Selective Serotonin Reuptake Inhibitor Drugs Research Articles

Paroxetine alleviates ulcerative colitis in mice via restoring intestinal microbiota homeostasis and metabolism.

Ulcerative colitis (UC) is an inflammatory bowel disease and psychological factors may be one of its pathogeneses. Selective serotonin reuptake inhibitor drug such as paroxetine with an effective anti-depression ability may be a new option for UC treatment. To evaluate the therapeutic effect of paroxetine on the exacerbation of UC symptoms caused by depression, a dual model of C57BL/6 mice was established using dextran sulphate sodium and chronic unpredictable mild stress (CUMS). Behavioural experiments, H&E staining and the level of 5-hydroxytryptamine (5-HT) in the brain were used to demonstrate successful replication of the CUMS model. The levels of 5-HT, TNF-α and IL-1β in the colon and the activity of MPO in the serum were determined by ELISA kits. The levels of some gut microbiota in the faeces were measured by qPCR and faecal differential metabolites were analysed by 1H NMR. The results indicate that CUMS can exacerbate UC symptoms in mice by exacerbating inflammation, and UC+CUMS can disrupt gut microbiota and fatty acid metabolism. Paroxetine can improve the mental state of mice, reduce serum MPO activity, but increase TNF-α and IL-1β levels in the colon. In addition, paroxetine also can restore the intestinal flora of mice and improve intestinal absorption and metabolic function of amino acids and short-chain fatty acids.

Effect of Antidepressant Treatment on 5-HT4 Receptor Binding and Associations With Clinical Outcomes and Verbal Memory in Major Depressive Disorder

BackgroundBrain serotonin 4 receptor (5-HT4R) levels are lower in untreated patients with major depressive disorder (MDD) and are linked to verbal memory. Here, we investigated the relationship between 5-HT4R levels, clinical outcomes, and cognitive function in patients with MDD who initiated selective serotonin reuptake inhibitor drug treatment. MethodsNinety patients with moderate to severe depression underwent molecular brain imaging to measure 5-HT4R binding prior to antidepressant treatment with escitalopram. Pretreatment 5-HT4R binding was assessed for its ability to predict treatment outcome at weeks 4, 8, or 12. In 40 patients who were rescanned 8 weeks posttreatment, change in cerebral 5-HT4R binding was correlated with change in verbal memory and with change in depressive symptoms, as evaluated by the 6-item Hamilton Depression Rating Scale. ResultsAfter 8 weeks of serotonergic intervention, neostriatal 5-HT4R binding was reduced by 9%. Global change in 5-HT4R binding from baseline was associated with verbal memory outcomes, but not with overall clinical depressive symptom outcomes. Pretreatment 5-HT4R binding did not predict clinical recovery status at week 8 and was not associated with change in the 6-item Hamilton Depression Rating Scale scores. ConclusionsIn patients with moderate to severe MDD, treatment with selective serotonin reuptake inhibitors downregulated neostriatal 5-HT4R levels, which is consistent with the notion that the drugs increase cerebral extracellular serotonin. The less global brain 5-HT4R levels were downregulated after selective serotonin reuptake inhibitors, the more verbal memory improved, highlighting the potential importance of 5-HT4R as a treatment target in MDD. The findings offer insights into mechanisms that underlie antidepressant effects and point to new directions for precision medicine treatments for MDD.

