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Psychopharmacohazardology: Major hazards of treating depression and anxiety

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Comprehensive Therapy

Abstract

Balancing the benefits and risks of prescribing psychotherapeutic drugs requires knowledge of both drug hazards as well as risk of untreated psychiatric illness. Screening for medical illnesses, substance abuse, suicidality, and unusual side effects is essential throughout treatment.

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References

  1. Crimmins EM, Saito Y. Trends in healthy life expectancy in the United States, 1970–1990: Gender, racial, and educational differences. Soc Sci Med.. 2001;52:1629–1641.

    Article  PubMed  CAS  Google Scholar 

  2. Grover SA, Gray-Donald K, Joseph L, Abrahamowicz M, Coupal L. Life expectancy following dietary modification or smoking cessation. Estimating the benefits of a prudent lifestyle. Arch Intern Med. 1994;154:1697–1704.

    Article  PubMed  CAS  Google Scholar 

  3. Oberman A, Principles of Preventive Health Care. In: Goldman L, Bennett JC, ed. Cecil Textbook of Medicine. 21st Ed Philadelphia: WB Saunders; 2000:26–28.

    Google Scholar 

  4. Blair-West GW, Cantor CH, Mellsop GW, Eyeson-Annan ML. Lifetime, suicide risk in major depression: sex and age determinants. J Affect Disord. 1999;55:171–178.

    Article  PubMed  CAS  Google Scholar 

  5. Janicak PG, Davis JM, Preskorn SH, Ayd FJ Jr. Principles and Practice of Psychopharmacotherapy. 3rd Ed. Philadelphia: Lippincott Williams & Wilkins; 2001.

    Google Scholar 

  6. Schatzberg AF, Nemeroff CB. Essentials of Clinical Psychopharmacology. Washington DC: American Psychiatric Publishing Inc; 2001.

    Google Scholar 

  7. Glauser J. Tricyclic antidepressant poisoning. Cleve Clin J Med. 2000;67:704–6, 709–13, 717–9.

    PubMed  CAS  Google Scholar 

  8. Rose JC, Unis AS. A mortality index for postmarketing surveillance of new medications. Am J Emerg Med. 2000;18:176–179.

    Article  PubMed  CAS  Google Scholar 

  9. Grohmann R, Ruther E, Engel RR, Hippius H. Assessment of adverse drug reactions in psychiatric inpatients with the AMSP drug safety program: Methods and first results for tricyclic antidepressants and SSRI. Pharmacopsychiatry. 1999;32:21–28.

    PubMed  CAS  Google Scholar 

  10. Barbey JT, Roose SP. SSRI safety in overdose. J Clin Psychiatry. 1998;59 Suppl 15:42–48.

    PubMed  CAS  Google Scholar 

  11. Dalfen AK, Stewart DE. Who develops severe or fatal adverse drug reactions to selective serotonin reuptake inhibitors? Can J Psychiatry. 2001;46:258–263.

    PubMed  CAS  Google Scholar 

  12. Aydin N, Anac E, Caykoylu A, Akcay F. Neuroleptic malignant syndrome due to citalopram overdose. Can J Psychiatry. 2000;45:941–942.

    PubMed  CAS  Google Scholar 

  13. Pisani F, Oteri G, Costa C, Di Raimondo G, Di Perri R. Effects of psychotropic drugs on seizure threshold. Drug Saf. 2002;25:91–110.

    Article  PubMed  CAS  Google Scholar 

  14. Joffe RT, MacQueen GM, Marriott M, Robb J, Begin H, Young LT. Induction of mania and cycle, acceleration in bipolar disorder: Effect of different classes of antidepressant. Acta Psychiatry Scand. 2002;105:427–430.

    Article  CAS  Google Scholar 

  15. Henry C, Sorbara F, Lacoste J, Gindre C, Leboyer M. Anti-depressant-induced mania in bipolar patients: Identification of risk factors. J Clin Psychiatry. 2001;62:249–255.

