Safety of Electroconvulsive Therapy-Duloxetine Combination

Eraslan, Defne; Genç, Yasin; Odabasioglu, Gurkan; Ergun, Berk Murat; Öztürk, Özgür

doi:10.1097/yct.0b013e318212eca2

Cited by 6 publications

(4 citation statements)

References 14 publications

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“…Ultimately, we can provide some strong evidence that the combination of duloxetine and ECT is at least as safe as the combination of sertraline and ECT. Eraslan et al reported two patients with suicidal ideas and psychotic features which were treated with duloxetine (30 mg) and ECT successfully without any important complications [11]. A report from Heinz et al has shown postictal ventricular tachycardia after co-administration of ECT with duloxetine and lithium [22].…”

Section: Discussionmentioning

confidence: 99%

“…Duloxetine, a relatively new SNRI, is effective with doses of 40 to 120 mg daily and can alleviate symptoms of depression. The safety of the combination of ECT with duloxetine has been only reported as case reports, and there is no clinical trial published in the literature to evaluate this combination regarding safety [11]. Toxicities of the combination of other antidepressants and ECT have been reported.…”

Section: Introductionmentioning

confidence: 99%

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Safety of Electro-Convulsive Therapy in Combination with Duloxetine in Treatment-resistant Depressive Patients: A Randomized Clinical Trial

Fakhraei

Farjam

Sarani

et al. 2023

GMJ

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Background: There are several strategies in the management of treatment-resistant depression (TRD), including the administration of other antidepressants, augmentation therapy, electro-convulsive therapy (ECT), and a combination of ECT and antidepressants. The safety of ECT combined with any medication must be confirmed. The aim of this study was to assess the safety of duloxetine and ECT combination therapy. Materials and Methods: In this randomized clinical trial, the probable side effects of ECT plus duloxetine were compared with ECT plus sertraline in two groups of admitted TRD patients. Patients with general medical diseases and/or any contraindications to ECT or any of the two drugs were excluded. General side effects, including nausea, vomiting, and headache reported by patients (hours after ECT) as well as cardiotoxicity by electrocardiogram (immediately after any ECT episode), cognitive status by mini-mental state examination (MMSE, one month after the last ECT), and seizure duration were recorded for each patient. Results: No significant differences were observed in nausea, vomiting, headache, and myalgia between ECT+duloxetine and ECT+sertraline groups. Heart rate, QTc interval, ST-T change, and the incidence of arrhythmia were the same between the two arms of the study. Also, no prolonged seizures and status epilepticus were recorded among the studied patients. The MMSE revealed no marked differences in the cognitive status among patients of the two groups. Conclusion: ECT+duloxetine and ECT+sertraline were equally safe in patients with TRD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Safety of Electro-Convulsive Therapy in Combination with Duloxetine in Treatment-resistant Depressive Patients: A Randomized Clinical Trial

Fakhraei

Farjam

Sarani

et al. 2023

GMJ

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“…Studies suggest that a combination therapy consisting of SNRI and ECT is far more effective than using one of the mentioned treatments alone [7]. Although few cases reports approved the safety of duloxetine and ECT combination therapy, no animal studies or clinical trials support the safety of this approach of treatment [8,9]. However, some evidence is that combining other SNRI drugs with ECT to treat TRD in some doses may lead to cardiovascular complications such as asystole and ventricular tachycardia [10,11].…”

Section: Introductionmentioning

confidence: 99%

Evaluating the Effect of Electroconvulsive Shock and Duloxetine Combination Therapy on Behavioral, Cardiovascular, and Brain Oxidative Stress Markers in the Rats

