Undesired weight gain is a common complaint of patients receiving pharmacological treatment for m... more Undesired weight gain is a common complaint of patients receiving pharmacological treatment for major affective disorders. It has been found to jeopardize patient compliance and may pose additional health hazards. A review of the literature on weight gain associated with tricyclic antidepressants, monoamine oxidase inhibitors, and lithium was carried out with the aim of deriving practical management strategies. Tricyclic antidepressants were found to stimulate appetite, carbohydrate craving, and a dose-dependent continuous weight gain of 0.57 to 1.37 kg per month of treatment. Proposed mechanisms include noradrenergic or antihistaminic inhibition of satiety and decreased metabolic rate. Novel serotonergic and dopaminergic antidepressants were found to be anorectic. Monoamine oxidase inhibitors may stimulate appetite and potentiate insulin-induced hypoglycemia. Lithium maintenance therapy stimulates weight gains of over 10 kg in 20% of patients. Documented mechanisms include insulin-like actions on carbohydrate and fat metabolism, polydipsia, and sodium retention. Recommendations regarding choice of antidepressant drug as well as dietary and behavioral strategies to prevent excessive weight gain are presented. Potential adjunctive drug approaches to severe weight gain are reviewed.
Child and Adolescent Psychopharmacology News, 2003
... Challenges in Using SSRIs in Young Anxious Children 5 ... Given that at least one third of ch... more ... Challenges in Using SSRIs in Young Anxious Children 5 ... Given that at least one third of children with ADHD have comorbid anxiety disor-ders, venlafaxine has a potential clini-cal role ... Venlafaxine versus stimulant therapy in pa-tients with dual diagnosis ADD and depres-sion ...
Journal of Child and Adolescent Psychopharmacology, 2001
... and Adolescents E. JANE GARLAND, MD and ELIZABETH A. BAERG, MD ... The disinhibition as-socia... more ... and Adolescents E. JANE GARLAND, MD and ELIZABETH A. BAERG, MD ... The disinhibition as-sociated with the amotivational syndrome also appears to be different in quality from the typical behavioral activation seen when SSRIs are initiated in children (Riddle et al. 1991). ...
Human Psychopharmacology-clinical and Experimental, 1991
We and others have previously reported that the non-specific serotonin receptor antagonist methys... more We and others have previously reported that the non-specific serotonin receptor antagonist methysergide inhibits the PRL response to ECT wheras the 5HT-2 antagonists ketanserin and ritanserin have no effect. In the present study the effect of serotonin uptake inhibition on this neuroendocrine response was examined in two separate placebo-controlled experiments. According to our results neither clomipramine (25 mg orally) nor fluoxetine (20 mg orally) affected the PRL response to ECT. An analysis of the placebo day data from 32 subjects indicates that a high PRL response to ECT is associated with female sex and bilateral electrode placement.
In order to further examine the possible role of endogenous opioid peptides and vasopressin in th... more In order to further examine the possible role of endogenous opioid peptides and vasopressin in the phenomenon of dexamethasone nonsuppression, we studied the effect of naloxone, vasopressin, and vasopressin-naloxone combination on cortisol secretion following dexamethasone pretreatment. Nine healthy males were given 1 mg dexamethasone at 23.00 h. The following day starting at 12.30 h and at 90-min intervals they received intravenously naloxone (0.2 mg/kg), arginine vasopressin 3 units, or the two drugs combined. The order of drug administration was counterbalanced using a Latin square design. Blood samples were drawn at 15-min intervals, and plasma aliquots were assayed for cortisol and dexamethasone. Naloxone failed to induce an escape from dexamethasone suppression. Four of the 9 subjects responded with an escape from dexamethasone suppression in response to vasopressin alone. The observed variability in response to vasopressin was unrelated to dexamethasone plasma levels but was associated with a decrease in systolic blood pressure. Peak cortisol levels were lowest in response to naloxone and highest in response to vasopressin. There was no evidence of an increased cortisol response to the coadministration of naloxone with vasopressin compared to vasopressin alone. These results fail to implicate an opioidergic mechanism in the pathophysiology of dexamethasone nonsuppression.
Page 1. CACAP 2008 Position Paper on Using SSRIs in Children and Adolescents Authors: Jane Garlan... more Page 1. CACAP 2008 Position Paper on Using SSRIs in Children and Adolescents Authors: Jane Garland, Adil Virani, Stan Kutcher Introduction ... JAm Acad Child Adolesc Psychiatry 2004;43:93059. 19. Goodyer I, Dubicka B, Wilkinson P, Kelvin R, Roberts C, Byford S, et al. ...
