Considerations on Safety Concerns About Citalopram Prescribing

Sheeler, Robert D.; Ackerman, Michael J.; Richelson, Elliott; Nelson, Thomas K.; Staab, Jeffrey P.; Tangalos, Eric G.; Dieser, Lisa M.; Cunningham, Julie L.

doi:10.1016/j.mayocp.2012.07.009

Cited by 18 publications

(8 citation statements)

References 7 publications

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“…Indeed, for antidepressants debate exists, e.g. regarding the necessity and appropriate frequency of monitoring of the electrocardiogram (ECG), notwithstanding a recent FDA warning [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Monitoring of somatic parameters at outpatient departments for mood and anxiety disorders

et al. 2018

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IntroductionSomatic complications account for the majority of the 13–30 years shortened life expectancy in psychiatric patients compared to the general population. The study aim was to assess to which extent patients visiting outpatient departments for mood and anxiety disorders were monitored for relevant somatic comorbidities and (adverse) effects of psychotropic drugs–more specifically a) metabolic parameters, b) lithium safety and c) ECGs—during their treatment.MethodsWe performed a retrospective clinical records review and cross-sectional analysis to assess the extent of somatic monitoring at four outpatient departments for mood and anxiety disorders in The Netherlands. We consecutively recruited adult patients visiting a participating outpatient department between March and November 2014. The primary outcome was percentage of patients without monitoring measurements. Secondary outcomes were number of measurements per parameter per patient per year and time from start of treatment to first measurement.ResultsWe included 324 outpatients, of whom 60.2% were female. Most patients were treated for depressive disorders (39.8%), anxiety disorders (16.7%) or bipolar or related disorders (11.7%) and 198 patients (61.1%) used at least one psychotropic drug. For 186 patients (57.4%), no monitoring records were recorded (median treatment period 7.3 months, range 0–55.6). The median number of measurements per parameter per year since the start of outpatient treatment for patients with monitoring measurements was 0.31 (range 0.0–12.9). The median time to first monitoring measurement per parameter for patients with monitoring measurements was 3.8 months (range 0.0–50.7).DiscussionSomatic monitoring in outpatients with mood and anxiety disorders is not routine clinical practice. Monitoring practices need to be improved to prevent psychiatric outpatients from undetected somatic complications.

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Section: Introductionmentioning

confidence: 99%

Monitoring of somatic parameters at outpatient departments for mood and anxiety disorders

et al. 2018

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“…And, sertraline (Zoloft) and paroxetine (Paxil) are the only FDAapproved medications for PTSD. Although the efficacy of SSRIs has proven to be very high in many sufferers, there are adverse effects (including cognitive dysfunction, weight gain, sexual dysfunction, sedation, dependence, and withdrawal) (Haddad 1998;Nelson and Philbrick 2012;Sheeler et al 2012) that limit the utility of SSRIs and indicate a major unmet medical need to explore more promising treatments for PTSD.…”

Section: Introductionmentioning

confidence: 99%

Anxiolytic effects of ketamine in animal models of posttraumatic stress disorder

Zhang¹,

Zhou

et al. 2014

Psychopharmacology

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This study investigated the effectiveness of ketamine, a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist, in alleviating the enhanced anxiety and fear response in both a mouse model of PTSD induced by inescapable electric foot shocks and a rat model of PTSD induced by a time-dependent sensitization (TDS) procedure. First, we evaluated the effect of ketamine on behavioral deficits in a mouse model of PTSD that consisted of foot shocks followed by three situational reminders. Our results showed that the aversive procedure induced several behavioral deficiencies, such as increased freezing behavior and anxiety, as well as reduced time spent in an aversive-like context, which were reversed by repeated treatment with ketamine. The effect of ketamine on behavioral changes after exposure to TDS was also investigated, and the levels of brain-derived neurotrophic factor (BDNF) in the hippocampus were measured. The results revealed that after TDS, the rats showed a significant increase in contextual freezing and a decrease in the percentage of time spent in and numbers of entries into open arms in the elevated plus maze test. As a positive control drug, sertraline (Ser, 15 mg/kg, i.g.), a selective serotonin reuptake inhibitor (SSRI) ameliorated these behavioral deficits. These behavioral effects were mimicked by chronic ketamine treatment. Furthermore, ketamine normalized the decreased BDNF level in the hippocampus in post-TDS rats. Taken together, these results suggest that ketamine exerts a therapeutic effect on PTSD that might be at least partially mediated by an influence on BDNF signaling in the hippocampus.

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“…The selective serotonin reuptake inhibitors (SSRIs) sertraline and paroxetine are the only medications currently approved by the Federal Drug Administration for the treatment of PTSD, but their effects are modest, and in some PTSD populations, including American male combat veterans, they were found to be ineffective. In addition, there are adverse effects (include cognitive dysfunction, weight gain, sexual dysfunction, sedation, dependence and withdrawal) that should be considered (Haddad, 1998;Nelson and Philbrick, 2012;Sheeler et al, 2012). Although benzodiazepines (BZDs) (e.g.…”

Section: Introductionmentioning

confidence: 99%

Anxiolytic-like effects of YL-IPA08, a potent ligand for the translocator protein (18 kDa) in animal models of post-traumatic stress disorder

Zhang¹,

Qiu²,

Zhao³

et al. 2014

Int. J. Neuropsychopharm.

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Recently, the translocator protein (18 kDa) (TSPO), previously called peripheral benzodiazepine receptor (PBR) and both the starting point and an important rate-limiting step in neurosteroidogenesis, has received increased attention in the pathophysiology of post-traumatic stress disorder (PTSD) because it affects the production of neurosteroids, reinforcing the hypothesis that selective TSPO ligands could potentially be used as anti-PTSD drugs. As expected, we showed that chronic treatment with YL-IPA08 [N-ethyl-N-(2-pyridinylmethyl)-2-(3,4-ichlorophenyl)-7-methylimidazo [1,2-a] pyridine-3-acetamide hydrochloride], a potent and selective TSPO ligand synthesized by our institute, caused significant suppression of enhanced anxiety and contextual fear induced in the inescapable electric foot-shock-induced mouse model of PTSD and the time-dependent sensitization (TDS) procedure. These effects were completely blocked by the TSPO antagonist PK11195. Furthermore, YL-IPA08 could increase the level of allopregnanolone in the prefrontal cortex and serum of post-TDS rats, and these effects were antagonized by PK11195. In summary, the findings from the current study showed that YL-IPA08, a potent and selective TSPO ligand, had a clear anti-PTSD-like effect, which might be partially mediated by binding to TSPO and the subsequent synthesis of allopregnanolone.

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Considerations on Safety Concerns About Citalopram Prescribing

Cited by 18 publications

References 7 publications

Monitoring of somatic parameters at outpatient departments for mood and anxiety disorders

Monitoring of somatic parameters at outpatient departments for mood and anxiety disorders

Anxiolytic effects of ketamine in animal models of posttraumatic stress disorder

Anxiolytic-like effects of YL-IPA08, a potent ligand for the translocator protein (18 kDa) in animal models of post-traumatic stress disorder

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