Serotoninergic Antidepressants Research Articles

Mental disorders of the depressive and anxiety spectrum in neuroendocrine tumors: prevalence, pathogenesis, clinical particulars

Neuroendocrine tumors (NETs) are a heterogeneous group of slowly progressing tumors from neuroendocrine cells able to secrete biologically active substances. The most striking clinical manifestation of functioning NETs is the carcinoid syndrome, which is caused by serotonin overproduction and is most often associated with hot flashes, diarrhea, and abdominal pain. The prevalence of depressive and anxiety spectrum disorders in NETs patients can amount to 30–50%. The development of depressive and anxiety spectrum disorders in NETs can occur both through a nosogenic mechanism facilitated by a long pre-diagnostic stage, the presence of a serious disease with severe somatic symptoms and resulting significant decrease in quality of life. The mental disorders may be a result of somatogenic factors, which include an imbalance of significant mediators in the central nervous system (in particular, serotonin), as well as chronic inflammation and abnormalities of the body's immune defense. In the treatment of patients with NETs and verified anxiety and depressive disorders, special attention is paid to the safety of prescribing the first-line therapy, the selective serotonin reuptake inhibitors. The side effects of these agents are related to the activity of serotonin receptor agonists in the gut, which results in diarrhea and increased gastrointestinal motility, the symptoms similar to the carcinoid syndrome manifestations. The accumulated evidence allows concluding on the relative safety of serotoninergic antidepressants in NETs patients, but does not exclude some groups of patients with an increased risk of complications related to an additional effect on serotonin metabolism. Current knowledge on the prevalence, pathogenesis and treatment of depressive and anxiety spectrum disorders, comorbid to NETs, are limited and contradictory. Therefore, further studies with a larger patient samples are required to identify key factors of the pathophysiology and manifestation of mental disorders in NETs patients, which would generally facilitate the optimization of their treatment.

Role of Serotoninergic Antidepressants in the Development of Autism Spectrum Disorders: A Systematic Review.

Autism spectrum disorders (ASDs) are one of the most common, highly heritable neurodevelopmental diseases affecting 1-2% of children under the age of 3. Although studies have implicated genetic predispositions, environmental risk factors, and maternal depression as the pathophysiology of ASD, it remains unclear. The association between antidepressant (AD) usage during pregnancy and the likelihood of ASD in children is still debatable. We carried out a systematic review to determine the relation of ASD with AD in offspring exposed to ADs in utero. We used the following terms of medical subject heading (MeSH) and keywords separately and in combination: “antidepressants,” “maternal/pregnancy depression,” “autism spectrum disorders/autism,” and “selective serotonin reuptake inhibitors (SSRI).” Our data search was conducted on PubMed, PubMed Central, Google Scholar, and Cochrane, which resulted in 28,141 articles. We identified and eliminated duplicates and then screened 9,965 articles by title and abstract. We then applied eligibility criteria over 143 relevant articles; a quality assessment was performed, and finally we included 18 selected studies.Mothers who had taken ADs during pregnancy for at least two medication prescription cycles and children detected to have ASD from two years to 18 years of age were included. We excluded articles in languages other than English, grey literature, case reports, letters to the editor, books, documents, animal studies, and studies published before 2017. Out of 18 studies, 17 evaluated ASD as the primary outcome, and for one study, the outcome was child behavioral as well as neurodevelopmental changes. Other additional outcomes studied were attention deficit hyperactivity disorder (ADHD), preterm birth, spontaneous abortion, small for gestational age, maternal mental illness, and persistent pulmonary hypertension. After adjusting for confounding factors, in six studies, the higher correlations between ASD and ADs were eliminated. Also, paternal AD use, maternal pre-conceptional AD drug use, and maternal depression itself are additional factors that raise the incidence of ASD.

