Impact Of Antidepressant Medications Research Articles

The impact of antidepressant medications on the course of inflammatory bowel diseases

Introduction and Objective: Inflammatory bowel diseases (IBD) and anxiety, as well as depressive disorders, can coexist. Depression may affect IBD symptoms and vice versa. The aim of our study is to determine the impact of different classes of antidepressant medications in the treatment of IBD with comorbid depressive episodes, to summarize the most commonly used therapies, and to identify the most effective practices in treating inflammatory diseases with coexisting depressive episodes. Materials and Methods: A review of the available literature was conducted by searching the PubMed and Google Scholar databases using the following keywords: inflammatory bowel diseases, depression, antidepressants, in both English and Polish, up until July 19, 2024. To ensure the high quality of the narrative review, the SANRA scale (a scale for the quality assessment of narrative review articles) was used. Results: Studies indicate that depressive symptoms occur in approximately 25-27.5% of patients with inflammatory bowel diseases (IBD). Treatment of depression in IBD patients often includes the use of antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs), which not only reduce depression but also exhibit anti-inflammatory effects. SSRIs may also be effective in improving patients' quality of life; however, they may cause side effects such as diarrhea and an increased risk of bleeding. In addition to SSRIs, other antidepressants, such as serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and atypical antipsychotics, are also used and may have a beneficial impact on the course of the disease. Conclusions: In patients with IBD and comorbid depression, SSRIs are most commonly used, followed by TLPDs, SNRIs, and atypical antipsychotics. Drugs from these groups may have a beneficial effect on depressive symptoms, but also affect the course of IBD. Further clinical studies are needed to establish precise guidelines for the use of these drugs in patients with IBD.

Antidepressants and alcohol use disorder: A multicenter study on the mediating role of depression symptom changes.

Alcohol use disorder (AUD) and depression are highly prevalent and tied to significant psychological, physiological, social and economic consequences. Their co-occurrence presents a complex clinical challenge, as the impact of antidepressant medication on AUD outcomes remains equivocal. In this multicenter, longitudinal study we investigated the relationship between antidepressant medication and changes in depression symptoms and alcohol use in AUD patients. We analyzed data from 153 detoxified AUD patients who attended a 12-week residential treatment program between 2015 and 2019. Within a mediation analysis, adopting a bootstrapping approach and a quasi-Bayesian framework, we estimated the total, direct, and mediated effects of antidepressants on the percentage of daysabstinent to assess the role of changes in depression symptoms as a mediating factor. The mediation analysis revealed a dual impact pathway model with a negative direct effect of antidepressants on abstinence (p = 0.004) and a positive indirect effect, mediated through the reduction of depression symptoms (p = 0.002). The findings of the mediation analysis show that patients treated with antidepressants and whose depression symptoms do not improve over time show more relapses, while patients treated with antidepressants who achieve a reduction in depression symptoms show fewer relapses over time. Thus, to optimize treatment outcome, depression symptoms should be vigilantly monitored when antidepressants are prescribed during AUD treatment.

Impact of antidepressant medication on the analgetic effect of repetitive transcranial magnetic stimulation treatment of neuropathic pain. Preliminary findings from a registry study.

Repetitive transcranial magnetic stimulation (rTMS) has been found to be effective in chronic neuropathic pain conditions. However, information about the combined effects of rTMS and antidepressant treatment is scarce. We studied the outcome of rTMS and concurrent antidepressant treatment in patients with neuropathic pain. In this retrospective, real-world study, 34 patients with neuropathic pain, who were considered resistant or not benefitting from conventional treatment, received rTMS treatment between 2017 and 2020. Pain-related factors were measured using the Numerical Rating Scale (NRS), Global Impression of Change (GIC), and Beck Depression Inventory. A decrease in pain intensity and pain interference assessed with NRS was observed after 10 treatment sessions in 16 patients. The impression of change was positive in 20 patients. Half of the patients (n=17) used antidepressant medication, while half (n=17) did not. A concurrent use of antidepressants with therapeutic rTMS was significantly linked with less pain intensity relief when compared with the nonuse of antidepressants (p=0.019). The impression of change was significantly in favor of the antidepressant nonuser group (p=0.002). No group differences in pain interference were found between the groups. Therapeutic rTMS for neuropathic pain is plausibly sensitive to interference with antidepressant medication. The exact mechanism of our findings remains to be elucidated; confirmatory studies are warranted.

