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Central Nervous System Effects of Essential Oil Compounds
Published in K. Hüsnü Can Başer, Gerhard Buchbauer, Handbook of Essential Oils, 2020
Elaine Elisabetsky, Domingos S. Nunes
The second-generation antidepressants include the selective serotonin reuptake inhibitors (SSRIs) and the selective serotonin-norepinephrine uptake inhibitors (SNRIs). Relatively selective norepinephrine uptake inhibitors are also in the market. First-generation antidepressants include the monoamine oxidase inhibitors (MAOIs) and the tricyclic antidepressants (TCAs), which enhance monoaminergic transmission either by inhibiting its intraneuronal metabolism or its reuptake from the synaptic cleft, respectively. Second-generation agents have fewer side effects than the older agents, though limitations in efficacy and extended latency for symptoms amelioration are common to all (Shelton and Od, 2011).
Common sleep disorders
Published in Ravi Gupta, S. R. Pandi Perumal, Ahmed S. BaHammam, Clinical Atlas of Polysomnography, 2018
Ravi Gupta, S. R. Pandi Perumal, Ahmed S. BaHammam
Rottach, K. G., Schaner, B. M., Kirch, M. H., Zivotofsky, A. Z., Teufel, L. M., Gallwitz, T., et al., (2008). Restless legs syndrome as side effect of second generation antidepressants. J Psychiatr Res. 43(1), 70-75. Epub 2008/05/13.
Development of palliative medicine in the United Kingdom and Ireland
Published in Eduardo Bruera, Irene Higginson, Charles F von Gunten, Tatsuya Morita, Textbook of Palliative Medicine and Supportive Care, 2015
46 Gartlehner G, Hansen RA, Morgan LC et al. Comparative benefits and harms of second-generation antidepressants for treating major depressive disorder: An updated meta-analysis. Ann Intern Med 2011;155:772-785. 47 Cipriani A, Furukawa TA, Salanti G et al. Comparative efficacy and acceptability of 12 new-generation antidepressants: A multipletreatments meta-analysis. Lancet 2009;373:746-758.
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
Regardless of the intervention used, a substantial proportion of patients do not adequately respond or achieve remission after initial treatment. For example, about 40% of patients treated with second-generation antidepressants do not respond, and approximately 70% do not achieve remission [10]. Partial or inadequate response is important to address because a lack of early improvement in symptoms (defined in RCTs as a 20%–30% reduction from baseline in a depression rating scale after 2–4 weeks) is a predictor of later antidepressant nonresponse/nonremission. However, there is only low-quality evidence to support early switching at 2 or 4 weeks for nonresponders to an initial antidepressant [48]. Inadequate responses to antidepressants can also prompt nonadherence, which can be an important driver of poor response to an antidepressant therapy [3,67]. In primary care settings where defining partial or inadequate response may be ambiguous, measurement-guided care using time-efficient patient- and clinician-completed rating scales may help with patient monitoring following initiation of an antidepressant (Figure 3). This can assist both the patient and provider in tracking and clinical management of symptoms and functioning over time, identifying factors influencing inadequate response, and understanding if treatment adjustments are needed [8,69].
Assessment of clinical outcomes of medicinal cannabis therapy for depression: analysis from the UK Medical Cannabis Registry
Published in Expert Review of Neurotherapeutics, 2022
Sajed Mangoo, Simon Erridge, Carl Holvey, Ross Coomber, Daniela A Riano Barros, Urmila Bhoskar, Gracia Mwimba, Kavita Praveen, Chris Symeon, Simmi Sachdeva-Mohan, James J Rucker, Mikael H Sodergren
Antidepressant medications are a key component of depression treatment [2]. Despite their widespread use, there is debate surrounding the efficacy of antidepressants [3]. A recent meta-analysis demonstrated that although second-generation antidepressants were more effective than placebo, the summary effect sizes were mostly modest, with response rates around 50% [3]. According to another meta-analysis, antidepressants have no or minimal effects in mild-to-moderate depression, whereas the effects were more substantial in very severe depression [4]. Despite second-generation antidepressants displacing tricyclic antidepressants due to improved tolerability, adverse effects remain an issue an dropout rates are significantly higher among patients administered second-generation antidepressants in randomized controlled trials (RCTs) compared to placebo [5].
Blood biomarkers and treatment response in major depression
Published in Expert Review of Molecular Diagnostics, 2018
Cristina Mora, Valentina Zonca, Marco A. Riva, Annamaria Cattaneo
The Guidelines for the management of patients with MDD indicate the use of second-generation antidepressant drugs as first-line treatments for patients with an episode of moderate or greater severity (as determined by symptom scales and/or functional impairment) [16]. The selective serotonin reuptake inhibitors (SSRIs), serotonin noradrenaline reuptake inhibitors (SNRIs), and other antidepressant drugs including agomelatine, bupropion, mirtazapine, and vortioxetine remain first-line recommendations for pharmacotherapy for MDD. Recommended second-line agents include tricyclic antidepressants (TCAs), trazodone, levomilnacipran, and vilazodone, despite their side effects. Third-line recommendations include monoamine oxidase inhibitors (IMAOs) and reboxetine. Furthermore, in order to achieve clinical improvement, particularly in the context of treatment-resistant depression, the NMDA antagonist Ketamine, used at subanesthetic dose, has emerged as a potential new option, which may produce a rapid antidepressant response [17].