Association of Systemic Medication Use with Intraocular Pressure in a Multiethnic Asian Population: the Singapore Epidemiology of Eye Diseases Study

Total Page:16

File Type:pdf, Size:1020Kb

Association of Systemic Medication Use with Intraocular Pressure in a Multiethnic Asian Population: the Singapore Epidemiology of Eye Diseases Study Supplementary Online Content Ho H, Shi Y, Chua J, et al. Association of systemic medication use with intraocular pressure in a multiethnic Asian population: the Singapore Epidemiology of Eye Diseases Study. JAMA Ophthalmol. Published online January 12, 2017. doi:10.1001/jamaophthalmol.2016.5318 eAppendix. Drugs According to Medication Class eTable 1. Subgroup Analysis According to Systemic Medical Condition eTable 2. Multivariable Linear Regression Models for Interactions Between Medication Classes This supplementary material has been provided by the authors to give readers additional information about their work. © 2017 American Medical Association. All rights reserved. Downloaded From: https://edhub.ama-assn.org/ on 10/03/2021 eAppendix. Drugs According to Medication Class The following list was used to identify the lists of drug names each participant was taking, classified according to medication class. ACE inhibitors Captopril, Coversyl, Enalapril, Glioten, Imidapril, Invoril, Lisinopril, Lisoril, Perindopril, Tanapril, Tanatril, Zestril Alpha-Glucosidase Inhibitors Acarbose, Glucobay Analgaesics Acugesic, Anarex, Codeine, Ibuprofen, Ketoprofen, Pacofen, Panadol, Panadeine, Paracetamol, Norgesic, Suniton, Tramadol Angiotensin Receptor Blockers Atacand, Candesartan, Coaprovel, Cozaar, Co-Diovan, Diovan, Exforge, Hyzaar, Irbesartan, Losartan, Micardis, Olmetec, Omelsartan, Telmisartan, Valsartan Anti-coagulants/Anti-platelets Clopidogrel, Dipyridamole, Perazodin, Plavix, Ticlid, Ticlopidine, Warfarin Anti-Depressants Amitriptyline, Deanxit, Depranil, Escitalopram, Fluvoxamine, Fluoxetine, Imipramine, Lexapro, Melitracen, Mirtazapine, Paroxetine, Prozac, Seroxat Anti-Histamines Adezio, Cetirizine, Chlorphenamine, Cinnarizine, Cyproheptadine, Hydroxyzine, Loratadine, Pilian, Piriton, Telfast, Xyzal, Zyrtec Aspirin Aspirin, Cardiprin Beta-blockers Atenolol, Betaloc, Beta-nicardia, Bisoprolol, Carvediol, Dilatrend, Hypernol, Inderal, Metoprolol, Nebivolol, Propranolol, Sotalol, Tenormin © 2017 American Medical Association. All rights reserved. Downloaded From: https://edhub.ama-assn.org/ on 10/03/2021 Biguanides Diabetmin, Glucophage, Metforal, Metformin Calcium Channel Blockers Adalat, Amlodipine, Bepridil, Diltiazem, Felodipine, Lacidipine, Nifedipine, Nifetex, Nif- ten, Norvasc, Plendil, Stamlo, Vascor, Verapamil Diuretics Amiloride, Chlorthiazide, Frusemide, Furosemide, Hydrochlorothiazide, Indapamide, Lasix, Moduretic, Natrilix, Spironolactone Fibrates Ciprofibrate, Fenofibrate, Gemfibrozil, Modalim, Recozil, Trolip H2 Receptor Antagonist Aciloc, Apo-ranitidine, Cimetidine, Famotidine, Ranitidine, Zantac, Insulin Actrapid, Aspart, Insulatard, Insulin, Lantus, Mixtard, NovoMix Nitrates Angsobide, Glyceryl Trinitrate, Gtn, Imdur, Isosorbide Mononitrate, Isosorbide Dinitrate, Iwdex NSAIDS Almiral, Arcoxia, Cataflam, Celecoxib, Diclofenac, Etoricoxib, Indocid, Indomethacin, Naproxen, Piroxicam, Rosiden, Sunprox, Voren Proton Pump Inhibitors Esomeprazole, Nexium, Omeprazole, Omezole, Rabeprazole Statins Apo-Lovastatin, Atorvastatin, Crestor, Lipitor, Lovastatin, Pravastatin, Rosuvastatin, Simtin, Simvastatin, Vytorin, Zocor Steroid Inhalers Beclomethasone, Betamethasone, Budesonide, Flixonase, Fluticasone, Mometasone, Nasonex, Seretide Sulphonylureas Amaryl, Daonil, Diamicron, Glibenclamide, Gliclazide, Glimepiride, Glipizide, Glucovance. Glyburide, Nateglinide, Starlix, Tolbutamide