Books: 'Serotonin and noradrenaline reuptake inhibitors'

1

Kulin, Nathalie A. Pregnancy outcome following first trimester maternal exposure to the newer selective serotonin reuptake inhibitors. Ottawa: National Library of Canada = Bibliothèque nationale du Canada, 1999.

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2

Anchors, Michael. Safer than Phen-Fen! Rocklin, CA: Prima Pub., 1997.

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3

Finnerup, Nanna Brix, and Troels Staehelin Jensen. Management issues in neuropathic pain. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0133.

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Neuropathic pain is a common complication to cancer, cancer treatment, HIV, and other conditions that may affect the somatosensory nervous system. Neuropathic pain may be present in up to 40% of cancer patients and may persist independently of the cancer and affect the quality of life in disease-free cancer survivors. Particular surgical treatment and chemotherapy may cause chronic persistent neuropathic pain in cancer survivors. The diagnosis of neuropathic pain can be challenging and requires documentation of a nervous system lesion and pain in areas of sensory changes. The pharmacological treatment may include tricyclic antidepressants, selective serotonin noradrenaline reuptake inhibitors (duloxetine or venlafaxine), calcium channel α2↓ agonists (gabapentin or pregabalin), and opioids. Topical lidocaine and capsaicin, NMDA antagonists, carbamazepine, oxcarbazepine, and cannabinoids may be indicated. Due to limited efficacy or intolerable side effects at maximal doses, combination therapy is often required and careful monitoring of effect and adverse reactions is important.

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4

Clinical Pharmacology of Selective Serotonin Reuptake Inhibitors. Professional Communications, 1996.

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5

Jean-François, Baladi, Menon Devindas, and Trindade Evelinda, eds. Selective serotonin reuptake inhibitors (SSRIs) for major depression. Ottawa: Canadian Coordinating Office for Health Technology Assessment, 1997.

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6

Clare, Stanford S., ed. Selective serotonin reuptake inhibitors (SSRIs): Past, present, and future. Austin: R.G. Landes, 1999.

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7

1941-, Gastpar M., and Wakelin J. S, eds. Selective 5-HT reuptake inhibitors: Novel or commonplace agents? Basel: Karger, 1988.

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8

A, Montgomery S., ed. Selective serotonin reuptake inhibitors: the relevance of selectivity and specificityin clinical practice. CNS (Clinical Neuroscience) Publishers, 1991.

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9

Hadfield, Cynthia. Selective serotonin reuptake inhibitors and hyponatremia in the elderly: cause or coincidence? 1997.

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10

Gastpar, M. Selective 5-Ht Reuptake Inhibitors: Novel or Commonplace Agents? (Advances in Biological Psychiatry). S. Karger Publishers (USA), 1988.

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11

Salkeld, Erin Samantha Marie. The risk of postpartum haemorrhage (PPH) with selective serotonin reuptake inhibitors (SSRIs) and other antidepressants. 2006.

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12

Debra, Elfenbein, ed. Living with Prozac and other selective serotonin reuptake inhibitors (SSRIs) : personal accounts of life on antidepressants. [San Francisco, Calif.]: HarperSan Francisco, 1995.

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13

Y, Adi, National Co-ordinating Centre for HTA (Great Britain), and Health Technology Assessment Programme, eds. Clinical effectiveness and cost-consequence of selective serotonin reuptake inhibitors in the treatment of sex offenders. Alton: Core Research on behalf of the NCCHTA, 2002.

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14

B, Matchar David, United States. Agency for Healthcare Research and Quality., and Duke University Evidence-based Practice Center., eds. Testing for cytochrome P450 polymorphisms in adults with non-psychotic depression treated with selective serotonin reuptake inhibitors (SSRIs). Rockville, MD: Agency for Healthcare Research and Quality, 2007.

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15

Testing for cytochrome P450 polymorphisms in adults with non-psychotic depression treated with selective serotonin reuptake inhibitors (SSRIs). Rockville, MD: AHRQ, 2007.

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16

Steinberg, Martin. Treatment of Depression. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199959549.003.0006.

