YOU ARE NOW CONNECTED TO THE TOXLINE (1981 FORWARD, NON-ROYALTY) FILE. ==ANTIDEPRESSANTS== 7 AUTHOR anon TITLE Citalopram, nefazodone and venlafaxine: three new antidepressants SOURCE Int. Pharm. J.; VOL 10 ISS Jul-Aug 1996, P141-144, (REF 13) ABSTRACT IPA COPYRIGHT: ASHP An overview is presented of the effects of 3 new antidepressants, citalopram hydrobromide (Cipramil), nefazodone hydrochloride (Dutonin), and venlafaxine hydrochloride (Effexor), including the mechanism of action, effectiveness, potential advantages, adverse effects, costs, and therapeutic use. 4 AUTHOR Cohen LJ TITLE Rational drug use in the treatment of depression SOURCE Pharmacotherapy; VOL 17 ISS 1 1997, P45-61, (REF 201) ABSTRACT IPA COPYRIGHT: ASHP A review of the pharmacotherapy of depression, including therapy with tricyclic antidepressants, monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, bupropion hydrochloride (Wellbutrin), trazodone hydrochloride (Desyrel), nefazodone hydrochloride (Serzone), venlafaxine hydrochloride (Effexor), and mirtazapine (Remeron), is presented, and the adverse reactions, drug interactions, and dosages of these agents are discussed; guidelines for effective antidepressant therapy are provided. 4 AUTHOR Hirschfeld RM TITLE Long-term drug treatment of unipolar depression. SOURCE Int Clin Psychopharmacol; VOL 11, ISS 4, 1996, P211-7 (REF: 41) ABSTRACT Depression is characterized by a recurrent course in many patients, and as a potentially chronic illness. It therefore often requires a long-term treatment strategy. This article proposes answers to the questions involved in devising such a strategy, using the available literature. Cessation of treatment immediately after the observation of a response is associated with a high relapse rate, especially within the following 4 months, and all patients should therefore be treated for at least 3-6 months after the acute response to secure a stable remission. Patients at risk of recurrence should be considered for maintenance therapy thereafter. Such patients include those with prior episodes of depression within the last 5 years, those with a particularly severe or chronic depressive episode, those with residual symptoms scoring HAMD > 8 and also those whose age at onset was < 25 or < 60 years. Those who need maintenance therapy are likely to need it for a number of years, or indefinitely. SSRIs are better tolerated than TCAs or MAOIs and display similar efficacy in acute, continuation and maintenance treatment. They are less likely to be fatally toxic if taken in overdosage. There is growing evidence to support the use of a full therapeutic dose of antidepressant in maintenance treatment. 5 AUTHOR Moller HJ AUTHOR Volz HP TITLE Drug treatment of depression in the 1990s. An overview of achievements and future possibilities. SOURCE Drugs; VOL 52, ISS 5, 1996, P625-38 (REF: 84) ABSTRACT This article looks at the most important developments of antidepressants in the 1990s. The major properties of selective serotonin reuptake inhibitors, reversible and selective inhibitors of monoamine oxidase type A, selective serotonin and noradrenaline reuptake inhibitors, and noradrenergic and specific serotonergic antidepressants are discussed. On the basis of the specific advantages and disadvantages of these compounds, unmet medical needs in the psychopharmacological treatment of depression are considered and the profile of an ideal antidepressant is outlined, followed by some closing remarks on potential new mechanisms of action. The most important progress in the past 10 years has been the development of compounds which possess markedly reduced binding capacities at receptor sites not linked to their antidepressive actions. This development has improved tolerability, both in therapeutic use and in overdose. Three main therapeutic needs have still to be met: (i) superior efficacy to tricyclic antidepressants; (ii) a faster onset of action; and (iii) reliable effectiveness in the treatment of therapy-resistant depression. 