MODL-12. REPURPOSING SSRI/SNRI TARGETING NEUROTRANSMITTER SIGNALING TO SENSITIZE DMG TO CDK9 INHIBITORS

Abstract BACKGROUND Diffuse Midline Glioma (DMG) comprise a subset of aggressive pediatric brain tumors with few effective therapies. Cyclin-dependent kinase 9 inhibitors (CDK9i) like zotiraciclib (ZTR) are in clinical trials for adult and pediatric glioma, but resistance frequently develops. In this study, we find that co-treatment with CDK9i and brain penetrant, FDA-approved drugs targeting neurotransmitter signaling alters DMG transcription and reduces DMG growth and tumorigenesis. METHODS We conducted drug screens to assess DMG response to a sub-threshold dose of ZTR combined with a library of ~220 bioactive and FDA-approved compounds. Combinatorial effects of CDK9i+SSRI/SNRI treatment were confirmed through in vitro dose curve studies and in orthotopic DMG xenograft models. We identified downstream targets of CDK9i+SSRI/SNRI treatment through phospho-proteomic profiling, RNAseq analysis, immunofluorescence staining, and Western blotting. RESULTS Our targeted drug screens identified SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin and norepinephrine reuptake inhibitors) that increase DMG sensitivity to a low dose of zotiraciclib (ZTR). Follow-up studies confirm that combinations of structurally distinct CDK9i (ZTR, AZD4573) and SSRI/SNRI (sertraline, duloxetine) synergistically reduce DMG growth in neurospheres, induce the apoptotic marker cleaved caspase 3, and reduce the expression of proliferation markers. Additional proteogenomic analyses define downstream targets of CDK9i+SSRI co-treatment, including differential phosphorylation of chromatin regulators and RNA Polymerase 2 (Pol2)-associated elongation factors and splicing machinery. Further RNAseq studies reveal robust transcriptional changes induced by CDK9i+SSRI treatment characterized by altered expression of developmental and synaptic signaling genes. Finally, pilot pre-clinical studies find that CDK9i+SSRI treatment reduces tumor growth and increases progression free survival in a DMG xenograft model. CONCLUSIONS We have identified synergistic CDK9i+SSRI drug combinations that can be applied to alter malignant gene regulation and reduce DMG growth in vitro and in xenografts. These studies provide a basis for a drug-repurposing strategy to combine SSRI/SNRI and CDK9 inhibitors for DMG treatment.

Prevalence of Parasomnias and Restless Leg Syndrome in Patients taking Psychotropic Medications (Antidepressants and Antipsychotics): A Cross-Sectional Hospital-based Study

Prevalence of Parasomnias and Restless Leg Syndrome in Patients taking Psychotropic Medications (Antidepressants and Antipsychotics): A Cross-Sectional Hospital-based Study

(075) Practice Patterns of Sexual Medicine Experts Towards Postorgasmic Illness Syndrome

Abstract Introduction POIS is a rare, but debilitating cluster of symptoms, occurring after ejaculation with unknown mechanism. Unfortunately, limited information is available on POIS diagnosis, treatment, and disease management Objective To investigate the practice patterns of sexual medicine experts towards POIS Methods Worldwide sexual medicine experts were invited to participate anonymously in an online, open survey using SurveyMonkey. Results 211 sexual medicine experts filled the survey. The mean age of the participants was 45.4 years. The majority of the participants were urologists (83.9%). Most of the participants (53.5%) considered POIS to be an important sexual dysfunction that should be treated. Most participants stated that the available information about POIS was inadequate for both patients and physicians (65.9% and 66.3%, respectively). 47.9% of the participants stated psychological disorder, 46.4% stated bio-psycho-social reasons, 41.2% stated a transient deregulation of the autonomic nervous system, and 39.8% stated autoimmune or allergic type reaction for the responsibility for the pathophysiology of POIS. 56.4% of the participants stated that they would refer the patient for psychotherapy/sexual therapy to a sexologist, 41.7% would prefer antihistamine drugs to manage symptoms, and 38.4% would prefer Selective Serotonin Reuptake Inhibitor (SSRI) drugs for treatment of POIS. Conclusions This survey study among sexual medicine experts from different parts of the world has developed representative estimates of knowledge, attitudes and practice patterns regarding POIS worldwide. Furthermore, sexual medicine experts stated that there is not adequate information available about POIS for physicians and patients. Disclosure No.

Development and Evaluation of an Orodispersible Tablet Formation for the Delivery of a Hydrophobic Drug.

