The Experts below are selected from a list of 213 Experts worldwide ranked by ideXlab platform
Ray E. Clouse - One of the best experts on this subject based on the ideXlab platform.
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Tricyclic Antidepressants for Chronic Vomiting in Diabetic Patients
Digestive diseases and sciences, 2006Co-Authors: Mandeep S. Sawhney, Chandra Prakash, Patrick J. Lustman, Ray E. ClouseAbstract:Chronic vomiting in diabetic patients often is unresponsive to prokinetic agents and poorly explained by delayed gastric emptying or neuropathy. This retrospective study examines clinical response to Tricyclic Antidepressants, a treatment of reported benefit in nondiabetic patients with unexplained vomiting syndromes. Outcomes were studied in 24 diabetic outpatients who had been treated with Tricyclic Antidepressants specifically for nausea and vomiting after an unsatisfactory response to prokinetic therapy. Symptom patterns and treatment response were determined from chart review and telephone interview. Ten patients (42%) had recurrent, stereotypical vomiting episodes with symptom-free intervals suggesting cyclic vomiting syndrome; 14 (58%) had persistent symptoms. By chart review, at least moderate symptom response to Tricyclic antidepressant treatment (median dosage, 50 mg/day) occurred in 88% of subjects, with complete or nearly complete resolution of symptoms in one-third. At follow-up interview, 77% self-reported at least moderate symptom improvement during therapy and 68% rated Tricyclic Antidepressants the most effective treatment received. Duration of diabetes, presence of neuropathy, and psychiatric status were not predictive of treatment outcome in multivariate analysis, but a cyclical symptom pattern attenuated antidepressant response (P< 0.05). In this retrospective review, the majority of diabetic patients with chronic vomiting and incomplete response to prokinetic therapy benefited from Tricyclic Antidepressants in low-dose, open-label regimens and rated them the most effective treatment received. This therapeutic option should be further studied in diabetic patients considering the morbidity of chronic vomiting in this population.
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cyclic vomiting syndrome in adults clinical features and response to Tricyclic Antidepressants
The American Journal of Gastroenterology, 1999Co-Authors: Chandra Prakash, Ray E. ClouseAbstract:Cyclic vomiting syndrome in adults: clinical features and response to Tricyclic Antidepressants
Enma Rosero - One of the best experts on this subject based on the ideXlab platform.
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risk of fractures with selective serotonin reuptake inhibitors or Tricyclic Antidepressants
Annals of Pharmacotherapy, 2009Co-Authors: Regina Ginzburg, Enma RoseroAbstract:OBJECTIVETo evaluate the literature associating the risk of fracture during antidepressant therapy.DATA SOURCESLiterature was identified via MEDLINE (1970–August 2008) using the search terms selective serotonin-reuptake inhibitors, Tricyclic Antidepressants, Antidepressants, and fracture. Reference citations from publications identified were also reviewed. All articles in English identified from the data sources were evaluated.DATA SYNTHESISSelective serotonin-reuptake inhibitors (SSRIs) are generally prescribed over other classes of Antidepressants because they are considered to be relatively safer. Recent evidence, however, suggests that SSRIs may be associated with an increased risk of fractures. Thirteen clinical studies were identified in the literature search (7 case controls, 5 prospective cohorts, 1 cross-sectional). Most studies compared SSRIs with Tricyclic Antidepressants (TCAs) and found similar or greater risk of fracture associated with use of an SSRI. This risk appeared to be highest at the...
Wim Van Den Brink - One of the best experts on this subject based on the ideXlab platform.
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Response to Tricyclic Antidepressants: Independent of gender?
The American journal of psychiatry, 2004Co-Authors: Tamar Wohlfarth, Jitschak G. Storosum, André J.a. Elferink, Barbara J. Van Zwieten, Annemarie Fouwels, Wim Van Den BrinkAbstract:OBJECTIVE: The authors examined gender differences in response to Tricyclic Antidepressants. METHOD: A total of 30 randomized, placebo-controlled trials that included 3,886 patients (1,555 men and 2,331 women), submitted between 1979 and 1991 in order to obtain marketing authorization, were reviewed. Gender differences in response to treatment were tested in various multiple regression models using a variety of response definitions. RESULTS: Different response definitions all pointed to no gender difference in the efficacy of Tricyclic Antidepressants. The estimated effect size was similar for women younger and older than age 50 and for men. CONCLUSIONS: Tricyclic antidepressant response is independent of gender.
I Hindmarch - One of the best experts on this subject based on the ideXlab platform.
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safety and tolerability considerations Tricyclic Antidepressants vs selective serotonin reuptake inhibitors
Acta Psychiatrica Scandinavica, 2000Co-Authors: Steven W Peretti, R Judge, I HindmarchAbstract:Peretti S, Judge R, Hindmarch I. Safety and tolerability considerations: Tricyclic Antidepressants vs. selective serotonin reuptake inhibitors. Acta Psychiatr Scand 2000: 101: 17–25. © Munksgaard 2000. Objective: An important consideration in the choice of an antidepressant is its safety and tolerability. Method: We present a review of literature, clinical trials and meta-analyses regarding the safety and tolerability of the Tricyclic Antidepressants (TCAs) and the selective serotonin reuptake inhibitors (SSRIs) in depressed patients. Results: The SSRIs have a very favourable side-effect profile compared to the TCAs and are associated with fewer treatment discontinuations. Unlike the TCAs, they do not cause anticholinergic, hypotensive or sedating reactions, and are not associated with impaired cognitive function. Their most common side-effects (nausea, vomiting, nervousness, insomnia, headache and sexual dysfunction) are usually mild and typically disappear as treatment continues. The SSRTs also exhibit lower toxicity and lower lethality when taken in an overdose situation. Although the safety profiles of the principal SSRTs appear to be comparable, there is some data showing important differences in the severity and frequency of specific adverse events. Conclusion: The SSRTs have a more favourable safety profile than the TCAs in both acute and long-term treatment of major depression.
Siegfried Kasper - One of the best experts on this subject based on the ideXlab platform.
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comparison of compliance between serotonin reuptake inhibitors and Tricyclic Antidepressants a meta analysis
International Clinical Psychopharmacology, 1995Co-Authors: S A Montgomery, Siegfried KasperAbstract:A meta-analysis of 67 published randomized controlled clinical trials comparing selective serotonin reuptake inhibitors (SSRIs) and Tricyclic Antidepressants (TCAs), which measured discontinuation rates for side effects and lack of performed. All multiple publications and trials using non-TCA comparators were excluded. Ten studies were placebo controlled; these were analysed separately. Overall, the difference in withdrawals due to side effects of SSRIs and TCAs was -4.5% (p=0.0004) and that due to lack of efficacy was 0.1% (p=0.86). In the placebo-controlled trials the differences between the two groups were -7.9% and -0.1% (p=0.06 and 0.96), respectively. These results demonstrate that SSRIs have a significant and clinically important advantage over TCAs with respect to tolerability, whereas efficacy is similar. Treatment failure due to poor compliance can increase health-care costs: therefore, in selecting an antidepressant for the first-line treatment of for depressive disorders, the risks, benefits and costs of each type of treatment need to be critically evaluated