6 AUTHOR Cohen LJ TITLE Rational drug use in the treatment of depression. SOURCE Pharmacotherapy; VOL 17, ISS 1, 1997, P45-61 (REF: 200) ABSTRACT New drugs are being developed for the management of depression in response to the growing awareness of the prevalence and disability associated with the disorder and the need for agents with improved side effect profiles. All antidepressants are equally effective for treating uncomplicated unipolar depression without psychotic features. For patients with atypical depression with prominent anxiety, agitation, sleep loss, and irritability, monoamine oxidase inhibitors are the first choice. Data are accumulating supporting the efficacy of selective serotonin reuptake inhibitors (SSRIs) in these depressive subtypes. Factors to consider when choosing an antidepressant include spectrum of adverse effects, long-term tolerability, dosing schedule, clinically significant drug interactions, underlying medical conditions, earlier response to therapy, and pharmacoeconomics. Based on these criteria, it is suggested that a trial with the SSRIs be attempted first. Venlafaxine and nefazodone are newer agents with mechanisms of action that have advantages over tricyclic antidepressants and monoamine oxidase inhibitors. Choosing a drug that is effective, tolerable, and convenient will improve the likelihood of achieving and maintaining a full remission. It will also decrease the morbidity and mortality of this very treatable disease. 8 AUTHOR Stoudemire A TITLE New antidepressant drugs and the treatment of depression in the medically ill patient. SOURCE Psychiatr Clin North Am; VOL 19, ISS 3, 1996, P495-514 (REF: 85) ABSTRACT The advent of the SSRIs, venlafaxine, bupropion, and nefazodone, has greatly expanded pharmacologic treatment options for the depressed medically ill patient. Although the relatively benign side effects of these medications on cardiac conduction and blood pressure allow for more liberal use in the medically ill, these drugs nevertheless have different capacities for adverse drug interactions that must be considered. Nevertheless, such interactions can usually be avoided or managed by knowledgeable clinicians cognizant of the pharmacodynamic and pharmacokinetic principles outlined in this article. 17 AUTHOR Malt UF AUTHOR Beckman S AUTHOR Ekeberg O AUTHOR Gunby B AUTHOR Jorgensen J AUTHOR Lingjaerde O AUTHOR Skomedal T TITLE [Drug therapy of depression in general practice] SOURCE Tidsskr Nor Laegeforen; VOL 112, ISS 26, 1992, P3294-7 (REF: 29) ABSTRACT The authors advocate use of the Montgomery-Asberg Depression Rating Scale in general practice as a screening instrument for depression. A score of 20 and above for more than two weeks indicates a need for treatment with antidepressant drugs. The treatment should continue with full dosage for at least two months after the patient has been cured. In order to maintain the patient's quality of life, reduce risk of drug-related toxicity and improve compliance, we recommend alfa-2-receptor blocker, a selective 5HT-re-uptake inhibitor or a selective monoamino-oxidase A inhibitor as the first drug choice for treatment of depression by general practitioners. Monitoring serum levels of the drug may be helpful, especially in persons who do not respond to treatment. 12 AUTHOR Grimsley SR AUTHOR Jann MW TITLE Paroxetine, sertraline, and fluvoxamine: new selective serotonin reuptake inhibitors SOURCE Clin. Pharm.; VOL 11 ISS Nov 1992, P930-957, 976-977, (REF 240) ABSTRACT IPA COPYRIGHT: ASHP The pharmacology and pharmacokinetics, adverse effects, drug interactions, efficacy, and dosage and administration of the new serotonergic reuptake inhibitors (SSRIs) paroxetine, sertraline hydrochloride (Zoloft), and fluvoxamine are reviewed. Clinical experience has demonstrated all 3 drugs to be effective in treatment of depression. They may be especially useful in elderly patients, in those who cannot tolerate alternate treatments, and in those who do not respond to adequate trials of other antidepressant therapies. This article qualifies for 1 h of U.S. CE credit by the ACPE. 14 AUTHOR Guthrie SK TITLE Sertraline: new specific serotonin reuptake blocker SOURCE DICP Ann. Pharmacother.; VOL 25 ISS Sep 1991, P952-961, (REF 64) ABSTRACT IPA COPYRIGHT: ASHP A review of the pharmacokinetics, indications, dosage, and side effects of sertraline hydrochloride (Zoloft) is presented. Studies have shown sertraline to be efficacious in the treatment of depression and obsessive-compulsive disorder. The daily dose will range from 50 to 200 mg/day for the treatment of depression. The most prominent adverse effects are gastrointestinal. This article qualifies for 1 hour U.S. CE credit by the ACPE.