Orodispersible tablet (ODT) is a promising avenue for drug delivery, offering a dosage form that can be disintegrated instantaneously in the mouth and released the drug that dissolves or disperses in the saliva without the addition of water. ODT can effectively boost the dissolution rate and consequently the bioavailability of several hydrophobic drugs. Additionally, ODT is very attractive and suitable for specific patients who are unable to swallow the traditional tablet. The basic approach in the fabrication of oral tablets for hydrophobic drugs relies on the utilization of superdisintegrants which allow prompt disintegration of tablets after swallowing. In the present investigation, escitalopram oxalate was chosen as a model drug, which is a hydrophobic, antidepressant, selective serotonin reuptake inhibitor (SSRI) drug. Nine formulas of escitalopram oxalate ODTs were prepared by varying the concentrations of three different superdisintegrants: sodium starch glycolate, croscarmellose sodium, and crospovidone to improve the dissolution and release of escitalopram oxalate. Each was used in three different concentrations (2.5%, 5%, and 7.5%), and all the ODTs were prepared by the direct compression method. The micrometric characterization of the powder blend used in the formulations was investigated such as angle of repose, bulk and tapped densities, compressibility percent (Carr's index), and Hausner ratio. Furthermore, the prepared ODTs were characterized in terms of weight variation, thickness, diameter, hardness, friability, in vitro disintegration, wetting time, water absorption ratio, drug content, in vitro dissolution, and accelerated stability study. The results showed that the formula (ODT9) that contained 7.5% of the superdisintegrant sodium starch glycolate had superior characteristics in almost all the tests, with a dissolution rate of 100% after 6 minutes. Also, it was stable under the accelerated stability conditions.

Selective serotonin re-uptake inhibitors affect craniofacial structures in a mouse model.

Selective serotonin re-uptake inhibitors (SSRI) widely used in the treatment of depression, anxiety, obsessive compulsive disorder, fibromyalgia, and migraine are among the most heavily prescribed drug class in the United States (US). Along with an overall rise in SSRI use, these medications are increasingly used by pregnant individuals and recent preclinical and clinical studies have indicated that SSRIs may increase the prevalence of congenital abnormalities and birth defects of the craniofacial region. Our group has developed pre-clinical models of study, including those that mimic the clinical use of SSRI in mice. Here we designed a study to interrogate a commonly prescribed SSRI drug, Citalopram, for its effects on craniofacial and dental development when introduced in utero. Pre-natal exposure to a clinically relevant dose of citalopram resulted in changes in craniofacial form identified by an increase in endocast volume in SSRI exposed postnatal day 15 mouse pups. More specifically, cranial length and synchondrosis length increased in SSRI exposed pups as compared to control pups of the same age. Additionally, growth center (synchondrosis) height and width and palate length and width decreased in SSRI exposed pups as compared to control un-exposed pups. Effects of SSRI on the molars was minimal. Craniofacial growth and development continue to be an area of interest in the investigation of in utero pharmaceutical drug exposure. Altogether these data indicate that prenatal SSRI exposure affects craniofacial form in multiple tissues and specifically at growth sites and centers of the skull.

Dose of selective serotonin reuptake inhibitors and risk of upper gastrointestinal bleeding in older adults.

Selective serotonin reuptake inhibitors (SSRIs) have been associated with an increased risk of upper gastrointestinal bleeding (UGIB) in older patients but little is known about the risk associated with individual SSRI drugs and doses. To quantify the risk of UGIB in relation to individual SSRI use in older adults. We conducted a nested case-control study within a cohort of 9565 patients aged ⩾65 years prescribed SSRIs from 2000 to 2013 using claims data of universal health insurance in Taiwan. Incident cases of UGIB during the follow-up period were identified and matched with three control subjects. Conditional logistic regression was used to estimate the odds ratio (OR) of UGIB associated with individual SSRI use and cumulative dose. UGIB risk increased with the increasing cumulative doses of SSRIs (adjusted OR: 1.28, 95% confidence interval (CI): 1.02-1.62 for the highest vs. the lowest tertile). Compared with users of other SSRIs, fluoxetine users were at an increased risk of UGIB (adjusted OR: 1.25, 95% CI: 1.03-1.50) with a dose-response manner, whereas paroxetine users had 29% decreased odds (95% CI: 0.56-0.91). The increased risk was only observed among current fluoxetine users. Fluoxetine therapy was associated with an increased risk of UGIB in a dose-response manner among older adults.

SSRIs in the course of COVID-19 pneumonia: Evidence of effectiveness of antidepressants on acute inflammation. Aretrospective study.