Specificities of the Use of Psychotropic Drugs in Bariatric Surgery

IntroductionBariatric surgery is considered an effective treatment against obesity. Psychiatric illness is relatively common in patients who have undergone bariatric surgery. Over one-third of these patients are prescribed psychotropic drugs, particularly antidepressants. Unlike medications for diabetes, hypertension or hyperlipidemia, which are generally reduced and at times discontinued, postsurgery psychotropic use is only slightly reduced. The surgical intervention and the subsequent weight loss can affect several pharmacokinetic parameters, leading to a possible need of dosing adjustment.ObjectivesTo review the influence of bariatric surgery on the use and pharmacokinetics of psychotropic drugs.MethodsNon-systematic review of literature through search on PubMed/MEDLINE for publications from 2011 to 2021, following the terms psychotropic and bariatric surgery. Textbooks were consulted.ResultsIt is difficult to predict how psychotropics will be affected by bariatric surgery because of interindividual differences and limited data. Malabsorptive surgical procedures have a relatively greater potential to alter drug exposure. Medication disintegration, dissolution, absorption, metabolism and excretion have been found to be altered in postbariatric patients. Antidepressants are the best studied psychotropics in the bariatric population and their absorption is reduced. The risk of gastric bleeds with bariatric surgery will probably be increased by serotoninergic antidepressants. Antipsychotics and mood stabilisers are not well studied in these patients. Depot antipsychotics avoid the risk of reduced absorption after surgery. Lithium use requires particular close monitoring.Conclusions Close treatment monitoring and the ongoing monitoring of symptoms are needed after bariatric surgery. Many patients may not require significant changes to drug treatment after surgery.DisclosureNo significant relationships.

Features of obsessive autoerotic behavior in men

The study objective is to investigate clinical features of obsessive autoerotic behavior in men and to develop a complex of therapeutic interventions. Materials and methods Comparison and analysis of psychopathic characteristics of 60 patients were performed. The group 1 included 28 patients with schizoid personality disorder, the group 2 included 14 patients with obsessive compulsive disorder, the group 3 included 18patients with schizotypal disorder. Results. Presence of obsessive autoerotic behavior and its clinical and psychopathological features are considered an important criterion of mental pathology diagnosis. A program of effective therapy and rehabilitation for these disorders is proposed: in patients with schizoid personality disorder — serotoninergic antidepressants and low doses of antipsychotics; in patients with obsessive compulsive disorder — anxiolytics (for several subsequent weeks), selective serotonin reuptake inhibitors and low doses of antipsychotics; in patients with schizotypal disorder — atypical antipsychotics predominantly in combination with selective serotonin reuptake inhibitors. Social rehabilitation of patients is also necessary for all groups. It is directed towards learning social skills of appropriate interactions with the partner considering their needs, capabilities, personal preferences both in intimate relations and everyday life. Conclusion. Features of obsessive autoerotic behavior (pretentiousness, preferring these sexual activities to real sexual contacts with an available partner, persistent character et al.) can serve as a criterion for diagnosis of mental pathology and basis for therapy selection. In selection of medications, clinical manifestations of mental disorders are considered.

P.604 The interaction between inflammation and neural plasticity controls the efficacy of serotoninergic antidepressants

P.604 The interaction between inflammation and neural plasticity controls the efficacy of serotoninergic antidepressants

Therapeutic implications of the serotonin transporter gene in depression

Abstract Background A natural variant of the serotonin transporter gene has been studied in mood disorders and its treatment with serotonin transporter inhibitors. It is now available on gene testing profiles to help guide treatment. But the actual interpretation of the data regarding clinical actionable items is controversial. Methods A review is undertaken to understand the role of the short form in the biology of the brain and its effect on depression and response to serotoninergic antidepressants. Results There are naturally occurring variants of the serotonin reuptake transporter (SERT) gene that express approximately 50 % fewer SERT units in the synapse. People with these low-expressing variants (frequently referred to as the ‘short form’) are more likely to: 1) develop depression in the setting of adversity; 2) attempt or re-attempt suicide; 3) respond inadequately to an antidepressant; 4) develop side effects when taking an antidepressant; or 5) develop rapid cycling if they have bipolar illness. Emerging data suggest that due to the similarity between these natural variants and the mechanism of action of most antidepressants, chronic use of antidepressants may significantly worsen these consequences in patients with the low-expressing variants or induce similar outcomes in people that do not have the short form variants. Conclusions Greater caution is required regarding exposure to serotonin reuptake inhibitors (or serotonin/norepinephrine reuptake inhibitors) for people that have the low expressing short form variants of SERT.

