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Gianni Forti - One of the best experts on this subject based on the ideXlab platform.
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original research epidemiology selective serotonin Reuptake Inhibitor induced sexual dysfunction
The Journal of Sexual Medicine, 2009Co-Authors: Giovanni Corona, Elisa Bandini, Francesco Lotti, Valentina Boddi, Giulia Rastrelli, Alessandra Sforza, Edoardo Mannucci, Carlo Faravelli, Valdo Ricca, Gianni FortiAbstract:ABSTRACT Introduction Sexual dysfunctions are often present in subjects with mood disturbances; however. antidepressants can induce per se sexual dysfunctions. Aim To explore the relationship between the use of selective serotonin Reuptake Inhibitors (SSRIs), non-SSRIs antidepressants and benzodiazepines (BDZ), hormonal parameters, and reported sexual dysfunction (as assessed by the Structured Interview on Erectile Dysfunction [SIEDY]) in male subjects with comparable psychopathological symptoms (as assessed by the Middlesex Hospital Questionnaire [MHQ] a self-reported test for the screening of mental disorders in a non-psychiatric setting). Methods A consecutive series of 2,040 (mean age 51 ± 13 years) male patients with sexual dysfunction was studied. Main Outcome Measures Several hormonal and biochemical parameters were investigated, along with SIEDY and the MHQ. Results Higher prolactin was observed only in patients using SSRIs, whereas no other hormonal difference was found after adjustment for confounders. Use of SSRIs was associated with a twofold risk for patient hypoactive sexual desire and with a higher impairment of reported erectile function. However, no difference in penile blood flow was observed. A very high risk (sevenfold) for delayed ejaculation (DE) was observed in SSRI users. Interestingly, the association with the mild, but not severe, form of DE was observed also in subjects using non-SSRI antidepressants (3.35 [1.48–7.59]; P Conclusions SSRIs can negatively affect all the steps of the male sexual response cycle (desire–arousal–excitement–orgasm). SSRI-associated sexual dysfunction has a deleterious effect on both auto- and couple-erotic performances. Conversely, other antidepressants and BDZ are less often associated with sexual impairment. Corona G, Ricca V, Bandini E, Mannucci E, Lotti F, Boddi V, Rastrelli G, Sforza A, Faravelli C, Forti G, and Maggi M. Selective serotonin Reuptake Inhibitor-induced sexual dysfunction. J Sex Med 2009;6:1259–1269.
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selective serotonin Reuptake Inhibitor induced sexual dysfunction
The Journal of Sexual Medicine, 2009Co-Authors: Giovanni Corona, Elisa Bandini, Francesco Lotti, Valentina Boddi, Giulia Rastrelli, Alessandra Sforza, Edoardo Mannucci, Carlo Faravelli, Valdo Ricca, Gianni FortiAbstract:ABSTRACT Introduction Sexual dysfunctions are often present in subjects with mood disturbances; however. antidepressants can induce per se sexual dysfunctions. Aim To explore the relationship between the use of selective serotonin Reuptake Inhibitors (SSRIs), non-SSRIs antidepressants and benzodiazepines (BDZ), hormonal parameters, and reported sexual dysfunction (as assessed by the Structured Interview on Erectile Dysfunction [SIEDY]) in male subjects with comparable psychopathological symptoms (as assessed by the Middlesex Hospital Questionnaire [MHQ] a self-reported test for the screening of mental disorders in a non-psychiatric setting). Methods A consecutive series of 2,040 (mean age 51 ± 13 years) male patients with sexual dysfunction was studied. Main Outcome Measures Several hormonal and biochemical parameters were investigated, along with SIEDY and the MHQ. Results Higher prolactin was observed only in patients using SSRIs, whereas no other hormonal difference was found after adjustment for confounders. Use of SSRIs was associated with a twofold risk for patient hypoactive sexual desire and with a higher impairment of reported erectile function. However, no difference in penile blood flow was observed. A very high risk (sevenfold) for delayed ejaculation (DE) was observed in SSRI users. Interestingly, the association with the mild, but not severe, form of DE was observed also in subjects using non-SSRI antidepressants (3.35 [1.48–7.59]; P Conclusions SSRIs can negatively affect all the steps of the male sexual response cycle (desire–arousal–excitement–orgasm). SSRI-associated sexual dysfunction has a deleterious effect on both auto- and couple-erotic performances. Conversely, other antidepressants and BDZ are less often associated with sexual impairment. Corona G, Ricca V, Bandini E, Mannucci E, Lotti F, Boddi V, Rastrelli G, Sforza A, Faravelli C, Forti G, and Maggi M. Selective serotonin Reuptake Inhibitor-induced sexual dysfunction. J Sex Med 2009;6:1259–1269.