Thyroid Hormones Euthyrox, Levothyroxine, Thyroxine © 2017 American Medical Association. All rights reserved. Downloaded From: https://edhub.ama-assn.org/ on 10/03/2021 eTable 1. Subgroup Analysis According to Systemic Medical Condition Participants with Participants with Participants with Hypertension Diabetes Hyperlipidaemia Medication Class β (SE) p-value β (SE) p-value β (SE) p-value ACE inhibitors 0.52 (0.13) <0.001 - - - - ARB 0.43 (0.19) 0.025 - - - - Beta blockers -0.41 (0.11) <0.001 - - - - Sulphonylureas - - 0.33 (0.14) 0.014 - - Biguanides - - 0.16 (0.13) 0.232 - - Statins - - - - 0.29 (0.15) 0.054 SE: standard error; BMI: body mass index; HbA1c: glycosylated hemoglobin; BP: blood pressure; ACE: angiotensin converting enzyme; ARB: angiotensin receptor blockers. Model adjusted for concurrent use of other medications, in addition to age, gender, BMI, ethnicity and specific health conditions. © 2017 American Medical Association. All rights reserved. Downloaded From: https://edhub.ama-assn.org/ on 10/03/2021 eTable 2. Multivariable Linear Regression Models for Interactions Between Medication Classes No adjustments Adjusted for ACE-I use Adjusted for β-Blocker use β SE p-value β SE p-value β SE p-value ACE-I 0.34 0.23 0.14 - - - - - - β-Blockers -0.47 0.14 <0.001 0.32 0.27 0.22 - - - Statins 0.39 0.13 0.003 -0.21 0.25 0.41 -0.12 0.21 0.56 Biguanides 0.38 0.21 0.08 -0.15 0.30 0.61 -0.20 0.32 0.53 Sulfonylureas 0.74 0.30 0.014 0.26 0.32 0.43 0.04 0.33 0.89 Adjusted for Statin use Adjusted for Biguanide use Models were adjusted for age, sex, body mass index, β SE p-value β SE p-value glycosylated hemoglobin levels and blood pressure. ACE-I - - - - - - Abbreviation: SE, standard β-Blockers - - - - - - error of mean Statins - - - - - - Biguanides 0.22 0.28 0.44 - - - Sulfonylureas -0.48 0.30 0.11 -0.28 0.30 0.36 © 2017 American Medical Association. All rights reserved. Downloaded From: https://edhub.ama-assn.org/ on 10/03/2021.
Recommended publications
  • Paroxetine Shows No Effect on Drinking
    28 Addiction Psychiatry C LINICAL P SYCHIATRY N EWS • September 2007 Paroxetine Shows No E VIDENCE-BASED P SYCHIATRIC M EDICINE Effect on Drinking Abuse of Bupropion BY MICHELE G. SULLIVAN The patients’ average age was 29 The Problem caloric intake, or sleep. On self-rating scales, Mid-Atlantic Bureau years; 50% were male. At base- You work in one of America’s contemporary bupropion was perceived as an active drug only line, their mean score on the Lei- long-term psychiatric treatment centers, also as often as placebo. The investigators con- C HICAGO — Paroxetine can bowitz Social Anxiety Scale (LSAS) known as a state prison. Inmates who come to cluded, “It is unlikely that bupropion will give take the anxiety out of the drinker, was about 90, indicating severe so- outpatient appointments and complain of de- rise to [amphetaminelike] patterns of abuse but it cannot take the drinking out cial anxiety. Anxiety had its onset pressive symptoms frequently request bupro- among normals or among those predisposed of the anxious person. at age 12 years in these patients; pion (Wellbutrin). The history they provide is to psychostimulant abuse.” (The study came The drug did uncouple anxiety the use of alcohol to cope with speciously similar: “It’s the only antidepressant from the Baylor College of Medicine, the and drinking in patients who use symptoms followed about a that’s ever worked.” You start to inquire about Houston Veterans Administration Medical alcohol to cope with severe gener- decade later. They were moder- how this medication is used in the prison Center, and the Burroughs Wellcome Research alized social anxiety, Dr.