Post-stroke Depression Increases Disability More Than 15% in Ischemic Stroke Survivors: A Case-Control Study.

We performed a retrospective, case-control study in consecutive ischemic stroke patients admitted to our stroke rehabilitation unit. Patients were matched for severity of neurological impairment (evaluated with the Canadian Neurological Scale, CNS), age (difference within 1 year), and onset admission interval (difference within 3 days). Participants were divided into two subgroups according to the presence or absence of PSD. Aim was to assess the specific influence of post-stroke depression (PSD) and antidepressant treatment on both basal functional status and rehabilitation outcomes. All PSD patients were treated primarily with serotoninergic antidepressants (AD). The final sample included 280 patients with depression (out of 320 found in a whole case series of 993 ischemic patients, i.e., 32.25%) and 280 without depression. Forty patients with depression were excluded because they had a history of severe psychiatric illness or aphasia, with a severe comprehension deficit. On one hand, PSD patients obtained lower Barthel Index (BI) and Rivermead Mobility Index (RMI) scores at both admission and discharge, with minor effectiveness of rehabilitative treatment and longer length of stay; on the other hand, this group had a lower percentage of dropouts. Lastly, PSD patients showed a different functional outcome, based on their response to antidepressant therapy, that was significantly better in responders than in non-responders (13.13%). Our results confirm the unfavorable influence of PSD on functional outcome, despite pharmacological treatment.

Modulation of Serum Brain-Derived Neurotrophic Factor by a Single Dose of Ayahuasca: Observation From a Randomized Controlled Trial.

Serotonergic psychedelics are emerging as potential antidepressant therapeutic tools, as suggested in a recent randomized controlled trial with ayahuasca for treatment-resistant depression. Preclinical and clinical studies have suggested that serum brain-derived neurotrophic factor (BDNF) levels increase after treatment with serotoninergic antidepressants, but the exact role of BDNF as a biomarker for diagnostic and treatment of major depression is still poorly understood. Here we investigated serum BDNF levels in healthy controls (N = 45) and patients with treatment-resistant depression (N = 28) before (baseline) and 48 h after (D2) a single dose of ayahuasca or placebo. In our sample, baseline serum BDNF levels did not predict major depression and the clinical characteristics of the patients did not predict their BDNF levels. However, at baseline, serum cortisol was a predictor of serum BDNF levels, where lower levels of serum BDNF were detected in a subgroup of subjects with hypocortisolemia. Moreover, at baseline we found a negative correlation between BDNF and serum cortisol in volunteers with eucortisolemia. After treatment (D2) we observed higher BDNF levels in both patients and controls that ingested ayahuasca (N = 35) when compared to placebo (N = 34). Furthermore, at D2 just patients treated with ayahuasca (N = 14), and not with placebo (N = 14), presented a significant negative correlation between serum BDNF levels and depressive symptoms. This is the first double-blind randomized placebo-controlled clinical trial that explored the modulation of BDNF in response to a psychedelic in patients with depression. The results suggest a potential link between the observed antidepressant effects of ayahuasca and changes in serum BDNF, which contributes to the emerging view of using psychedelics as an antidepressant. This trial is registered at http://clinicaltrials.gov (NCT02914769).

