Medically serious adverse effects of newer antidepressants

Mago, Rajnish; Mahajan, Rajeev; Thase, Michael E.

doi:10.1007/s11920-008-0041-2

Cited by 28 publications

(30 citation statements)

References 68 publications

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“…For instance, the risk of gastrointestinal bleeding was 3.6 times higher in patients taking SSRIs compared to those who do not use these medications. This effect was increased to 12.2 times the risk in the general population for patients who take SSRIs and NSAIDs simultaneously [10]. Barbui et al in a case-control study also found a modestly increased risk of gastrointestinal (GI) bleeding with usage of SSRIs, but no increased risk with tricyclic antidepressants.…”

Section: Discussionmentioning

confidence: 96%

“…McCloskey et al [6] demonstrated alterations of the platelet function assay in patients taking SSRIs compared to those on a non-serotonergic antidepressant. Mago et al [10] suggested that PFA should be evaluated before elective surgery in patients taking SSRIs. although no data were offered to define the benefits of this test in the presurgical setting.…”

Section: Discussionmentioning

confidence: 99%

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Antidepressants and the risk of abnormal bleeding during spinal surgery: a case–control study

et al. 2012

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Introduction Antidepressant medications are widely used by patients requiring spinal surgery. In spite of a generally favorable safety profile of newer antidepressants, several prior studies have suggested an association between use of serotonergic antidepressants and excessive bleeding. This study was designed to determine if there was any association between antidepressant use and the risk of excessive intraoperative blood loss during spinal surgery, and whether particular types of antidepressants were specifically associated with this increased blood loss. Materials and methods A retrospective case control study was conducted utilizing a population of 1,539 patients who underwent elective spinal fusion by a single surgeon at one medical center. Of the included patients, 213 used antidepressant medication and 1,326 patients did not use any type of antidepressant medication. Of patients taking antidepressants, 37 patients were excluded based on exclusion criteria, leaving 176 patients suitable for inclusion. The study group (176 patients) consisted of all patients who used an antidepressant medication for at least a 2-week period prior to spinal surgery. A control group of 352 patients were assembled from a random sample of 1,326 patients operated on by the same surgeon during the same time period in a two-to-one ratio with study group. Intraoperative blood loss was the primary outcome variable and was compared between the study and control group and between individuals in the study group taking serotonergic (SSRIs or SNRIs) or non-serotonergic antidepressants. Other variables, including length of hospital stay and surgical category, were also collected and analyzed separately. Results Overall, the mean blood loss (BL) for the antidepressant group was 298 cc, 23% more than the 241 cc lost by the procedure-and level-matched control group (p = 0.01). Patients taking serotonergic antidepressants also had statistically significant higher blood loss than the matched control group as a whole (334 vs. 241 cc, p = 0.015). This difference was also found in subgroups of patients who underwent anterior cervical discectomy and fusion, lumbar instrumented fusion, or anterior/posterior lumbar fusion. Blood loss was also higher in the subgroup of patients taking bupropion (708 cc, p = 0.023) compared with the control group. The mean length of hospital stay

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Antidepressants and the risk of abnormal bleeding during spinal surgery: a case–control study

et al. 2012

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“…In contrast, the use of SSRIs and SNRIs has increased because of higher safety profile [35,36], although cardiovascular adverse effects, abnormal bleeding, hyponatremia, seizures, and agranulocytosis should be kept in mind while treating cancer patients [37]. Psychostimulants (e.g., methylphenidate, pemoline, d-amphetamine)are useful in the treatment of depression in cancer, in terminally ill patients, because of their rapid onset of action and effect concentration and attention problems and also on fatigue [38].…”

Section: Balaji Et Almentioning

confidence: 99%

Management of Depression in Terminally Ill Patients – A Critical Review

Balaji

Nayak

2017

Asian J Pharm Clin Res

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Depression is a well-recognized risk factor for shortened life span from cancer. Depression is among the main causes of disability in the world leading to increased suffering and mortality. As per research surveys over the years, prevalence among cancer patients varies widely from 3% to 38% for major depression and 1.5-52% for depression spectrum syndromes. The need of the hour is to effectively treat depression in cancer patients so that the quality of life can be improved and thereby patient survival. Both psychological and pharmacological interventions and the combination of both very much effective in treating depression in cancer patients. A broad range of therapies now exist, and the art of such therapy is the strategic selection of components from several models to best respond to the needs of the individual patient and his/her family in the specific circumstances, whether clinical, psychological, spiritual, or social.

