Brain 5-HT neurotransmission during paroxetine treatment

1998 ◽  
Vol 172 (1) ◽  
pp. 49-52 ◽  
Author(s):  
P. A. Sargent ◽  
D. J. Williamson ◽  
P. J. Cowen
Keyword(s):  
Healthy Subjects ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Experimental Studies ◽  
Repeated Administration ◽  
Cortisol Response ◽  
Adaptive Changes ◽  
Compulsive Disorder ◽  
Depressed Patients ◽  
Clinical Consequences ◽  
Paroxetine Treatment

BackgroundAnimal experimental studies suggest that repeated administration of selective serotonin reuptake inhibitors (SSRIs) produces complex adaptive changes in brain serotonin (5-HT) pathways. The effect of these adaptive changes on different aspects of brain 5-HT neurotransmission and their clinical consequences are not well understood.MethodWe studied the effect of repeated administration of the SSRI, paroxetine (20 mg daily), on the Cortisol responses to the 5-HT precursor, 5-hydroxytryptophan (5-HTP), in healthy subjects and depressed patients.ResultsIn healthy subjects, following one week of paroxetine treatment there was a large increase in the Cortisol response to 5-HTP. This increase had all but disappeared following 3 weeks treatment. In contrast, in depressed patients treated with paroxetine for 8 weeks, the Cortisol response to 5-HTP was significantly increased.ConclusionsSSRI treatment in depressed patients produces a persistent increase in the Cortisol response to 5-HTP, a probable measure of neurotransmission at central 5-HT2 receptors. Potentiation of 5-HT2 neurotransmission is unlikely to account for the efficacy of SSRIs in major depression but might underlie their actions in obsessive–compulsive disorder and also perhaps certain of their adverse effects, notably sexual dysfunction.

Effect of Valine on 5-HT-mediated Prolactin Release in Healthy Volunteers, and on Mood in Remitted Depressed Patients

1995 ◽  
Vol 167 (2) ◽  
pp. 238-242 ◽  
Author(s):  
D. J. Williamson ◽  
S. F. B. McTavish ◽  
S. B. G. Park ◽  
P. J. Cowen
Keyword(s):  
Depressive Symptoms ◽  
Healthy Subjects ◽  
Antidepressant Drug ◽  
Experimental Studies ◽  
Healthy Male ◽  
Prolactin Release ◽  
Depressed Patients ◽  
Symptomatic Relapse ◽  
Male Subjects ◽  
Antidepressant Drug Treatment

BackgroundAnimal experimental studies suggest that the amino acid valine may decrease brain serotonin (5-HT) function by inhibiting the transport of the 5-HT precursor, L-tryptophan, across the blood barrier. The aim of the present study was to assess whether valine could decrease brain 5-HT function in healthy subjects and provoke symptomatic relapse in recently remitted depressed patients taking antidepressant drug treatment.MethodWe studied the effect of valine (30 g) on the prolactin (PRL) response to the 5-HT releasing agent, d-fenfluramine, in healthy male subjects and on the mood of 12 remitted depressed patients taking either selective serotonin re-uptake inhibitors (n = 10) or lithium and amitriptyline (n = 2).ResultsValine significantly lowered the PRL response to d-fenfluramine in healthy subjects. In the remitted depressives, valine caused a mild but detectable lowering of mood on a number of measures but only one patient experienced a significant relapse in mood.ConclusionsValine administration may decrease brain 5-HT neurotransmission in humans. This effect could explain the mild increase in depressive symptoms in patients taking 5-HT-potentiating drugs.

When to Choose Paroxetine Treatment in Skin-Picking Disorder: A Case Report

2022 ◽  
pp. 155005942110733
Author(s):  
Mehmet K. Arıkan ◽  
Muazzez Ç. Oba ◽  
Reyhan İlhan ◽  
Mehmet C. Mat
Keyword(s):  
Case Report ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Treatment Success ◽  
Skin Lesions ◽  
Alpha Power ◽  
Obsessive Compulsive ◽  
Skin Picking ◽  
Compulsive Disorder ◽  
Skin Picking Disorder ◽  
Paroxetine Treatment

Skin picking disorder (SPD) characterized by repetitive compulsive scratching in the absence of a primary skin disease is strongly associated with psychiatric comorbidities, including obsessive-compulsive disorder (OCD) and depression (MDD). Selective serotonin reuptake inhibitors (SSRIs) have been used in the treatment of SPD with variable success. Nevertheless, the optimum treatment choice for SPD is an issue for clinicians. This case report presents a 32-year-old female SPD patient treated with four-week paroxetine monotherapy. Based upon the clinical interview and standardized questionnaires, the patient was diagnosed with OCD with depressive features and Skin Picking Disorder. In addition to symptom severity scales, quantitative electroencephalography (qEEG) was also applied. Paroxetine treatment was started (titrated from 5 to 40 mg/day) and doubled each week. After four-week paroxetine monotherapy, OCD symptoms were diminished, and skin lesions were completely regressed leaving solely post inflammatory hyperpigmentation. Post-treatment qEEG assessment also showed a normalization of frontal alpha power and amplitude asymmetry. It can be concluded that if OCD includes SPD with abnormal EEG patterns; then the treatment success using paroxetine will be very high.

