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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    • "We found that, of the antidepressants, SSRIs, particularly fluoxetine, showed the highest levels ofuse. ThisY yes, the medicine is present on the list, N no, the medicine is not present on the list, NA not available a SSRI antidepressants selective serotonin reuptake inhibitor antidepressants finding makes sense given the greater tolerability of SSRIs and the correspondingly greater toxicity of tricyclic antidepressants, particularly in terms of their cardiotoxicity[27]. Effective marketing, particularly that associated with the launch of fluoxetine, may contribute to the high levels of SSRI use. "
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    ABSTRACT: Background The World Health Organization Essential Medicines List (WHO-LIST) and national essential medicines lists differ because many countries face significant challenges, such as product availability, cost, product quality and epidemiological disease profiles. In Brazil, governments pay for drugs that are included on the federal, state and municipal government (REMUME) lists. The extent to which municipal lists differ from state and national lists and from the WHO-LIST is unclear. We investigate the use of the WHO-LISTas a tool with which to evaluate the selection process for the essential psychiatric medicines in the public system coverage list of Brazilian communities (cities) and the use of the target drugs. Methods Municipal health secretaries were interviewed regarding the selection process for REMUMEs and the antidepressants and benzodiazepines included in REMUMEs and reference lists. We calculated the use of REMUME drugs that appeared or did not appear on reference lists according to the defined daily dose (DDD) per 10,000 inhabitants. Results Local physicians and pharmacists without specific training or explicit criteria developed the REMUMEs. Of the 13 drugs and 24 products (i.e., the different dosages of these 13 drugs) in the REMUMEs, 8 drugs and 10 products were included in at least one reference list and in one municipal list; 4 drugs and 6 products were included in at least one reference list but in none of the municipal lists; and 7 drugs and 8 products were included in at least one municipal list but in none of the reference lists. The antidepressants that appeared in at least one municipal list but in none of the reference lists represented 25.1 % (mean 60.9 DDD/10,000 inhabitants-day) of the usage. The benzodiazepines that appeared in at least one of the municipal lists but in none of the reference lists represented 14.7 % mean 18.5 DDD/10,000 inhabitants-day) of the usage. Conclusions Brazilian cities have no rigorous processes for selecting the drugs that appear on their lists, and drugs that do not appear on the reference lists represent a significant proportion of antidepressant and benzodiazepine use, resulting in public health and social problems.
    Full-text · Article · Jan 2016 · BMC Public Health
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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.
    Full-text · Article · Apr 2014 · Journal of Korean Medical Science
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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.
    Full-text · Article · Feb 2014 · Iranian journal of pharmaceutical research (IJPR)
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