Sertraline- and Mirtazapine-Induced Severe Neutropenia

Ozcanli, Tuba; Ünsalver, Barış Önen; Özdemir, Sebati; Ozmen, Mustafa

doi:10.1176/appi.ajp.162.7.1386

Cited by 28 publications

(16 citation statements)

References 3 publications

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“…71,72 Reports of neutropenia associated with mirtazapine may theoretically increase the risk of neutropenia related to CHC immunotherapy, however, this adverse effect has not been observed to date in CHC treatment trials involving mirtazapine, although study sample sizes are limited (largest n = 36). 72,73 Trazodone, a serotonin antagonist-reuptake inhibitor, is often used as a hypnotic at lower doses, although the literature has questioned its effectiveness in insomniacs. 74 In addition to common side effects such as dizziness, sedation, and psychomotor impairment, cases of hepatotoxicity with trazodone have been published in the literature.…”

Section: Insomniamentioning

confidence: 99%

A Review of Sleep Disturbance in Hepatitis C

Sockalingam¹,

Alosaimi²,

Novák³

2010

Journal of Clinical Gastroenterology

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Sleep disturbances occur in up to 60% of patients with chronic hepatitis C (CHC) and is often interrelated with comorbid psychiatric disorders. Moreover, neuropsychiatric complications of interferon-alpha during CHC treatment can manifest as sleep problems. Newly diagnosed sleep disturbance occurs in up to 60% and 30% of untreated CHC patients and patients undergoing interferon-alpha therapy, respectively. However, the presentation of insomnia in patients with CHC is influenced by significant psychiatric comorbidity, such as depression, and medical conditions, such as anemia and hypothyroidism. Therefore, prompt recognition using screening tools and exclusion of comorbid conditions contributing sleep pathology can enhance treatment outcomes. Owing to the paucity of studies, treatment recommendations for sleep disorders in CHC patients are derived from recommendations from general sleep disorder treatment guidelines. Further research is needed to elucidate the efficacy of pharmacological and nonpharmacological treatments of sleep disorders in CHC patients.

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Section: Insomniamentioning

confidence: 99%

A Review of Sleep Disturbance in Hepatitis C

Sockalingam¹,

Alosaimi²,

Novák³

2010

Journal of Clinical Gastroenterology

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“…Non-SSRI antidepressants present safety concerns as well. Mirtazapine is associated with an increased risk of bone marrow suppression and agranulocytosis [17], potentially placing the interferon-treated patient at increased risk for infection given the potential for bone marrow suppression from interferon. Nefazodone has been shown to induce hepatotoxicity and is contraindicated in patients with liver disease [18].…”

Section: Introductionmentioning

confidence: 99%

Preventing Relapse of Major Depression During Interferon-α Therapy for Hepatitis C—A Pilot Study

Gleason

Fucci²,

Yates

et al. 2007

Dig Dis Sci

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Depression is common in hepatitis C, exacerbated by interferon, and is a major reason for discontinuing interferon therapy. We aimed to determine (1) whether patients with a history of major depression could complete a course of peginterferon alpha-2a and ribavirin if pretreated with escitalopram and (2) the relapse rate of depression during the course of therapy in these subjects. Ten patients were enrolled in the study and treated with escitalopram. The Hamilton Depression Rating Scale (Ham-D) and other psychiatric scales were administered throughout the study. There were no statistically significant increases in mean Ham-D scores. No subjects were discontinued from the study due to depression relapse. Nine of 10 subjects maintained remission of depression throughout the study. We conclude that pretreatment with escitalopram in subjects with major depressive disorder in remission may prevent recurrence of major depression during a course of interferon and ribavirin therapy for hepatitis C.

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“…Also beneficial effects in the treatment of neuropathic pain were reported [115]. Further clinically relevant side effects of mirtazapine are the induction or aggravation of a restless-legs syndrome (RLS) [116,117] and rarely also clinical relevant neutropenia [118]. For Mianserine also agranulocytosis was reported [119].…”

Section: Noradrenergic and Specific Serotonergic Antidepressant / α-Rmentioning

confidence: 99%

Individualized Pharmacological Treatment of Depressive Disorders State of the Art and Recent Developments

Zirngibl¹

2014

J Depress Anxiety

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moderate and severe disability independent of socio demographic factors with increasing importance in the projection to the year 2030 [1]. The multifactorial genesis of depressive disorders requires a multimodal and individualized treatment. Typical symptoms of depression are summarized in Table 1. The severity of symptoms, diagnostic subtypes and presence of specific symptoms, as well as age and psychiatric or somatic comorbidity play a role influencing the course of illness and choice of treatment. The treatment which provides the best tolerability together with the highest likelihood of response should be preferred in treatment plans and algorithms. Treatment of depressive disorders mostly consists of a combination therapy, determined by the current clinical features. The main constituents of a multimodal antidepressant therapy are pharmacotherapy, psychotherapy using established therapeutic techniques, and social support. Less severe forms of depression

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Sertraline- and Mirtazapine-Induced Severe Neutropenia

Cited by 28 publications

References 3 publications

A Review of Sleep Disturbance in Hepatitis C

A Review of Sleep Disturbance in Hepatitis C

Preventing Relapse of Major Depression During Interferon-α Therapy for Hepatitis C—A Pilot Study

Individualized Pharmacological Treatment of Depressive Disorders State of the Art and Recent Developments

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