SSRIs

Treatment-Resistant Depression: Clinical Conundrum

In this podcast episode, we take on the challenge of treatment-resistant depression and its therapeutic options. Dr. Philip Cowen (University of Oxford) provided insights for this clinical conundrum with a simple algorithm.

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The Role of Serotonin (5-HT) in Impulsivity/Aggression, Anxiety/Stress and Cognition

This presentation reviews the effects of serotonin receptors (5-HTR) on domains such as impulsivity/aggression, anxiety/stress, and cognition. It also discusses findings from neuroimaging studies involving 5-HT1A and 5-HT2A receptors.

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

Author: Flavio Guzman, MD Paroxetine (Paxil, Seroxat, Aropax) is an SSRI approved for major depressive disorder and most anxiety disorders. In clinical practice, many clinicians use it for patients with anxious depression. However, this observation hasn’t been specifically studied in randomized controlled trials. Regarding its side effects profile, important features include higher risk for sexual…

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Citalopram and Escitalopram: A Summary of Key Differences and Similarities

Author: Flavio Guzman, MD Editor Psychopharmacology Institute Citalopram (Celexa) and escitalopram (Lexapro) are two commonly prescribed SSRIs used for the treatment of depression and anxiety disorders. This brief multimedia tutorial explores the differences and similiarities between these two SSRIs. Introduction: Basic Concepts Let me highlight some useful points before getting into more detail about these two…

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Adverse Effects of SSRIs

Author: Flavio Guzman, MD The video below is a brief (length 2:30) overview on the adverse effects of SSRIs. Contents: General concepts Gastrointestinal side effects CNS adverse effects: Basal ganglia Mental effects Sexual dysfunction Download Video Transcript Hello, this is Dr. Flavio Guzman, I´m the editor of Psychopharmacology Institute. In this short video I’m going…

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