    [Show full text]
  • Review Article Antidepressant Treatment for Acute Bipolar Depression: an Update
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Crossref Hindawi Publishing Corporation Depression Research and Treatment Volume 2012, Article ID 684725, 10 pages doi:10.1155/2012/684725 Review Article Antidepressant Treatment for Acute Bipolar Depression: An Update Ben H. Amit1, 2 and Abraham Weizman1, 2 1 Geha Mental Health Center, Research Unit, P.O. Box 102, Petach Tikva 49100, Israel 2 Sackler Faculty of Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv 69978, Israel Correspondence should be addressed to Ben H. Amit, [email protected] Received 23 October 2011; Accepted 29 November 2011 Academic Editor: Po-See Chen Copyright © 2012 B. H. Amit and A. Weizman. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. While studies in the past have focused more on treatment of the manic phase of bipolar disorder (BD), recent findings demonstrate the depressive phase to be at least as debilitating. However, in contrast to unipolar depression, depression in bipolar patients exhibits a varying response to antidepressants, raising questions regarding their efficacy and tolerability. Methods.Weconducteda MEDLINE and Cochrane Collaboration Library search for papers published between 2005 and 2011 on the subject of antidepres- sant treatment of bipolar depression. Sixty-eight articles were included in the present review. Results. While a few studies did advo- cate the use of antidepressants, most well-controlled studies failed to show a robust effect of antidepressants in bipolar depression, regardless of antidepressant class or bipolar subtype.
    [Show full text]
  • Acute and Chronic Treatment with 5-HT Reuptake Inhibitors Differentially Modulate Emotional Responses in Anxiety Models in Rodents
    Psychopharmacology (1994) 113:463-470 Psychopharmacology © Springer-Verlag 1994 Acute and chronic treatment with 5-HT reuptake inhibitors differentially modulate emotional responses in anxiety models in rodents Guy GriebeP, Jean-Luc Moreau 2, Francois Jenck 2, Ren6 Misslin 1, James R. Martin z 1 Laboratoire de Psychophysiologie, 7 rue de l'Universit~, F-67000 Strasbourg, France 2 Pharma Division, Prectinical Research, F. Hoffmann-La Roche Ltd, CH-4002, Basel, Switzerland Received March 17, 1993 /FinaI version May 24, 1993 Abstract. This study investigated behavioural effects of 1992). However, several studies reported intriguing ob- very potent 5 HT reuptake inhibitors after acute treat- servations early in treatment (Saletu and Gfiinberger ment (cianopramine and citalopram), as well as after 1985; Gorman et al. 1987; Van Praag 1988 ;.Westenberg chronic treatment (cianopramine), in two behavioural and den Boer 1988; Humble et al. 1989; Giesecke 1990; models of anxiety: 1) the light/dark choice procedure in Montgomery 1991; Westenberg 1992). These authors mice and 2) the elevated plus-maze test in rats. In addi- noted activating effects at the beginning of treatment tion, the responses of mice to novelty in a free explora- with a 5-HT reuptake blocker, described as racing tion paradigm were assessed after acute administration thoughts, anxiety, nervousness, tremor, insomnia, jitteri- of both drugs. A single injection of cianopramine or ness, emotional discomfort and agitation; this effect dis- citalopram increased neophobic reactions in the free ex- appeared with subsequent treatment. It is hypothesized ploration test. Furthermore, these drugs increased the that the acute increased availability of 5-HT resulting avoidance reaction to a brightly illuminated chamber in from reuptake inhibition would initially produce an- the light/dark choice procedure as well as to open arms xiogenic-like effects until adaptive changes of the 5-HT in the elevated plus-maze test.