The impact of antidepressant medications on glutamatergic and GABAergic neurotransmitter systems: a systematic review of pharmacological [1H] MRS studies

The impact of antidepressant medications on glutamatergic and GABAergic neurotransmitter systems: a systematic review of pharmacological [1H] MRS studies

Association of different antidepressant classes with clinical attachment level and alveolar bone loss in patients with periodontitis: A retrospective study.

Our study aimed to determine the relationship of antidepressant medicine use with periodontal diseases, exploring the association of different pharmacological classes of antidepressant with observations of clinical attachment loss (CAL) and alveolar bone level (BL) in patients with periodontitis. Existing evidence on the impact of antidepressant medication on periodontal tissues has focused on some classes only and is still unclear. Therefore, this retrospective study evaluated the association of different antidepressant classes with clinical attachment loss (CAL) and alveolar bone level (BL). This study was carried out in a population of patients aged≥30years old with periodontitis who sought treatment at the University of Florida from 2014 to 2018. The following variables were obtained from patients' records; usage of antidepressant medications and their pharmacological classes (selective serotonin reuptake inhibitors [SSRI], serotonin-norepinephrine reuptake inhibitors [SNRI], tricyclic, atypical, and monoamine oxidase inhibitors [MAO]), age, gender, smoking habit, mild systemic diseases, CAL, and cement-enamel junction (CEJ) and alveolar bone crest (BC) distance, defined as BL, in the Ramfjord index teeth. Five hundred and eighty-two periodontitis patients were evaluated, of which 113 (19.4%) were antidepressant users. Antidepressant users exhibited significantly lower BL and fewer sites with severe CAL (≥5mm), than non-users (p<.05). Among all single-class antidepressant users, the SSRI users showed significantly less CAL and lower BL than non-users (p<.05). Patients taking combinations of the different classes of antidepressants also showed better CAL and BL than non-users. Generalized linear models, including variables such as gender, age, systemic diseases, and smoking, demonstrated that antidepressant users were more likely to have lower mean BL and fewer sites with severe bone loss (i.e. BL>3 and >5mm) than non-users (p<.05). Antidepressant medications were associated with higher alveolar bone level and less clinical attachment loss in patients with periodontitis. When the different classes of antidepressants were analyzed individually, only the SSRI class users and the multiple-class users showed significantly less periodontal breakdown than non-users.

The mother, the infant and the mother-infant relationship: What is the impact of antidepressant medication in pregnancy

BackgroundBoth antidepressant use and depression in pregnancy have the potential to impact on outcomes for the women, their mother-infant relationship and their infants. MethodsData were obtained from 485 pregnant women within Mercy Pregnancy and Emotional Wellbeing Study, a pregnancy cohort study. The sampling frame was in three groups: those depressed women taking antidepressants in pregnancy, women with diagnosed depression not taking an antidepressant and control women. Depression was measured using the Structured Clinical Interview for DSM-IV and repeat Edinburgh Postnatal Depression Scale and antidepressant use by repeat self-report, hospital records and blood levels. In addition, data on key maternal, parenting and infant outcomes were collected. ResultsThis study found, for women taking SNRI antidepressant medication there was an elevated rate of pregnancy hypertension. Infants exposed to antidepressants had lower Apgar scores and higher birth weight and this was not associated with dose or class of antidepressant. In contrast, women with higher depressive symptoms had lower maternal antenatal attachment and higher postpartum parenting stress. Both women with depression and those taking antidepressants were less likely to initiate breastfeeding. On the Ages and Stages Questionnaire, there was a significant difference in communication skills in SSRI antidepressant exposed infants at 12 months. LimitationsIndividual antidepressants could not be examined and development was only measured to 12 months ConclusionsOverall, the study identified that antidepressant treatment in pregnancy was significantly associated with only a limited number of poorer maternal and infant outcomes and was not associated with poorer parenting outcomes.

