Efficacy and Side Effects of Mianserin, a Tetracyclic Antidepressant A
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
Differential Effects on Suicidal Ideation of Mianserin, Maprotiline and Amitriptyline S
Br. J. clin. Pharmac. (1978), 5, 77S-80S DIFFERENTIAL EFFECTS ON SUICIDAL IDEATION OF MIANSERIN, MAPROTILINE AND AMITRIPTYLINE S. MONTGOMERY Academic Department of Psychiatry, Guy's Hospital Medical School, London Bridge, London SE1 9RT, UK B. CRONHOLM, MARIE ASBERG Karolinska Institute, Stockholm D.B. MONTGOMERY Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, U K 1 Eighty patients suffering from primary depressive illness were treated for 4 weeks, following a 7-d (at least) no-treatment period, with either mianserin 60 mg daily (n = 50), maprotiline 150 mg at night- time (n = 15) or amitriptyline 150 mg at night-time (n = 15) in double-blind controlled trials run con- currently in the same hospital on protocols having the same design and entry criteria. 2 The effects of the three drugs were examined for their proffle of action using a new depression rating scale (Montgomery and Asberg Depression Scale, MADS) claimed to be more sensitive to change. There was no significant difference in mean entry scores or mean amelioration of depression on the MADS or the Hamilton Rating Scale (HRS) between the three drugs, but individual items on the MADS did show significant differences in amelioration. A highly significant (P < 0.01) difference was observed in favour of mianserin against maprotiline on both items of'suicidal thoughts' and 'pessimistic thoughts' on the MADS. The suicidal item on the HRS showed a similar tendency which did not reach significance. 3 This finding is considered in relation to a possible mode of action of mianserin and the relevance to reported subgroups ofdepressive illness with increased suicidal ideation. -
Medication: Amitriptyline 10 Mg
Amitriptyline (Elavil) COMPLEX CHRONIC DISEASES PROGRAM Medication Handout Date: May 15, 2018 Medication: Amitriptyline 10 mg What is Amitriptyline? Amitriptyline belongs to a group of medications called tricyclic antidepressants (TCAs) that were first used to treat depression. It works by altering the levels of certain neuro- transmitters in the brain such as noradrenalin and serotonin. They have since been found to be effective for many different uses such as: pain, helping with sleep quality (but is not a sleeping pill), irritable bowel syndrome (with diarrhea), migraine prevention, and interstitial cystitis. Expected Benefit: Usually takes several weeks to notice a benefit You may not notice a benefit until you get to a dose of 25 mg Watch for possible side effects: This list of side effects is important for you to be aware of; however, it is also important to remember that not all side effects happen to all people. Many of these less serious side effects will improve over the first few days of taking the medications. If you have problems with these side effects talk with your doctor or pharmacist: Dry mouth – this is the most common side; the others are much less frequent Hangover effect – too sleepy in the morning Blurred vision Urinary retention, trouble with urination Tiredness, dizziness that is more than usual Diarrhea or constipation Stopping the medication: Do NOT stop taking this medication suddenly without asking your doctor – this medication is usually decreased slowly (at higher doses) before it is stopped completely How to use this medication: Take this medication with or without food Dosing Schedule: Start with 5 mg (½ tablet) 2 hrs before bed Increase dose according to table below Many patients can only tolerate 20 or 30 mg If you don’t have dry mouth or side effects, you can continue slowly increasing the dose to a maximum of 70 mg You can stay at a lower dose (stop increasing) if you get side effects (usually dry mouth). -
Clomipramine | Memorial Sloan Kettering Cancer Center