Relationships between inflammation and mood have been observed in terms of pro-inflammatory effects induced by depressive conditions and, in parallel, by an antidepressant-induced favorable effect on the recovery of inflammatory states. Selective serotonin reuptake inhibitor (SSRI) drugs were hypothesized to improve the prognosis of COVID-19 pneumonia, a typical acute inflammation, in terms of decreased mortality rate and pro-inflammatory cytokine serum levels. The medical records of COVID-19 pneumonia inpatients at Careggi University Hospital (Florence) were analyzed for prognosis and Interleukin 6 (IL-6) after admission for over a period of 22months. Medical records of patients treated at admission and not discontinued until discharge with an SSRI or with vortioxetine were identified. Two groups, one treated with antidepressants, the other not treated, were evaluated according to the mentioned parameters. Multiple linear regression and logistic regression were performed. The entire sample composed of 1236 records (recovered patients 77.1%, deceased patients 22.9%). The treated group (n=107) had a better prognosis than the untreated group in spite of age and comorbidity both being greater than in the untreated group. Correspondingly, IL-6 levels in the treated group were significantly lower (p<0.01) than the levels in the untreated group, in every comparison. Outcomes of this study support the hypothesis of the favorable influence of some antidepressants on the prognosis of COVID-19, possibly mediated by IL-6 modulation. Reduction in acute inflammation induced by the action of antidepressants was confirmed.

Cytotoxicity and reversal effect of sertraline, fluoxetine, and citalopram on MRP1- and MRP7-mediated MDR.

Cancer is one of the leading causes of death worldwide, and the development of resistance to chemotherapy drugs is a major challenge in treating malignancies. In recent years, researchers have focused on understanding the mechanisms of multidrug resistance (MDR) in cancer cells and have identified the overexpression of ATP-binding cassette (ABC) transporters, including ABCC1/MRP1 and ABCC10/MRP7, as a key factor in the development of MDR. In this study, we aimed to investigate whether three drugs (sertraline, fluoxetine, and citalopram) from the selective serotonin reuptake inhibitor (SSRI) family, commonly used as antidepressants, could be repurposed as inhibitors of MRP1 and MRP7 transporters and reverse MDR in cancer cells. Using a combination of in silico predictions and in vitro validations, we analyzed the interaction of MRP1 and MRP7 with the drugs and evaluated their ability to hinder cell resistance. We used computational tools to identify and analyze the binding site of these three molecules and determine their binding energy. Subsequently, we conducted experimental assays to assess cell viability when treated with various standard chemotherapies, both with and without the presence of SSRI inhibitors. Our results show that all three SSRI drugs exhibited inhibitory/reversal effects in the presence of chemotherapies on both MRP1-overexpressed cells and MRP7-overexpressed cells, suggesting that these medications have the potential to be repurposed to target MDR in cancer cells. These findings may open the door to using FDA-approved medications in combination therapy protocols to treat highly resistant malignancies and improve the efficacy of chemotherapy treatment. Our research highlights the importance of investigating and repurposing existing drugs to overcome MDR in cancer treatment.

Straightforward paper sensors for the detection of SSRI drugs using tyrosine functionalized GQDs: Fluorescence ‘turn-off’ turns on the crucial dosage monitoring

All socioeconomic classes are impacted by the COVID-19 epidemic, with stress being one of the biggest symptoms causing indigestion, breathlessness, heart disease, obesity, and many more. The most commonly used selective serotonin reuptake inhibitors (SSRIs) drugs include, escitalopram, sertraline, paroxetine, and fluoxetine are provided by doctors. If the medicines are not taken in the recommended dosage, at the correct intervals, which can occasionally be fatal because persons with depression are susceptible to mood fluctuations. There are no appropriate ways to monitor high dosages in clinical laboratories, the requirement for simple, novel material with cutting-edge technology to do so is essential. Herein, we report the application of a single fluorescent probe, Tyrosine-GQDs for the detection of SSRI drugs. Upon addition of SSRI drugs into the Tyrosine-GQDs, the fluorescence emission intensity of Tyrosine-GQDs decreased due to the complex formation through H-bonding which is evidenced by the rise of new peaks in fluorescence spectra and lifetime measurements. The calculated detection limit proves that the designed nanoprobe is highly sensitive and selective towards escitalopram, sertraline, paroxetine, and fluoxetine are 0.13 × 10−6 M, 0.15 × 10−6 M, 0.07 × 10−6 M, and 0.07 × 10−6 M, respectively. A paper-based fluorescent sensor is fabricated using the designed probe which is efficient in the detection of the dosage of SSRI drugs.