Towards Improving Post-SSRI Sexual Dysfunction by Using Nutriceuticals: Lessons from a Case Study

Post-selective serotonin reuptake inhibitors (SSRIs) sexual dysfunction (PSSD) is a new clinical entity occurring after the antidepressant intake, and it is characterized by the fact that patients continue to present sexual side effects after the discontinuation of the drugs. PSSD mainly consists of hypo-anesthesia of the genital area, loss of libido, and erectile dysfunction. Although different management options have been proposed, there is no consensus on the treatment for this syndrome. Herein we report on a young man affected by PSSD who regained sexual functioning after 3-month treatment with EDOVIS, a dietary supplement containing L-citrulline and other commonly used aphrodisiacs.Clinicians should be aware about the possibility of persistent sexual side effects induced by serotoninergic antidepressants and take into considerations the use of nutraceuticals to overcome PSSD.

The interaction between inflammation and neural plasticity controls the efficacy of serotoninergic antidepressants

The interaction between inflammation and neural plasticity controls the efficacy of serotoninergic antidepressants

Serotoninergic antidepressants amplify the influence of the living condition on mood in depressed patients enrolled in the STAR*D study

Serotoninergic antidepressants amplify the influence of the living condition on mood in depressed patients enrolled in the STAR*D study

Serotoninergic antidepressants positively affect platelet ADAM10 expression in patients with Alzheimer's disease.

Studies have demonstrated a decreased platelet ADAM10 expression in patients with Alzheimer's Disease (AD), classifying this protein as a blood-based AD biomarker. About 50% of the patients with AD are diagnosed with depression, which is commonly treated with tricyclic and tetracyclic antidepressants, monoaminoxidade (MAO) inhibitors and, more preferably, with selective serotonin reuptake inhibitors (SSRIs). Considering that a large proportion of patients with AD takes antidepressant medications during the course of the disease we investigated the influence of this medication on the expression of platelet ADAM10, which is considered the main α-secretase preventing beta-amyloid (βA) formation. Blood was collected for protein extraction from platelets. ADAM10 was analyzed by using western blotting and reactive bands were measured using β-actin as endogenous control. Platelet ADAM10 protein expression in patients with AD was positively influenced by serotoninergic medication. More studies on the positive effects of serotonergic antidepressants on ADAM10 platelet expression should be performed in order to understand its biological mechanisms and to verify whether these effects are reflected in the central nervous system. This work represents an important advance for the study of AD biomarkers, as well as for more effective pharmacological treatment of patients with AD and associated depression.

Choosing the safest acute combination therapy during prophylactic treatment: pharmacokinetic and pharmacodynamic considerations.

Drugs used in the treatment of migraine have been recently reported to be highly associated with the occurrence of clinically significant drug-drug interactions (DDIs). The multiple drug therapy regimen is widely used for migraine treatment, particularly for chronic migraine. In fact, additional pharmacological agents are usually administered during an acute migraine attack in patient chronically treated with prophylactic therapy. The wide variety of drugs available for migraine prophylactic and acute treatment, and consequently their pharmacological interactions, might complicate the choice of a safe combination therapy. The most frequently used drugs for the prophylactic therapy of migraine belong to the antiepileptic, β-blockers, tricyclic, SSRIs and SNRIs antidepressants and antihistamine medications while acute migraine attacks are treated with triptans, NSAIDs and ergot derivatives. Moreover, in the last few years several of the latter drugs have been combined in new formulations for clinical use in order to improve treatment efficacy and, consequently, the compliance of the patient. Drug-drug interactions might occur at receptors level, both in the Central Nervous System (CNS) and in the periphery, at the major metabolic pathways levels (i.e., CYP450 enzymes) and at the protein binding level. One of the most widely known examples of the severity of such interactions is represented by the serotoninergic syndrome induced by the co-administration of serotoninergic antidepressants and triptans. In the management of chronic migraine, usually prophylactic treatment is already administered, therefore the choice of an additional drug for the acute attack should be decided considering the specific DDIs. Therefore, the aim of this study was to schematically discuss the prophylactic-acute drug-drug interactions from a pharmacokinetic and pharmacodynamic point of view.

