“Novel Psychopharmacology for Depressive Disorders”

Fornaro, Michele; Berardis, Domenico De; Anastasia, Annalisa; Fusco, Andrea

doi:10.1007/978-981-33-6044-0_22

Cited by 12 publications

(2 citation statements)

References 78 publications

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“…A combination with decreased bone density under SSRI therapy might also explain this observation [17]. Concerning the development of more effective and safer antidepressant drugs in the future, it might also be useful to investigate agents other than SSRIs for their potential to prevent PSD [18].…”

Section: Discussionmentioning

confidence: 99%

Selective Serotonin Reuptake Inhibitors for the Prevention of Post-Stroke Depression: A Systematic Review and Meta-Analysis

Richter

James

Ebert

et al. 2021

JCM

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There are controversial data on the efficacy and safety profile of selective serotonin reuptake inhibitors (SSRIs) to prevent post-stroke depression (PSD). We performed a systematic search in MEDLINE and SCOPUS databases to identify randomized-controlled trials questioning the use of early SSRI therapy in the post-stroke population and its effect on PSD incidence. We included 6 studies with 6560 participants. We extracted the data on PSD occurrence in association with the treatment arm (SSRI versus placebo), as reported by each study. For safety analysis, we extracted the information on adverse events. A random-effects model was used to calculate the pooled relative risk estimates. Early SSRI therapy was associated with a significant reduction of PSD occurrence compared to placebo (10.4% versus 13.8%; relative risk: 0.75 [95% CI, 0.66–0.86]; absolute risk reduction: 3.4%). SSRI therapy increases the risk of bone fracture (RR 2.28 [95% CI, 1.58–3.30]) and nausea (RR 2.05 [95% CI, 1.10–3.82]) in the post-stroke population. Considering the risk-benefit ratio of early SSRI therapy in the post-stroke population, future research should identify high-risk patients for PSD to improve the risk-benefit consideration of this therapy for use in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Selective Serotonin Reuptake Inhibitors for the Prevention of Post-Stroke Depression: A Systematic Review and Meta-Analysis

Richter

James

Ebert

et al. 2021

JCM

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“…Two recent, preliminary, real-world studies highlighted the effectiveness of vortioxetine in improving depressive symptoms in MDD + AUD patients, with also beneficial effects in reducing alcohol consumption [ 23 , 24 ]. New antidepressants with glutamatergic activity ( i.e ., ketamine, esketamine), recently approved for treatment-resistant depression, are currently being tested for further conditions [ 25 ]. A case series on comorbid MDD + AUD patients described that treatment with naltrexone and ketamine was associated with improvement in depressive symptoms, as well as in alcohol craving and consumption [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

Update on Pharmacological Treatment for Comorbid Major Depressive and Alcohol Use Disorders: The Role of Extended-release Trazodone

Nicola

Pepe

Panaccione

et al. 2023

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Major Depressive Disorder (MDD) and Alcohol Use Disorder (AUD) are major public health concerns because of their high prevalence and clinical and functional severity. MDD and AUD commonly co-occur, but effective therapeutic approaches for comorbidity are still scarce. Available evidence on selective serotonin reuptake inhibitors and tricyclic antidepressants held mixed results, and further pharmacological categories have been less investigated. Trazodone is an approved antidepressant drug for adults and has shown efficacy on symptoms like anxiety and insomnia ob- served in AUD patients as well. Thus, this study aims to evaluate the effect of extended-release trazo- done on clinical and functional features in MDD + AUD subjects. Methods: One hundred MDD + AUD outpatients were retrospectively evaluated at 1, 3, and 6 months of treatment with extended-release trazodone (150-300 mg/day, flexibly dosed). Improvement in de- pressive symptoms was the primary outcome measure. Changes in anxiety, sleep, functioning, quality of life, clinical global severity, and alcohol craving were also investigated. Results: Trazodone reduced depressive symptoms (p < 0.001) with 54.5% remission at the endpoint. Similar improvements were observed in all secondary outcomes, including anxiety, sleep alterations, and craving (p < 0.001). Only mild side effects were reported and disappeared over time. Conclusion: Extended-release trazodone displayed good antidepressant properties in MDD + AUD patients, ameliorating overall symptomatology, functioning, and quality of life, with a good safety/ tolerability profile. Further, it significantly improved sleep disturbances and craving symptoms, which are associated with drinking relapse and worse outcomes. Therefore, trazodone might represent a promising pharmacological option for MDD + AUD patients.

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