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Most depression in the elderly can be effectively treated in the primary care setting. Psychiatric referral should be considered in the setting of severe depression, suicidal ideation, prior suicide attempts, multiple risk factors, psychotic symptoms, bipolar disorder, poor response to prior treatment, or high medical comorbidity. Combining pharmacological and psychosocial interventions is most likely to be effective. Available antidepressants include serotonin-specific reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, novel mechanism agents, tricyclic antidepressants, and monoamine oxidase inhibitors. Antidepressant selection should take into account adverse effects, medical comorbidities, potential medication interactions, and patient preferences. Additional strategies (e.g. augmentation) are available for treatment resistant depression. Available psychotherapies include supportive, cognitive-behavioral, interpersonal, and problem solving. Lifestyle interventions (e.g. exercise) may be helpful adjuncts. Given limited evidence for antidepressant treatment in cognitive impairment, for those with mild to moderate depression severity, non-pharmacological interventions should be attempted first.

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17

Schneier, Franklin R., Hilary B. Vidair, Leslie R. Vogel, and Philip R. Muskin. Anxiety, Obsessive-Compulsive, and Stress Disorders. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199326075.003.0006.

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Patients with generalized anxiety disorder experience anxiety related to multiple areas, such as work, finances, and illness. Discrete, unexpected panic attacks and anticipatory anxiety characterize patients with panic disorder. Patients with social anxiety disorder have fear of embarrassment in social situations. Patients with obsessive-compulsive disorder are preoccupied with and distressed by inappropriate thoughts, urges, and images. The four cardinal features of posttraumatic stress disorder are intrusive reexperiencing of the initial trauma, avoidance, persistent negative alterations in cognitions and mood, and alterations in arousal and activity. One element common to patients suffering from most of the anxiety disorders is an elevated sensitivity to threat, which appears to involve brain systems identified to mediate “fear” responses, including the amygdala. The selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are the first-line pharmacotherapy treatment for obsessive-compulsive disorder and most of the anxiety and stress disorders. Cognitive-behavioral therapy for anxiety, obsessive-compulsive, and stress disorders is an empirically validated time-limited treatment.

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18

Beach, Scott R., and Theodore A. Stern. Antidepressants in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0044.

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Selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), and atypical antidepressants are considered first-line agents for depression in the intensive care unit (ICU) setting, and are preferred over older antidepressants due to their more benign side effect profile and tolerability. This chapter reviews the literature on the use of antidepressants in the ICU. Common side effects of SSRIs include insomnia and gastrointestinal discomfort, while citalopram may uniquely cause prolongation of the QTc interval. All SSRIs carry a risk for the development of serotonin syndrome following overdose. SNRIs are similar to SSRIs in their side effect profile, although they are more likely to cause hypertension. Mirtazapine is strongly associated with sedation and weight gain. Stimulants may also be used to treat depression in the medically ill, and can be particularly effective in treating apathy, low energy, and loss of appetite. Monotherapy is typically the initial treatment strategy and low doses are generally recommended in the ICU setting. Efficacy may not be apparent for up to 8 weeks. Patients who have been taking an antidepressant prior to their arrival in the ICU should continue on the medication so as to prevent discontinuation syndrome. Delirium may warrant cessation of the antidepressant and potentially dangerous medication interactions also need to be evaluated. At present, there is no evidence to suggest that an antidepressant should be initiated after a significant physical or emotional trauma.

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19

Thornton, Kevin, and Michael Gropper. Diagnosis, assessment, and management of hyperthermic crises. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0247.

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Malignant hyperthermia, the neuroleptic malignant syndrome (NMS), and the serotonin syndrome are the principal disorders associated with life-threatening hyperthermia in the intensive care unit. While each is a clinically unique entity, all can progress to multisystem organ dysfunction with acidosis, shock, and death. MH usually results from exposure to halogenated volatile anaesthetics and/or succinylcholine and symptoms of increased CO2 production and respiratory acidosis progress rapidly without prompt intervention, including the administration of dantrolene. NMS is a syndrome of rigidity and altered mental status seen most commonly in patients being treated with antipsychotic medications. The serotonin syndrome is seen in patients treated with serotonergic agents including selective serotonin reuptake or monoamine oxidase inhibitors and tricyclic antidepressants. The salient clinical finding is clonus, but agitation, altered mental status and autonomic dysfunction are common. Recognizing the non-specific features of these syndromes presents a challenge as they are life-threatening if not treated promptly and correctly with specific therapies.