A comparative overview of SSRI-sertraline and SNRI-desvenlafaxine

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. The common features of all the depressive disorders are sadness, emptiness, or irritable mood, accompanied by somatic and cognitive changes that significantly affect the individual’s capacity to function. Depression is commonly treated in primary care, and SSRI drugs are frequently used as the first line of treatment. Selective Serotonin Reuptake Inhibitors (SSRIs) have the advantage of the ease of dosing and low toxicity in overdose. They are also the first-line medications for late-onset depression. Selective Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs), which include venlafaxine, desvenlafaxine, duloxetine, and levomilnacipran can be used as first-line agents, particularly in patients with significant fatigue or pain syndromes associated with the episode of depression. SNRIs also have an important role as second-line agents in patients who have not responded to SSRIs. The pharmacokinetics, pharmacodynamics, uses, side effects, and contraindications of desvenlafaxine, an SNRI, and sertraline, an SSRI are compared in this article.

Review on Surface-Modified Electrodes for the Enhanced Electrochemical Detection of Selective Serotonin Reuptake Inhibitors (SSRIs).

Selective serotonin re-uptake inhibitors (SSRIs) are one of the most commonly prescribed classes of antidepressants used for the treatment of moderate to severe depressive disorder, personality disorders and various phobias. This class of antidepressants was created with improved margins of safety. However, genetic polymorphism may be responsible for the high variability in patients' responses to treatment, ranging from failure to delayed therapeutic responses to severe adverse effects of treatment. It is crucial that the appropriate amount of SSRI drugs is administered to ensure the optimum therapeutic efficacy and intervention to minimise severe and toxic effects in patients, which may be the result of accidental and deliberate cases of poisoning. Determining SSRI concentration in human fluids and the environment with high sensitivity, specificity and reproducibility, and at a low cost and real-time monitoring, is imperative. Electrochemical sensors with advanced functional materials have drawn the attention of researchers as a result of these advantages over conventional techniques. This review article aims to present functional materials such as polymers, carbon nanomaterials, metal nanomaterials as well as composites for surface modification of electrodes for sensitive detection and quantification of SSRIs, including fluoxetine, citalopram, paroxetine, fluvoxamine and sertraline. Sensor fabrication, sensor/analyte interactions, design rationale and properties of functional material and the electrocatalytic effect of the modified electrode on SSRI detection are discussed.

The anti-depression function of selective serotonin reuptake inhibitor

Depression is one of the world's most serious public health issues. What is worse, the number of people suffering from depression is expanding and shows a younger-age trend. The primary treatment for depression is drug therapy. Selective serotonin reuptake inhibitors (SSRIs), as the second generation of novel antidepressants, are highly recognized antidepressant medicines that are widely utilized in clinical practice and have become first-line drugs for the treatment of depression. This article provides a thorough and detailed introduction to SSRIs. It focuses mostly on the etiology of depression, the specific mechanism of SSRIs, the specific application of SSRIs, and properties of distinct SSRI drugs. This article looks at the superiority and significance of SSRI medicines in the treatment of depression. At the same time, the limitations and shortcomings of SSRI drugs were discussed, and the future development of SSRI drugs was envisaged.

The effect of antidepressants on the severity of COVID-19 in hospitalized patients: A systematic review and meta-analysis.