PATIENT & CAREGIVER EDUCATION Clomipramine This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider. Brand Names: US Anafranil Brand Names: Canada Anafranil; MED ClomiPRAMINE; TARO-Clomipramine Warning Drugs like this one have raised the chance of suicidal thoughts or actions in children and young adults. The risk may be greater in people who have had these thoughts or actions in the past. All people who take this drug need to be watched closely. Call the doctor right away if signs like low mood (depression), nervousness, restlessness, grouchiness, panic attacks, or changes in mood or actions are new or worse. Call the doctor right away if any thoughts or actions of suicide occur. This drug is not approved for use in all children. Talk with the doctor to be sure that this drug is right for your child. What is this drug used for? It is used to treat obsessive-compulsive problems. It may be given to you for other reasons. Talk with the doctor. Clomipramine 1/8 What do I need to tell my doctor BEFORE I take this drug? If you have an allergy to clomipramine or any other part of this drug. If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had. If you have had a recent heart attack. If you are taking any of these drugs: Linezolid or methylene blue. -
Cambridgeshire and Peterborough Joint Prescribing Group MEDICINE REVIEW
Cambridgeshire and Peterborough Joint Prescribing Group MEDICINE REVIEW Name of Medicine / Trimipramine (Surmontil®) Class (generic and brand) Licensed indication(s) Treatment of depressive illness, especially where sleep disturbance, anxiety or agitation are presenting symptoms. Sleep disturbance is controlled within 24 hours and true antidepressant action follows within 7 to 10 days. Licensed dose(s) Adults: For depression 50-75 mg/day initially increasing to 150-300 mg/day in divided doses or one dose at night. The maintenance dose is 75-150 mg/day. Elderly: 10-25 mg three times a day initially. The initial dose should be increased with caution under close supervision. Half the normal maintenance dose may be sufficient to produce a satisfactory clinical response. Children: Not recommended. Purpose of Document To review information currently available on this class of medicines, give guidance on potential use and assign a prescribing classification http://www.cambsphn.nhs.uk/CJPG/CurrentDrugClassificationTable.aspx Annual cost (FP10) 10mg three times daily: £6,991 25mg three times daily: £7,819 150mg daily: £7,410 300mg daily: £14,820 Alternative Treatment Options within Class Tricyclic Annual Cost CPCCG Formulary Classification Antidepressant (FP10) Amitriptyline (75mg) Formulary £36 Lofepramine (140mg) Formulary £146 Imipramine (75mg) Non-formulary £37 Clomipramine (75mg) Non-formulary £63 Trimipramine (75mg). TBC £7,819 Nortriptyline (75mg) Not Recommended (pain) £276 Doxepin (150mg) TBC £6,006 Dosulepin (75mg) Not Recommended (NICE DO NOT DO) £19 Dosages are based on possible maintenance dose and are not equivalent between medications Recommendation It is recommended to Cambridgeshire and Peterborough CCG JPG members and through them to local NHS organisations that the arrangements for use of trimipramine are in line with restrictions agreed locally for drugs designated as NOT RECOMMENDED:. -
Review: Multiple Daily Doses of Antidepressants Are Not More Effective Than Single Daily Doses
Evid Based Mental Health: first published as 10.1136/ebmh.5.2.57 on 1 May 2002. Downloaded from Review: multiple daily doses of antidepressants are not more effective than single daily doses Yildiz A, Sachs GS. Administration of antidepressants. Single versus split dosing: a meta-analysis. J Affect Disord 2001 Oct;66:199–206. QUESTIONS: In patients with depression, are multiple daily doses (MDD) of antidepressants more effective than single daily doses (SDD)? Does the pharmacokinetic half life of a drug influence the antidepressant activity of single daily doses? Data sources mean improvement from baseline was 90% for SDD Source of funding: Studies were identified by searching {PubMed}* with the and 87% for MDD. not stated. terms antidepressants, single daily dosing versus, multi- ple daily dosing, and antidepressant efficacy. Conclusions For correspondence: Dr A Yildiz, Dokuz In patients with depression, multiple daily doses of anti- Eylul Medical School, depressants are not more effective than single daily Study selection Izmir, Turkey and doses. Grouping the