Purpose/Background
Emotional adverse effects due to antidepressant use may cause difficulties for the clinician in the treatment of depression. In this prospective study, the emotional adverse effects of antidepressants were evaluated in various aspects.
Methods/Procedures
Ninety eight patients diagnosed with major depressive disorder were included in the study. At 2nd, 4th, 8th, 12th, and 16th weeks, patients were assessed with Montgomery-Asberg Depression Rating Scale (MADRS), and the antidepressant dose was increased in patients with less than a 50% reduction at each visit compared with the initial MADRS score. The Oxford Questionnaire on the Emotional Side-effects of Antidepressants (OQESA) was used at the 8th-week and 16th-week visits.
Findings/Results
A significant difference is found in the OQESA score at the 8th-week visit compared with the 16th-week assessment (P < 0.001, t = 5.73). There were significant correlations between MADRS scores and OQESA scores both at the 8th (r = 0.346, P = 0.05) and the 16th (r = 0.490, P < 0.001) weeks. In regression analyses, at eighth-week assessment, MADRS score (B = 1.487, P = 0.002) and selective serotonin reuptake inhibitor use (B = 14.014, P = 0.023) had a significantly predicted OQESA score.
Implications/Conclusions
In this study, it is found that, as the rate of remitted patients is increased, OQESA scores get decreased, and furthermore, the OQESA score of the remitted group is statistically low when compared with that of the nonremitted group at the 8th- and 16th-week visits. Oxford Questionnaire on the Emotional Side-effects of Antidepressants and MADRS scores are significantly correlated in all assessments. These results suggest that the score obtained from OQESA may be related not only to the emotional adverse effects of antidepressants but also to the residual symptoms of depression.
Background:
Hyperprolactinemia is one of the most common endocrine disorders of the hypothalamic-pituitary axis. Hyperprolactinemia and galactorrhea are rarely seen as adverse effects of antidepressant drugs.
Case presentation:
Thirty-three years old women, between 2011 and 2017, three depressive episodes were observed. Initially, fluoxetine was used, no galactorrhea was detected. Secondly, she was given escitalopram and visited the clinic with amenorrhea and galactorrhea. Her serum prolactin levels were 50.88 ng/mL and MRI findings were normal. Escitalopram was discontinued and prescribed cabergoline and then prolactin levels were 16.56 ng/mL in the third month. During the vortioxetine treatment, she developed galactorrhea and prolactin level was 43.65 ng/mL. Vortioxetine was discontinued and it was measured at 20.14 ng/mL after 4 weeks of drug-free observation.
Conclusion:
Vortioxetine is a multimodal agent that modulates a select population of 5-HT receptors. To literature, there was no case presentation of galactorrhea observed during the use of vortioxetine. Galactorrhea associated with SSRIs are limited to case presentations. Antidepressants are thought to cause galactorrhea through tuberoinfundibular dopaminergic neurons or postsynaptic serotonergic neurons in the hypothalamus. When galactorrhea was observed during antidepressant drug use, prolactin levels and MRI should be investigated, and termination/replacement of antidepressant treatment is recommended if necessary.
Duloksetin serotonin-nöradrenalin geri alım intibitörü (SNGİ) grubu bir antidepresandır. Nöradrenerjik etkileri ağrılı fiziksel belirtilerin tedavisine katkı sağlar.
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