A Comprehensive Review of Treatment Options for Premenstrual Syndrome and Premenstrual Dysphoric Disorder.

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome that involves a combination of emotional and physical symptoms that result in significant functional impairment. Because of the debilitating nature of PMDD, multiple treatment options have been considered. This review provides a comprehensive overview of these therapeutic regimens to help health care professionals provide adequate treatment for PMDD and premenstrual syndrome. The treatments that are reviewed are organized into the following categories: psychiatric, anovulatory, supplements, herbal, nonpharmacological, and other. Selective serotonin reuptake inhibitors have been established as the first-line treatment for PMDD. Although luteal phase or continuous dosing can be used, additional research is needed to more thoroughly compare the efficacies and differential symptom response of continuous, semi-intermittent, luteal phase, and symptoms-onset dosing. The psychiatric medications venlafaxine, duloxetine, alprazolam, and buspirone have also been found to be useful treatments for PMDD. Various anovulatory-related treatments have demonstrated efficacy; however, the use of some of these treatments remains limited due to potential side effects and/or the availability of cheaper alternatives. Although a variety of supplement and herbal-related treatments have been proposed, with some warranting further research, at this time only calcium supplementation has demonstrated a consistent therapeutic benefit. In conclusion, serotoninergic antidepressants have been established as the first-line treatment option for PMDD; however, there are a variety of additional treatment options that should be considered if a patient fails to achieve an adequate therapeutic response with a selective serotonin reuptake inhibitor.

Serotonin Syndrome During Opioid Therapy – the Underdiagnosed Adverse Interaction and Its Implications for the Management of Chronic Pain

The complexity of chronic pain demands interdisciplinary treatment approaches, however, complex analgesic regimens pose risks for potential adverse drug interactions. Effective management of chronic pain is further complicated by the presence of associated comorbidities, especially depression. As a result, is common for these patients to be prescribed opioid analgesics with antidepressant medications. The first ones may significantly affect serotonin kinetics in the presence of other serotoninergic agents, increasing intrasynaptic serotonin levels. Serotonin syndrome (SS) is a rare and potentially life-threatening iatrogenic complication of serotoninergic polypharmacy. It typically appears after initiation or dose escalation of the offending agent to a regimen that generally includes other serotoninergic agents (like antidepressants drugs and opioids) and all drugs that directly or indirectly increase central serotonin neurotransmission at postsynaptic 5-HT1A and 5-HT2A receptors can produce serotonin syndrome. Individual vulnerability appears to play a role in the development of this complication. Aims To report a clinical case of SS in a 62-yr-old woman with postmastectomy pain syndrome, resulting from the addition of duloxetine to a medication regimen of sertraline and fentanyl. The review of the literature serves as an overview of the epidemiology, pathophysiology, clinical features, differential diagnosis and prevention of SS. Methods Literature review and clinical case description. Results and Conclusions To our knowledge, few case-reports have been published including duloxetine as a precipitant agent of SS. Clinicians should be alert to this potential iatrogenic adverse interaction of serotoninergic antidepressants with commonly prescribed opioid analgesics in chronic pain patients.

Dynamics of Anxious Depression during Treatment with Antidepressants with Different Mechanisms of Action

The dynamics of anxious depression during treatment with selective serotoninergic antidepressants with different mechanisms of action were studied. A total of 61 patients with a predominance of anxiety in the structure of depression (ICD-10 F32.1, F33.1, F34.1) took part in the study. Monotherapy was with Zoloft (sertraline) and Coaxil (tianeptine), the former at a dose of 50 mg/day and the latter at a dose of 37.5 mg/day; treatment duration was four weeks. The main study methods were clinical pyschopathological, psychometric (Hamilton depression and anxiety scales, and the Sheehan self-assessment scale), and statistical. The therapeutic efficacies of the study agents were found to be comparable in relation to a number of the characteristics of their influences on the structure and dynamics of clinical signs.