studies by pharmacokinetic half life Harvard Medical Studies were selected if they were randomised control- of the drug does not show an advantage for multiple School, Boston, MA, led trials (RCTs) that compared dosing schedules of the daily doses over single daily doses. USA same antidepressant (with 1 group receiving SDD) and if Agul_yildiz@hotmail. the total daily dose in the SDD and MDD groups were *Information provided by author. com the same. COMMENTARY Data extraction Single daily doses of antidepressants have always been considered inappropriate for Data were extracted on study characteristics, drug short elimination half life drugs. -
FDA Approved Drugs with Broad Anti-Coronaviral Activity Inhibit SARS-Cov-2 in Vitro
bioRxiv preprint doi: https://doi.org/10.1101/2020.03.25.008482; this version posted March 27, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under aCC-BY-NC-ND 4.0 International license. FDA approved drugs with broad anti-coronaviral activity inhibit SARS-CoV-2 in vitro Stuart Weston1, Rob Haupt1, James Logue1, Krystal Matthews1 and Matthew B. Frieman*1 1 - Department of Microbiology and Immunology, University of Maryland School of Medicine, 685 W. Baltimore St., Room 380, Baltimore, MD, 21201, USA *Corresponding author. Email: [email protected] Key words: SARS-CoV-2, nCoV-2019, COVID-19, drug repurposing, FDA approved drugs, antiviral therapeutics, pandemic, chloroquine, hydroxychloroquine AbstraCt SARS-CoV-2 emerged in China at the end of 2019 and has rapidly become a pandemic with over 400,000 recorded COVID-19 cases and greater than 19,000 recorded deaths by March 24th, 2020 (www.WHO.org) (1). There are no FDA approved antivirals or vaccines for any coronavirus, including SARS-CoV-2 (2). Current treatments for COVID-19 are limited to supportive therapies and off-label use of FDA approved drugs (3). Rapid development and human testing of potential antivirals is greatly needed. A potentially quicker way to test compounds with antiviral activity is through drug re-purposing (2, 4). Numerous drugs are already approved for use in humans and subsequently there is a good understanding of their safety profiles and potential side effects, making them easier to test in COVID-19 patients. -
NORPRAMIN® (Desipramine Hydrochloride Tablets USP)
NORPRAMIN® (desipramine hydrochloride tablets USP) Suicidality and Antidepressant Drugs Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of NORPRAMIN or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. NORPRAMIN is not approved for use in pediatric patients. (See WARNINGS: Clinical Worsening and Suicide Risk, PRECAUTIONS: Information for Patients, and PRECAUTIONS: Pediatric Use.) DESCRIPTION NORPRAMIN® (desipramine hydrochloride USP) is an antidepressant drug of the tricyclic type, and is chemically: 5H-Dibenz[bƒ]azepine-5-propanamine,10,11-dihydro-N-methyl-, monohydrochloride. 1 Reference ID: 3536021 Inactive Ingredients The following inactive ingredients are contained in all dosage strengths: acacia, calcium carbonate, corn starch, D&C Red No. 30 and D&C Yellow No. 10 (except 10 mg and 150 mg), FD&C Blue No. 1 (except 25 mg, 75 mg, and 100 mg), hydrogenated soy oil, iron oxide, light mineral oil, magnesium stearate, mannitol, polyethylene glycol 8000, pregelatinized corn starch, sodium benzoate (except 150 mg), sucrose, talc, titanium dioxide, and other ingredients. -
Current P SYCHIATRY
Current p SYCHIATRY N ew Investigators Tips to manage and prevent discontinuation syndromes Informed tapering can protect patients when you stop a medication Sriram Ramaswamy, MD Shruti Malik, MBBS, MHSA Vijay Dewan, MD Instructor, department of psychiatry Foreign medical graduate Assistant professor Creighton University Department of psychiatry Omaha, NE University of Nebraska Medical Center Omaha, NE bruptly stopping common psychotropics New insights on psychotropic A —particularly antidepressants, benzodi- drug safety and side effects azepines, or atypical antipsychotics—can trigger a discontinuation syndrome, with: This paper was among those entered in the 2005 • rebound or relapse of original symptoms Promising New Investigators competition sponsored • uncomfortable