Tag Archives: Fluvoxamine

Alzheimer’s Therapy: Antidepressants

Overview. Major depression affects approximately 15% of Alzheimer’s disease patients. By comparison, 5-12% of the general population aged 15 years or older in the major pharmaceutical markets experience at least one episode of major depression per year. Because depression itself may lead to declines in cognition and function, treatment of depression in Alzheimer’s disease patients… Read More »

Treatment of Social Anxiety Disorder

Current recommended treatment options for social anxiety disorder include pharmacotherapy and cognitive behavioural therapy (CBT). Although several randomised controlled trials (RCTs) have failed to show efficacy for beta-adrenoceptor antagonists in generalised social anxiety disorder (SAD), it has been suggested that these agents may be useful in non-generalised social anxiety disorder (SAD), patients with performance anxiety… Read More »

Treatment of Anxiety in the Medically Ill

Psychotherapy An overemphasis on psychopharmacology in the care of medically ill patients may result in overlooking the value of psychotherapy. The first step in the treatment of anxiety is to spend time listening to and talking with the patient. Just as in psychotherapy with any patient, empathic listening is a powerful tool to relieve distress.… Read More »

When to Introduce Antipsychotics

Question. When do you feel antipsychotics should be used to treat anxiety? My patient is very distressed, cannot concentrate and has a hard time with rational thought. He suggested this as a possible option, but what do you think? Answer. Unless the anxiety is really secondary to a psychotic process, I would argue that the… Read More »

Pharmacologic Treatment in Children and Adolescents for OCD

Clomipramine (Anafranil) Clomipramine (Anafranil), a tricyclic antidepressant (TCA) and potent serotonin re-uptake inhibitor, was used in the first controlled pharmacologic treatment trial in children and adolescents for OCD. Nineteen pediatric patients (mean age, 14.5 ± 2.3 years) were studied in a 12-week double-blind placebo-controlled crossover study (5 weeks of active medication) (). Doses of clomipramine… Read More »

Pharmacological Treatment of Pain

While medications are often prescribed for all types of chronic pain, research has consistently shown that several classes have proven efficacy for the treatment of neuropathic pain. Ideally, pharmacotherapy of pain would be specifically selected on the basis of considerations of etiology (e.g., ischemic, neuropathic), pathophysiology (e.g., demyelination, central pain), and anatomy (e.g., C fibers,… Read More »

Selected Chronic Pain Conditions

Postherpetic Neuralgia Postherpetic neuralgia is defined as pain persisting or recurring at the site of shingles at least 3 months after the onset of the acute varicella zoster viral rash. Postherpetic neuralgia occurs in about 10% of patients with acute herpes zoster. More than half of patients over 65 years of age with shingles develop… Read More »

Minor Depression

Etiology and Pathophysiology Minor depression is only a proposed diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and there are no International Classification of Diseases codes to categorize it. The proposed diagnostic category for minor depression in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition describes a depressive disorder that… Read More »

Minor Depression: Duloxetine, Venlafaxine, and Milnacipran

Serotonin-Norepinephrine Reuptake Inhibitors Several antidepressants have dual action at both serotonergic and noradrenergic receptors. The most notable are the serotonin/norepinephrine reuptake inhibitors, particularly extended-release venlafaxine (Wyeth’s Effexor XR) and milnacipran (bioMerieux-Pierre Fabre’s Ixel/Dalcipran, Asahi Kasei/Janssen-Kyowa’s Toledomin; available only in France and Japan). The noradrenergic and specific serotonergic antidepressants (NaSSAs) mirtazapine (Organon’s Remeron/Remergil), nefazodone (Bristol-Myers Squibb’s… Read More »

Minor Depression: Escitalopram, Paroxetine, Sertraline, and Fluoxetine

Selective Serotonin Reuptake Inhibitors The seven available agents in the selective serotonin reuptake inhibitor class are citalopram (Lund-beck’s Cipramil, Forest Laboratories’ Celexa, generics) and its single enan-tiomer, escitalopram (Lundbeck’s Cipralex, Forest’s Lexapro); paroxetine (GSK’s Paxil/Seroxat, Novartis’s Frosinor, generics); the controlled-release version of paroxetine (GSK’s Paxil CR); sertraline (Pfizer’s Zoloft); fluoxetine (Eli Lilly’s Prozac, generics); and… Read More »