Adverse effects of interactions between antidepressants and medications used in treatment of cardiovascular disorders

Woroń, Jarosław; Siwek, Marcin; Gorostowicz, Aleksandra

doi:10.12740/pp/onlinefirst/96286

Cited by 30 publications

(24 citation statements)

References 42 publications

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“…Literature shows that the use of sertraline is associated with the low risk for QTc prolongation ( Funk and Bostwick, 2013 ). Also, studies point out that this SSRI is often recommended as a safe and effective antidepressant in the group of patients with cardiovascular diseases ( Mohapatra et al, 2005 ; Funk and Bostwick, 2013 ; Woroń et al, 2019 ). Due to the widespread use of NSAID in this population, special attention should be taken because their use may increase cardiotoxic capacity of the SSRIs.…”

Section: Discussionmentioning

confidence: 99%

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Unprescribed and unnoticed: Retrospective chart review of adverse events of interactions between antidepressants and over-the-counter drugs

et al. 2022

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Aim: To systematically evaluate prevalence and clinical characteristics of adverse effects of antidepressants and OTC drugs interactions in a retrospective chart review.Methodology: Dataset of 1,145 registered adverse events were evaluated. Reports were selected for further analysis if pharmacoepidemiological avaluation indicated the presence of high probability of a causal relationship between antidepressants and OTC interaction and the occurrence of side effect. Following variables were extracted from the records: sex, age, medical comorbidities, antidepressant and other concomitant medications, clinical consequences ant the possible interaction mechanisms.Results: 368 showed causal relationship with the simultaneous use of antidepressant with another drug. 15 adverse events (4%) were related to the use of OTC medicine, particularly omeprazole, diphenhydramine, Japanese ginkgo biloba, ibuprofen, diclofenac and sildenafil. All of the analysed side effects were categorized as the result of pharmacokinetic interactions. Here we report identified OTC drugs with corresponding antidepressants and clinical manifestations of DDI. Omeprazole: agomelatine (nausea, abnormal dreams), fluoxetine (extrapyramidal symptoms, paresthesias), sertraline (vertigo, yawning), escitalopram (oral vesiculation). Diphenhydramine: sertraline (diaphoresis, insomnia, vertigo), paroxetine (pruritus, headache), duloxetine (oropharyngeal pain). Japanese ginkgo biloba: citalopram (bradycardia), trazodone (vertigo, taste pervesion), mianserine (restless legs syndrome). Diclofenac: escitalopram (oral vesiculation), and fluoxetine (restless legs syndrome). Ibuprofen: agomelatine (anxiety and nausea), sertraline and omeprazole (QTc prolongation). Sildenafil: fluoxetine (genital oedema) and sertraline (myocardial infarction).Conclusion: The use of OTC drugs by the patients should be monitored. Pharmacokinetic interactions between nonprescribed medicines and antidepressants may increase concentration and severity of side effects of latter ones.

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Section: Discussionmentioning

confidence: 99%

“…The group of patients particularly vulnerable to the occurrence of side events are those receiving psychopharmacological treatment ( Woroń and Siwek, 2018 ; Woroń et al, 2019 ; Siwek et al, 2020 ). Psychotropic medication is commonly used.…”

Section: Introductionmentioning

confidence: 99%

Unprescribed and unnoticed: Retrospective chart review of adverse events of interactions between antidepressants and over-the-counter drugs

et al. 2022

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“…Propranolol is a recognized drug for treatment of hypertension and cardiovascular disease (42)(43)(44). Propranolol is a non-selective β1 and β2-AR blocker that has been used since 1964 to treat coronary artery insufficiency (45).…”

Section: Discussionmentioning

confidence: 99%

Effect and mechanism of propranolol on promoting osteogenic differentiation and early implant osseointegration