PDB11 - The Impact of Antidepressant Medications on Clinical Outcomes of Patients with Type 2 Diabetes: A Systematic Review

Antidepressant usage has risen sharply in patients with diabetes, calling into question the intervening effects on glucose metabolism. The aim of the current study was to assess the impact of antidepressant utilization on clinical outcomes of adult patients with type 2 diabetes mellitus. A systematic literature search was conducted according to PRISMA guidelines using three databases (PsycINFO, PubMed, and SCOPUS) to identify relevant articles through December 2017. Controlled search terminology included ‘diabetes mellitus’ in combination with ‘antidepressant’, ‘blood glucose’, ‘hemoglobin A1c’ (HgbA1c), ‘fasting blood glucose’ (FBG) and related terms. Relevant studies assessing the effect of antidepressant therapy upon glucose-related outcomes were included. Non-English studies, non-human studies, case reports and review articles were excluded. The key outcome being evaluated was the overall influence of antidepressant therapy upon HgbA1c or FBG. Among 990 articles identified, 25 studies were included in the final review. Samples included in studies ranged from 18 to 95 years, with study durations ranging from 8 weeks to 6 years. Among included studies, nine (36%) were US-based. A total of 14 studies (56%) indicated that antidepressant usage was associated with improvement in either FBG or HgbA1c while nine studies (36%) showed no association or non-statistically significant changes and two studies (8%) indicated negative association in HgbA1c or fasting plasma glucose. Antidepressants evaluated in the studies included milnacipran, fluoxetine, agomelatine, sertraline, citalopram, alprazolam, nortriptyline, bupropion, fludiazepam, and paroxetine compared with placebo, cognitive behavioral therapy (CBT) or no treatment. Some important limitations found in the evaluated studies were small sample size (ranging from 13 to 7016 patients) and not considering antidepressant adherence level and severity of diabetes. With antidepressants being increasingly prescribed in patients with diabetes, it is important to understand their impact on clinical outcomes of diabetes, potentially influencing treatment decisions in diabetes care.

Association between cortisol awakening response and memory function in major depression

While impaired memory and altered cortisol secretion are characteristic features of major depression, much less is known regarding the impact of antidepressant medication. We examined whether the cortisol awakening response (CAR) is increased in depressed patients with and without medication compared with healthy controls (HC) and whether CAR is associated with memory function in each group. We examined 21 patients with major depression without medication, 20 depressed patients on antidepressant treatment, and 41 age-, sex- and education-matched healthy subjects. We tested verbal (Auditory Verbal Learning Task) and visuospatial (Rey figure) memory and measured CAR on two consecutive days. Patient groups did not differ in severity of depression. We found a significant effect of group (p = 0.03) for CAR. Unmedicated patients exhibited a greater CAR compared with medicated patients (p = 0.04) with no differences between patient groups and HC. We found a significant effect of group for verbal (p = 0.03) and non-verbal memory (p = 0.04). Unmedicated patients performed worse compared with medicated patients and HC in both memory domains. Medicated patients and HC did not differ. Regression analyses revealed a negative association between CAR and memory function in depressed patients, but not in HC. While in unmedicated depressed patients the magnitude of CAR is associated with impaired memory, medicated patients showed a smaller CAR and unimpaired cognitive function compared with HC. Our findings are compatible with the idea that antidepressants reduce CAR and partially restore memory function even if depressive psychopathology is still present.

Varicella Zoster Virus-Specific Immune Responses to a Herpes Zoster Vaccine in Elderly Recipients With Major Depression and the Impact of Antidepressant Medications

The Depression Substudy of the Shingles Prevention Study (SPS) was designed to evaluate the association between major depression and immune responses to a high-titer live attenuated varicella zoster virus (VZV) vaccine (zoster vaccine), which boosts cell-mediated immunity (CMI) to VZV and decreases the incidence and severity of herpes zoster (HZ). The Depression Substudy was a 2-year longitudinal cohort study in 92 community-dwelling adults≥60 years of age who were enrolled in the SPS, a large, double-blind, placebo-controlled Veterans Affairs Cooperative zoster vaccine efficacy study. Forty subjects with major depressive disorder, stratified by use of antidepressant medications, and 52 age- and sex-matched controls with no history of depression or other mental illness had their VZV-CMI measured prior to vaccination with zoster vaccine or placebo and at 6 weeks, 1 year, and 2 years postvaccination. Depressed subjects who were not treated with antidepressant medications had lower levels of VZV-CMI following administration of zoster vaccine than nondepressed controls or depressed subjects receiving antidepressants even when antidepressant medications failed to alter depressive symptom severity (P<.005). Similar results were obtained taking into account the time-varying status of depression and use of antidepressant medications, as well as changes in depressive symptoms, during the postvaccination period. Depressed patients have diminished VZV-CMI responses to zoster vaccine, and treatment with antidepressant medication is associated with normalization of these responses. Because higher levels of VZV-CMI correlate with lower risk and severity of HZ, untreated depression may increase the risk and severity of HZ and reduce the efficacy of zoster vaccine.

