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The two polymorphisms of oxidative drug metabolism, the debrisoquine and the S-mephenytoin hydroxylation polymorphism, affect the metabolism of a number of drugs including many neuroleptics, antidepressants and certain benzodiazepines. The capacity to hydroxylate debrisoquine is bimodally...
Depression is a long term illness that is for the most part recurrent. Placebo controlled studies have shown that if antidepressant treatment of an acute episode is discontinued early relapse of the inadequately treated episode is likely. A continuation treatment period of at least 4 months is...
Risk factors in antidepressant therapy can be related to concurrent conditions such as medical illness, other drug therapy and risk of drug-drug interactions, high age and particular features such as genetic polymorphism in drug oxidation, which is particularly important for antidepressants....
A case of sudden death in a 42-year-old woman is presented. The case illustrates that sudden death is one type of catastrophic outcome that can result from genetically determined or drug-induced slow metabolism of tricyclic antidepressants.
Selective serotonin re-uptake inhibitors are often combined with tricyclic antidepressants (TCA) in the aim of optimalizing pharmacotherapy of the psychiatric patient. However, the real clinical benefit is still not well documented, but it is known, that fluoxetine and fluvoxamine interact with...
The prevalence of depression is higher among elderly than among younger people. If atypical depression, masked depression and dysthymic disorders are included, the prevalence is around 15% in a basic population above 65 years of age. In affective disorders in the elderly, not only environmental...
A pain-relieving effect of tricyclic antidepressants has been documented in double-blind, controlled studies in different chronic organic pain conditions. Antidepressants appear to be especially useful for treatment of peripheral neuropathic pain. The effect appears to be independent of the...
The TCA efficacy in the treatment of depressive illness is well established. Cardiac side effects, however, present serious disadvantages in TCA therapy, and are a risk particularly for the elderly and for all age groups of patients with pre-existing heart disease and in overdose. The SSRIs a...
Cytochrome P450 denotes a group of heme proteins which catalyse the oxidation of numerous drugs and other chemicals. For six drug-metabolizing P450s one or more drugs as substrate have been identified. Variability in elimination and drug-drug interactions can be predicted if the overall...
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