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Addressing the side effects of contemporary antidepressant drugs: a comprehensive review
왕승민,한창수,박원명,이수정,Ashwin A. Patkar,Prakash S. Masand,배치운 전남대학교 의과학연구소 2018 전남의대학술지 Vol.54 No.2
Randomized trials have shown that selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) have better safety profiles than classical tricyclic antidepressants (TCAs). However, an increasing number of studies, including meta-analyses, naturalistic studies, and longer-term studies suggested that SSRIs and SNRIs are no less safe than TCAs. We focused on comparing the common side effects of TCAs with those of newer generation antidepressants including SSRIs, SNRIs, mirtazapine, and bupropion. The main purpose was to investigate safety profile differences among drug classes rather than the individual antidepressants, so studies containing comparison data on drug groups were prioritized. In terms of safety after overdose, the common belief on newer generation antidepressants having fewer side effects than TCAs appears to be true. TCAs were also associated with higher drop-out rates, lower tolerability, and higher cardiac side-effects. However, evidence regarding side effects including dry mouth, gastrointestinal side effects, hepatotoxicity, seizure, and weight has been inconsistent, some studies demonstrated the superiority of SSRIs and SNRIs over TCAs, while others found the opposite. Some other side effects such as sexual dysfunction, bleeding, and hyponatremia were more prominent with either SSRIs or SNRIs.
Overactive Bladder Successfully Treated with Duloxetine in a Female Adolescent
왕승민,이해국,권용실,이정태,이경욱 대한정신약물학회 2015 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.13 No.2
Overactive bladder (OAB) is defined as urgency, usually with frequency and nocturia, and with or without urge incontinence. Duloxetine, an antidepressant that inhibits reuptake of serotonin and norepinephrine, is indicated for the treatment of stress urinary incontinence in Europe. In this paper, we present a case of a 17-year-old female patient with OAB and depressive symptoms who was successfully treated with duloxetine. This case suggests duloxetine can be an option for patient with OAB, and it also highlights the need for further studies of duloxetine’s use in the treatment of OAB.
한창수,이수정,전태연,배치운,왕승민 전남대학교 의과학연구소 2015 전남의대학술지 Vol.51 No.2
Major depressive disorder (MDD) is a recurrent, chronic, and devastating disorder leadingto serious impairment in functional capacity as well as increasing public healthcare costs. In the previous decade, switching therapy and dose adjustment of ongoingantidepressants was the most frequently chosen subsequent treatment option forMDD. However, such recommendations were not based on firmly proven efficacy datafrom well-designed, placebo-controlled, randomized clinical trials (RCTs) but on practicalgrounds and clinical reasoning. Aripiprazole augmentation has been dramaticallyincreasing in clinical practice owing to its unique action mechanisms as well as provenefficacy and safety from adequately powered and well-controlled RCTs. Despite the increaseduse of aripiprazole in depression, limited clinical information and knowledgeinterfere with proper and efficient use of aripiprazole augmentation for MDD. The objectiveof the present review was to enhance clinicians’ current understanding of aripiprazoleaugmentation and how to optimize the use of this therapy in the treatment ofMDD.