Farjam

Hekmat

Kouhpayeh

et al. 2021

GMJ

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Background: Electroconvulsive Therapy (ECT) as a well-established and effective therapeutic approach for the treatment of various psychiatric disorders is an excellent option to treat the major depressive disorder (MDD). The goal of this experimental study was to determine the possible sides effects of electroconvulsive shock (ECS) and duloxetine, a serotonin-norepinephrine Reuptake Inhibitors (SNRIs), and evaluate the safety of this therapeutic approach on behavioral factors, cardiovascular function, and brain oxidative stress markers on mice. Materials and Methods: Animals were divided into different groups receiving either ECS or different doses (10, 20, 40, 80, or 120 mg) of duloxetine alone or together. We evaluated the behavioral factors associated with administration of ECS with or without duloxetine. In addition, we monitored the ECGs (electrocardiogram) of animals prior to and after the experiment and also evaluated the oxidative stress markers including TAC, MDA, and GSH mice’s brains. Results: We did not detect any significant differences in terms of heart rate, RR interval, PR interval, QT, or corrected QT (QTc) between groups that received different doses of duloxetine in combination with ECS compare to the control group. Our findings suggest that while administration of ECS solely increased the oxidative stress markers and decreased the antioxidant capacity of the brain, a combination of duloxetine and ECS at certain doses alleviates the oxidative stress condition and increases the antioxidant capacity of the brain. Conclusion: Overall, this study suggests that the combination of ECS and duloxetine is safe and considerable for further studies on human subjects.

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“…Duloxetine is a novel inhibitor of the reuptake of serotonin and noradrenaline, and used for the treatment of MDD. There are several published reports about the combined use of quetiapine with duloxetine in clinical [ 6 – 9 ], which demonstrate to improve the efficiency and the side effects are mild. One case of severe urinary retention requiring urinary catheterization associated with treatment of depression with duloxetine and quetiapine had been reported [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

A rapid LC-MS/MS method for simultaneous determination of quetiapine and duloxetine in rat plasma and its application to pharmacokinetic interaction study

Chen

Cui

et al. 2019

Journal of Food and Drug Analysis

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Combinations of new antidepressants like duloxetine and second-generation antipsychotics like quetiapine are used in clinical treatment of major depressive disorder, as well as in forensic toxicology scenarios. The drug–drug interaction (DDI) between quetiapine and duloxetine is worthy of attention to avoid unnecessary adverse effects. However, no pharmacokinetic DDI studies of quetiapine and duloxetine have been reported. In the present study, a rapid and sensitive liquid chromatography tandem mass spectrometry (LC-MS/MS) method was developed for simultaneous determination of quetiapine and duloxetine in rat plasma. A one-step protein precipitation with acetonitrile was applied for sample preparation. The analytes were eluted on an Eclipse XDB-C 18 column using the mixture of acetonitrile and 2 mM ammonium formate containing 0.1% formic acid at a gradient elution within 6.0 min. Quantification was performed in multiple-reaction-monitoring mode with the ion transitions m/z 384.4 → 253.2 for quetiapine, m/z 298.1→154.1 for duloxetine and m/z 376.2→165.2 for IS (haloperidol), respectively. Good linearity was obtained in the range of 0.50–100 ng/mL for quetiapine (r 2 = 0.9972) and 1.00–200 ng/mL for duloxetine (r 2 = 0.9982) using 50 μL of rat plasma, respectively. The method was fully validated with accuracy, precision, matrix effects, recovery and stability. The validated data have met the acceptance criteria in FDA guideline. The method was applied to a pharmacokinetic interaction study and the results indicated that quetiapine had significant effect on the enhanced plasma exposure of duloxetine in rats under combination use. This study could be readily applied in therapeutic drug monitoring of major depressive disorder patients receiving such drug combinations.

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Safety of Electroconvulsive Therapy-Duloxetine Combination

Cited by 6 publications

References 14 publications

Safety of Electro-Convulsive Therapy in Combination with Duloxetine in Treatment-resistant Depressive Patients: A Randomized Clinical Trial

Safety of Electro-Convulsive Therapy in Combination with Duloxetine in Treatment-resistant Depressive Patients: A Randomized Clinical Trial

Evaluating the Effect of Electroconvulsive Shock and Duloxetine Combination Therapy on Behavioral, Cardiovascular, and Brain Oxidative Stress Markers in the Rats

A rapid LC-MS/MS method for simultaneous determination of quetiapine and duloxetine in rat plasma and its application to pharmacokinetic interaction study

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