Clinical Depression and the subsequent low immunity is a comorbidity that can act as a risk factor for the severity of COVID-19 cases. Antidepressants such as Selective serotonin reuptake inhibitor and Serotonin-norepinephrine reuptake inhibitors are associated with immune-modulatory effects, which dismiss inflammatory responses and reduce lung tissue damage. The current systematic review and meta-analysis aims to evaluate the effect of antidepressant drugs on the prognosis and severity of COVID-19 in hospitalized patients. A systematic search was carried out in PubMed/Medline, EMBASE, and Scopus up to June 14, 2022. The following keywords were used: "COVID-19", "SARS-CoV-2", "2019-nCoV", "SSRI", "SNRI", "TCA", "MAOI", and "Antidepressant". A fixed or random-effect model assessed the pooled risk ratio (RR) with 95% CI. We considered P < 0.05 as statistically significant for publication bias. Data were analyzed by Comprehensive Meta-Analysis software, Version 2.0 (Biostat, Englewood, NJ). Fourteen studies were included in our systematic review. Five of them were experimental with 2350, and nine of them were observational with 290,950 participants. Eight out of fourteen articles revealed the effect of antidepressants on reducing the severity of COVID-19. Selective serotonin reuptake inhibitors drugs, including Fluvoxamine, Escitalopram, Fluoxetine, and Paroxetine, and among the Serotonin-norepinephrine inhibitors medications Venlafaxine, are reasonably associated with reduced risk of intubation or death. Five studies showed no significant effect, and only one high risk of bias article showed the negative effect of antidepressants on the prognosis of Covid-19. The meta-analysis of clinical trials showed that fluvoxamine could significantly decrease the severity outcomes of COVID-19 (RR: 0.763; 95% CI: 0.602-0.966, I2: 0.0). Most evidence supports that the use of antidepressant medications, mainly Fluvoxamine, may decrease the severity and improve the outcome in hospitalized patients with SARS-CoV-2. Some studies showed contradictory findings regarding the effects of antidepressants on the severity of COVID-19. Further clinical trials should be conducted to clarify the effects of antidepressants on the severity of COVID-19.

Influence of selective serotonin reuptake inhibitors (SSRIs) in the development of bruxism

ABSTRACT Objective To identify the relationship between the use of selective serotonin reuptake inhibitors (SSRIs) as pharmacological treatment and the development of bruxism. Methods A systematic literature search was performed in PubMed and Scopus databases, which included articles written within the last 30 years. The working hypothesis was that there is a significant association between using SSRIs as an antidepressant medication and developing bruxism. Results A total of four articles were included in the systematic review. All the articles are related to SSRI antidepressants and bruxism. Conclusion The results indicate that there is an apparent association between SSRI drug treatment and the development of bruxism. The methods of evaluation and analysis were different in each article and cannot be considered conclusive; however, there is sufficient information to elucidate the impact of SSRI drugs on the development of bruxism.

The Impact of SSRI Use on the Clinical Outcome and Prognosis of COVID-19 Patients: A Single-Center Prospective Study

Background: Recent studies have found a link between the usage of selective serotonin reuptake inhibitors (SSRIs) and a lower mortality rate in COVID-19 cases. Objective: The goal of current research was evaluating the effectiveness of SSRI drugs on improvement of COVID-19 patients. Methods: This prospective case-control study, compared SSRI-treated patients with matched control patients not treated with SSRIs at Masih Daneshvari Hospital on a population of 350 patients diagnosed with COVID-19 from March 15th 2021 to March 16th 2022. Results: ICU admission rates were significantly more in the control group than in the case group (44.8% vs. 25.9%; p-value=0.0002; Odds Ratio (OR)= 2.32). Intubation was reported for more cases in the control group than the case group (26.7% vs. 11.4%; p-value=0.0002; OR=2.84). Mortality rate was found to be significantly more in the control group than the case group (23.0% vs. 10.8%; p-value=0.0002; OR=2.46). Furthermore, the subgroup analyses on Fluvoxamine and Sertraline showed that Hospitalization period, ICU admission rates, and intubation were all reported to be significantly smaller in each case subgroups as against the control group. Conclusion: Our assessments underlined the potential efficacy of SSRIs in improving COVID-19 patients’ prognosis, since the use of SSRIs were shown to be associated with shorter hospital stay and ICU stay, lower ICU admission rates and intubation rates, and ultimately decreased mortality rates.