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20

Reid, Jemma E., Samar Reghunandanan, Ann Roberts, and Naomi A. Fineberg. Standard Evidence-Based Pharmacological Treatment for OCD. Edited by Christopher Pittenger. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190228163.003.0040.

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This chapter reviews standard pharmacological treatments for OCD and the evidence supporting them. Selective serotonin reuptake inhibitors (SSRIs) remain the pharmacological treatment of choice and are associated with improved health-related quality of life. Improvements are usually sustained over time as long as treatment is continued. Discontinuation is associated with relapse and loss of quality of life, implying that treatment should continue long-term. A substantial minority of patients who fail to respond to SSRIs may benefit from dose elevation, switch to clomipramine, or adjunctive antipsychotic, though long-term trials validating the effectiveness and tolerability of these strategies are relatively lacking.

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21

Walsh, Kelda H., and Christopher J. McDougle. Impulsivity in Childhood. Edited by Jon E. Grant and Marc N. Potenza. Oxford University Press, 2012. http://dx.doi.org/10.1093/oxfordhb/9780195389715.013.0130.

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This chapter discusses impulse control disorders in children 12 years of age and younger. In this age group, the available research focuses on fire setting/pyromania, trichotillomania, and pathological gambling. Less well studied are kleptomania, intermittent explosive disorder, and the impulse control disorder not otherwise specified, pathological skin picking. Clinical presentation, diagnosis, epidemiology, age of onset, risk factors, sociocultural factors, and comorbidity will be reviewed. Psychotherapeutic interventions for the age group will be explored, with particular emphasis on behavioral therapy. The available literature on psychopharmacological treatments, particularly selective serotonin reuptake inhibitors and opioid antagonists, will also be explored.

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22

Koen, N., T. Amos, J. Ipser, and D. Stein. Antidepressants in Post-Traumatic Stress Disorder. Edited by Charles B. Nemeroff and Charles R. Marmar. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190259440.003.0034.

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This chapter discusses the use of antidepressants in treating symptoms of posttraumatic stress disorder (PTSD). Tricyclic antidepressants were the first psychotropic agents to be studied systematically and rigorously for the treatment of PTSD. While early studies focused both on the tricyclics and monoamine oxidase inhibitors (MAOIs), more recent work has centered on the selective serotonin reuptake inhibitors (SSRIs); and paroxetine and sertraline are currently approved by the U.S. Food and Drug Administration (FDA) for use in this disorder. However, given the relatively small effect sizes in SSRI trials of PTSD, there is a need for ongoing psychopharmacological research to understand underlying mechanisms of antidepressant efficacy and to optimize response to pharmacotherapy. Further data on pediatric PTSD and on medication prophylaxis are needed before routine antidepressant treatment can be endorsed in these contexts.

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23

Benedek, David M., and Gary H. Wynn. Pharmacologic Treatment of Adults with Trauma- and Stressor-Related Disorders. Edited by Frederick J. Stoddard, David M. Benedek, Mohammed R. Milad, and Robert J. Ursano. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190457136.003.0022.

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This chapter reviews evidence-based pharmacological treatments for posttraumatic stress disorder, acute stress disorder, and adjustment disorder in adults. Emphasis is given to treatments that have received the strongest recommendations in published practice guidelines, clinical trials, and meta-analyses. Mention is also made of pharmacological interventions introduced subsequent to changes in diagnostic definitions that occurred with the shift to the category trauma- and stress-related disorders in the Diagnostic and Statistical Manual of Mental Disorders (fifth edition). Medications covered in this chapter are across a broad range of classes and include serotonin specific reuptake inhibitors (SSRIs), antipsychotics, anticonvulsants, and benzodiazepines. The discussion addresses medications used as monotherapy and as medication augmentation.

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24

Dougherty, Darin D., Scott L. Rauch, and Michael A. Jenike. Treatments for Obsessive-Compulsive Disorder. Oxford University Press, 2015. http://dx.doi.org/10.1093/med:psych/9780199342211.003.0017.