new physical and psycho- by the Neuroleptic Malignant Syndrome Information Service (NMSIS). The theme of this year’s competition logical symptoms was “New insights on psychotropic drug safety and • physiologic withdrawal at times. side effects.” To increase health professionals’ awareness of URRENT SYCHIATRY 1 C P is honored to publish this peer- the risk of these adverse effects, this article reviewed, evidence-based article on a clinically describes discontinuation syndromes associated important topic for practicing psychiatrists. with various psychotropics and offers strategies to NMSIS is dedicated to reducing morbidity and anticipate, recognize, and manage them. mortality of NMS by improving medical and psychiatric care of patients with heat-related disorders; providing -
LUMIN Mianserin Hydrochloride Tablets
AUSTRALIAN PRODUCT INFORMATION LUMIN Mianserin hydrochloride tablets 1 NAME OF THE MEDICINE Mianserin hydrochloride 2 QUALITATIVE AND QUANTITATIVE COMPOSITION Mianserin belongs to the tetracyclic series of antidepressant compounds, the piperazinoazepines. These are chemically different from the common tricyclic antidepressants. Each Lumin 10 tablet contains 10 mg of mianserin hydrochloride and each Lumin 20 tablet contains 20 mg of mianserin hydrochloride as the active ingredient. Lumin also contains trace amounts of sulfites. For the full list of excipients, see Section 6.1 List of Excipients. 3 PHARMACEUTICAL FORM Lumin 10: 10 mg tablet: white, film coated, normal convex, marked MI 10 on one side, G on reverse Lumin 20: 20 mg tablet: white, film coated, normal convex, marked MI 20 on one side, G on reverse 4 CLINICAL PARTICULARS 4.1 THERAPEUTIC INDICATIONS For the treatment of major depression. 4.2 DOSE AND METHOD OF ADMINISTRATION Lumin tablets should be taken orally between meals, preferably with a little fluid, and swallowed without chewing. Use in Children and Adolescents (< 18 years of age) Lumin should not be used in children and adolescents under the age of 18 years (see section 4.4 Special Warnings and Precautions for use). Adults The initial dosage of Lumin should be judged individually. It is recommended that treatment begin with a daily dose of 30 mg given in three divided doses or as a single bedtime dose and be adjusted weekly in the light of the clinical response. The effective daily dose for adult patients usually lies between 30 mg and 90 mg (average 60 mg) in divided doses or as a single bedtime dose. -
PRODUCT MONOGRAPH ELAVIL® Amitriptyline Hydrochloride Tablets
PRODUCT MONOGRAPH ELAVIL® amitriptyline hydrochloride tablets USP 10, 25, 50 and 75 mg Antidepressant AA PHARMA INC. DATE OF PREPARATION: 1165 Creditstone Road Unit #1 August 29, 2018 Vaughan, ON L4K 4N7 Control No.: 217626 1 PRODUCT MONOGRAPH ELAVIL® amitriptyline hydrochloride tablets USP 10, 25, 50, 75 mg THERAPEUTIC CLASSIFICATION Antidepressant ACTIONS AND CLINICAL PHARMACOLOGY Amitriptyline hydrochloride is a tricyclic antidepressant with sedative properties. Its mechanism of action in man is not known. Amitriptyline inhibits the membrane pump mechanism responsible for the re-uptake of transmitter amines, such as norepinephrine and serotonin, thereby increasing their concentration at the synaptic clefts of the brain. Amitriptyline has pronounced anticholinergic properties and produces EKG changes and quinidine-like effects on the heart (See ADVERSE REACTIONS). It also lowers the convulsive threshold and causes alterations in EEG and sleep patterns. Orally administered amitriptyline is readily absorbed and rapidly metabolized. Steady-state plasma concentrations vary widely and this variation may be genetically determined. Amitriptyline is primarily excreted in the urine, mostly in the form of metabolites, with some excretion also occurring in the feces. INDICATIONS AND CLINICAL USE ELAVIL® (amitriptyline hydrochloride) is indicated in the drug management of depressive illness. ELAVIL® may be used in depressive illness of psychotic or endogenous nature and in selected patients with neurotic depression. Endogenous depression is more likely to be alleviated than are other depressive states. ELAVIL® ®, because of its sedative action, is also of value in alleviating the anxiety component of depression. As with other tricyclic antidepressants, ELAVIL® may precipitate hypomanic episodes in patients with bipolar depression. These drugs are not indicated in mild depressive states and depressive reactions. -
