Browsing by Subject "antidepressants"
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(2021)Aims: Schizophrenia is characterized by cognitive impairment that associates with many problems in everyday life and functioning. Earlier research has hypothesized that antidepressant medication may associate with better cognitive functioning among schizophrenia patients, but empirical results are mixed. This study explored the profile of schizophrenia patients that use antidepressants and asked whether there is an association between antidepressant use and cognitive performance in a clinical patient sample. Because of effects on the central nervous system, benzodiazepines and anticholinergic medications were also considered. Methods: Study participants were drawn from the SUPER-Finland cohort, which was collected among patients with psychotic illnesses in 2016–2018 from all university hospital districts across Finland (n=10474). The analysis included working-age (18–70) patients with a schizophrenia diagnosis (F20) and complete results from the brief cognitive assessment (n=3411). Information about regular medications and psychosocial factors were gathered through questionnaire and interview. Cognition was assessed with CANTAB (Cambridge Neuropsychological Test Automated Battery), out of which the subtests measuring reaction time (RTI) and visual learning (PAL) were included. The association of antidepressants on cognition was examined using both pooled antidepressants and various antidepressant groups as predictors in linear regression models. Gender, age, age of diagnosis, living status, relationship, education, and psychological distress were controlled in the models. Results: Over 35% of schizophrenia patients regularly used at least one antidepressant. On average, schizophrenia patients using antidepressants experienced lower well-being and more psychological distress than patients without antidepressants. The use of antidepressants was not generally associated with better or poorer cognitive performance. However, the use of SNRI antidepressants was associated with a significantly faster reaction time. The use of benzodiazepines was associated with poorer cognitive performance in both reaction time and visual learning. Conclusions: The results support the conclusion that there is generally no meaningful association between antidepressants and better cognitive performance in schizophrenia. However, the association of SNRI-medicines with a slightly faster reaction time is promising and warrants further research. Several psychosocial factors were associated with the cognitive performance of schizophrenia patients, which underlines the need for supporting psychosocial well-being in cognitive rehabilitation.
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(2021)Aims: Schizophrenia is characterized by cognitive impairment that associates with many problems in everyday life and functioning. Earlier research has hypothesized that antidepressant medication may associate with better cognitive functioning among schizophrenia patients, but empirical results are mixed. This study explored the profile of schizophrenia patients that use antidepressants and asked whether there is an association between antidepressant use and cognitive performance in a clinical patient sample. Because of effects on the central nervous system, benzodiazepines and anticholinergic medications were also considered. Methods: Study participants were drawn from the SUPER-Finland cohort, which was collected among patients with psychotic illnesses in 2016–2018 from all university hospital districts across Finland (n=10474). The analysis included working-age (18–70) patients with a schizophrenia diagnosis (F20) and complete results from the brief cognitive assessment (n=3411). Information about regular medications and psychosocial factors were gathered through questionnaire and interview. Cognition was assessed with CANTAB (Cambridge Neuropsychological Test Automated Battery), out of which the subtests measuring reaction time (RTI) and visual learning (PAL) were included. The association of antidepressants on cognition was examined using both pooled antidepressants and various antidepressant groups as predictors in linear regression models. Gender, age, age of diagnosis, living status, relationship, education, and psychological distress were controlled in the models. Results: Over 35% of schizophrenia patients regularly used at least one antidepressant. On average, schizophrenia patients using antidepressants experienced lower well-being and more psychological distress than patients without antidepressants. The use of antidepressants was not generally associated with better or poorer cognitive performance. However, the use of SNRI antidepressants was associated with a significantly faster reaction time. The use of benzodiazepines was associated with poorer cognitive performance in both reaction time and visual learning. Conclusions: The results support the conclusion that there is generally no meaningful association between antidepressants and better cognitive performance in schizophrenia. However, the association of SNRI-medicines with a slightly faster reaction time is promising and warrants further research. Several psychosocial factors were associated with the cognitive performance of schizophrenia patients, which underlines the need for supporting psychosocial well-being in cognitive rehabilitation.
