Antidepressants

SSRIs and Bleeding Risk: What Does the Evidence Say?

Do SSRIs increase bleeding risk? This presentation reviews what the current literature says on the risk of GI, perioperative, postpartum and cerebral bleeding with SSRI use.

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Do Depression Efficacy Trials Apply to Your Clinical Practice? An Interview with Dr. Mark Zimmerman

Dr. Mark Zimmerman, professor of psychiatry and human behavior at Brown University, speaks about depression efficacy trials and their clinical implications.
This interview is part of a series covering the 2018 ASCP Annual Meeting.

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Treatment-Resistant Depression: Augmentation with Second-Generation Antipsychotics (Aripiprazole vs Quetiapine)

Prof. Philip Cowen Professor of Psychopharmacology Department of Psychiatry University of Oxford, UK This presentation compares advantages and disadvantages of using quetiapine vs. aripiprazole as augmentation for treatment-resistant depression. It also addresses the common question of when to augment (antidepressant + SGA) vs. when to switch (prescribing a different antidepressant). Combination and Augmentation: Clarifying Concepts…

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Inflammation and Depression: Use of Anti-Inflammatory Agents and The Role of Inflammatory Markers (CRP)

Prof. Philip Cowen Professor of Psychopharmacology Department of Psychiatry University of Oxford, UK This presentation summarizes recent findings on the role of inflammation in depression. A study suggests patients with elevated levels of inflammatory markers (C-reactive protein) have a differential response to a specific antidepressant. The efficacy of celecoxib and infliximab in treatment-resistant depression is…

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Mirtazapine Essentials: MOA, Indications, Adverse Effects, Pharmacokinetics and Dosing

Author: Flavio Guzman, MD Mirtazapine (Remeron) is a noradrenergic and specific serotonergic antidepressant (NaSSA), it doesn’t have effects as monoamine reuptake inhibitor. A significant feature is its effect as histamine 1 antagonist. This antihistamine effect is linked to sedation and weight gain. Mirtazapine is commonly used in the elderly population. In this group of patients…

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Fluvoxamine Essentials: Mechanism of Action, Indications, Pharmacokinetics and Dosing

Author: Flavio Guzman, MD Besides being a SERT inhibitor, fluvoxamine is an agonist at sigma 1 receptors. The drug is approved in the US for the treatment of OCD but not depression. This is interesting as this is a widely used antidepressant in other countries. Fluvoxamine has the potential for drug-drug interactions through inhibition of…

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Sertraline Essentials: Mechanism of Action, Indications, Pharmacokinetics and Dosing

Author: Flavio Guzman, MD Sertraline is a moderate inhibitor of CYP2D6. In terms of drug-drug interactions this is not as significant as with fluoxetine or paroxetine. It has a similar side effects profile to other SSRIs. The dosage range goes from 50 to 200 mg/day. Pharmacology and MOA   Sertraline is an inhibitor of the…

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Antidepressant Discontinuation Syndrome: Diagnosis, Prevention and Management

Author: Flavio Guzman, MD Discontinuation symptoms can occur with all antidepressant classes, and you will see many articles referring to SSRI discontinuation syndrome. The reason is that SSRIs are by far the most commonly prescribed antidepressant class. This syndrome consists of usually mild and reversible symptoms that can be grouped into six categories. As a…

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The Psychopharmacology of Fluoxetine: Mechanism of Action, Indications, Pharmacokinetics and Dosing

Author: Flavio Guzman, MD Fluoxetine has activating properties that make it a good option for patients with retarded depression or atypical depression. However, we should avoid activation in patients with insomnia and agitation. There is something that makes fluoxetine unique: its long half-life, we will discuss the advantages and disadvantages of this in clinical practice.…

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Reviewing Bupropion for Depression: An Update with Dr. Derek Tracy

In this episode we interview Dr. Derek Tracy on the use of bupropion for depression. Dr. Tracy is a Consultant Psychiatrist and the Associate Clinical Director for Crisis, Inpatient, and Rehabilitation services at Oxleas NHS Foundation Trust, London. He is a BRC research fellow and the neuromodulation lead at the Institute of Psychiatry, Psychology, and Neuroscience, King’s…

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