EPA-1240 – Sexual dysfunction and antidepressant medications in male depressed patients

Introduction Sexual dysfunction, such as low libido, erectile dysfunction and anorgasmia, is very common in patients taking serotoninergic antidepressants (SSRIs). These adverse effects persist throughout the treatment period, are not self-limited, and drive many male patients to treatment discontinuation in order to recuperate normal sexual functioning. Objectives - Aims The purpose of the present study was to investigate the sexual function of male patients treated with antidepressants for major depression, before initiation of treatment, during treatment and two months following withdrawal of SSRIs. Methods This observational study comprised 25 male patients (age: 30–50 years) followed-up on an outpatient basis for major depression. Sexual functioning was assessed with the Arizona Sexual Experience Scale (ASEX) and depressive symptoms with the Hamilton Rating Scale for Depression (HDRS) at three time points: baseline (period free of medication), three months after starting treatment with SSRIs, and two months following antidepressant discontinuation. Paired samples t-tests were used for comparisons between numeric variables at the three time points and Spearman's correlation coefficients were calculated between factors associated with sexual dysfunction. Results Mean values ??(± SD) of ASEX and HDRS scores at the initial, second and final assessment are shown in Table 1. Initial assessment Second assessment Final assessment ASEX 17.8± 5.4 25.6±7.9* 12.9±5.8** HDRS 22.3±4.2 4.2±3.4* 7.3±5.2** Correlation coefficients between ASEX, HDRS and age at the three points of evaluation are presented in Table 2. ASEX 1 Spearman's rho Sig. (2-tailed) ASEX 2 Spearman's rho Sig. (2-tailed) ASEX 3 Spearman's rho Sig. (2-tailed) HDRS 1 0.775 HDRS 2 0.318 0.340 HDRS 3 0,719 Age 0.842 Age 0.554 0.062 Age 0.856 Conclusions Antidepressants (SSRIs) have a negative impact on sexual functioning of male depressed patients. Quality of sexual functioning is negatively associated with age and the severity of depressive symptoms before the administration of antidepressant treatment. Sexual functioning significantly improves after discontinuation of antidepressants; this improvement is even superior to the pre-treatment period of sexual functioning.

521 – Serotoninergic antidepressants and anticoagulants in psychogeriatric wards, mental hospital kromeriz, czech republic - what shall we do to prevent from serious drug interactions?

Introduction Both serotoninergic antidepressants and anticoagulants are widely udes in psychogeriatry. These drugs can develop drug interactions with subsequent risk of bleeding. Objectives, aims To determine risk of potential drug interactions between serotoninergic antidepressants and anticoagulants serotoninergic antidepressants and anticoagulants with subsequent risk of bleeding. Methods Retrospective analysis of medical records and laboratory checks (INR values) in senior patients treated with serotoninergic antidepressants and anticoagulants (Mental hospital Kromeriz, Czech republic, year 2011). Results In 15.5% of patients treated with combination serotoninergic antidepressant / anticoagulant the dosage of anticoagulant had to be decreased due to unwanted elevation of INR value. In 0.6% of patients the risk of bleeding was clinically evident. Conclusion Serotoninergic antidepressants and anticoagulants are common drugs used in treating seniors with mental disorder and potential drug interactions between them should be taken into account.