    Article  PubMed  CAS  Google Scholar 

  16. Post RM, Altshuler LL, Frye MA, et al. Rate of switch in bipolar patients prospectively treated with second-generation antidepressants as augmentation to mood stabilizers. Bipolar Disord. 2001;3:259–265.

    PubMed  CAS  Google Scholar 

  17. Nissen D. Mosby’s Drug Consult 2000. 2002, St. Louis: Elsevier Science.

    Google Scholar 

  18. Azaz-Livshits T, Hershko A, Ben-Chetrit E. Paroxetine associated hepatoxicity: A report of 3 cases and a review of the literature. Pharmacopsychiatry. 2002;35:112–115.

    Article  PubMed  CAS  Google Scholar 

  19. Odeh M, Misselevech I, Boss JH, Oliven A. Severe hepatotoxicity with jaundice associated with paroxetine. Am J Gastroenterol. 2001;96:2494–2496.

    Article  PubMed  CAS  Google Scholar 

  20. Kirby D, Ames D. Hyponatraemia and selective serotonin re-uptake inhibitors in elderly patients. Int J Geriatr Psychiatry. 2001;16:484–493.

    Article  PubMed  CAS  Google Scholar 

  21. Kirby D, Harrigan S, Ames D. Hyponatraemia in elderly psychiatric patients treated with selective serotonin reuptake inhibitors and venlafaxine: A retrospective controlled study in an inpatient unit. Int J Geriatr Psychiatry. 2002;17:231–237.

    Article  PubMed  Google Scholar 

  22. Gilman PK. Serotonin syndrome: History and risk. Fundam Clin Pharmacol.. 1998;12:482–491.

    Article  Google Scholar 

  23. Fisher AA, Davis MW. Serotonin syndrome caused by elective serotonin reuptake-inhibitors-metoclopramide interaction. Ann Pharmacother. 2002;36:67–71.

    Article  PubMed  Google Scholar 

  24. DeSilva KE, Le Flore DB, Marston BJ, Rimland D. Serotonin syndrome in HIV-infected individuals receiving antiretroviral therapy and fluoxetine. Aids. 2001;15:1281–1285.

    Article  PubMed  CAS  Google Scholar 

  25. Chechani V. Serotonin syndrome presenting as hypotonic coma and apnea: Potentially fatal complications of selective serotonin receptor inhibitor therapy. Crit Care Med. 2002;30:473–476.

    Article  PubMed  Google Scholar 

  26. McDaniel WW. Serotonin syndrome: Early management with cyproheptadine. Ann Pharmacother. 2001;35:870–873.

    Article  PubMed  CAS  Google Scholar 

  27. Gillman PK. The serotonin syndrome and its treatment. J Psychopharmacol. 1999;13:100–109.

    Article  PubMed  CAS  Google Scholar 

  28. Black K, Shea C, Dursun S, Kutcher S. Selective serotonin reuptake inhibitor discontinuation syndrome: Proposed diagnostic criteria. J Psychiatry Neurosci. 2000;25:255–261.

    PubMed  CAS  Google Scholar 

  29. Barrickman LL, Perry PJ, Allen AJ, et al. Bupropion versus methylphenidate in the treatment of attention-deficit, hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 1995;34:649–657.

    Article  PubMed  CAS  Google Scholar 

  30. Conners CK, Casat CD, Gualtieri CT, et al. Bupropion hydrochloride in attention deficit disorder with hyperactivity. J Am Acad Child Adolesc Psychiatry. 1996;35:1314–1321.

    Article  PubMed  CAS  Google Scholar 

  31. Kuperman S, Perry PJ, Gaffney GR, et al. Bupropion SR vs. methylphenidate vs. placebo for attention deficit hyperactivity disorder in adults. Ann Clin Psychiatry. 2001;13:129–134.

    Article  PubMed  CAS  Google Scholar 

  32. Wilens TE, Spencer TJ, Biederman J, et al. A controlled clinical trial of bupropion for attention deficit hyperactivity disorder in adults. Am J Psychiatry. 2001;158:282–288.