    [Show full text]
  • Geriatric Psychopharmacology: Anti-Depressants Amber Mackey, D.O
    Geriatric Psychopharmacology: Anti-depressants Amber Mackey, D.O. University of Reno School of Medicine Department of Psychiatry Chief Resident, PGY-4 Pharmacologic issues in the elderly More likely to experience drug induced adverse events Cardiac effects: Prolonged QTc, arrhythmias, sudden death Peripheral/central anticholinergic effects: constipation, delirium, urinary retention, delirium, and cognitive dysfunction Antihistaminergic effects: sedation Antiadrenergic effects: postural hypotension Other effects: Hyponatremia, bleeding, altered bone metabolism Pharmacokinetic Organ system Change consequence Circulatory system Decreased concentration Increased or decreased of plasma albumin and free concentration of drugs increased α1-acid in plasma glycoprotein Gastrointestinal Table tract 20-1 Decreased intestinal and Decreased rate of drug splanchnic blood flow absorption Kidney Decreased glomerular Decreased renal filtration rate clearance of active metabolites Liver Decreased liver size; Decreased hepatic decreased hepatic blood clearance flow; variable effects on cytochrome P450 isozyme activity Muscle Decreased lean body mass Altered volume of and increased adipose distribution of lipid-soluble tissue drugs, leading to increased elimination half-life Table 20-1, Physiological changes in elderly persons associated with altered pharmacokinetics, American Psychiatric Publishing Textbook of Geriatric Psychiatry, Fifth Edition, Chapter 20: Psychopharmacology. Other issues Illnesses that effect the elderly also play a role in diminishing
    [Show full text]
  • Antidepressant Medications: U.S. Food and Drug Administration
    Antidepressant Medications: U.S. Food and Drug Administration-Approved Indications and Dosages for Use in Adults The therapeutic dosing recommendations for antidepressant medications are based on U.S. Food and Drug Administration (FDA)-approved product labeling. Nevertheless, the dosing regimen is adjusted according to a patient’s individual response to pharmacotherapy. The FDA-approved indications and dosages for the use of antidepressant medications in adults are provided in this table. Some of the antidepressant medications are FDA-approved for the treatment of or as adjunct therapy for Parkinson’s disease. This indication is not discussed in this document because of its very specific focus and individualized treatment regimens. All of the antidepressant medications listed are for oral administration unless otherwise stated. Information on the generic availability of antidepressant medications can be found by searching the Electronic Orange Book at https://www.accessdata.fda.gov/scripts/cder/ob/default.cfm on the FDA website. Generic Medication Indication Initial Dose Maximum Dose Other Information Availability amitriptyline[1] depression Outpatients: Outpatients: Outpatients may be initiated at 50 mg Yes 75 mg per day; 150 mg per day; to 100 mg once a day at bedtime. Dose Hospitalized patients: Hospitalized patients: increases should be made gradually by 100 mg per day 300 mg per day 25 mg to 50 mg as necessary, preferably in the late afternoon or evening. Lower doses are recommended for elderly patients. Take in divided doses. amoxapine[2] depression 50 mg 2 or 3 times a day 400 mg per day; May increase dose to 100 mg 2 to 3 times Yes Hospitalized patients a day by the end of the first week.
