallucinations, disorganised speech), cognitive symptoms (such as trouble focusing or paying attention or using information to make decisions), and negative symptoms (such as diminished emotional expression, avolition, alogia, and anhedonia). Antipsychotic drugs are often only partially effective, particularly in treating negative symptoms, indicating the need for additional treatment...
May 26, 2018: Cochrane Database of Systematic Reviews
Åse Marit Leere Øiestad, Ritva Karinen, Sidsel Rogde, Stian Nilsen, Kari-Beate Boye Eldor, Gerd-Wenche Brochmann, Marianne Arnestad, Elisabeth Leere Øiestad, Mariana Dadalto Peres, Lena Kristoffersen, Vigdis Vindenes
Peripheral blood (PB) is considered to be the golden standard for measuring postmortem drug concentrations. In several cases, PB is however not available, but information regarding drug findings might still be crucial in order to determine the cause of death. Antidepressants are frequently detected in postmortem samples from forensic toxicology cases, but the literature investigating concentrations in other matrices than peripheral and heart blood is limited.We here describe a study for comparison of concentrations for a large number of different drugs in six different matrices...
May 14, 2018: Journal of Analytical Toxicology
Kamal Gandotra, Peijun Chen, George E Jaskiw, P Eric Konicki, Kingman P Strohl
No abstract text is available yet for this article.
May 15, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Chittaranjan Andrade
A large number of antidepressant drugs are available across the world. All have been compared against placebo, and many have been compared with some but not all other antidepressants. There is therefore little information about a hierarchy of the efficacy and acceptability of these drugs. About 9 years ago, a network meta-analysis attempted to rank the efficacy and acceptability of 12 newer antidepressant drugs in adults with major depressive disorder. Very recently, this network meta-analysis was updated to include 21 antidepressant drugs, most of which were introduced during the 1980s and afterward...
March 2018: Journal of Clinical Psychiatry
Yumi Akagawa, Akihiro Ueno, Junji Ikeda, Wataru Ishii, Yukiko Shishido-Hara, Yoshiki Sekijima
Patient 1 was a 59-year-old woman receiving prednisolone for idiopathic hypereosinophilia. Brain MRI of patient 1 disclosed slight gadolinium enhancement at lesions, indicating inflammation. Patient 2 was a 32-year-old woman with systemic lupus erythematosus under immunosuppressive therapy. Brain biopsy of patient 2 showed balanced infiltration of CD8+ and CD4+ T lymphocytes at the sites of lesions. Both subjects were diagnosed as having progressive multifocal leukoencephalopathy (PML) shortly after the onset of neurological symptoms and were treated with a combination of mefloquine, mirtazapine, and risperidone...
May 25, 2018: Rinshō Shinkeigaku, Clinical Neurology
Sandra Abou Kassm, Wadih Naja
BACKGROUND: Antidepressant withdrawal manic states are intriguing and under-recognized phenomena. The associated patho-physiological pathways are ill defined and the inclusion of the phenomena in the bipolar spectrum disorders is questionable. This study aims to update a review on antidepressant discontinuation manic states published in 2008 and to look for hints alluding to bipolar disorder in the affected published cases and in the literature. It also reviews the different hypotheses proposed to explain discontinuation mania...
August 1, 2018: Journal of Affective Disorders
Abdulrahman Al-Majed, Ahmed H Bakheit, Raed M Alharbi, Hatem A Abdel Aziz
Mirtazapine is one of antidepression which is used mainly in the treatment of depression, moreover, it is sometimes used in the treatment of anxiety disorders, insomnia, nausea, and vomiting, and to produce weight gain when desirable. The action of mirtazapine is an antagonist of certain adrenergic and serotonin receptors, and, furthermore, the drug is used strong as antihistamine, and it is occasionally defined as a noradrenergic and specific serotonergic antidepressant (NaSSA). The comprehensive profile of mirtazapine gives more detailed information about nomenclature, formulae, elemental analysis, and appearance...
2018: Profiles of Drug Substances, Excipients, and related Methodology
Rei Monden, Annelieke M Roest, Don van Ravenzwaaij, Eric-Jan Wagenmakers, Richard Morey, Klaas J Wardenaar, Peter de Jonge
BACKGROUND: Studies have shown similar efficacy of different antidepressants in the treatment of depression. METHOD: Data of phase-2 and -3 clinical-trials for 16 antidepressants (levomilnacipran, desvenlafaxine, duloxetine, venlafaxine, paroxetine, escitalopram, vortioxetine, mirtazapine, venlafaxine XR, sertraline, fluoxetine, citalopram, paroxetine CR, nefazodone, bupropion, vilazodone), approved by the FDA for the treatment of depression between 1987 and 2016, were extracted from the FDA reviews that were used to evaluate efficacy prior to marketing approval, which are less liable to reporting biases...
August 1, 2018: Journal of Affective Disorders
Faruk Uguz, Keziban Turgut, Adem Aydin, Mehmet Ak
No abstract text is available yet for this article.
April 9, 2018: American Journal of Therapeutics
Anne Bénard-Laribière, Elodie Pambrun, Anne-Laure Sutter-Dallay, Sophie Gautier, Caroline Hurault-Delarue, Christine Damase-Michel, Isabelle Lacroix, Bernard Bégaud, Antoine Pariente
AIMS: We explored the patterns of antidepressant use during pregnancy. METHODS: A cohort of women who started a pregnancy in 2014 was identified using data from the French reimbursement healthcare system (covering approximately 99% of the population). Antidepressant usage (initiated before or during pregnancy) was assessed. Explored changes in antidepressant treatment were: associations, switches, discontinuation and resumption of antidepressants during pregnancy...
April 17, 2018: British Journal of Clinical Pharmacology
G Melo, K L Dutra, R Rodrigues Filho, A O L Ortega, A L Porporatti, B Dick, C Flores-Mir, G De Luca Canto
The purpose of this study was to systematically review the literature for studies that investigated the association between use of psychotropic medications and presence of sleep bruxism (SB). Observational studies were selected in a two-phase process. Searches were performed on six electronic databases, and a grey literature search was conducted on three databases. SB diagnosis was based on questionnaires or clinical examinations; no polysomnography examinations were performed. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies...
July 2018: Journal of Oral Rehabilitation
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