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There is overwhelming evidence of the most rigorous type supporting the efficacy of serotonin reuptake inhibitors (SRIs) in the treatment of obsessive-compulsive disorder (OCD). Along with SRIs, behavior therapy must be considered a viable first-line therapy. The best available data suggest that behavior therapy, and perhaps cognitive therapy, is at least as effective as medication in some instances and may be superior with respect to risks, costs, and enduring benefits. A variety of second-line medication treatments for OCD have been studied in a controlled or systematic fashion. Augmentation of SRIs with antipsychotics, buspirone, or clonazepam is provisionally recommended based on the available data. Other monotherapies and augmentation strategies find very limited support at present.

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25

Greenberg, Jennifer L., Alexandra Sullivan, and Sabine Wilhelm. Treating Children and Adolescents with Body Dysmorphic Disorder. Edited by Katharine A. Phillips. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190254131.003.0028.

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Body dysmorphic disorder (BDD) is a common and severe disorder that typically has its onset during adolescence. Youth with BDD appear more severely ill than adults in terms of having poorer insight and a higher likelihood of having attempted suicide. Despite BDD’s severity and early onset, there is only limited research on its treatment in youth. Cognitive-behavioral therapy (CBT) and serotonin reuptake inhibitors (SRIs) are the first-line treatments for BDD in adults and appear to be effective for adolescents with BDD. This chapter provides an overview of the treatment of BDD in youth, including cognitive-behavioral and pharmacologic approaches, and an illustrative case example. The chapter also addresses cosmetic treatment for BDD in children and adolescents, which appear to be ineffective.

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26

Stewart, Jessica Ann, L. Mark Russakoff, and Jonathan W. Stewart. Pharmacotherapy, ECT, and TMS. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199326075.003.0016.

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Physicians’ attention to patients’ concerns and attitudes about taking medication will engender adherence, as will close monitoring of potentially disconcerting side effects. The primary indication for antipsychotic medications is the treatment of psychotic disorders and mania, even in the absence of psychosis. The more troublesome side effects of antipsychotic medications include increased appetite and weight gain; extrapyramidal side effects, tardive dyskinesia, and neuroleptic malignant syndrome. Antidepressants are effective for treating depressive illness, including major depression, persistent depressive disorder (dysthymia) and premenstrual dysphoric disorder. They are also often used effectively in the treatment of anxiety disorders, obsessive-compulsive disorder, bulimia nervosa, and somatic symptom disorders. Selective serotonin reuptake inhibitors (SSRIs) are generally well tolerated. Other important categories of medications include mood stabilizers and anxiolytics.

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27

Simpson, H. Blair. Overview of the Treatment of OCD. Edited by Christopher Pittenger. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190228163.003.0036.

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Obsessive-Compulsive Disorder (OCD) is a chronic and disabling disorder with a lifetime prevalence of 2% to 3%. This chapter briefly introduces the different treatment strategies for OCD and provides a treatment algorithm for use in clinical practice. It discusses aspects of cognitive-behavioral therapy (CBT), including variants such as exposure and response prevention therapy (ERP), and acceptance and commitment therapy (ACT), as well as clinical considerations. It also covers pharmacotherapy for OCD, including serotonin reuptake inhibitors (SRIs) and various augmentation strategies for them such as CBT and antipsychotics. There are sections addressing treatment of children and adolescents, and other treatments for OCD such as transcranial magnetic stimulation (TMS) or surgery. Subsequent chapters review these different treatment strategies in more detail and are referred to throughout this chapter.

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28

Stewart, S. Evelyn, and Clare Bleakley. Treatment of Pediatric OCD. Edited by Christopher Pittenger. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190228163.003.0042.

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Appropriate OCD treatment has the potential to reverse negative impacts on the developmental trajectory of youth with this disease. First-line treatments for pediatric OCD have been well established, including cognitive behavior therapy (CBT), serotonin reuptake inhibitors (SRI), and the combination thereof. However, a significant proportion of OCD-affected youth do not achieve response or remission following initial treatment, and access to OCD-focused CBT treatment is often limited. Knowledge of CBT and SRI response predictors, mechanisms of action, and augmentation strategies for pediatric OCD should be exploited to guide individual clinical decision making. Further investigation is required to identify specific management approaches in treatment-resistant cases and putative OCD subtypes. This chapter summarizes proven first-line pharmacological and psychological treatments, discusses potential augmentation strategies, and suggests practical management tips for use in pediatric OCD.

