QTc-Zeit-Verlängerung unter Therapie mit Agomelatin

Kozian, Ralf; Syrbe, Günther

doi:10.1055/s-0030-1248578

Cited by 10 publications

(2 citation statements)

References 9 publications

(12 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Compared to TCAs, selective serotonin reuptake inhibitors (SSRIs) and newer classes of antidepressants (ADs) have been suggested to have safer cardiovascular profiles ( Grimsley and Jann, 1992 ; Leonard, 1993 ; Kasper et al, 1996 ; Pacher et al, 1999 ; Ray et al, 2004 ; Fernandez et al, 2007 ; Zemrak and Kenna, 2008 ). However, an increasing number of case reports ( Friberg et al, 2006 ; Winkler et al, 2006 ; Kozian and Syrbe, 2010 ; Deshmukh et al, 2012 ) and pharmacovigilance studies ( Sadanaga et al, 2004 ; Wilting et al, 2006 ; Astrom-Lilja et al, 2008 ; Martinez et al, 2010 ) have revealed arrhythmias ( Leonard et al, 2011 ), QT interval prolongation ( Girardin et al, 2013 ; for review see Vieweg et al, 2009 ), and orthostatic hypotension during treatment with the new ADs. This has led to the ongoing discussion about their cardiovascular safety profiles ( Pacher and Kecskemeti, 2004 ).…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Adverse Reactions During Antidepressant Treatment: A Drug Surveillance Report of German-Speaking Countries Between 1993 and 2010

Spindelegger

Παπαγεωργίου

Grohmann

et al. 2014

International Journal of Neuropsychopharmacology

View full text Add to dashboard Cite

Background:Antidepressants (ADs) are known to have the potential to cause various cardiovascular adverse drug reactions (ADRs). The tricyclic antidepressants (TCAs) were first revealed to be a possible source of cardiovascular ADRs. In recent years, newer classes of ADs were also suggested to have a higher risk of cardiovascular adverse effects. In particular, the selective serotonin reuptake inhibitors (SSRIs) were suspected to have the potential to induce QTc interval prolongation, and therefore increase the risk of ventricular arrhythmia. This descriptive study is based on the continuous pharmacovigilance program of German-speaking countries (Austria, Germany, and Switzerland), the Arzneimittelsicherheit in der Psychiatrie (AMSP), which assesses severe ADRs occurring in clinical routine situations.Methods:Of 169 278 psychiatric inpatients treated with ADs between 1993 and 2010, 198 cases of cardiovascular ADRs (0.12%) were analyzed.Results:Our study showed that the incidence rates of cardiovascular ADRs were highest during treatment with monoamine oxidase inhibitors (0.27%), TCAs (0.15%), and serotonin noradrenaline reuptake inhibitors (0.14%); the risk of occurring during treatment with SSRIs (0.08%) was significantly lower. The noradrenergic and specific serotonergic AD mirtazapine (0.07%) had a significantly lower risk of cardiovascular ADRs than all other ADs. Severe hypotension was the most frequent ADR, followed by hypertension, arrhythmia, and in some rare cases heart failure.Conclusions:Despite certain limitations due to the AMSP study design, our observations on cardiovascular ADRs can contribute to a better knowledge of the cardiovascular risk profiles of antidepressants in the clinical routine setting. However, prospective studies are needed to verify our findings.

show abstract

Section: Introductionmentioning

confidence: 99%

Cardiovascular Adverse Reactions During Antidepressant Treatment: A Drug Surveillance Report of German-Speaking Countries Between 1993 and 2010

Spindelegger

Παπαγεωργίου

Grohmann

et al. 2014

International Journal of Neuropsychopharmacology

View full text Add to dashboard Cite

show abstract

“…Agomelatine has not shown adverse events related to sexual function, unlike active comparators (venlafaxine and escitalopram) 108,109. One case of reversible QTc prolongation has been reported 110. This is a known side effect of other antidepressants, having been reported with both tricyclics and serotonin reuptake inhibitors in overdose,111–113 particularly in the elderly 114.…”

Section: Safety Of Agomelatinementioning

confidence: 99%

Mood Disorders, Circadian Rhythms, Melatonin and Melatonin Agonists

Salva

Hartley

2012

J Cent Nerv Syst Dis

View full text Add to dashboard Cite

Recent advances in the understanding of circadian rhythms have led to an interest in the treatment of major depressive disorder with chronobiotic agents. Many tissues have autonomous circadian rhythms, which are orchestrated by the master clock, situated in the suprachiasmatic nucleus (SNC). Melatonin (N-acetyl-5-hydroxytryptamine) is secreted from the pineal gland during darkness. Melatonin acts mainly on MT1 and MT2 receptors, which are present in the SNC, regulating physiological and neuroendocrine functions, including circadian entrainment, referred to as the chronobiotic effet. Circadian rhythms has been shown to be either misaligned or phase shifted or decreased in amplitude in both acute episodes and relapse of major depressive disorder (MDD) and bipolar disorder. Manipulation of circadian rhythms either using physical treatments (such as high intensity light) or behavioral therapy has shown promise in improving symptoms. Pharmacotherapy using melatonin and pure melatonin receptor agonists, while improving sleep, has not been shown to improve symptoms of depression. A novel antidepressant, agomelatine, combines 5HT2c antagonist and melatonin agonist action, and has shown promise in both acute treatment of MDD and in preventing relapse.

show abstract

Depression and Anxiety Disorders

2021

The Maudsley Prescribing Guidelines in Psychiatry

View full text Add to dashboard Cite

Depression is widely recognised as a major public health problem around the world. The basic principles of prescribing are described in this chapter, along with a summary of NICE guidance. This chapter concentrates on the use of antidepressants and offers advice on drug choice, dosing, switching strategies and sequencing of treatments. Management of treatment‐resistant depression has been informed by the STAR*D programme. The 2019 PANDA trial results support the prescription of selective serotonin reuptake inhibitor antidepressants in a wider group of participants than previously thought, including those with mild to moderate symptoms who do not meet diagnostic criteria for depression or generalised anxiety disorder. Over the last two decades, ketamine, an uncompetitive N‐Methyl‐D‐Aspartate receptor antagonist and dissociative anaesthetic, has emerged as a novel and effective rapid‐acting antidepressant. Psychotic depression is an under‐identified disorder and may have a life‐time risk of up to 1%.

show abstract

QTc-Zeit-Verlängerung unter Therapie mit Agomelatin

Cited by 10 publications

References 9 publications

Cardiovascular Adverse Reactions During Antidepressant Treatment: A Drug Surveillance Report of German-Speaking Countries Between 1993 and 2010

Cardiovascular Adverse Reactions During Antidepressant Treatment: A Drug Surveillance Report of German-Speaking Countries Between 1993 and 2010

Mood Disorders, Circadian Rhythms, Melatonin and Melatonin Agonists

Depression and Anxiety Disorders

Contact Info

Product

Resources

About