Antidepressant efficacy and side effect burden: an updated guide for clinicians

Kutzer, Tatum; Dick, Michelle; Scudamore, Trevor; Wiener, Mark; Schwartz, Thomas L.

doi:10.7573/dic.2020-2-2

“…Current lifestyles, especially in Western countries, are associated with the well-known diseases of civilization within which we can frame depression. Being able to understand what behavioral factors can modulate the incidence of this disease will allow us to carry out interventions at the level of prevention and interventions at the behavioral level that is more efficient and without secondary effects such as those of traditional pharmacological treatments [ 38 , 39 , 40 , 41 ].…”

Section: Discussionmentioning

confidence: 99%

Behavioral Patterns of Depression Patients and Control Population

Carreira-Míguez

¹

,

Navarro-Jiménez

²

,

Clemente-Suárez

³

2022

IJERPH

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Behavioral and multifactorial factors, such as psychological, nutritional, dental pathology, and physical activity habits, are factors that control depression. The objective of the present study was to analyze the differences in the behavioral, psychological, nutritional, dental pathology, and physical activity patterns of the depressed and control population. Forty-eight participants with depression (45.7 ± 12.0) and one hundred participants in a control group without any pathology or medication (48.9 ± 7.9) were interviewed using an online questionnaire. The multifactorial items of psychology, oral behavior, nutritional habits, and physical activity profile were analyzed through a set of questionnaires. The results showed how the depression group showed significantly higher psychological measures related to personality, anxiety, depression, loneliness, perceived stress, and psychological inflexibility than the control group. The control group showed significantly higher weekly vitality, vitality at the end of the week, weekly frequency of juice, wine, coffee, fresh vegetable salad, and Bristol scale than the depression group. Higher values of migraine headache, weekly soft drink frequency, and digestion after meals were found in the depression group. In addition, patients with depression also presented poor dental health, presenting higher rates of gastritis or heartburn, dry mouth, dental sensitivity, and sick days per year than the control group. Both groups presented a pattern of low physical activity. This information allows a better understanding of a multifactorial disease, as well as the creation of intervention and prevention protocols for this disease at a behavioral and lifestyle level.

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“…Conventional antidepressants such as the selective serotonin reuptake inhibitors were developed based on the monoamine hypothesis. These drugs have a relatively good therapeutic effect in some patients but also elicit adverse effects in others ( Kutzer et al, 2020 ; Ramic et al, 2020 ). Therefore, the search for new antidepressants is an urgent task for scientists.…”

Section: Pharmacological Effects Of Paeoniflorin In Depressionmentioning

confidence: 99%

A review for the pharmacological effects of paeoniflorin in the nervous system

Hong

¹

,

Lu

²

,

Wu

³

et al. 2022

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Paeoniflorin, a terpenoid glycoside compound extracted from Paeonia lactiflora Pall, shows preventive and therapeutic effects in various types of nervous system disorders. However, to date, no comprehensive knowledge on the pharmacological effects of paeoniflorin on the nervous system is available online. Clarification of this issue may be useful for the development of paeoniflorin as a new drug for the treatment of nervous system disorders. To this end, the authors summarize the pharmacological aspects of paeoniflorin and its possible mechanisms, such as restoration of mitochondrial function; inhibition of neuroinflammation, oxidative stress, and cellular apoptosis; activation of adenosine A1 receptor, cAMP response element-binding protein (CREB) and extracellular signal-regulated kinase 1/2 (ERK1/2); or enhancement of brain-derived neurotrophic factor and serotonin function, in the prevention of disorders such as cerebral ischemia, subarachnoid hemorrhage, vascular dementia, Alzheimer’s disease, Parkinson’s disease, depression, post-traumatic syndrome disorder, and epilepsy, by reviewing the previously published literature.

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“…When using TCAs for PPD, plasma concentration and impact on breast milk shall be closely monitored; response rate and effective rate in PPD patients receiving SSRIs were higher than those receiving TCAs [ 16 ]. MAOIs are usually not used in PPD treatment due to relatively more adverse effect [ 17 ]. Except traditional antidepressants, brexanolone, a positive metamorphosis regulator of gamma-aminobutyric acid A receptor, showed to be effective in the treatment of moderate and severe PPD in recent study [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Shuganjieyu Capsule Alone or in Combination with Other Antidepressants in the Treatment of Postpartum Depression: A Meta-Analysis

Wang

¹

,

Fan

²

,

He

³

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To evaluate the efficacy and safety of Shuganjieyu capsule alone or in combination with other antidepressants in the treatment of postpartum depression. Methods. Related control and randomized studies till August 1, 2021, were retrieved from the following databases: PubMed, Cochrane, CNKI, CMB, Wan-Fang, and VIP. Outcomes included HAMD reduction from baseline, response rate, and adverse events rate. Review Manager 5.3 was used in the present meta-analysis. Results. 16 studies including 1409 participants were included in the present study. In comparison of single Shuganjieyu capsule versus regular antidepressant, 8, 6, and 4-week HAMD reduction of the Shuganjieyu group were significantly higher (8-week MD: 3.1 (1.54, 4.66), p < 0.0001 ; 6-week MD: 0.71 (0.10, 1.31), p = 0.02 ; and 4-week MD: 0.82 (0.34, 1.30), p = 0.0008 ), response rates were comparable for the two groups (OR: 1.51 (0.87, 2.63), p = 0.014 ), and the adverse event rate of the Shuganjieyu group was significantly lower (OR: 0.22 (0.15, 0.32), p < 0.00001 ). In comparison of combination of Shuganjieyu capsule with regular antidepressant versus regular antidepressant alone, the 8, 6, 4, 2, and 1-week HAMD reduction and response rate of combination of Shuganjieyu with the regular antidepressant group were significantly larger (8-week MD: 3.2 (1.34, 5.06), p = 0.0007 ; 6-week MD: 4.00 (2.72, 5.28), p < 0.00001 ; 4-week MD: 3.33 (1.94,4.73), p < 0.00001 ; 2-week MD: 2.69 (1.34, 4.03), p < 0.0001 ; 1-week MD: 2.27 (0.69, 3.86), p = 0.005 ; and response rate OR: 4.69 (2.27, 9.68), p < 0.0001 ) and the adverse event rate was comparable for the two groups (OR: 1.26 (0.73, 2.17), p = 0.41 ). Conclusion. Compared with regular antidepressants, single Shuganjieyu capsule has similar efficacy and better safety profile; when Shuganjieyu capsule is combined with regular antidepressants, the efficacy is improved significantly without increasing adverse events. Therefore, Shuganjieyu capsule was effective and safe for postpartum, making it worth further investigation and popularization.

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Antidepressant efficacy and side effect burden: an updated guide for clinicians

Cited by 13 publications

References 57 publications

Behavioral Patterns of Depression Patients and Control Population

Behavioral Patterns of Depression Patients and Control Population

A review for the pharmacological effects of paeoniflorin in the nervous system

Efficacy and Safety of Shuganjieyu Capsule Alone or in Combination with Other Antidepressants in the Treatment of Postpartum Depression: A Meta-Analysis

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