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Scahill, Lawrence, and Jaimie Rojas. Pediatric Psychopharmacology: Commonly Used Medications in Children. Edited by Thomas H. Ollendick, Susan W. White, and Bradley A. White. Oxford University Press, 2018. http://dx.doi.org/10.1093/oxfordhb/9780190634841.013.49.

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Pediatric psychopharmacology is a relatively young field. Through the decade of the 1990s and into the early 2000s, there was an unprecedented increase in the number of new psychotropic drugs and new formulations of older drugs. During this period, there was also a series of well-intended federal policies that provided pressure and incentives for pharmaceutical companies to conduct studies of new medications in children. The National Institutes of Health also provided funding for investigator-initiated clinical trials. Although still less than optimal, we now have a body of data on stimulants, selective serotonin reuptake inhibitors, and atypical antipsychotics. These three psychotropic drug classes are the most commonly used in children and adolescents. This chapter charts the rise in use of these drug classes and presents their risks and benefits.

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30

Deramecourt, Vincent, Florence Lebert, and Florence Pasquier. Frontotemporal dementia. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199644957.003.0036.

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Frontotemporal dementia (FTD) is the second most common form of dementia in persons younger than 65 years after Alzheimer’s disease. The FTD spectrum is characterized by clinical, molecular and genetic heterogeneity. Core features of FTD are behavioural and language manifestations and the clinical spectrum of FTD currently includes a behavioural variant, progressive nonfluent aphasia and semantic dementia. The most common behavioural features are disinhibition, apathy, loss of empathy, hyperorality and perseveration. Neuroimaging usually demonstrates focal atrophy and hypometabolism in the anterior part of the frontal and temporal lobes. A careful history and neuropsychological examination, and judicious use of neuroimaging, can help distinguish FTD from other common forms of dementia, especially Alzheimer’s disease, vascular dementia, and dementia with Lewy bodies. Although no specific pharmacological treatments for FTD exists, symptom management with serotonin reuptake inhibitors and non pharmacological interventions have been shown to be beneficial.

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31

Geracioti, Thomas D., Jeffrey R. Strawn, and Matthew D. Wortman. Mechanisms of Action in the Pharmacology of PTSD. Edited by Israel Liberzon and Kerry J. Ressler. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190215422.003.0020.

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This chapter reviews medications currently available for PTSD in the context of their mechanisms of action, pathophysiological relevance, and clinical efficacy data. It systematically reviews aminergic mechanisms in PTSD pharmacology, including commonly used serotonin and norepinephrine agents, selective reuptake inhibitors and receptors drugs, as well as dopaminergic agents and psychostimulants. It also discusses the use of anticonvusants and antianxiety agents that modulate GABAergic and glutamatergic signaling, such as carbamazepine, VPA, benzodiazepines, gabapentine, and others. It also reviews other clinically available agents as well as HPA axis-modulating compounds, both for treatment and secondary prevention of PTSD. It concludes with the suggestion that clinical selection of one or more of these medications for PTSD should be based on individual patient considerations, including target symptoms, PTSD subtype, post-traumatic interval, comorbidities, genotypes for CYP450 enzymes, and genetic polymorphisms of clinical relevance.

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32

Burger, John. Side Effects of Medications and Mitigation Strategies. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190461508.003.0009.

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Sexual dysfunction is a common side effect of many common medications, including the first-line agents for treating post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), and attention-deficit hyperactivity disorder (ADHD). Selective serotonin and norepinephrine reuptake inhibitors have been especially well studied. This chapter reviews the different classes of medications used to treat PTSD, TBI, and ADHD that can cause sexual side effects as well as several strategies important in understanding the source of sexual symptoms. Specific mitigation strategies are then reviewed, including changing the dose, switching within a class, switching to a different class, adding an augmenting agent, watching and waiting, and taking drug holidays. Key research supporting each strategy is presented and discussed with consideration for the typical responses of both men and women. Strength of research is also weighed. Finally, some considerations for future treatment strategies are considered.