Jenny Guidi - One of the best experts on this subject based on the ideXlab platform.
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withdrawal symptoms after serotonin noradrenaline Reuptake Inhibitor discontinuation systematic review
Psychotherapy and Psychosomatics, 2018Co-Authors: Giovanni A Fava, Giada Benasi, Marcella Lucente, Emanuela Offidani, Fiammetta Cosci, Jenny GuidiAbstract:Background: Serotonin-noradrenaline Reuptake Inhibitors (SNRI) are widely used in medical practice. Their discontinuation has been associated with a wide range of symptoms. The aim of this paper is to identify the occurrence, frequency, and features of withdrawal symptoms after SNRI discontinuation. Methods: PRISMA guidelines were followed to conduct a systematic review. Electronic databases included PubMed, the Cochrane Library, Web of Science, and MEDLINE from the inception of each database to June 2017. Titles, abstracts, and topics were searched using a combination of the following terms: “duloxetine” OR “venlafaxine” OR “desvenlafaxine” OR “milnacipran” OR “levomilnacipran” OR “SNRI” OR “second generation antidepressant” OR “serotonin norepinephrine Reuptake Inhibitor” AND “discontinuation” OR “withdrawal” OR “rebound.” Only published trials in the English language were included. Results: Sixty-one reports met the criteria for inclusion. There were 22 double-blind randomized controlled trials, 6 studies where patients were treated in an open fashion and then randomized to a double-blind controlled phase, 8 open trials, 1 prospective naturalistic study, 1 retrospective study, and 23 case reports. Withdrawal symptoms occurred after discontinuation of any type of SNRI. The prevalence of withdrawal symptoms varied across reports and appeared to be higher with venlafaxine. Symptoms typically ensued within a few days from discontinuation and lasted a few weeks, also with gradual tapering. Late onset and/or a longer persistence of disturbances occurred as well. Conclusions: Clinicians need to add SNRI to the list of drugs potentially inducing withdrawal symptoms upon discontinuation, together with other types of psychotropic drugs. The results of this study challenge the use of SNRI as first-line treatment for mood and anxiety disorders.
Giovanni Corona - One of the best experts on this subject based on the ideXlab platform.
