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Antidepressant Drugs
Published in Sahab Uddin, Rashid Mamunur, Advances in Neuropharmacology, 2020
NDRIs inhibit the reuptake of both NA and dopamine in the brain. For example, bupropion is an NDRI antidepressant mainly used in the cessation of smoking (Fava et al., 2005) and enhances the monoaminergic signaling with no appreciable serotonergic activity (Ascher et al., 1995; Stahl et al., 2004; Stahl, 1996; Richelson, 1996). Bupropion does not inhibit MAO and postsynaptic H, α, β, 5-HT, DA, or M receptors (Baldessarini, 2001; Ascher et al., 1995; Stahl et al., 2004; Dong and Blier, 2001) and therefore free from the sedation, cognitive impairment, or hypotensive effects (Stahl et al., 2004). Adverse effects include dryness of mouth, insomnia, headache, restlessness, anxiety, constipation, nasopharyngitis, and fatigue (Patel et al., 2016).
Nail tic disorders
Published in Archana Singal, Shekhar Neema, Piyush Kumar, Nail Disorders, 2019
The choice of the pharmacological agent depends on the type of co-existent psychiatric disorder, which includes four broad categories: anxiety, depression, psychosis, and obsessive-compulsive disorder. Accordingly, patient may require sedatives, antidepressants, or antipsychotic treatment.3Disorders like onychophagia and onychotillomania are treated in line with obsessive-compulsive disorders.Selective serotonin re-uptake inhibitors (SSRIs) such as sertraline, which are used in the treatment of OCD, can be added in severe cases of onychophagia and onychotillomania.10,18N-acetyl Cysteine has also been found to be effective in some cases by regulation of reward/reinforcement system through glutamine.27Nail tic disorders associated with bipolar disorders can be treated with drugs like lithium, while those associated with depression may require anti-depressants like norepinephrine-dopamine reuptake inhibitor such as bupropion and tricyclic antidepressants like amitriptyline.Severe or refractory cases of habit tic deformity can also be treated in terms of obsessive-compulsive disorders with drugs like SSRIs.Treatment with multivitamin supplements including biotin has also shown to be effective in some cases.21,22
Considerations when selecting an antidepressant: a narrative review for primary care providers treating adults with depression
Published in Postgraduate Medicine, 2023
C. Brendan Montano, W. Clay Jackson, Denise Vanacore, Richard Weisler
ADHD is frequently comorbid with both BPD and MDD, and a mean prevalence of 7.8% of comorbid ADHD in individuals with depression has been reported, complicating identification and management of each disorder [16,63,77]. Depressive symptoms in adults with ADHD may manifest as a result of coping with lower hedonic tone, and in one study, up to 28% of individuals referred to a tertiary clinic for mood and anxiety disorders had undetected ADHD [16,78]. Symptoms of ADHD may also be masked by substance use disorder, as individuals with ADHD have double the risk of substance abuse and dependence compared with the general population [79]. Symptoms of ADHD respond best to catecholaminergic agents such as psychostimulants or norepinephrine-dopamine reuptake inhibitors such as bupropion, which has shown potential off-label use for treatment of ADHD [80]. In addition, viloxazine, an SNRI previously used for treatment of MDD in Europe, was recently approved by the FDA for treatment of ADHD and has shown promise as a nonstimulant option [27,81,82]. Serotonergic agents alone do not improve symptoms of ADHD; thus, initiation of treatment with an SSRI alone for MDD in an individual with comorbid ADHD is likely to yield unsatisfactory response to treatment for either MDD or ADHD [16].
Rethinking the medication management of major depression
Published in Expert Review of Neurotherapeutics, 2023
Our proposed approach needs testing, but is readily usable by psychiatrists. Further studies are needed to guide use of antidepressant blood levels for most newer antidepressants. Ongoing evaluation of pharmacogenetic tests in guiding medication choices for MDD is also needed. The use of generic drugs has steadily increased in the US over the past two decades. Formularies that encourage selection of cheaper medications through copayment or coinsurance tiers have been a principal driver of generic drug use [193]. Despite anecdotal reports that some generics have less bioavailability compared with brand-name drugs, a study using two U.S. large commercial insurance databases reported comparable clinical outcomes with use of generic drugs compared with brand-name products [194]. Research on treatment of depression has appropriately focused over the past two decades on searching for drugs with new mechanism of action and targets, which is crucial but, there have been too few studies on how to better utilize currently available medications. A recent successful example in this regard is the dextromethorphan-bupropion combination, which has just been approved by FDA for MDD treatment [195]. Dextromethorphan has anti-NMDA receptor antagonist and SNRI properties. When combined with the norepinephrine-dopamine reuptake inhibitor bupropion, improvement of depressive symptoms is observed in as short as one week.
A Single Low-Dose of Methylphenidate Improves Abnormal Visual Field Testing
Published in Current Eye Research, 2021
Amir Sternfeld, Omer Y. Bialer, Dotan Keidar, Elinor Megiddo, Ivan Budnik, Hadas Stiebel-Kalish, Tami Livnat
Methylphenidate (trade name Ritalin™, Novartis Pharmaceuticals Corporation) is a central nervous system stimulant registered and widely used for the treatment of attention-deficit hyperactivity disorder (ADHD) and narcolepsy.17,18 The postulated mechanism of action is as a neuronal norepinephrine–dopamine reuptake inhibitor, thus increasing their bioavailability. It has an approximate duration of action of 2–4 hours for the immediate release drug.19 Common adverse effects include insomnia, anxiety, nervousness, and weight loss. More serious adverse effects include psychosis, tachycardia and hypertension.17,18 Methylphenidate (MPH) is recently gaining popularity as a cognitive enhancer for non-ADHD individuals.20,21 Numerous studies reported improvement in working memory, speed of processing, attention, vigilance, anxiety and motivation following a single-dose MPH.21–23 These properties can be harnessed to improve VF testing performance without inducing a change in the functional architecture of the visual system.11,12