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33

Ganança, Licínia, David A. Kahn, and Maria A. Oquendo. Mood Disorders. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199326075.003.0003.

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This chapter discusses the mood disorders. Major depressive disorder is characterized by neurovegetative changes, anhedonia, and suicidal ideation. Persistent depressive disorder is a milder form of depression, lasting for at least 2 years, with little or no remission during that time... Psychotic features can occur in both depressive and manic episodes. Premenstrual dysphoric disorder is diagnosed through use of a prospective daily symptom ratings log showing a cyclical pattern over at least 2 consecutive months. Patients with mood episodes with mixed features have a high risk of suicide. Some patients with bipolar disorder and major depressive disorder may develop catatonic features characterized by marked psychomotor disturbance. Selective serotonin reuptake inhibitors (SSRIs) are the usual first-line medication treatment for patients with major depressive disorder. For patients with bipolar disorder the mainstays of somatic therapy are lithium and the anticonvulsants valproate and carbamazepine.

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34

McCloskey, Michael S., Mitchell E. Berman, and Kurtis Noblett. Assessment and Treatment of Intermittent Explosive Disorder. Edited by Jon E. Grant and Marc N. Potenza. Oxford University Press, 2012. http://dx.doi.org/10.1093/oxfordhb/9780195389715.013.0099.

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Intermittent explosive disorder (IED), a DSM-IV-TR disorder characterized by significant acts of aggression and violence, is being increasingly recognized as a prevalent and chronic disorder. Given the personal, social, and economic costs associated with IED, there is a clear need for well-validated assessment measures and efficacious treatments. However, there are currently no published, well-validated diagnostic measures of IED. With regard to treatment, preliminary evidence from a few randomized clinical trials suggests that selective serotonin reuptake inhibitors and cognitive behavioral psychotherapy may be effective in treating IED. However, more research is needed before either can be considered an empirically supported treatment for IED. In this chapter, we discuss (1) challenges in developing reliable and valid assessments for IED and (2) issues relevant to developing and testing psychological and pharmacological treatment interventions for IED.

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35

Walters, Jenna L. Complex Regional Pain Syndrome. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190217518.003.0025.

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Complex regional pain syndrome (CRPS) is a neuropathic pain condition classified as type 1 and type 2. The two classifications are distinguished by the presence of documented nerve injury in CRPS type 2. The symptoms of CRPS, including cold, blue, and painful extremities, are believed to occur from vasoconstriction caused by sympathetic dysfunction. Treatment in CRPS focuses on targeting neuropathic and sympathetically maintained pain. Traditional antineuropathic pain medications include membrane stabilizers and serotonin and norepinephrine reuptake inhibitors. Corticosteroids and nonsteroidals target the inflammatory process present in the initial stages of CRPS. Bone resorption has been treated with calcium-modulating drugs. Interventional therapies include sympathetic blockade of the affected extremity, spinal cord stimulation, and intrathecal drug delivery. All these therapies have been implemented in an effort to facilitate functional restoration of the affected limb. Physical and occupational therapies have demonstrated some of the most significant improvements in pain, mobility, and function.

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36

Kimmel, Ryan J., Peter P. Roy-Byrne, and Deborah S. Cowley. Pharmacological Treatments for Panic Disorder, Generalized Anxiety Disorder, Specific Phobia, and Social Anxiety Disorder. Oxford University Press, 2015. http://dx.doi.org/10.1093/med:psych/9780199342211.003.0015.

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Selective serotonin reuptake inhibitors (SSRIs) are the first-line pharmacological treatment for panic disorder based on their low rate of side effects, lack of dietary restrictions, and absence of tolerance. SSRIs and venlafaxine are attractive first-line treatments for social anxiety disorder. Pharmacological treatments of choice for generalized anxiety disorder are buspirone and antidepressants, including SSRIs and venlafaxine. Benzodiazepines, although effective for all these disorders, lack efficacy for comorbid depression and carry the risk of physiological dependence and withdrawal symptoms. Their greatest utility seems to be as an initial or adjunctive medication for patients with disabling symptoms requiring rapid relief and for those unable to tolerate other medications. Chronic treatment with benzodiazepines is generally safe and effective but should probably be reserved for patients nonresponsive or intolerant to other agents. Larger trials are necessary to determine whether pharmacological agents might be useful as monotherapies, or adjuncts to exposure psychotherapy, for specific phobia.