The impact of escitalopram on vagally mediated cardiovascular function to stress and the moderating effects of vigorous physical activity: a randomized controlled treatment study in healthy participants

Recent concerns over the impact of antidepressant medications, including the selective serotonin reuptake inhibitors (SSRIs), on cardiovascular function highlight the importance of research on the moderating effects of specific lifestyle factors such as physical activity. Studies in affective neuroscience have demonstrated robust acute effects of SSRIs, yet the impact of SSRIs on cardiovascular stress responses and the moderating effects of physical activity remain to be determined. This was the goal of the present study, which involved a double-blind, randomized, placebo-controlled, cross-over trial of a single-dose of escitalopram (20 mg) in 44 healthy females; outcomes were heart rate (HR) and its variability. Participants engaging in at least 30 min of vigorous physical activity at least 3 times per week (regular exercisers) showed a more resilient cardiovascular stress response than irregular vigorous exercisers, a finding associated with a moderate effect size (Cohen's d = 0.48). Escitalopram attenuated the cardiovascular stress response in irregular exercisers only (HR decreased: Cohen's d = 0.80; HR variability increased: Cohen's d = 0.33). HR during stress under escitalopram in the irregular exercisers was similar to that during stress under placebo in regular exercisers. These findings highlight that the effects of regular vigorous exercise during stress are comparable to the effects of an acute dose of escitalopram, highlighting the beneficial effects of this particular antidepressant in irregular exercisers. Given that antidepressant drugs alone do not seem to protect patients from cardiovascular disease (CVD), longitudinal studies are needed to evaluate the impact of exercise on cardiovascular stress responses in patients receiving long-term antidepressant treatment.

Drugs and Acupuncture: The Energetic Impact of Antidepressant Medications

ABSTRACT Many patients seeking acupuncture are taking antidepressants, yet rarely do they appreciate the impact such drugs might have on the acupuncture process. In this paper, the author explores the energetic effect of antidepressants, using side-effect profiles and the impressions of other practitioners. The argument is made that antidepressants can interfere with acupuncture and can even prevent patients from getting to the root of their illness.

The impact of antidepressant treatment on population health: synthesis of data from two national data sources in Canada

BackgroundIn randomized, controlled trials, antidepressant medications have been shown to reduce the duration of major depressive episodes and to reduce the frequency of relapse during long-term treatment. The epidemiological impact of antidepressant use on episode duration and relapse frequency, however, has not been described.MethodsData from two Canadian general health surveys were used in this analysis: the National Population Health Survey (NPHS) and the Canadian Community Health Survey (CCHS). The NPHS is a longitudinal study that collected data between 1994 and 2000. These longitudinal data allowed an approximation of episode incidence to be calculated. The cross-sectional CCHS allowed estimation of episode duration. The surveys used the same sampling frame and both incorporated a Short Form version of the Composite International Diagnostic Interview.ResultsEpisodes occurring in antidepressant users lasted longer than those in non-users. The apparent incidence of major depressive episodes among those taking antidepressants was higher than that among respondents not taking antidepressants. Changes in duration and incidence over the data collection interval were not observed.ConclusionsThe most probable explanation for these results is confounding by indication and/or severity: members of the general population who are taking antidepressants probably have more highly recurrent and more severe mood disorders. In part, this may have been due to the use of a brief predictive diagnostic interview, which may be prone to detection of sub-clinical cases. Whereas antidepressant use increased considerably over the data-collection period, differences in episode incidence and duration over time were not observed. This suggests that the impact of antidepressant medications on population health may have been less than expected.