    [Show full text]
  • Selective Serotonin Reuptake Inhibitors and Gastrointestinal Bleeding: a Case-Control Study
    Selective Serotonin Reuptake Inhibitors and Gastrointestinal Bleeding: A Case-Control Study Alfonso Carvajal1*, Sara Ortega1, Lourdes Del Olmo1, Xavier Vidal2,3, Carmelo Aguirre4, Borja Ruiz4, Anita Conforti5, Roberto Leone5, Paula Lo´ pez-Va´zquez6,7, Adolfo Figueiras6,7, Luisa Iba´n˜ ez2,3 1 Instituto de Farmacoepidemiologı´a, Universidad de Valladolid, Valladolid, Spain, 2 Department of Pharmacology, Therapeutics and Toxicology, Universitat Auto`noma de Barcelona, Fundacio´ Institut Catala` de Farmacologia, WHO Collaborating Centre for Research and Training in Pharmacoepidemiology, Barcelona, Spain, 3 Clinical Pharmacology Service, Hospital Universitari Vall d’Hebron, Barcelona, Spain, 4 Pharmacovigilance Unit, Galdakao-Usansolo Hospital, Bizkaia, Spain, 5 Servizio di Farmacologia Medica, Universita` de Verona, Italy, 6 Departmento de Medicina Preventiva y Salud Pu´blica, Universidad de Santiago de Compostela, Santiago de Compostela, Spain, 7 Consorcio de Investigacio´n Biome´dica en Epidemiologı´a y Salud Pu´blica (CIBER en Epidemiologı´a y Salud Pu´blica - CIBERESP), Spain Abstract Background: Selective serotonin reuptake inhibitors (SSRIs) have been associated with upper gastrointestinal (GI) bleeding. Given their worldwide use, even small risks account for a large number of cases. This study has been conducted with carefully collected information to further investigate the relationship between SSRIs and upper GI bleeding. Methods: We conducted a case-control study in hospitals in Spain and in Italy. Cases were patients aged $18 years with a primary diagnosis of acute upper GI bleeding diagnosed by endoscopy; three controls were matched by sex, age, date of admission (within 3 months) and hospital among patients who were admitted for elective surgery for non-painful disorders. Exposures to SSRIs, other antidepressants and other drugs were defined as any use of these drugs in the 7 days before the day on which upper gastrointestinal bleeding started (index day).
    [Show full text]
  • Selective Serotonin Reuptake Inhibitors and Adverse Effects: a Narrative Review
    Review Selective Serotonin Reuptake Inhibitors and Adverse Effects: A Narrative Review Amber N. Edinoff 1,*, Haseeb A. Akuly 1 , Tony A. Hanna 1, Carolina O. Ochoa 2, Shelby J. Patti 2, Yahya A. Ghaffar 2, Alan D. Kaye 3, Omar Viswanath 4,5,6, Ivan Urits 3,7 , Andrea G. Boyer 8, Elyse M. Cornett 3 and Adam M. Kaye 9 1 Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Science Center Shreveport, Shreveport, LA 71103, USA; [email protected] (H.A.A.); [email protected] (T.A.H.) 2 School of Medicine, Louisiana State University Health Shreveport, Shreveport, LA 71103, USA; [email protected] (C.O.O.); [email protected] (S.J.P.); [email protected] (Y.A.G.) 3 Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA 71103, USA; [email protected] (A.D.K.); [email protected] (I.U.); [email protected] (E.M.C.) 4 College of Medicine-Phoenix, University of Arizona, Phoenix, AZ 85004, USA; [email protected] 5 Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE 68124, USA 6 Valley Anesthesiology and Pain Consultants—Envision Physician Services, Phoenix, AZ 85004, USA 7 Southcoast Physicians Group Pain Medicine, Southcoast Health, Wareham, MA 02571, USA 8 Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29464, USA; [email protected] 9 Department of Pharmacy Practice, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA 95211, USA; [email protected] * Correspondence: [email protected]; Tel.: +1-(318)-675-8969 Citation: Edinoff, A.N.; Akuly, H.A.; Hanna, T.A.; Ochoa, C.O.; Patti, S.J.; Abstract: Depression is the most prevalent psychiatric disorder in the world, affecting 4.4% of the Ghaffar, Y.A.; Kaye, A.D.; Viswanath, global population.