The Influence of Comorbid Anxiety Disorders on the Selection of Antidepressant Medication in Depressed Patients

CNS Spectrums ◽  
2006 ◽  
Vol 11 (S1) ◽  
pp. 4-6
Author(s):  
Mark Zimmerman
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Anxiety Disorders ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Antidepressant Medication ◽  
Severe Depression ◽  
Major Depressive ◽  
Atypical Depression ◽  
Compulsive Disorder ◽  
Depressed Patients

Although there is a wide array of choices of antidepressants, there is little empirical evidence to guide clinicians in their selection. Most reviews of the antidepressant literature, including the American Psychiatric Association's (APA) Practice Guideline for the Treatment of Major Depressive Disorder, conclude that these medications are generally equally effective. Consistent with this, a recent metaanalysis of studies comparing two or more new-generation antidepressants found little evidence that any medication was superior to the others. Although the APA guideline suggests that the choice of antidepressant be based principally on side effects, tolerability, patient preference, and cost, it also reviewed evidence of differential treatment response related to patients' clinical profiles. For patients with nonpsychotic, nonbipolar major depressive disorder (MDD), the guideline indicated that the presence of anxiety symptoms, atypical features, melancholic subtype, symptom severity, and borderline personality disorder may be associated with differential response to antidepressants. Selective serotonin reuptake inhibitors (SSRIs) are recommended for high anxiety, SSRIs and clomipramine for obsessive-compulsive disorder (OCD) symptoms, tricyclic antidepressants (TCAs) for severe depression and melancholia, and SSRIs and monoamine oxidase inhibitors (MAOIs) for atypical depression.What is most striking in the guideline's review is how limited in scope and utility are the data to guide the outpatient psychiatrist in selecting an antidepressant. Melancholia and severe depression are relatively infrequently encountered in the outpatient setting. The most common comorbidities in depressed outpatients are anxiety disorders, but the guideline simply says that bupropion may be anxiogenic and should be avoided, and that although MAOIs may work well in depressed patients with anxiety, other medications are preferred. It does not discuss the possible influence of specific comorbidities on antidepressant selection.

scholarly journals Comprehensive phenotyping revealed transient startle response reduction and histopathological gadolinium localization to perineuronal nets after gadodiamide administration in rats

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Johanna Habermeyer ◽  
Janina Boyken ◽  
Julia Harrer ◽  
Fabio Canneva ◽  
Veronika Ratz ◽  
...  
Keyword(s):  
Neuronal Cell ◽  
Cell Loss ◽  
Repeated Administration ◽  
Perineuronal Net ◽  
Treatment Groups ◽  
Long Time ◽  
Clinical Consequences ◽  
Molecular Weight Fractions ◽  
Clinical Mri ◽  
Pathway Deregulation

AbstractGadolinium based contrast agents (GBCAs) are widely used in clinical MRI since the mid-1980s. Recently, concerns have been raised that trace amounts of Gadolinium (Gd), detected in brains even long time after GBCA application, may cause yet unrecognized clinical consequences. We therefore assessed the behavioral phenotype, neuro-histopathology, and Gd localization after repeated administration of linear (gadodiamide) or macrocyclic (gadobutrol) GBCA in rats. While most behavioral tests revealed no difference between treatment groups, we observed a transient and reversible decrease of the startle reflex after gadodiamide application. Residual Gd in the lateral cerebellar nucleus was neither associated with a general gene expression pathway deregulation nor with neuronal cell loss, but in gadodiamide-treated rats Gd was associated with the perineuronal net protein aggrecan and segregated to high molecular weight fractions. Our behavioral finding together with Gd distribution and speciation support a substance class difference for Gd presence in the brain after GBCA application.

scholarly journals Personality traits and treatment outcome in obsessive-compulsive disorder

2008 ◽  
Vol 30 (3) ◽  
pp. 246-250 ◽  
Author(s):  
Felipe Corchs ◽  
Fábio Corregiari ◽  
Ygor Arzeno Ferrão ◽  
Tania Takakura ◽  
Maria Eugênia Mathis ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Personality Traits ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Behavioral Therapy ◽  
Temperament And Character Inventory ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Scale Scores ◽  
Character Inventory ◽  
Poor Treatment

OBJECTIVE: Comorbidity with personality disorders in obsessive-compulsive patients has been widely reported. About 40% of obsessive-compulsive patients do not respond to first line treatments. Nevertheless, there are no direct comparisons of personality traits between treatment-responsive and non-responsive patients. This study investigates differences in personality traits based on Cloninger's Temperament and Character Inventory scores between two groups of obsessive-compulsive patients classified according to treatment outcome: responders and non-responders. METHOD: Forty-four responsive and forty-five non-responsive obsessive-compulsive patients were selected. Subjects were considered treatment-responsive (responder group) if, after having received treatment with any conventional therapy, they had presented at least a 40% decrease in the initial Yale-Brown Obsessive Compulsive Scale score, had rated "better" or "much better" on the Clinical Global Impressions scale; and had maintained improvement for at least one year. Non-responders were patients who did not achieve at least a 25% reduction in Yale-Brown Obsessive Compulsive Scale scores and had less than minimal improvement on the Clinical Global Impressions scale after having received treatment with at least three selective serotonin reuptake inhibitors (including clomipramine), and at least 20 hours of cognitive behavioral therapy. Personality traits were assessed using Temperament and Character Inventory. RESULTS: Non-responders scored lower in self-directedness and showed a trend to score higher in persistence than responders did. CONCLUSION: This study suggests that personality traits, especially self-directedness, are associated with poor treatment response in obsessive-compulsive patients.

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