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original research epidemiology selective serotonin Reuptake Inhibitor induced sexual dysfunction
The Journal of Sexual Medicine, 2009Co-Authors: Giovanni Corona, Elisa Bandini, Francesco Lotti, Valentina Boddi, Giulia Rastrelli, Alessandra Sforza, Edoardo Mannucci, Carlo Faravelli, Valdo Ricca, Gianni FortiAbstract:ABSTRACT Introduction Sexual dysfunctions are often present in subjects with mood disturbances; however. antidepressants can induce per se sexual dysfunctions. Aim To explore the relationship between the use of selective serotonin Reuptake Inhibitors (SSRIs), non-SSRIs antidepressants and benzodiazepines (BDZ), hormonal parameters, and reported sexual dysfunction (as assessed by the Structured Interview on Erectile Dysfunction [SIEDY]) in male subjects with comparable psychopathological symptoms (as assessed by the Middlesex Hospital Questionnaire [MHQ] a self-reported test for the screening of mental disorders in a non-psychiatric setting). Methods A consecutive series of 2,040 (mean age 51 ± 13 years) male patients with sexual dysfunction was studied. Main Outcome Measures Several hormonal and biochemical parameters were investigated, along with SIEDY and the MHQ. Results Higher prolactin was observed only in patients using SSRIs, whereas no other hormonal difference was found after adjustment for confounders. Use of SSRIs was associated with a twofold risk for patient hypoactive sexual desire and with a higher impairment of reported erectile function. However, no difference in penile blood flow was observed. A very high risk (sevenfold) for delayed ejaculation (DE) was observed in SSRI users. Interestingly, the association with the mild, but not severe, form of DE was observed also in subjects using non-SSRI antidepressants (3.35 [1.48–7.59]; P Conclusions SSRIs can negatively affect all the steps of the male sexual response cycle (desire–arousal–excitement–orgasm). SSRI-associated sexual dysfunction has a deleterious effect on both auto- and couple-erotic performances. Conversely, other antidepressants and BDZ are less often associated with sexual impairment. Corona G, Ricca V, Bandini E, Mannucci E, Lotti F, Boddi V, Rastrelli G, Sforza A, Faravelli C, Forti G, and Maggi M. Selective serotonin Reuptake Inhibitor-induced sexual dysfunction. J Sex Med 2009;6:1259–1269.
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selective serotonin Reuptake Inhibitor induced sexual dysfunction
The Journal of Sexual Medicine, 2009Co-Authors: Giovanni Corona, Elisa Bandini, Francesco Lotti, Valentina Boddi, Giulia Rastrelli, Alessandra Sforza, Edoardo Mannucci, Carlo Faravelli, Valdo Ricca, Gianni FortiAbstract:ABSTRACT Introduction Sexual dysfunctions are often present in subjects with mood disturbances; however. antidepressants can induce per se sexual dysfunctions. Aim To explore the relationship between the use of selective serotonin Reuptake Inhibitors (SSRIs), non-SSRIs antidepressants and benzodiazepines (BDZ), hormonal parameters, and reported sexual dysfunction (as assessed by the Structured Interview on Erectile Dysfunction [SIEDY]) in male subjects with comparable psychopathological symptoms (as assessed by the Middlesex Hospital Questionnaire [MHQ] a self-reported test for the screening of mental disorders in a non-psychiatric setting). Methods A consecutive series of 2,040 (mean age 51 ± 13 years) male patients with sexual dysfunction was studied. Main Outcome Measures Several hormonal and biochemical parameters were investigated, along with SIEDY and the MHQ. Results Higher prolactin was observed only in patients using SSRIs, whereas no other hormonal difference was found after adjustment for confounders. Use of SSRIs was associated with a twofold risk for patient hypoactive sexual desire and with a higher impairment of reported erectile function. However, no difference in penile blood flow was observed. A very high risk (sevenfold) for delayed ejaculation (DE) was observed in SSRI users. Interestingly, the association with the mild, but not severe, form of DE was observed also in subjects using non-SSRI antidepressants (3.35 [1.48–7.59]; P Conclusions SSRIs can negatively affect all the steps of the male sexual response cycle (desire–arousal–excitement–orgasm). SSRI-associated sexual dysfunction has a deleterious effect on both auto- and couple-erotic performances. Conversely, other antidepressants and BDZ are less often associated with sexual impairment. Corona G, Ricca V, Bandini E, Mannucci E, Lotti F, Boddi V, Rastrelli G, Sforza A, Faravelli C, Forti G, and Maggi M. Selective serotonin Reuptake Inhibitor-induced sexual dysfunction. J Sex Med 2009;6:1259–1269.
Charlotta Sundblad - One of the best experts on this subject based on the ideXlab platform.