    [Show full text]
  • Va / Dod Depression Practice Guideline Provider Care Card Antidepressant
    VA / DOD DEPRESSION PRACTICE GUIDELINE PROVIDER CARE CARD CARD ANTIDEPRESSANT MEDICATION TABLE 7 Refer to pharmaceutical manufacturer’s literature for full prescribing information SEROTONIN SELECTIVE REUPTAKE INHIBITORS (SSRIs) GENERIC BRAND NAME ADULT STARTING DOSE MAX EXCEPTION SAFETY MARGIN TOLERABILITY EFFICACY SIMPLICITY Citalopram Celexa 20 mg 60 mg Reduce dose Nausea, insomnia, for the elderly & No serious systemic sedation, Fluoxetine Prozac 20 mg 80 mg those with renal toxicity even after headache, fatigue or hepatic substantial overdose. dizziness, sexual AM daily dosing. Paroxetine Paxil 20 mg 50 mg failure Drug interactions may dysfunction Response rate = Can be started at Sertraline Zoloft 50 mg 200 mg include tricyclic anorexia, weight 2 - 4 wks an effective dose antidepressants, loss, sweating, GI immediately. First Line Antidepressant Medication carbamazepine & distress, tremor, Drugs of this class differ substantially in safety, tolerability and simplicity when used in patients warfarin. restlessness, on other medications. Can work in TCA (tricyclic antidepressant) nonresponders. Useful in agitation, anxiety. several anxiety disorders. Taper gradually when discontinuing these medications. SEROTONIN and NOREPHINEPHRINE REUPTAKE INHIBITORS GENERIC BRAND NAME ADULT STARTING DOSE MAX EXCEPTION SAFETY MARGIN TOLERABILITY EFFICACY SIMPLICITY Reduce dose Take with food. Venlafaxine IR Effexor IR 75 mg 375 mg for the elderly & Comparable to BID or TID No serious systemic those with renal SSRIs at low dose. dosing with IR. toxicity. or hepatic Nausea, dry mouth, Response rate = Daily dosing Downtaper slowly to Venlafaxine XR Effexor XR 75 mg 375 mg failure insomnia, anxiety, 2 - 4 wks with XR. prevent clinically somnolence, head (4 - 7 days at Can be started at significant withdrawal ache, dizziness, ~300 mg/day) an effective dose Dual action drug that predominantly acts like a Serotonin Selective Reuptake inhibitor at low syndrome.
    [Show full text]
  • Antidepressant Agents Step Therapy Criteria with Medical Diagnoses Option*
    ϯ ϯ ϯ † A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association Antidepressant Agents Step Therapy Criteria with Medical Diagnoses Option* * Medical diagnoses are required for implementation of this option. Brand Generic Dosage Form Celexa® citalopram tableta, oral solutiona Cymbalta® duloxetine delayed-release capsule Effexor® venlafaxine tableta Effexor XR® venlafaxine extended-release capsule Lexapro® escitalopram tablet, oral solution Luvox® CR fluvoxamine extended-release capsule Paxil® paroxetine hydrochloride tableta, oral suspensiona Paxil CR® paroxetine hydrochloride controlled-release tableta Pexeva® paroxetine mesylate tablet PristiqTM desvenlafaxine extended-release tablet Prozac® fluoxetineb capsulea, tableta, oral solutiona Remeron® mirtazapine tableta RemeronSolTab® mirtazapine orally disintegrating tableta venlafaxine XR venlafaxine extended-release tablet Wellbutrin® bupropion tableta Wellbutrin SR® bupropion sustained-release tableta Wellbutrin XL® bupropion extended-release tableta Zoloft® sertraline tableta, oral concentratea a - currently available as generic b - Prozac® WeeklyTM and Sarafem® brand are not included in this step therapy program HCSC_CS_S_Antidepressant_ST_AR0109.doc Page 1 of 16 © Copyright Prime Therapeutics LLC. 01/2009 All Rights Reserved FDA APPROVED INDICATIONS1-18 The following information is taken from individual drug prescribing information and is provided here as background information only. Not all
    [Show full text]
  • Apo-Paroxetine
    New Zealand Data Sheet APO-PAROXETINE 1. PRODUCT NAME APO-PAROXETINE 20mg film-coated tablet 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Paroxetine hydrochloride 20mg Excipient(s) with known effect Contains lactose For the full list of excipients, see section 6.1 3. PHARMACEUTICAL FORM White, oval-shaped, biconvex, film-coated tablet. Partial bisect and engraved “20” on one side, other side plain. Each tablet is approximately 11.5mm long by 6.3mm wide and typically weighs 237mg. 4. CLINICAL PARTICULARS 4.1 Therapeutic indications Adults aged 18 years and older Major Depressive Disorder: Paroxetine is indicated for the treatment of major depressive disorder (MDD). Paroxetine is indicated for the prevention of relapse and also recurrence of further depressive episodes (see section 5 Pharmacological Properties). Obsessive Compulsive Disorder: Paroxetine is indicated for the treatment of Obsessive-Compulsive Disorder (OCD) (see section 5 Pharmacological Properties). Panic Disorder: Paroxetine is indicated for the treatment of Panic Disorder with and without agoraphobia (see section 5 Pharmacological Properties). Social Anxiety Disorder/Social Phobia: Paroxetine has been shown to be effective in the treatment of Social Anxiety Disorder/social phobia Generalised Anxiety Disorder: Paroxetine has been shown to be effective in the treatment of Generalised Anxiety Disorder (see section 5 Pharmacological Properties). Post-Traumatic Stress Disorder: Paroxetine has been shown to be effective in the treatment of Post-Traumatic Stress Disorder. Children and adolescents (<18 years) Paroxetine is not indicated for use in children or adolescents aged <18 years (see section 4.4 Special warnings and precautions for use). Controlled clinical studies in children and adolescents with major depressive disorder failed to demonstrate efficacy, and do not support the use of paroxetine in the treatment of depression in this population (see section 4.4 Special warnings and precautions for use).