Therapeutic potential of selective serotonin reuptake inhibitor and anti-inflammatory COX-2 inhibitors drugs for epilepsy

Epilepsy is a neurological disease caused by disturbances in the electrical propagation between neurons, which causes great damage to patients' lives, and can even lead to death. There are several proposals to understand its biochemical functioning, so current pharmacological treatments are based on the interruption of electrical conduction or modulation of neurotransmitters, such as phenobarbital and phenytoin. Thus, the present work aims to analyze the therapeutic potential of drugs such as COX-2 inhibitors and selective serotonin reuptake inhibitors (SSRIs) in the control of epilepsy. Thus, a narrative review of the literature was carried out using the “PubMed” database in order to find the theoretical bases and experimental works that demonstrate the mechanism of such drugs. The work concludes that SSRIs and COX-2 inhibitors have several mechanisms that can theoretically treat epilepsy, this is due to the establishment of a higher concentration of the neurotransmitter serotonin, as well as a reduction in the formation of quinolinic acid, which is a potential neurotoxic agent. which contributes to epileptogenesis.

Severe Pulmonary Stenosis in a Newborn with Antenatal Exposure to Selective Serotonin Reuptake Inhibitor Drug: A Case Report

Depression in pregnancy is being recognized as a major contributor to adverse maternal and fetal outcomes. Recent years have seen significant research focused on the development of safe pharmacological methods to treat depression in pregnancy, resulting in the common use of selective serotonin reuptake inhibitors (SSRIs) as a first line of treatment. There have been a few reports of congenital birth defects associated with the consumption of SSRIs during pregnancy, particularly congenital heart defects. Several studies have attempted to evaluate the relationship between SSRI use and congenital heart defects in neonates, but they were inconclusive. In this report, a case where maternal SSRI intake during two consecutive pregnancies was associated with neonatal pulmonary valve stenosis, raising the possibility of a correlation between the usage of a certain SSRI, and a particular congenital heart defect has been described. Keywords: Congenital heart defects, Depression, Pregnancy, Pulmonary valve stenosis, Serotonin uptake inhibitors

A randomized clinical trial: Comparison of group acceptance and commitment therapy with drug on quality of life and depression in patients with obsessive-compulsive disorder.

Background:Acceptance and commitment therapy (ACT) is one of the newest treatment strategies that has been developed rapidly to improve the treatment of patients with obsessive–compulsive disorder (OCD). The aim of this study was to evaluate and compare the effect of ACT and selective serotonin reuptake inhibitors (SSRIs) drugs on the severity of depression symptoms and quality of life (QOL) in obsessive–compulsive patients.Materials and Methods:A randomized clinical trial with a control group was conducted including 27 patients with OCD. Based on the Diagnostic and Statistical Manual of Mental Disorders-5 criteria for OCD diagnosis, participants were recruited from Tamasha Counseling Center and obsessive–compulsive clinic in the Psychosomatic Research Center in Isfahan, Iran. Selected patients were allocated to two groups (14 in ACT the group and 13 in the drug group with SSRI with a simple random sampling method. ACT group was treated by an ACT therapist in eight 1-h sessions. Data were collected by the World Health Organization QOL Questionnaire (WHOQOL-BREF) and Depression subscale of DASS-42 at admission, after the intervention, and 3 months thereafter. Therapists and evaluators were blind to each other's work. Data were analyzed using analysis of variance with repeated measures method using IBM SPSS Statistics software (V 23, IBM Corporation, Armonk, NY, USA).Results:Results revealed that both treatments (ACT and SSRIs drug therapy) had significant impacts on reducing depression subscales scores and increasing WHOQOL-BREF scores at posttreatment (P < 0.05). There were no significant differences in QOL scores between the two groups after the intervention and follow-up (P > 0.05). Nevertheless, drug therapy presented a significantly greater improvement in depression scores of patients than those resulting from ACT (P = 0.005). The persistence of treatment effects continued after 3 months (follow-up) in both groups.Conclusion:ACT is equal to SSRIs drug therapy in terms of improving QOL in patients with OCD. However, SSRIs are more effective in treating depression in obsessive–compulsive patients. It may be presumed that ACT without any chemical side effect is equal to drug and is preferred for patients who either cannot use drugs or prefer not to have a drug treatment.