The problem of safety of pharmacotherapy of affective disorders: new opportunities | Ukrainian Medical Journal

Burchinsky S.G.

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The problem of safety of pharmacotherapy of affective disorders: new opportunities

The problem of safety of pharmacotherapy of affective disorders: new opportunities

January 19, 2022

763

Neurology and Psychiatry

Keywords :

Specialities :

Neurology and Psychiatry

Resume

The article considers the problem of finding effective pharmacotherapy of affective and, first of all, depressive disorders. Today, despite the wide choice of antidepressants and mood-stabilizers of different generations and with different types of action, the effectiveness of all strategies for the treatment of depression often remains unsatisfactory. It is noted that safety characteristics are a leading factor in the widespread introduction of the drug in clinical practice. The risks of side effects of the main groups of conventional antidepressants (tricyclic antidepressants, selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors) were assessed, including effects on the cardiovascular system, metabolic processes, sexual function, cognition, sleep. The expediency of including in everyday practice innovative drugs with antidepressant and thymostabilizing properties was noted, which allows to significantly improve the safety of treatment in accordance with modern world standards while maintaining the effectiveness of treatment of affective disorders.

References

1. Марута Н.А. (2001) Современные депрессивные расстройства (клинико-психопатологические особенности, диагностика, терапия). Укр. вісн. психоневрол., 9(4): 79–82.
2. Напрєєнко О.К., Логановський К.М., Сиропятов О.Г. та ін. (2013) Нециркулярні депресії. Софія-А, Київ, 623 с.
3. Купко Н. (2019) Скринінг та діагностика депресії в умовах первинної ланки охорони здоров’я. НейроNews, 9: 24–28.
4. Schatzberg A., DeBattista C. (2015) Manual of Clinical Psychopharmacology (Eight Edition). Washington: Amer. Psychiat. Publ., 687 p.
5. Бурчинский С.Г. (2021) Депрессия и тревога у пациентов после перенесенного COVID-19: возможности комбинированной терапии. Журн. неврол. им. Н.Б. Маньковского, 9(1–2): 15–21.
6. Abad V.C., Guilleminault C. (2005) Sleep and psychiatry. Dialogues Clin. Neurosci., 7: 291–303.
7. Klaser K., Thompson E.J., Nguyen L.H. et al. (2021) Anxiety and depression symptoms after COVID-19 infection: results from the COVID Symptom Study app. MedRxiv. doi 10.1101/2021.07.07/21260137.
8. Bueno-Notivol J., Gracia-Garcia P., Olaya B. et al. (2020) Prevalence of depression during the COVID-19 outbreak: a meta-analysis of community-based studies. Int. J. Clin. Health Psychol.doi:10.1016/j.ijchp.2020.07.007.
9. Свістільник Р.В., Поліщук В.А. (2021) Антидепресанти та ризики з боку серцево-судинної системи. Позитивні і негативні сторони використання в клінічній практиці. Здоров’я України, 19: 75–77.
10. Leonard C.E., Bilker W.B., Newcomb C. et al. (2011) Antidepressants and the risk of sudden cardiac death and ventricular arrhythmia. Pharmacoepidemiol. Drug Saf., 20: 903–913.
11. Emul E., Dalkiran M., Samim S. еt al. (2009) The influence of depression and venlafaxine at therapeutic doses on atrial conduction. J. Psychopharmacol., 23: 163–167.
12. Liu L., Fuller M., Behymer T.P. et al. (2020) Selective serotonine reuptake inhibitors and intracerebral hemorrhage risk and outcome. Stroke, 51: 1135–1141.
13. Kivrak Y., Guvenc T.S., Akbulut N. et al. (2014) Accelerated hypertension after venlafaxine usage. Case Rep. Psychiat. doi 10.1155/2014/659715.
14. Wathra R., Mulsand B.H., Thompson L. et al. (2020) Hypertension and orthostatic hypotension with venlafaxine treatment in depresses older adults. J. Psychopharmacol., 34: 1112–1118.
15. Beyazyuz M., Albayrak Y., Eglimez O.B. et al. (2013) Relationship between SSRI and metabolic syndrome abnormalities in patients with generalized anxiety disorder: a prospective study. Psychiat. Investig., 10: 148–154.
16. Chavez-Castillo M., Ortega A., Nava M. et al. (2018) Metabolic risk in depression and treatment with selective serotonine reuptake inhibitors: are the metabolic syndrome and an increase in cardiovascular risk unavoidability? Vessel Plus. doi 10.20517/2574-1209.2018.02.
17. Felger J.C. (2019) Role of inflammation in depression and treatment implications. Handb. Exp. Pharmacol., 250: 255–286.
18. Clayton A.H., Crost H.A., Handiwaba L. (2014) Antidepressants and sexual dysfunction: mechanisms and clinical implications. Postgrad. Med., 126: 91–99.
19. Gregorian R.S., Golden K.A., Bahce A. et al. (2002) Antidepressant-induced sexual dysfunction. Ann. Pharmacother., 36: 1577–1589.
20. Moraros J., Nwankwo C., Patten S.B. et al. (2017) The association of antidepressant drug usage with cognitive impairments or dementia, including Alzheimer’s disease: a systematic review and meta-analysis. Depress. Anxiety, 34: 217–226.
21. Бурчинский С.Г. (2012) Нарушения сна при депрессиях: новые возможности антидепрессантов. Укр. неврол. журн., 2: 84–89.
22. Lam R.W. (2006) Sleep disturbances and depression: a challenge for antidepressants. Int. Clin. Psychopharmacol., 21(suppl. 1): S25–S29.
23. Gillman P.K. (2007) Tricyclic antidepressant pharmacology and therapeutic drug interactions updated. Brit. J. Pharmacol., 151: 737–748.
24. Price J., Cole V. (2009) Emotional side-effects of selective serotonin reuptake inhibitots: qualitative study. Brit. J. Psychiat., 195: 211–217.
25. pubmed.ncbi.nlm.nih.gov/27186622/
26. Coppen A., Bollander-Gouaille C. (2005) Treatment of depression: time to consider folic acid and vitamin B₁₂. J. Psychopharmacol., 19: 59–65.
27. Mischoulon D., Fava M. (2002) Role of S-adenosyl-methionine in the treatment of depression: a review of the evidence. Am. J. Clin. Nutr., 76 (suppl.): 1158S–1161S.
28. De Berardis D., Orsolini A., Serroni N. et al. (2016) A comprehensive review on the efficacy of S-adenosyl-methionine in major depressive disorder. CNS Neurol. Disord. Drug Target, 15: 1–10.
29. Alpert J.E., Papakostas G., Mischoulon D. et al. (2004) S-adenosyl-methionine (SAMe) as an adjunct for resistant major depressive disorder: an open trail following partial or nonresponse to selective serotonin reuptake inhibitors or venlafaxine. J. Clin. Psychopharmacol., 24: 661–664.