    [Show full text]
  • Drug Interactions with Antidepressants
    Drug Interactions with Antidepressants These tables contain information on some of the important drug interactions with the SSRIs and other antidepressants. It is not fully comprehensive or inclusive and it is especially important to check out the possibility of an interaction occurring with drug combinations that you are not familiar with. Individual susceptibility and response to a drug interaction can be quite variable and the clinical significance is often approached on a case by case basis. The notes on importance and management give some advice but specialised texts such as Stockley’s should be consulted for detailed information on clinical significance and management. Fluoxetine, paroxetine and citalopram are metabolised by the cytochrome P-450 system in the liver but are substrates for different isoenzymes and vary in their potential to inhibit the metabolism of other drugs. In general, citalopram is less likely to cause drug interactions due to enzyme inhibition than fluoxetine or paroxetine. Drug interactions due to enzyme inhibition or induction are pharmacokinetic drug interactions. SSRIs (and other antidepressants) can also cause pharmacodynamic drug interactions where there is no change in the drug concentration of the interacting drug but the effects are additive or antagonistic due to the drug’s pharmacological properties. Examples include additive sedation with CNS depressants and serotonin syndrome with other serotonergic drugs. In Table 1 “All’ refers to the three SSRIs available in New Zealand; paroxetine, fluoxetine and citalopram. Table 2 refers to TCAs in general although individual drugs have different properties which can increase the risk of an interaction; for example amitriptyline is one of the most sedative TCAs and clomipramine has marked serotonergic properties which increase the risk of serotonin syndrome if given with SSRIs.
    [Show full text]
  • Treatment of Premature Ejaculation with Paroxetine Hydrochloride
    International Journal of Impotence Research (1999) 11, 241±246 ß 1999 Stockton Press All rights reserved 0955-9930/99 $12.00 http://www.stockton-press.co.uk/ijir Treatment of premature ejaculation with paroxetine hydrochloride CG McMahon1* and K Touma1 1Australian Centre for Sexual Health, St. Luke's Hospital, Sydney, Australia Aims of this study: To evaluate the ef®cacy of chronic and `on demand' administration of paroxetine hydrochloride in the drug treatment of premature ejaculation (PE). Materials and methods: Ninty-four normally potent men, aged 18 ± 61 y (mean 39 y) with premature ejaculation were treated between January 1996 and March 1997, with oral paroxetine hydrochloride, a selective serotonin re-uptake inhibitor (SSRI). All men were either married or in a stable relationship. Sixty-four out of ninety-four men (Group A) were initially treated with paroxetine hydrochloride 20 mg administered once daily. Those men who responded with improved ejaculatory control within four weeks, were then treated with `on-demand' paroxetine hydrochloride (20 mg) administered 3 ± 4 h prior to planned intercourse. The remaining 33 out of 94 men (Group B) were initially treated with `on-demand' paroxetine hydrochloride 20 mg administered 3 ± 4 h prior to planned intercourse. Results: The mean pre-treatment ejaculatory latency time (ELT) of both group A and B was 0.4 min (range 0 ± 1 min) in 205 intercourses at a frequency of 0.4 intercourses PEr week. In group A after four weeks of daily administration of paroxetine, the mean ELT was 4.5 min (range 1- anejac.) in 761 intercourses at a frequency of 2.4 intercourses per week.
    [Show full text]