et al. 2021

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The present study aimed to investigate the effect of β-receptor blocker propranolol on early osseointegration of pure titanium implants and the underlying molecular regulatory mechanisms. An implant osseointegration model using the tibial metaphysis of New Zealand rabbits was established. The rabbits were divided into control and low-, medium-and high-dose propranolol groups. The formation of implant osseointegration was detected by X-ray scanning. Mesenchymal stem cells (MScs) and osteoblasts (OBs) were isolated and cultured in vitro, isoproterenol was supplemented to simulate sympathetic action and propranolol was subsequently administrated. The effect of propranolol on cell proliferation and osteogenic differentiation were assessed by EdU, flow cytometry, alizarin red staining and alkaline phosphatase (ALP) detection. The expression levels of bone morphogenetic protein (BMP)2, RUNX family transcription factor (RunX)2, collagen (cOL)-1, osteocalcin (OcN) and β2-adrenergic receptor (AR) were detected by immunofluorescence, reverse transcription-quantitative PcR and western blot assay. Propranolol effectively promoted implant osseointegration in vivo, facilitated proliferation of OBs, inhibited proliferation of MScs and enhanced osteogenic differentiation of OBs and MScs. The calcium content and ALP activity of cells treated with propranolol were markedly higher than in the control group. Propranolol also elevated mRNA and protein expression levels of BMP2, RunX2, cOL-1 and OcN in tissue and cells, and decreased the expression of β2-AR. The present study demonstrated that the β-receptor blocker propranolol promoted osteogenic differentiation of OBs and MScs and enhanced implant osseointegration. The present study provided a novel insight into the application and regulatory mechanisms of propranolol.

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“…So when β-blockers alleviate the pathological function, it also antagonizes the normal physiological effects, which is harmful to patients. Over the past years, more and more evidence has accumulated indicating that long-acting β-blockers can lead to some detrimental effects (Woron et al, 2019). In addition to β-blockers, anti-TGF-β antibodies have also been considered as potential antifibrotic agents (Kuwahara et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

Disruption of STAT6 Signal Promotes Cardiac Fibrosis Through the Mobilization and Transformation of CD11b+ Immature Myeloid Cells

et al. 2020

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Cardiac fibrosis is an important pathological basis of various cardiovascular diseases. The roles of STAT6 signal in allergy, immune regulation, tumorigenesis, and renal fibrosis have been documented. However, the function and mechanism of STAT6 signal in sympathetic overactivation-induced cardiac fibrosis have not been fully elucidated. This study explores the novel role of STAT6 signal in isoproterenol (ISO)-induced cardiac fibrosis through the regulation of inflammatory response and the differentiation of macrophages from immature myeloid cells. The expression levels of STAT6, β1adrenergic receptor (β1-AR), and inflammatory factors [interleukin α (IL-1α), IL-6, IL-18, and transforming growth factor β (TGF-β)] in CD11b + myeloid cells were analyzed with a microarray study. The levels of IL-6 and TGF-β1 in the CD11b + myeloid cells-derived macrophages were detected with reverse transcriptase-polymerase chain reaction (RT-PCR). STAT6-knockout (KO) and WT mice were used to establish a murine cardiac fibrosis model by ISO injection. Cardiac fibroblasts were isolated from the hearts of newborn STAT6-KO and WT mice, and STAT6 expression was measured by Western blotting and RT-PCR after ISO stimulation, while α-smooth muscle actin (α-SMA) expression was detected by immunofluorescence and immunohistochemistry staining. Cardiac function and pathological characteristics were examined by echocardiography and immunohistochemistry staining, respectively. Immunohistochemistry staining with anti-CD11b was performed to detect the infiltration of CD11b + myeloid cells in heart tissue. Flow cytometry analysis was used to measure the percentages of CD11b + myeloid cells and CD11b + Ly6C + macrophages in the peripheral blood. The results showed that STAT6 was highly expressed in CD11b + myeloid cells located in injured hearts, and STAT6 expression in cardiac fibroblasts was down-regulated after ISO treatment. STAT6 deficiency further aggravated ISO-induced increased expression of α-SMA in cardiac fibroblasts, myocardial fibrosis, and cardiac dysfunction. The activation of ISO/β1-AR signal aggravated cardiac inflammatory infiltration, promoted CD11b + myeloid cell mobilization, and enhanced CD11b + Ly6C +/low macrophage differentiation, which was further exacerbated by STAT6 deficiency. Furthermore, β1-AR mRNA

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Adverse effects of interactions between antidepressants and medications used in treatment of cardiovascular disorders

Cited by 30 publications

References 42 publications

Unprescribed and unnoticed: Retrospective chart review of adverse events of interactions between antidepressants and over-the-counter drugs

Unprescribed and unnoticed: Retrospective chart review of adverse events of interactions between antidepressants and over-the-counter drugs

Effect and mechanism of propranolol on promoting osteogenic differentiation and early implant osseointegration

Disruption of STAT6 Signal Promotes Cardiac Fibrosis Through the Mobilization and Transformation of CD11b+ Immature Myeloid Cells

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