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effects of the androgen antagonist flutamide and the serotonin Reuptake Inhibitor citalopram in bulimia nervosa a placebo controlled pilot study
Journal of Clinical Psychopharmacology, 2005Co-Authors: Charlotta Sundblad, Mikael Landen, Tomas Eriksson, Lars Bergman, Elias ErikssonAbstract:Prompted by previous studies suggesting that bulimia nervosa in women may be associated with elevated serum levels of testosterone, we have evaluated the possible effect of androgen antagonism in this condition. To this end, women meeting the DSM-IV criteria of bulimia nervosa, purging type, were treated in a one-center study with the androgen receptor antagonist flutamide (n = 9), the serotonin Reuptake Inhibitor citalopram (n = 15), flutamide plus citalopram (n = 10), or placebo (n = 12) for 3 months using a double-blind design. Self-rated global assessment of symptom intensity suggests all active treatments to be superior to placebo. The reduction in binge eating compared with baseline was statistically significant in both groups given flutamide but not in the groups given citalopram only or placebo. A moderate and reversible increase in serum transaminase levels led to discontinuation in two subjects in the flutamide group. It is concluded that blockade of androgen receptors may reduce some of the symptoms of bulimia nervosa in women.
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The Serotonin Reuptake Inhibitor Paroxetin Is Superior to the Noradrenaline Reuptake Inhibitor Maprotiline in the Treatment of Premenstrual Syndrome
Neuropsychopharmacology, 1995Co-Authors: Elias Eriksson, Marina A. Hedberg, Björn Andersch, Charlotta SundbladAbstract:Recent studies indicate that antidepressant drugs with potent serotonin Reuptake inhibiting properties are effective in reducing the symptoms of premenstrual syndrome (PMS). In order to elucidate whether all antidepressant drugs are equally effective in the treatment of PMS or whether potent serotonin Reuptake inhibition is a prerequisite for reducing premenstrual complaints, women suffering from severe PMS were treated daily for three menstrual cycles with a selective serotonin Reuptake Inhibitor, paroxetine (n = 22), or with a selective noradrenaline Reuptake Inhibitor, maprotiline (n = 21); in addition, a placebo group was included (n = 22). Six symptoms (irritability, depressed mood, tension/anxiety, increased appetite/craving for carbohydrates, bloating, and breast tenderness) were rated by the participants daily throughout the study. With respect to all outcome measurements, the symptom reduction obtained with paroxetine was significantly superior to that obtained with placebo; with respect to irritability, increased appetite/carbohydrate craving, bloating, and breast tenderness, as well as global self-rating, paroxetine was significantly superior also to maprotiline. The clear-cut superiority of paroxetine over maprotiline indicates that not all antidepressant drugs are equally effective in the treatment of PMS; rather, like panic disorder and obsessive compulsive disorder, but in contrast to depression, PMS apparently responds better to serotonin Reuptake Inhibitors than to antidepressants with a noradrenergic profile.
George I Papakostas - One of the best experts on this subject based on the ideXlab platform.
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effects of s adenosylmethionine augmentation of serotonin Reuptake Inhibitor antidepressants on cognitive symptoms of major depressive disorder
European Psychiatry, 2012Co-Authors: Yechiel Levkovitz, Jonathan E Alpert, Carrie E Brintz, David Mischoulon, George I PapakostasAbstract:Abstract Major depressive disorder (MDD) is often accompanied by significant cognitive impairment, and there are limited interventions specific to this particular symptom. S-adenosylmethionine (SAMe), a naturally occurring molecule which serves as a major methyl-donor in human cellular metabolism, is required for the synthesis and maintenance of several neurotransmitters that have been implicated in the pathophysiology and treatment of cognitive dysfunction in MDD. Objectives This study is a secondary analysis of a clinical trial involving the use of adjunctive SAMe for MDD. Methods Forty-six serotonin-Reuptake Inhibitor (SRI) non-responders with MDD enrolled in a 6-week, double-blind, randomized trial of adjunctive oral SAMe were administered the self-rated cognitive and physical symptoms questionnaire (CPFQ), a validated measure of cognitive as well as physical symptoms of MDD, before and after treatment. Results There was a greater improvement in the ability to recall information ( P =0.04) and a trend towards statistical significance for greater improvement in word-finding ( P =0.09) for patients who received adjunctive SAMe than placebo. None of the remaining five items reached statistical significance. Conclusions These preliminary data suggest that SAMe can improve memory-related cognitive symptoms in depressed patients, and warrant replication.