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“…Os antidepressivos (ADs) têm sido associados com diversos efeitos colaterais, que se observam mesmo com os ADs mais recentes, ainda que sejam mais seguros que os mais antigos antidepressivos tricíclicos (ADTs) e inibidores da monoaminoxidase (IMAO) 1 . Entre os efeitos colaterais mais comuns e potencialmente graves está a hiponatremia, efeito que tem sido associado, principalmente, a doentes idosos e polimedicados (ou seja: diuréticos, antidiabéticos, anti--inflamatórios não esteroides) 1,2 .…”

Section: Introductionunclassified

“…Entre os efeitos colaterais mais comuns e potencialmente graves está a hiponatremia, efeito que tem sido associado, principalmente, a doentes idosos e polimedicados (ou seja: diuréticos, antidiabéticos, anti--inflamatórios não esteroides) 1,2 . A relação provável entre os ADs e a hiponatremia foi descrita pela primeira vez em 1974 com a amitriptilina e tem sido cada vez mais debatida desde a introdução dos inibidores seletivos da recaptação de serotonina (ISRS) 3 .…”

Section: Introductionunclassified

Hiponatremia associada a antidepressivos: uma revisão

Costa¹,

Marins²

2018

J. bras. psiquiatr.

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RESUMOObjetivo: Rever a literatura mais recente sobre a associação entre a hiponatremia e o uso de antidepressivos. Métodos: Pesquisa bibliográfica nas bases de dados PubMed e SciELO, com os descritores "antidepressive agents" e "hyponatremia", incluindo artigos de janeiro de 2006 a maio de 2016. Resultados: Foram incluídos 45 artigos. A idade, o sexo feminino e a polimedicação são os fatores de risco mais relevantes, e os sintomas dependem da gravidade da hiponatremia. A hiponatremia pode ter várias causas, sendo a mais comum a síndrome da secreção inapropriada do hormônio antidiurético. Entre os inibidores seletivos da recaptação de serotonina, o citalopram e o escitalopram apresentam risco superior, à semelhança da venlafaxina. O risco de hiponatremia parece ser inferior com as classes restantes, à exceção dos inibidores da monoaminoxidase. Recomenda-se um ionograma prévio ao tratamento em doentes com mais de 60 anos e, sempre, um ionograma um mês após o seu início. O primeiro passo do tratamento é a suspensão do fármaco, revertendo a maioria dos casos leves. No entanto, o tratamento deve ser individualizado, considerando os riscos da hiponatremia e da correção. Conclusões: A hiponatremia é um efeito colateral a considerar nos doentes que tomam antidepressivos. Quando a manutenção do tratamento é necessária, deve ser evitado o mesmo antidepressivo ou outro da mesma classe, sendo opções a trazodona, abupropiona, a agomelatina, a mirtazapina e a reboxetina, porque existem poucos relatos de hiponatremia com esses fármacos. ABSTRACTObjective: Review the most recent literature about the association between hyponatremia and antidepressives' intake. Methods: Bibliographic search in PubMed and SciELO databases, with the MeSH terms "antidepressive agents" and "hyponatremia", including articles between January 2006 and May 2016. Results: A total of 45 articles have been included. Age, female sex and polymedication are the main risk factors and symptoms depend on hyponatremia severity. Hyponatremia may have several causes, being the most common the syndrome of inappropriate antidiuretic hormone secretion. Between the selective serotonin reuptake inhibitors, citalopram and escitalopram presented a bigger risk, similarly to venlafaxine. Risk of hyponatremia seems smaller with the other antidepressives' classes, with exception to

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Medically serious adverse effects of newer antidepressants

Cited by 28 publications

References 68 publications

Antidepressants and the risk of abnormal bleeding during spinal surgery: a case–control study

Antidepressants and the risk of abnormal bleeding during spinal surgery: a case–control study

Management of Depression in Terminally Ill Patients – A Critical Review

Hiponatremia associada a antidepressivos: uma revisão

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