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37

Golier, Julia A., Andreas C. Michaelides, Maya Genovesi, Emily Chapman, and Rachel Yehuda. Pharmacological Treatment of Posttraumatic Stress Disorder. Oxford University Press, 2015. http://dx.doi.org/10.1093/med:psych/9780199342211.003.0019.

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Although psychotherapy is considered first-line treatment for posttraumatic stress disorder (PTSD), advances have been made in pharmacological treatment. Based on controlled clinical trials, antidepressants remain the first-line pharmacological treatment. Studies suggest that selective serotonin reuptake inhibitors reduce PTSD-specific symptoms and improve global outcome. Emerging evidence suggests efficacy for venlafaxine. Other individual agents found to be efficacious include imipramine and phenelzine. Prazosin is emerging as a beneficial adjunct for PTSD-related sleep disturbances and nightmares. Some evidence suggests that atypical antipsychotics may be efficacious against a broad range of symptoms, although the risk of metabolic side effects may limit widespread use. Trials are needed to assess whether anticonvulsants, cortisol-based treatments, sympatholytics, or other novel approaches are efficacious, and how pharmacotherapy can enhance psychotherapy outcomes. These studies should consider the goals of pharmacotherapy in PTSD and the subgroups of patients or clinical presentations most likely to benefit from pharmacological interventions.

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38

Phillips, Katharine A. Pharmacotherapy and Other Somatic Treatments for Body Dysmorphic Disorder. Edited by Katharine A. Phillips. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190254131.003.0025.

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This chapter discusses pharmacotherapy for body dysmorphic disorder (BDD), including barriers to treatment, essential groundwork for prescribing, first-line treatment with serotonin-reuptake inhibitors (SRIs), and optimal dosing and trial duration (higher SRI doses and longer trials are more often needed for BDD than for most other disorders). SRIs are the first-line medication treatment for both delusional BDD and nondelusional BDD. Medication may be used for BDD of mild to moderate severity, and it is essential for more severely ill and suicidal patients and for those with severe depressive symptoms. Pharmacotherapy that is optimized for BDD usually alleviates symptoms and not uncommonly leads to remission. The chapter also discusses steps to take when an SRI is not effective, such as raising the SRI dose even further as well as SRI augmentation and switching strategies. SRI continuation and discontinuation, and the potential usefulness of non-SRI medications and other somatic treatments are also discussed. Challenges that clinicians often encounter when treating BDD and that can be addressed with pharmacotherapy—severe depression, suicidality, and problematic substance use—are also discussed.

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39

Castriotta, Natalie, and Michelle G. Craske. Depression and Comorbidity with Panic Disorder. Edited by C. Steven Richards and Michael W. O'Hara. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199797004.013.027.

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Comorbidity between panic disorder and major depression is found in the majority of individuals with panic disorder and a substantial minority of individuals with major depression. Comorbidity between panic disorder and depression is associated with substantially more severe symptoms of each of the disorders, greater persistence of each disorder, more frequent hospitalization and help-seeking behavior, more severe occupational impacts, and a significantly higher rate of suicide attempts. These two disorders share many risk factors, such as neuroticism, exposure to childhood abuse, informational processing biases, and elevated amygdala activation in response to negative facial expressions. Research on the temporal priority of panic disorder and major depression has most frequently found that panic attacks and other symptoms of anxiety predate the onset of the first major depressive episode, but the first depressive episode predates the onset of full panic disorder. Treatment studies indicate that cognitive behavioral therapy (CBT) is the most effective treatment for panic disorder. Other forms of treatment include medication, particularly selective serotonin reuptake inhibitors. Comorbid depression does not appear to affect the outcome of CBT for a principal diagnosis of panic disorder, and CBT for panic disorder has positive, yet limited, effects on symptoms of depression.

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Books on the topic 'Serotonin and noradrenaline reuptake inhibitors'

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