Similar Effectiveness of Paroxetine, Fluoxetine, and Sertraline in Primary Care

Kroenke, Kurt; West, Suzanne L.; Swindle, Ralph; Gilsenan, Alicia; Eckert, George J.; Dolor, Rowena J; Stang, Paul; Zhou, Xiao Hua; Hays, Ron D.; Weinberger, Morris

doi:10.1001/jama.286.23.2947

Cited by 270 publications

(155 citation statements)

References 24 publications

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“…Both acute and long-term modulation of serotonergic neuronal activity has been implicated in many therapies that alleviate depression and other disorders (Kroenke et al, 2001). In addition, SSRIs have also been demonstrated effective in various animal models, which are utilized as preclinical screens for these drugs (Willner, 1990).…”

Section: Discussionmentioning

confidence: 99%

Elucidation of The Behavioral Program and Neuronal Network Encoded by Dorsal Raphe Serotonergic Neurons

Urban

Zhu

Marcinkiewcz

et al. 2015

Neuropsychopharmacol

124

100

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Elucidating how the brain's serotonergic network mediates diverse behavioral actions over both relatively short (minutes-hours) and long period of time (days-weeks) remains a major challenge for neuroscience. Our relative ignorance is largely due to the lack of technologies with robustness, reversibility, and spatio-temporal control. Recently, we have demonstrated that our chemogenetic approach (eg, Designer Receptors Exclusively Activated by Designer Drugs (DREADDs)) provides a reliable and robust tool for controlling genetically defined neural populations. Here we show how short-and long-term activation of dorsal raphe nucleus (DRN) serotonergic neurons induces robust behavioral responses. We found that both short-and long-term activation of DRN serotonergic neurons induce antidepressant-like behavioral responses. However, only short-term activation induces anxiogenic-like behaviors. In parallel, these behavioral phenotypes were associated with a metabolic map of whole brain network activity via a recently developed non-invasive imaging technology DREAMM (DREADD Associated Metabolic Mapping). Our findings reveal a previously unappreciated brain network elicited by selective activation of DRN serotonin neurons and illuminate potential therapeutic and adverse effects of drugs targeting DRN neurons.

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Section: Discussionmentioning

confidence: 99%

Elucidation of The Behavioral Program and Neuronal Network Encoded by Dorsal Raphe Serotonergic Neurons

Urban

Zhu

Marcinkiewcz

et al. 2015

Neuropsychopharmacol

124

100

View full text Add to dashboard Cite

show abstract

“…66 No evidence suggests that one SSRI is more effective than another. 67 However, citalopram and sertraline are the least likely to inhibit cytochrome p450 enzymes, thus minimizing exposure to pharmacokinetic interactions in cardiac patients taking multiple drugs. 68 One simple approach is for the clinician to become familiar with 1 of these 2 SSRIs and to use it as first-line treatment for all patients with newly diagnosed depression.…”

Section: Pharmacotherapymentioning

confidence: 99%

Depression and Cardiovascular Disease

Whooley¹

2006

JAMA

216

163

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Major depressive disorder is a risk factor for the development of incident coronary heart disease events in healthy patients and for adverse cardiovascular outcomes in patients with established heart disease. Depression is present in 1 of 5 outpatients with coronary heart disease and in 1 of 3 outpatients with congestive heart failure, yet the majority of cases are not recognized or appropriately treated. It is not known whether treating depression improves cardiovascular outcomes, but antidepressant treatment with selective serotonin reuptake inhibitors is generally safe, alleviates depression, and improves quality of life. This article evaluates the importance of major depression in patients with cardiovascular disease, and provides practical guidance for identifying and treating this disorder. CASE PRESENTATIONA 58-year-old man with a history of coronary heart disease (CHD), type 2 diabetes mellitus, hypertension, smoking, and alcohol dependence presented for routine medical care. He had initially sought medical attention for exertional angina 5 years previously, at which time he underwent exercise treadmill testing with thallium that was positive for reversible perfusion defects in the anterior, septal, and inferior walls. Subsequent coronary angiography revealed diffuse heavy calcifications in the left anterior descending artery with a moderate lesion prior to the first diagonal. Several major septal perforators had significant lesions at their origins. In the dominant right coronary artery, there were diffuse calcifications but no significant lesions. The left circumflex and large ramus intermedius were free of discrete lesions. Left ventricular function was normal.The patient underwent single-vessel (left internal mammary artery to left anterior descending artery) coronary artery bypass grafting (CABG) surgery. He was prescribed atenolol 100 mg/ d, lisinopril 40 mg/d, lovastatin 80 mg/d, aspirin 325 mg/d, metformin 850 mg 3 times a day, and glipizide 10 mg 2 times a day. Despite being nonadherent to his prescribed medications, he remained stable for 5 years, but then one day, while doing household chores, he suddenly developed chest pressure, shortness of breath, and diaphoresis that lasted 12 hours. On admission to the hospital his troponin I was elevated and peaked at 0.7 ng/mL (normal, <0.05 ng/mL), consistent with a myocardial infarction (MI). His electrocardiogram had not changed.

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“…14, 3, 2005 R. Walwxn and S. Wesselv compare three antidepressants, and this time used a sample size of 573 adult depressed patients recruited from primary care (Kroenke et al, 2001). They also failed to find any differences, but for the first time we can be more confident that had important differences existed, this study would have had the power to detect them.…”

Section: Bigger Psychiatric Trialsmentioning

confidence: 99%