Long-term antidepressant treatment: Alterations in cerebral capillary permeability

1980 ◽  
Vol 70 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Sheldon H. Preskorn ◽  
Boyd K. Hartman ◽  
H. Brent Clark
Keyword(s):  
Capillary Permeability ◽  
Antidepressant Treatment ◽  
Cerebral Capillary

scholarly journals 332 - Electroconvulsive therapy in older adults with major depression was not associated with cognitive decline during a 15-year follow-up

2020 ◽  
Vol 32 (S1) ◽  
pp. 91-91
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Major Depression ◽  
Cognitive Decline ◽  
Electroconvulsive Therapy ◽  
Antidepressant Treatment ◽  
Community Sample ◽  
Control Group

AUTHORS:Kerstin Johansson, Karolina Thömkvist, Ingmar Skoog and Sacuiu SF* (*presenter)OBJECTIVE:To determine the effects of electroconvulsive therapy (ECT) in major depression in relation to the development of dementia during long-term follow-up.METHOD:In an observational clinical prospective study of consecutive patients 70 years and older diagnosed with major depression at baseline 2000-2004 (n=1090), who were free of dementia and received antidepressant treatment, with or without ECT, we sought to determine if cognitive decline (mild cognitive impairment and dementia) during 15 -year follow-up was associated with receiving ECT at baseline. The control group was selected among the participants in the Gothenburg H70 Birth Cohort Studies matched by age group and sex 1:1.RESULTS:Among patients with affective syndromes 7% received ECT. During follow-up, 157 patients were diagnosed with dementia, equal proportions among those who received ECT (14.5%) and those who did not receive ECT (14.5%). The relation between ECT and cognitive decline remained non-significant irrespective antidepressive medication or presence of mild cognitive impairment at baseline.CONCLUSION:Preliminary results indicate that ECT was not associated with the development of cognitive decline in the long-term in a hospital-based cohort of 70+ year-olds. The results remain to verify against controls from a representative community sample.

Family Intervention Approach to Loss of Clinical Effect During Long-Term Antidepressant Treatment

2007 ◽  
Vol 68 (09) ◽  
pp. 1348-1351 ◽  
Author(s):  
Stefania Fabbri ◽  
Giovanni A. Fava ◽  
Chiara Rafanelli ◽  
Elena Tomba
Keyword(s):  
Clinical Effect ◽  
Antidepressant Treatment ◽  
Family Intervention ◽  
Intervention Approach

scholarly journals Patients’ attitudes to discontinuing not-indicated long-term antidepressant use: barriers and facilitators

2019 ◽  
Vol 9 ◽  
pp. 204512531987234 ◽  
Author(s):  
Rhona Eveleigh ◽  
Anne Speckens ◽  
Chris van Weel ◽  
Richard Oude Voshaar ◽  
Peter Lucassen
Keyword(s):  
Antidepressant Treatment ◽  
Controlled Trial ◽  
Comparative Method ◽  
Intervention Group ◽  
Barriers And Facilitators ◽  
Fear Of Recurrence ◽  
Important Barrier ◽  
Antidepressant Use ◽  
A Current

Background: Long-term antidepressant use has increased exponentially, though this is not always according to guidelines. Our previous randomized controlled trial (RCT) showed that participants using antidepressants long term without a proper indication were apprehensive to stop: only half were willing to attempt to discontinue their antidepressant use. The objective of this study was to explore participants’ barriers and facilitators for stopping long-term antidepressant use without a current proper indication. Methods: Semistructured interviews with participants from the intervention group of our RCT, a cluster-RCT in general practice in the Netherlands. The latter study was a stop trial with patients on long-term antidepressant use without a current indication (no psychiatric diagnosis). Participants of the intervention group of the RCT had been provided with advice to stop antidepressants. Participants of the current interview study were purposively sampled (from the intervention group of the RCT) to ensure diversity in age, sex, and intention to discontinue the antidepressant. Analysis was performed as an iterative process, based on the constant comparative method. Data collection proceeded until saturation was reached. Results: A total of 16 participants were interviewed. Fear (of recurrence, relapse, or to disturb the equilibrium) was the most important barrier; prior attempts fueled these anticipations. Also prominent as a barrier was the notion that antidepressants are necessary to counter a deficiency of serotonin. Facilitators were information on duration of usage given at the time of first prescription and confidence in a successful attempt. We found many participants struggling between barriers and facilitators to discontinue and participants not discontinuing while experiencing no barriers (ambivalence). Conclusion: Fear is an important motive for patients considering discontinuation of antidepressants. Serotonin deficiency as explanation for antidepressant effectiveness promotes life-long use and hinders discontinuation of antidepressant treatment. The prospect of discontinuation at first prescription can facilitate a future discontinuation attempt. General practitioners should be aware of their patients’ fears, expectations, and attributions toward antidepressant use/discontinuation, and of new developments in taper methods.

Presynaptic alpha-receptor subsensitivity after long-term antidepressant treatment

Science ◽  
1978 ◽  
Vol 202 (4365) ◽  
pp. 322-324 ◽  
Author(s):  
F. Crews ◽  
C. Smith
Keyword(s):  
Antidepressant Treatment

Treatment of Rapid-Cycling Bipolar Disorder

CNS Spectrums ◽  
2004 ◽  
Vol 9 (S2) ◽  
pp. 1-4
Author(s):  
Robert M. Post ◽  
Kiki D. Chang ◽  
Trisha Suppes ◽  
David L. Ginsberg
Keyword(s):  
Bipolar Disorder ◽  
Treatment Guidelines ◽  
Antidepressant Treatment ◽  
Rapid Cycling ◽  
Controlled Clinical Trials ◽  
Safety Considerations ◽  
Bipolar Patients ◽  
Patients Experience ◽  
Patient Use

AbstractApproximately 40% of bipolar patients experience rapid cycling, and half of these suffer from ultra-rapid or ultradian cycling. These patterns are also common in children. Rapid-cycling bipolar disorder is difficult to bring to remission and often requires treatment with four or more classes of psychotropic medications. Lithium, even in combination with anticonvulsants or antidepressants, is often associated with residual episodic depressions. Concerns with adjunctive antidepressant treatment include their low response and remission rates and their tendency to cause switch into mania. Atypical antipsychotics and selected agents within the anticonvulsant class are becoming increasingly important in the treatment of rapid cycling. In the absence of clear treatment guidelines, the use and sequencing of drugs in complex combination treatment remains exploratory, but should be individualized based on careful prospective mood charting by the patient. Use of several drugs below their side-effect thresholds may prevent certain side effects. In children, long-term safety considerations are particularly important in the absence of a strong controlled clinical trials database.

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