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(2021)Antidepressant use among children and adolescents has become more common in many countries. The prevalence of antidepressants is higher for boys but during adolescence girls’ have a higher antidepressant prevalence. In previous studies, the prevalence of selective serotonin re-uptake inhibitors (SSRI) has increased. The aim of this study was to investigate antidepressant use among Finnish children and adolescents aged 1–17 years during 2008–2019. The differences of antidepressant use in different age groups and genders were investigated. Furthermore, the secondary objective was to examine the trends in prevalence and costs of the five most commonly used antidepressant agents. This was a nation-wide register study. The data for this study was from Kelasto which is a statistical database maintained by the Social Insurance Institution of Finland. The extracted data was from 2008–2018 and included each persons’ age, gender, dispensed drug and costs. The data extracted was for 1–17-year-olds who had been dispensed reimbursed antidepressants from community pharmacies. The data was analyzed with Microsoft Office’s Excel program. The results were transferred in to tables and reported as prevalences by age groups, genders, antidepressants and costs. The prevalence of antidepressant use among children and adolescents was 5,0 per 1000 in 2008 and it increased to 10,3 by 2018. In the youngest age group of 1–6-year-olds, antidepressant use decreased. Antidepressant use increased slightly among 7–12-year-olds. Antidepressant use increased the most among 13–17-year-olds. 13–17-year-old girls had the higher antidepressant use prevalence throughout the study. The same group had a 2,4-fold increase in prevalence during the study period which accounted for the biggest increase in the study. The most used group of antidepressants was SSRIs. The total cost for antidepressants among children and adolescents increased by 73,7 % during the study period. The most commonly used antidepressant agents were fluoxetine, sertraline, escitalopram, mirtazapine, and venlafaxine, respectively. Fluoxetine was the most used agent throughout the study. In 2014, sertraline surpassed escitalopram and became the second most used antidepressant agent. Escitalopram and venlafaxine’s cost per user decreased during the study. The cost per user stayed stable for mirtazapine. Fluoxetine and sertraline’s cost per user increased. The Kelasto database does not include data on indications for prescriptions. The prevalence of antidepressants does not necessarily correlate directly to depression among children and adolescents because antidepressants can be used to treat other diseases. More studies need to be conducted on different off-label uses for antidepressants among children and adolescents. This study only investigated the trends on cost for the five most commonly used antidepressants. Further studies on antidepressant costs among children and adolescents are needed. Additionally, it is essential to investigate the reasons for the increase in antidepressant use among children and adolescents.
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(2022)The prevalence of major depressive disorder is increasing despite the increased standard of living. The prevailing hypothesis to explain depression is that there is an unbalance in information processing in relevant brain networks. Antidepressants (SSRIs, SNRIs) have been shown to induce a juvenile-like plasticity state (iPlasticity) in the brain that helps in rewiring the affected neuronal networks when combined with beneficial environmental stimuli (e.g. psychotherapy). However, it takes weeks to see the beneficial effects of conventional antidepressants on mood and they bring relief only to approximately two-thirds of the patients. There is an urgent need for more efficient and rapid-acting antidepressants. Preliminary data suggests that psychedelics may have potential to respond to this need. It is thought that the therapeutic effect of psychedelics rises from the molecular effects leading to structural and functional plasticity and behavioral changes. Molecular effects of psychedelics are believed to arise from the activation of serotonin 2A (5-HT2A) receptors. It is well established that serotonin 2A (5-HT2A) receptor activation lies behind the hallucinogenic effects of psychedelics, but its role in drug-induced plasticity is currently under debate. Signaling of brain-derived neurotrophic factor (BDNF) through its receptor TrkB has been proposed to underlie the plasticity-promoting effects of psychedelics. However, the mechanisms leading to increased BDNF/TrkB signaling after psychedelic administration are poorly understood. This thesis aimed to study the molecular mechanisms associated with psychedelic-induced plasticity in cortical neuronal cultures. The timeline of the effects of LSD was studied by analyzing the phosphorylation of neurotrophic signaling markers downstream of TrkB (mTOR and ERK) in primary neuronal cultures using Western blot. The role of the 5-HT2A receptor was assessed by combining 5-HT2A antagonist M100907 pretreatment with LSD treatment, followed by Western blot analyses of the same signaling markers mTOR and ERK. The degree of molecular effects of psychedelics was compared to the effects of classical antidepressant fluoxetine. Protein-fragment complementation assay (PCA) was used to evaluate the dimerization of the TrkB receptor in the presence of psychedelics and classical antidepressants. In this context, Western blot was also used to assess the phosphorylation of the plasticity-related BDNF signaling markers ERK and two tyrosines of TrkB receptor (Y515 and Y816) that mediate recruitment of neurotrophic signaling pathways. We found that psychedelic treatment promoted phosphorylation of mTOR and ERK significantly. These effects were not affected by pretreatment with M100907, indicating activation of BDNF/TrkB signaling by psychedelics is independent from 5-HT2A activation. Psychedelics were also shown to cause a significant increase in dimerization of TrkB whereas increase caused by fluoxetine was not significant. Lastly, psychedelics were shown to cause increase in phosphorylation of TrkB and ERK that were comparable to those induced by fluoxetine. These results highlight the potential of psychedelics to promote BDNF-mediated neurotrophic signaling associated with juvenile-like plasticity. Interestingly, the results show recruitment of BDNF/TrkB downstream signaling independently from 5-HT2A activation, which suggests that plasticity-promoting effects of psychedelics might be detached from their hallucinogenic effects.
Now showing items 1-4 of 4