1008 – Recurrent hyponatremia induced by antidepressants: purposely a case

Introduction Hyponatremia is an antidepressants known adverse effect, ADH secretion has been postulated in its etiology. Objectives To identify risk factors for hyponatremia induced by antidepressants and psychopharmacologic alternatives. Methods Literature search was performed in PubMed. We report of a case of recurrent hyponatremia treated in our center: woman, 57years old, HIV, HCV; performing 4 episodes of severe hyponatremia in 5 months of treatment involving thiazide, venlafaxine, citalopram, olanzapine,haloperidol, enalapril, escitalopram. Results Risk of hyponatremia is higher in patients treated with antidepressants (OR =2.97), especially serotoninergic antidepressants (OR =3.96). Elderly and thiazide increment that risk (OR =6.31 and OR=8.4 respectively), specially age, thiazide and SSRIs (OR =148). Higher prevalence in females, lower limit levels of sodium and low body weight. All SSRIs are likely to produce hyponatremia. The effect appears in the first month, it's not dose-dependent and recovers by interrupting treatment. Some cases have been reported following re-exposure to the same or different antidepressant: fluvoxamine and paroxetine (Arizon, 2002), duloxetine and escitalopram (Stovalle, 2009), sertraline and fluoxetine (Raphael, 2010), sertraline and citalopram (Pure, 2011). Conclusion E arly detection is important, as well as the evaluation of concomitant risk factors in all patients starting antidepressant. Some asymtomatic cases can be unnoticed by clinicians, so risk patients it seems necessary to control ion pretreatment periodically, and to chose safer treatments (bupropion, agomelatine, mirtazapine and reboxetine). In our case, age, sex, concomitant diseases, low sodium and low weight were determinants for the recurrence of the disorder.

Psychotropic drug effects on gene transcriptomics relevant to Parkinson's disease

Psychotropic drugs are widely prescribed in Parkinson's disease (PD) without regard to their pathobiological effects, and these drugs affect the transcription of a large number of genes. Effects of these drugs on PD risk gene transcription were therefore surveyed. Results summarize a comprehensive survey of psychotropic effects on messenger ribonucleic acid (mRNA) expression evident in published data for 70 genes linked to PD risk. Psychotropic drugs can meaningfully affect PD risk gene mRNA transcription, including antipsychotics (upregulate dopamine receptors D2 and D3 (DRD2, DRD3); downregulate low-density lipoprotein receptor-related protein 8 (LRP8), ubiquitin carboxyl-terminal esterase L1 (UCHL1, also known as PARK5)), haloperidol (upregulates DRD3, parkin (PRKN, also known as PARK2), DRD2; downregulates brain-derived neurotrophic factor (BDNF)), risperidone (upregulates monoamine oxidase B (MAOB), DRD2), olanzapine (upregulates transmembrane protein 163 (TMEM163), BDNF, glutathione S-transferase mu 1 (GSTM1), MAOB, DRD2, solute carrier organic anion transporter family, member 3A1 (SLCO3A1)), aripiprazole (upregulates DRD2), quetiapine, paliperidone, lurasidone, carbamazepine, and many antidepressants (upregulate BDNF), lithium and bupropion (downregulate BDNF), amitriptyline (upregulates DRD3, DRD2), imipramine (upregulates BDNF, DRD3, DRD2), desipramine (upregulates BDNF, DRD3), and fluoxetine (upregulates acid beta-glucosidase (GBA), coiled-coil domain containing 62 (CCDC62), BDNF, DRD3, UCHL1, unc-13 homolog B (UNC13B), and perhaps huntingtin interacting protein 1 related (HIP1R); downregulates microtubule-associated protein tau (MAPT), methylcrotonoyl-coenzyme A carboxylase I (MCCC1), GSTM1, 28kDa calbindin 1 (CALB1)). Fluoxetine effects on BDNF and UCHL1 in GEO Profiles were statistically robust. This report provides an initial summary and framework to understand the potential impact of psychotropic drugs on PD-relevant genes. Antipsychotics and serotoninergic antidepressants may potentially attenuate PD risk, and lithium and bupropion may augment risk, through MAPT, GBA, CCDC62, HIP1R, BDNF, and DRD2 transcription, with MAPT, GBA, and CCDC62 being strongly associated with PD risk in recent meta-analyses. Limitations of these findings and a research agenda to better relate them to the nigrostriatum and PD are discussed.