SSRIs
Limiting doses of citalopram
As a hospital or community pharmacist, you will hear about limiting doses of citalopram ( Cipram , etc). Experts say citalopram doses should not exceed 40 mg/day for anyone, or 20 mg/day for most patients over age 60. Higher doses of citalopram increase the risk of QT prolongation and the life-threatening arrhythmia, torsades. …
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SSRIs
Make sense when combining antidepressants
As a clinical pharmacist, you should individualize the choice of antidepressant combos. So the question is, does it make sense to combine antidepressants? Yes, sometimes. Fewer than half of patients with depression achieve remission with one first-line medication (SSRI, SNRI, etc). Adding a different medication class may wor…
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Neurology and Psychiatry
Atypical antipsychotics will be used more for treating depression
As a pharmacist, don't be surprised if you see atypical antipsychotics being used more often in treating depression. Both aripiprazole ( Abilify ) and olanzapine/fluoxetine ( Symbyax ) are already approved for resistant depression and quetiapine ( Seroquel ) will likely get a similar indication. More than half of patients with depression still have symptoms despi…
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SSRIs
SSRIs during pregnancy
Women will ask you whether they should stop taking SSRIs during pregnancy due to recent headlines about autism risk. They're hearing about a new study that suggests taking SSRIs in the second or third trimester is linked to a higher risk of autism. But this study has flaws and does not prove antidepressants CAUSE a…
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SSRIs
Depression and cardiovascular disease
Introduction ― Depression is common in patients with cardiovascular (CV) disease. Symptoms of depression are seen in 65% of patients after an acute myocardial infarction (MI). Major depressive disorder is diagnosed in up to 20% of patients after an acute coronary syndrome. Depression is associated with a doubling in the risk of a cardiovascular event within one to t…
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SSRIs
Address depression in patients after a heart attack
How to treat depression after a heart attack? this is important questions. Depression occurs in nearly half of heart attack patients and it's associated with a higher risk of CV events and death. Plus adherence to lifestyle changes and cardiovascular medications, antiplatelets, statins, etc may be even harder for patients with depression. But don't recommend …
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