Fluoxetine versus other types of pharmacotherapy for depression

Department of Medicine and Public Health, Section of Psychiatry, University of Verona, Policlinico "G.B.Rossi", Pzz.le L.A. Scuro, 10, 37134 Verona, Italy.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 02/2005; 4(4):CD004185. DOI: 10.1002/14651858.CD004185.pub2
Source: PubMed


The efficacy and tolerability of fluoxetine was compared to other antidepressants (tricyclics, heterocyclics and newer antidepressants) for the acute treatment of depressive illness. One hundred thirty-two randomised controlled trials were identified. Pooling the results from the trials, statistically significant differences in efficacy and in tolerability were found between fluoxetine and some antidepressants. However, it is difficult to draw clear clinically meaningful conclusions and more reliable data about antidepressants' safety profile are needed. Without more robust evidence, the researchers suggest that treatment decisions are to be based on considerations of drug toxicity, patient acceptability, and cost.

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    • "The New Zealand guidelines group, NICE, CANMAT, APA, Hong Kong, and ACP guidelines described SSRIs as having similar antidepressant effects to other agents but better tolerability (12, 14, 16, 17, 24, 25). More than ten meta-analyses have reported SSRIs to be as effective as TCAs (18, 20, 43, 44, 45), and many studies have reported that there is not much evidence that other antidepressants are more effective than SSRIs (43, 46, 47, 48, 49, 50). Furthermore, the New Zealand guidelines group reported that escitalopram is superior to other SSRIs and venlafaxine (14, 49). "
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    ABSTRACT: This paper aims to introduce, summarize, and emphasize the importance of the 'Evidence-Based, Pharmacological Treatment Guideline for Depression in Korea, Revised Edition'. The guideline broadly covers most aspects of the pharmacological treatment of patients in Korea diagnosed with moderate to severe major depression according to the DSM-IV TR. The guideline establishment process involved determining and answering a number of key questions, searching and selecting publications, evaluating recommendations, preparing guideline drafts, undergoing external expert reviews, and obtaining approval. A guideline adaptation process was conducted for the revised edition. The guideline strongly recommends pharmacological treatment considered appropriate to the current clinical situation in Korea, and should be considered helpful when selecting the appropriate pharmacological treatment of patients diagnosed with major depressive disorder. Therefore, the wide distribution of this guideline is recommended.
    Journal of Korean Medical Science 04/2014; 29(4):468-484. DOI:10.3346/jkms.2014.29.4.468 · 1.27 Impact Factor
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    • "Fluoxetine (FLX) is a highly active and selective serotonin reuptake inhibitor used for clinical depression for more than two decades (13). Recent studies have identified its potential to reverse MDR generated by two major pump proteins P-gp and MRP1 (12, 14 and 15). "
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    ABSTRACT: Chemotherapy research highly prioritizes overcoming the multidrug resistance (MDR) in human tumors. Liposomal formulation of fluoxetine, as a fourth generation chemosensitizer, was constructed and characterized for percent entrapment, release profile, morphology, particle size, zeta potential and stability. Liposomes were prepared using different active loading techniques. The influence of different formulation variables such as loading methodology, type of main lipid, addition of PEGylated lipid and cholesterol percentage was evaluated to achieve required entrapment efficiency, in vitro release behavior and stability. The studied parameters had significant effect on physicochemical characteristics of the nanocarriers. High fluoxetine encapsulation efficiency (83% ± 3%) and appropriate particle size (101 ± 12 nm) and zeta potential (-9 ± 2 mv) were achieved for PEGylation liposomes composed of DSPE-PEG, DSPC and cholesterol at respective molar ratio of 5:70:25. An in vitro fluoxetine release of about 20% in 48 h was observed from optimum formulation. Atomic force microscopy (AFM) studies confirmed homogeneous distribution of particles and spherical shape with smooth surface. The optimum formulation was stable for 9 days when incubated at 37 °C. The results of this study are very encouraging for application of the developed fluoxetine liposomal formulation in drug-resistant tumor models.
    Iranian journal of pharmaceutical research (IJPR) 02/2014; 13(Suppl):3-14. · 1.07 Impact Factor
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    • "Le lithium a également montré une efficacité dans la prévention de la rechute dépressive (M Bauer and Döpfmer 2000). En outre, il permettrait de diminuer le risque de passage à l'acte auto-agressif chez les patients souffrant d'un trouble de l'humeur (Andrea Cipriani et al. 2005). Cependant, les prescriptions de Lithium en ambulatoire aux Etats-Unis ont reculé chez les patients souffrant d'un trouble bipolaire et ce au profit des traitements anticonvulsivants, possiblement en raison de leur facilité d'utilisation et de leur tolérance aux yeux des prescripteurs (Blanco et al. 2002). "
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    ABSTRACT: OBJECTIF : La dépression est une maladie fréquente, grave et invalidante pour laquelle des traitements ont montré leur efficacité. Nous avons souhaité connaître les prescriptions médicamenteuses de sortie des patients hospitalisés pour dépression unipolaire au Centre Hospitalier du Rouvray en 2012 et évaluer leur adéquation aux recommandations. Afin de mieux appréhender la concordance avec les recommandations, nous avons analysé les prescriptions d’antipsychotiques dans l’épisode dépressif majeur en 2005, époque à laquelle ces stratégies n’étaient pas recommandées. METHODE : Les prescriptions médicamenteuses et les codes diagnostics des patients hospitalisés en 2012 ont été extraits et traités informatiquement pour ne conserver que les patients hospitalisés pour dépression unipolaire avec ou sans comorbidités psychiatriques. Ils ont ensuite été analysés et fait l’objet de comparaison en fonction de la sévérité de l’accès. RESULTATS : 424 patients répondaient aux critères d’inclusion. La majorité des patients étaient hospitalisés pour dépression sévère et la moitié présentaient une comorbidité d’abus- dépendance de substance, anxieuse ou de personnalité. Quatre-vingt-six pourcent des patients prenaient un antidépresseur. Une stratégie d’augmentation était présente chez 40% des patients et de manière significativement plus fréquente chez les patients sévères (51% versus 28%). En dehors des traitements sédatifs, les traitements les plus souvent associés aux antidépresseurs étaient les antipsychotiques de seconde génération (30%) les anticonvulsivants (10%) et le lithium (7%). Les antipsychotiques de seconde génération étaient significativement plus prescrits en 2012 qu’en 2005. CONCLUSION : Le traitement de la dépression au Centre Hospitalier du Rouvray en 2012 était conforme aux recommandations.
    10/2013, Supervisor: Pr. O. GUILLIN
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