A Drug Repositioning Approach Identifies Tricyclic Antidepressants As Inhibitors of Small Cell Lung Cancer and Other Neuroendocrine Tumors
Published OnlineFirst September 26, 2013; DOI: 10.1158/2159-8290.CD-13-0183 RESEARCH ARTICLE A Drug Repositioning Approach Identifi es Tricyclic Antidepressants as Inhibitors of Small Cell Lung Cancer and Other Neuroendocrine Tumors Nadine S. Jahchan 1 , 2 , Joel T. Dudley 1 , Pawel K. Mazur 1 , 2 , Natasha Flores 1 , 2 , Dian Yang 1 , 2 , Alec Palmerton 1 , 2 , Anne-Flore Zmoos 1 , 2 , Dedeepya Vaka 1 , 2 , Kim Q.T. Tran 1 , 2 , Margaret Zhou 1 , 2 , Karolina Krasinska 3 , Jonathan W. Riess 4 , Joel W. Neal 5 , Purvesh Khatri 1 , 2 , Kwon S. Park 1 , 2 , Atul J. Butte 1 , 2 , and Julien Sage 1 , 2 Downloaded from cancerdiscovery.aacrjournals.org on September 29, 2021. © 2013 American Association for Cancer Research. Published OnlineFirst September 26, 2013; DOI: 10.1158/2159-8290.CD-13-0183 ABSTRACT Small cell lung cancer (SCLC) is an aggressive neuroendocrine subtype of lung cancer with high mortality. We used a systematic drug repositioning bioinformat- ics approach querying a large compendium of gene expression profi les to identify candidate U.S. Food and Drug Administration (FDA)–approved drugs to treat SCLC. We found that tricyclic antidepressants and related molecules potently induce apoptosis in both chemonaïve and chemoresistant SCLC cells in culture, in mouse and human SCLC tumors transplanted into immunocompromised mice, and in endog- enous tumors from a mouse model for human SCLC. The candidate drugs activate stress pathways and induce cell death in SCLC cells, at least in part by disrupting autocrine survival signals involving neurotransmitters and their G protein–coupled receptors. The candidate drugs inhibit the growth of other neuroendocrine tumors, including pancreatic neuroendocrine tumors and Merkel cell carcinoma. -
Hyponatremia and Psychotropic Drugs
DOI: 10.5772/intechopen.79029 ProvisionalChapter chapter 2 Hyponatremia and Psychotropic Drugs MireiaMireia Martínez Cortés Martínez Cortés and Pedro Gurillo MuñozPedro Gurillo Muñoz Additional information is available at the end of the chapter http://dx.doi.org/10.5772/intechopen.79029 Abstract Given the widespread use of psychotropic drugs in the population, it’s important to consider hyponatremia as an avoidable and reversible adverse effect and include the detection of high-risk subjects to establish safer medications, as well as early detection measures in routine clinical practice. Although hyponatremia has been especially associ- ated with serotonergic antidepressants (SSRIs), there is also an elevated risk with tricy- clics, duals and heterocyclic antidepressants, due to the different mechanisms of action at the renal tubular level and the release of ADH. Hyponatremia secondary to tricyclics with slow CYP2D6 metabolizers have higher plasma concentrations of antidepressants metabolized by CYP2D6. Hyponatremia secondary to SSRIs appears in the first week of treatment, it is “not dose-dependent” and normalization of natremia occurs between 2 and 20 days after stopping the medication. Bupropion, trazodone, mianserin, reboxetine and agomelatine are a safe alternative. Also antiepileptics have been related to hypona- tremia. Both typical and atypical antipsychotics have been exposed to an increased risk of hyponatremia, even after adjusted factors such as age, sex and comorbidity. Other factors that favor the onset of hyponatremia act synergistically with psychotropic drugs, such as: advanced age, female sex, concomitant diuretic intake, low body weight and low sodium levels; NSAID, ACEIs, and warm. Keywords: hyponatremia, antipsychotic, antidepressant, antiepileptic, psychotropic drugs 1. Introduction Hyponatremia is the most frequent hydroelectrolytic disorder in clinical practice, both in hospital and outpatient settings [1].