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effects of s adenosylmethionine augmentation of serotonin Reuptake Inhibitor antidepressants on cognitive symptoms of major depressive disorder
Journal of Affective Disorders, 2012Co-Authors: Yechiel Levkovitz, Jonathan E Alpert, Carrie E Brintz, David Mischoulon, George I PapakostasAbstract:Abstract Background Major depressive disorder (MDD) is often accompanied by significant cognitive impairment, and there are limited interventions specific to this particular symptom. S-adenosyl methionine (SAMe), a naturally occurring molecule which serves as a major methyl-donor in human cellular metabolism, is required for the synthesis and maintenance of several neurotransmitters that have been implicated in the pathophysiology and treatment of cognitive dysfunction in MDD. Methods This study is a secondary analysis of a clinical trial involving the use of adjunctive SAMe for MDD. Forty-six serotonin-Reuptake Inhibitor (SRI) non-responders with MDD enrolled in a 6-week, double-blind, randomized trial of adjunctive oral SAMe were administered the self-rated cognitive and physical symptoms questionnaire (CPFQ), a validated measure of cognitive as well as physical symptoms of MDD, before and after treatment. Results There was a greater improvement in the ability to recall information (p = 0.04) and a trend toward statistical significance for greater improvement in word-finding (p = 0.09) for patients who received adjunctive SAMe than placebo. None of the remaining five items reached statistical significance. Conclusion These preliminary data suggest that SAMe can improve memory-related cognitive symptoms in depressed patients, and warrant replication.
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a meta analysis of clinical trials comparing milnacipran a serotonin norepinephrine Reuptake Inhibitor with a selective serotonin Reuptake Inhibitor for the treatment of major depressive disorder
European Neuropsychopharmacology, 2007Co-Authors: George I Papakostas, Maurizio FavaAbstract:Abstract Context Over the past few years, a number of studies have emerged suggesting that the treatment of major depressive disorder (MDD) with antidepressants which enhance both noradrenergic as well as serotonergic neurotransmission may result in higher response or remission rates than treatment with antidepressants which selectively enhance serotonergic neurotransmission. Objective The objective of this paper was to compare response rates among patients with MDD treated with either milnacipran, an antidepressant thought to simultaneously enhance both noradrenergic and serotonergic neurotransmission, or a selective serotonin Reuptake Inhibitor (SSRI). Data sources Medline/Pubmed were searched. No year of publication or language limits were used. Study selection Double-blind, randomized clinical trials comparing milnacipran with an SSRI for the treatment of MDD. Data extraction Data were extracted with the use of a pre-coded form. Data synthesis Analyses were performed comparing response rates between the two antidepressant agents. Data from 6 reports involving a total of 1082 outpatients with MDD were identified and combined using a random-effects model. Patients randomized to treatment with milnacipran were as likely to experience clinical response as patients randomized to treatment with an SSRI according to the MADRS (RR = 1.04, 95% CI: 0.88–1.23, p = 0.533) or the HDRS (RR = 1.06, 95% CI: 0.90–1.24, p = 0.456) for the random effects model. Simply pooling MADRS-based response rates between the two agents revealed a 58.9% response rate for milnacipran and a 58.3% response rate for the SSRIs. Similarly, HDRS-based response rates were 59.7% and 57.5%. There was also no difference in overall discontinuation rates (RR = 0.93; 95% CI: 0.76–1.14; p = 0.506), the rate of discontinuation due to adverse events (RR = 0.77; 95% CI: 0.55–1.1; p = 0.157), or the rate of discontinuation due to inefficacy (RR = 0.98; 95% CI: 0.7–1.38; p = 0.95) between the two groups. Conclusions These results suggest that milnacipran and the SSRIs do not differ with respect to their overall efficacy in the treatment of MDD.