    Article  PubMed  CAS  Google Scholar 

  33. Dunner DL, Zisook S, Billow AA, Batey SR, Johnston JA, Ascher JA. A prospective safety surveillance study for bupropion sustained-release in the treatment of depression. J Clin Psychiatry. 1998;59:366–373.

    PubMed  CAS  Google Scholar 

  34. Hesse LM, von Moltke LL, Shader RI, Greenblatt DJ. Ritonavir, efavirenz, and nelfinavir inhibit CYP2B6 activity in vitro: Potential drug interactions with bupropion. Drug Metab Dispos. 2001;29:100–102.

    PubMed  CAS  Google Scholar 

  35. Hernandez JL, Ramos FJ, Infante J, Rebollo M, Gonzalez. Severe serotonin syndrome induced by mirtazapine monotherapy. Ann Pharmacother. 2002;36:641–643.

    Article  PubMed  Google Scholar 

  36. Hui CK, Yuen MF, Wong WM, Lam SK, Lai CL. Mirtazapine-induced hepatotoxicity. J Clin Gastroenterol. 2002;35:270–271.

    Article  PubMed  CAS  Google Scholar 

  37. Carvajal GP, Garcia D, Sanchez SA, Velasco MA, Rueda D, Lucena MI. Hepatotoxicity associated with the new antidepressants. J Clin Psychiatry. 2002;63:135–137.

    Google Scholar 

  38. Stewart DE. Hepatic adverse reactions associated with nefazodone. Can J Psychiatry. 2002;47:375–377.

    PubMed  Google Scholar 

  39. Paoletti R, Corsini A, Bellosta S. Pharmacological interactions of statins. Atheroscler. Suppl. 2002;3:35–40.

    Article  CAS  Google Scholar 

  40. Thompson M, Samuels S. Rhabdomyolysis with simvastatin and nefazodone. Am J Psychiatry. 2002;159:1607.

    Article  PubMed  Google Scholar 

  41. Garton T. Nefazodone and cyp450 3a4 interactions with cyclosporine and tacrolimus1. Transplantation. 2002;74:745.

    Article  PubMed  Google Scholar 

  42. Olyaei AJ, deMattos AM, Norman DJ, Bennett WM. Interaction between tacrolimus and nefazodone in a stable renal transplant recipient. Pharmacotherapy. 1998;18:1356–1359.

    PubMed  CAS  Google Scholar 

  43. Ensrud KE, Blackwell TL, Mangione CM, et al. Central nervous system-active medications and risk for falls in older women. J Am Geriatr Soc. 2002;50:1629–1637.

    Article  PubMed  Google Scholar 

  44. Frels C, Williams P, Narayanan S, Gariballa SE. latrogenic causes of falls in hospitalised elderly patients: A case-control study. Postgrad Med J. 2002;78:487–489.

    Article  PubMed  CAS  Google Scholar 

  45. McGwin G Jr, Sims RV, Pulley L, Roseman JM. Relations among chronic medical conditions, medications, and automobile crashes in the elderly: A population-based case-control study. Am J Epidemiol. 2000;152:424–431.

    Article  PubMed  Google Scholar 

  46. Rickels K, DeMartinis N, Garcia-Espana F, Greenblatt DJ, Mandos LA, Rynn M. Imipramine and buspirone in treatment of patients with generalized anxiety disorder who are discontinuing long-term benzodiazepine therapy. Am J Psychiatry. 2000;157:1973–1979.

    Article  PubMed  CAS  Google Scholar 

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The author is a member of the speaker’s bureaus of Wyeth-Ayerst. Pfizer. Eli Lilly, GlaxoSmithKline, Bristol-Myers Squibb, and Sanofi-Synthelabo. the only off label uses mentioned are those of bupropion for attention deficit disorder and obesity, and of trazodone for its sedative effect.

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Zetin, M. Psychopharmacohazardology: Major hazards of treating depression and anxiety. Compr Ther 30, 18–24 (2004). https://doi.org/10.1007/s12019-004-0020-4

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  • DOI: https://doi.org/10.1007/s12019-004-0020-4

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