Undesired weight gain is a common complaint of patients receiving pharmacological treatment for m... more Undesired weight gain is a common complaint of patients receiving pharmacological treatment for major affective disorders. It has been found to jeopardize patient compliance and may pose additional health hazards. A review of the literature on weight gain associated with tricyclic antidepressants, monoamine oxidase inhibitors, and lithium was carried out with the aim of deriving practical management strategies. Tricyclic antidepressants were found to stimulate appetite, carbohydrate craving, and a dose-dependent continuous weight gain of 0.57 to 1.37 kg per month of treatment. Proposed mechanisms include noradrenergic or antihistaminic inhibition of satiety and decreased metabolic rate. Novel serotonergic and dopaminergic antidepressants were found to be anorectic. Monoamine oxidase inhibitors may stimulate appetite and potentiate insulin-induced hypoglycemia. Lithium maintenance therapy stimulates weight gains of over 10 kg in 20% of patients. Documented mechanisms include insulin-like actions on carbohydrate and fat metabolism, polydipsia, and sodium retention. Recommendations regarding choice of antidepressant drug as well as dietary and behavioral strategies to prevent excessive weight gain are presented. Potential adjunctive drug approaches to severe weight gain are reviewed.
Child and Adolescent Psychopharmacology News, 2003
... Challenges in Using SSRIs in Young Anxious Children 5 ... Given that at least one third of ch... more ... Challenges in Using SSRIs in Young Anxious Children 5 ... Given that at least one third of children with ADHD have comorbid anxiety disor-ders, venlafaxine has a potential clini-cal role ... Venlafaxine versus stimulant therapy in pa-tients with dual diagnosis ADD and depres-sion ...
Journal of Child and Adolescent Psychopharmacology, 2001
... and Adolescents E. JANE GARLAND, MD and ELIZABETH A. BAERG, MD ... The disinhibition as-socia... more ... and Adolescents E. JANE GARLAND, MD and ELIZABETH A. BAERG, MD ... The disinhibition as-sociated with the amotivational syndrome also appears to be different in quality from the typical behavioral activation seen when SSRIs are initiated in children (Riddle et al. 1991). ...
Human Psychopharmacology-clinical and Experimental, 1991
We and others have previously reported that the non-specific serotonin receptor antagonist methys... more We and others have previously reported that the non-specific serotonin receptor antagonist methysergide inhibits the PRL response to ECT wheras the 5HT-2 antagonists ketanserin and ritanserin have no effect. In the present study the effect of serotonin uptake inhibition on this neuroendocrine response was examined in two separate placebo-controlled experiments. According to our results neither clomipramine (25 mg orally) nor fluoxetine (20 mg orally) affected the PRL response to ECT. An analysis of the placebo day data from 32 subjects indicates that a high PRL response to ECT is associated with female sex and bilateral electrode placement.
In order to further examine the possible role of endogenous opioid peptides and vasopressin in th... more In order to further examine the possible role of endogenous opioid peptides and vasopressin in the phenomenon of dexamethasone nonsuppression, we studied the effect of naloxone, vasopressin, and vasopressin-naloxone combination on cortisol secretion following dexamethasone pretreatment. Nine healthy males were given 1 mg dexamethasone at 23.00 h. The following day starting at 12.30 h and at 90-min intervals they received intravenously naloxone (0.2 mg/kg), arginine vasopressin 3 units, or the two drugs combined. The order of drug administration was counterbalanced using a Latin square design. Blood samples were drawn at 15-min intervals, and plasma aliquots were assayed for cortisol and dexamethasone. Naloxone failed to induce an escape from dexamethasone suppression. Four of the 9 subjects responded with an escape from dexamethasone suppression in response to vasopressin alone. The observed variability in response to vasopressin was unrelated to dexamethasone plasma levels but was associated with a decrease in systolic blood pressure. Peak cortisol levels were lowest in response to naloxone and highest in response to vasopressin. There was no evidence of an increased cortisol response to the coadministration of naloxone with vasopressin compared to vasopressin alone. These results fail to implicate an opioidergic mechanism in the pathophysiology of dexamethasone nonsuppression.
Page 1. CACAP 2008 Position Paper on Using SSRIs in Children and Adolescents Authors: Jane Garlan... more Page 1. CACAP 2008 Position Paper on Using SSRIs in Children and Adolescents Authors: Jane Garland, Adil Virani, Stan Kutcher Introduction ... JAm Acad Child Adolesc Psychiatry 2004;43:93059. 19. Goodyer I, Dubicka B, Wilkinson P, Kelvin R, Roberts C, Byford S, et al. ...
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