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Journal Article 2007; 28(4): 395-400 PubMed PMID: 17693970 Citation  Keywords:  Adult, Case-Control Studies, Circadian Rhythm:physiology, Depressive Disorder, Major:drug therapy, Female, Fluoxetine:therapeutic use, Humans, Male, Psychiatric Status Rating Scales, Saliva:metabolism, Serotonin:metabolism, Serotonin Uptake Inhibitors:the.   

OBJECTIVES: The present study aimed to explore the circadian rhythm of salivary serotonin in patients with major depressive disorder before and after treatment with fluoxetine and its relationship with clinical therapeutic effect.

METHODS: This study investigated salivary serotonin in 13 outpatients with major depressive disorder and age- and sex-matched healthy controls. Depressed patients received six weeks fluoxetine treatment (20 mg/day), saliva was collected before and four weeks after treatment. A total of 8 time-point salivary serotonin was measured across the whole day. Multi-oscillator cosinor model was used to fit the rhythms.

RESULTS: Serotonin concentration in saliva ranged from 0.32 ng/ml to 9.62 ng/ml. Salivary serotonin showed prominent circadian rhythm in 91% depressed patients and 92% healthy subjects. Circadian amplitude tend to be higher after fluoxetine treatment in depressed patients, so as the ultradian cycle amplitude. The serotonin circadian amplitude (After minus Before) was positively correlated with the decrease of Zung Self-Rating Depression Scale(SDS) scores at day 42 whereas there was no such correlation at day 28. There was no significant difference in the parameters of mesor, acrophase, harmonic and area under curve among three groups.

CONCLUSIONS: Salivary serotonin in patients with major depressive disorder showed clear circadian rhythm. The relationship between the increase of salivary serotonin amplitude and clinical response deserve further study....

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Journal Article 2007; 28(1): 33-38 PubMed PMID: 17277734 Citation  Keywords:  Adult, Antidepressive Agents:therapeutic use, Anxiety:physiopathology, Combined Modality Therapy, Double-Blind Method, Female, Humans, Male, Middle Aged, Panic Disorder:physiopathology, Prefrontal Cortex:physiopathology, Serotonin Uptake Inhibitors:therap.   

BACKGROUND: Transcranial magnetic stimulation (rTMS) can modulate cortical activity. The goal of our study was to assess whether rTMS would facilitate effect of serotonin reuptake inhibitors in patients with panic disorder.

METHOD: Fifteen patients suffering from panic disorder resistant to serotonin reuptake inhibitor (SRI) therapy were randomly assigned to either active or to sham rTMS. The aim of the study was to compare the 2 and 4 weeks efficacy of the 10 sessions 1 Hz rTMS with sham rTMS add on SRI therapy. We use 1 Hz, 30 minutes rTMS, 110% of motor threshold administered over the right dorso-lateral prefrontal cortex (DLPFC). The same time schedule was used for sham administration. Fifteen patients finished the study,. Psychopathology was assessed using the rating scales CGI, HAMA, PDSS and BAI before the treatment, immediately after the experimental treatment and 2 weeks after the experimental treatment by an independent reviewer.

RESULTS: Both groups improved during the study period but the treatment effect did not differ between groups in any of the instruments.

CONCLUSION: Low frequency rTMS administered over the right dorso-lateral prefrontal cortex after 10 sessions did not differ from sham rTMS add on serotonin reuptake inhibitors in patients with panic disorder....

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Journal Article 2006; 27(1-2): 174-176 PubMed PMID: 16648807 Citation  Keywords:  Adolescent, Adult, Aged, Cataplexy:complications, Citalopram:therapeutic use, Ejaculation:drug effects, Female, Humans, Male, Middle Aged, Narcolepsy:complications, Retrospective Studies, Serotonin Uptake Inhibitors:therapeutic use, Sleep,.   

BACKGROUND: Narcolepsy with cataplexy is a debilitating sleep disease of which some symptoms can be treated with antidepressants. The antidepressant escitalopram is considered the most specific serotonin reuptake inhibitor.

PATIENTS AND METHODS: Ten patients (5 men and 5 women, age range 18-77 years) suffering from narcolepsy with cataplexy occurring at least weekly were treated with escitalopram 5 or 10 mg a day for 28-98 days. These patients were barred from taking any drugs influencing cataplexy and also had no other diseases affecting sleep or vigilance.

RESULTS: The mean number of cataplexies per week in 8 compliant patients declined significantly from 6.7 (+/-SD=7.2) to 0.3 (+/-0.6), P=0.02 (Sign test). Cataplexy completely disappeared in 6 patients. Subjective daytime sleepiness, power of concentration, quality of night sleep and mood remained unchanged. During the treatment, two patients had ejaculation disturbances. Two patients withdrew from the therapy (one because of ejaculation disturbance, the other for unknown reason).

CONCLUSION: Escitalopram proved to have anticataplectic effects in this small-scale open-label study....

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Journal Article 2018; 39(3): 205-208 PubMed PMID: 30431739 Citation  Keywords:  Adult, Aged, Bipolar Disorder:complications, Female, Humans, Injections, Intramuscular, Injections, Intravenous, Logistic Models, Male, Middle Aged, Multivariate Analysis, Psychomotor Agitation:drug therapy, Retrospective Studies, Serotonin Uptake Inhibit.   

OBJECTIVES: Trazodone is a multifunctional triazolopyridine drug with antidepressant, anxiolytic, sedative, and hypnotic properties. The current retrospective study was designed to investigate the effectiveness of trazodone for reducing acute psychomotor activation (PA) in patients with bipolar disorder (BD). We specifically reasoned that a parenteral route of administration could offer potential advantages in this clinical setting. METHODS: We assessed the effectiveness and safety of parenteral trazodone in a retrospective study conducted in 64 inpatients with BD and acute PA. The effectiveness assessment was the Clinical Global Impression Scale - Severity Of Illness (CGI-S) rated before the administration of parenteral trazodone (baseline) and at the end of treatment. A post-treatment reduction in CGI-S score ≥ 20% compared with baseline was considered as the primary outcome measure. RESULTS: Administration of parenteral trazodone was associated with significant improvements in CGI-S scores from baseline (5.4 ± 0.9) to the end of the study (4.2 ± 1.0; p < 0.001, Wilcoxon matched-pairs signed-ranks test). A total of 34 patients (53.1%) showed a post-treatment reduction in CGI-S score ≥ 20% compared to baseline. Multivariable binary logistic regression analysis using a forward selection procedure identified treatment duration (in days) as the only independent predictor of post-treatment reduction in CGI-S score ≥ 20% (odds ratio: 1.28; 95% confidence interval: 1.02-1.60, p <0.05). Adverse effects occurred in 13 (20.3%) patients. CONCLUSIONS: Parenteral trazodone is well-tolerated and effective in 53.1% of patients with BP and acute PA. Treatment duration was identified as an independent predictor of response in our sample....

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