A Retrospective, Pilot Study of De Novo Antidepressant Medication Initiation in Intensive Care Unit Patients and Post-ICU Depression

Haines, Daniel; Hild, Johanna; He, Jia; Stun, Lucy; Ballew, Angie; Green, Justin L.; Satterwhite, Lewis; Flynn, Brigid C.

doi:10.1155/2017/5804860

Cited by 7 publications

(4 citation statements)

References 27 publications

(33 reference statements)

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“…[51][52][53][54] For example, given previous work suggesting the high rates of incomplete or non-response to antidepressants in ICU survivors, clinical trials to test the efficacy of depression-focused psychotherapies to ameliorate cognitive decline could be considered. 51,55 Finally, post-ICU stroke was an independent risk factor for post-ICU cognitive impairment. This could be due to the long-term effects from hypoxic injury from ICU hospitalization causing cerebral hypoperfusion, or from inadequately controlled cardiovascular risk factors leading to post-ICU stroke.…”

Section: Discussionmentioning

confidence: 95%

“…This points to the need to develop targeted therapeutic approaches for depression separate from delirium to prevent dementia in ICU survivors. 51–54 For example, given previous work suggesting the high rates of incomplete or non‐response to antidepressants in ICU survivors, clinical trials to test the efficacy of depression‐focused psychotherapies to ameliorate cognitive decline could be considered 51,55 . Finally, post‐ICU stroke was an independent risk factor for post‐ICU cognitive impairment.…”

Section: Discussionmentioning

confidence: 99%

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Risk factors for dementia in older intensive care unit (ICU) survivors

Wang,

Perkins,

Chi

et al. 2023

Alzheimer's & Dementia

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INTRODUCTIONAs the number of older intensive care unit (ICU) survivors grows, there is an urgent need to identify modifiable risk factors for post‐ICU dementia.METHODSWe performed a secondary data analysis of 3144 ICU patients ≥ 50 years of age without a history of dementia or severe mental illness who were screened as part of the Pharmacological Management of Delirium (PMD) study. Delirium was assessed using the Confusion Assessment Method for the ICU. Dementia was identified using International Classification of Diseases Ninth and Tenth revision codes for dementia or prescription of anti‐dementia medication.RESULTSAverage age (standard deviation) was 65.2 ± 9.5 years; 50.4% were female; and 37.3% were Black. Analyses identified stroke (adjusted hazard ratio [HR] 2.49; 95% confidence interval [CI: 1.52, 4.07], P < 0.001), and depression (adjusted HR 3.03; 95% CI [1.80, 5.10], P < 0.001) as post‐ICU risk factors for dementia.DISCUSSIONFuture studies will need to examine whether interventions targeting post‐ICU stroke and depression can lower dementia incidence in ICU survivors.Highlights Risk factors for post–intensive care unit (ICU) dementia were distinct from those of Alzheimer's disease. Cardiovascular risk factors were not associated with dementia in older ICU survivors. Post‐ICU stroke was associated with a higher risk of dementia in older ICU survivors. Post‐ICU depression was associated with a higher risk of dementia in older ICU survivors.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Risk factors for dementia in older intensive care unit (ICU) survivors

Wang,

Perkins,

Chi

et al. 2023

Alzheimer's & Dementia

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“…Selective serotonin reuptake inhibitors or serotonin–noradrenalin reuptake inhibitor (dual) antidepressants can help manage depressive symptoms in the ICU [ 55 ]. Dual antidepressants have the added benefit of proven efficacy against neuropathic pain [ 56 ].…”

Section: Multimodal Analgesic Therapeutic Approachmentioning

confidence: 99%

Sedation and Analgesia for Toxic Epidermal Necrolysis in the Intensive Care Unit: Few Certainties, Many Questions Ahead

Kattan

Elgueta

Merino

et al. 2023

JPM

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Toxic epidermal necrolysis (TEN) is a rare, acute mucocutaneous life-threatening disease. Although research has focused on the pathophysiological and therapeutic aspects of the disease, there is a paucity of data in the literature regarding pain management and sedation in the intensive care unit (ICU). Most therapies have been extrapolated from other situations and/or the general ICU population. These patients present unique challenges during the progression of the disease and could end up requiring invasive mechanical ventilation due to inadequate pain management, which is potentially avoidable through a comprehensive treatment approach. In this review, we will present clinical and pathophysiological aspects of TEN, analyze pain pathways and relevant pharmacology, and propose therapeutic alternatives based on a rational and multimodal approach.

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“…The effectiveness of classic treatments in the sepsis survivor population is also still in question. For example, a retrospective study showed that the de novo initiation of antidepressant medications in patients who were in treatment before ICU admission did not substantially decrease the prevalence of post-ICU depression [22].…”

Section: Introductionmentioning

confidence: 99%

What Animal Models Can Tell Us About Long-Term Psychiatric Symptoms in Sepsis Survivors: a Systematic Review

et al. 2021

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Lower sepsis mortality rates imply that more patients are discharged from the hospital, but sepsis survivors often experience sequelae, such as functional disability, cognitive impairment, and psychiatric morbidity. Nevertheless, the mechanisms underlying these long-term disabilities are not fully understood. Considering the extensive use of animal models in the study of the pathogenesis of neuropsychiatric disorders, it seems adopting this approach to improve our knowledge of postseptic psychiatric symptoms is a logical approach. With the purpose of gathering and summarizing the main findings of studies using animal models of sepsis-induced psychiatric symptoms, we performed a systematic review of the literature on this topic. Thus, 140 references were reviewed, and most of the published studies suggested a time-dependent recovery from behavior alterations, despite the fact that some molecular alterations persist in the brain. This review reveals that animal models can be used to understand the mechanisms that underlie anxiety and depression in animals recovering from sepsis.

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A Retrospective, Pilot Study of De Novo Antidepressant Medication Initiation in Intensive Care Unit Patients and Post-ICU Depression

Cited by 7 publications

References 27 publications

Risk factors for dementia in older intensive care unit (ICU) survivors

Risk factors for dementia in older intensive care unit (ICU) survivors

Sedation and Analgesia for Toxic Epidermal Necrolysis in the Intensive Care Unit: Few Certainties, Many Questions Ahead

What Animal Models Can Tell Us About Long-Term Psychiatric Symptoms in Sepsis Survivors: a Systematic Review

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