Paroxetine/sertraline

The efficacy of paroxetine, sertraline, and escitalopram was established in large controlled trials.58-60 SSRIs improve social anxiety and phobic avoidance and reduce overall disability. 

Maprotiline, Moclobemide, Mianserin, Fluoxetine (Prozac), Paroxetine, Sertraline, Fluvoxamine, Citalopram, Venlafaxin (generic IR formulation and the brand Venlafaxine XR), Mirtazapine, Flupentixol-melitracen (Deanxit), Tianeptine, Extract of St. John s Wort, Buspirone Depression and anxiety... 

Social anxiety disorder Escitalopram Fluvoxamine Paroxetine Sertraline Venlafaxine XR Citalopram Clonazepam Buspirone Gabapentin Miitazapine Phenelzine Pregabalin... 

Response rates of SSRIs in SAD ranged from 50% to 80% after 8 to 12 weeks of treatment. Paroxetine, sertraline, and venlafaxine extended release are approved for treatment of generalized SAD and are first-line agents. 

SSRls Citalopram Escitalopram Flnoxetine Flnvoxamine Paroxetine Sertraline... 

Serotonin-Boosting Antidepressants. The SSRIs have also been studied in the treatment of generalized social anxiety disorder, and paroxetine, sertraline, and venlafaxine are effective. Preliminary data suggests that the serotonin-boosting atypical antidepressants (mirtazapine and nefazodone) may also be helpful. Like the MAOIs, they appear to be effective at doses comparable to those used to treat depression. They may help avoidant patients to gradually increase their social interaction and become more assertive. 

Antidepressants tricyclics, fluoxetine, paroxetine, sertraline, mirtazepine, venlafaxine, mianserin Antipsychotics phenothiazines, haloperidol, clozapine, olanzapine, quetiapine... 

Many currently used antidepressants are chiral drugs (for example, tricyclic antidepressants, mianserin, mirtazepine, venlafaxine, reboxetine, fluoxetine, paroxetine, sertraline, citalopram), some of which are administered as racemates (such as the tricyclics, mianserin, mirtazepine, fluoxetine, reboxetine, venlafaxine, citalopram) while others are given as single isomers (paroxetine and sertraline). 

Serotonin-specific inhibitors (SSRI) include fluoxetine, paroxetine, sertraline, citalopram and others. They are not more effective than the tricyclic antidepressants but may suit some patients better and are generally safer in overdose (see Geddes et al., 1999). While the SSRIs are devoid of the cardiac effects (membrane stabilisation, inhibition of conduction) of the tricyclics in overdose, they increase the risk of hemorrhage into the gut or brain. 

SSRIs and similar drugs (e.g., citalopram, fluoxetine, fluvoxam-ine, paroxetine, sertraline) Stimulation of 5-HT receptors Increased serotonergic effects and increased likelihood of adverse reactions (e.g., serotonergic syndrome) Avoid concurrent use... 

Selective serotonin reuptake inhibitors. Currently available selective serotonin reuptake inhibitors (SSRIs) include fluoxetine, paroxetine, sertraline, fluvoxamine, and citalopram. At present, expert opinion does not support the usefulness of these serotonergic compounds in the treatment of core ADHD symptoms (National Institute of Mental Health, 1996). Nevertheless, because of the high rates of comorbidity in ADHD, these compounds are frequently combined with effective anti-ADHD agents (see Combined Pharmacotherapy, below). Since many psychotropics are metabolized by the cytochrome P450 system (Nemeroff et ah, 1996), which in turn can be inhibited by the SSRIs, caution should be exercised when combining agents, such as the TCAs, with SSRIs. 

In children and adolescents, the half-times for antidepressants such as paroxetine, sertraline, and citalopram are between 14 and 16 hours (Clein and Riddle, 1995 Findling et ah, 1999 (Axelson et ak, 2000 a,b). This suggests that these medications, particular when prescribed at lower doses, need to be administered twice a day. Otherwise, children and adolescents can expe-... 

FIGURE 39.2 Treatment algorithm for pediatric obsessive-compulsive disorder (OCD). In adjusting cognitive behavior therapy (CBT), increase frequency or intensity, or alter the setting or format, e.g., have it be home based or day treatment. CMI, clomipramine DMI, desipramine NT, nortriptyline SSRI, selective serotonin reuptake inhibitor (fluoxetine, fluvoxamine, paroxetine, sertraline, citalopram). 

In most cases, SSRIs are the first choice for drugs to combat OCD. Clomipramine, fluvoxamine, fluoxetine, paroxetine, sertraline, and citalopram are all SSRIs that have been proven effective in reducing OCD symptoms. However, in about 40 to 60% of patients, these drugs do not completely alleviate all the symptoms. When this is the case, a second type of drug called a neuroleptic is often added. Neuroleptic drugs, such as haloperidol, clozapine, risperidone, and chlorpromazine... 

Venlafaxine, paroxetine, sertraline, imipramine, and trazodone have all proven effective in relieving symptoms of GAD. Venlafaxine, a combined serotonin and norepinephrine reuptake blocker, may be an exceptionally good choice for people who have other psychiatric illnesses in addition to GAD, or when it is not clear whether the patient has GAD or a depressive illness, or both. Although, to date, only certain SSRIs have been... 

P450 IID6 -fin women Inhibited by OCs Hydroxylation of nortriptyline and desipramine, haloperidol, clozapine, risperidone, venlafaxine Fluoxetine, fluvoxamine, paroxetine, sertraline... 

Although the efficacy of tricyclic antidepressants in the treatment of unipolar depression is beyond reproach, the side-effect profile of these agents makes them less desirable as first-line therapeutic agents. Introduction of selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, paroxetine, sertraline, citalopram and fluvoxamine in the past decade has revolutionized the treatment of depression universally. The side-effect profile of SSRIs, such as nausea, diarrhea and sexual dysfunction, is considerably more benign than that of tricyclic drugs. Multiple controlled trials have proven the efficacy of SSRIs vs. placebo (Nemeroff, 1994). Recently, a number of SNRIs (serotonin and noradrenaline reuptake inhibitors) and so-called atypical antidepressants have been marketed that may have additional advantages over SSRIs, such as more rapid onset of action (venlafaxine. mirtazapine) and low sexual side-effect potential ( bupropion, nefazodone). Additionally, it appears that venlafaxine may be more efficacious in cases of treatment-refractory depression (Clerc et al., 1994 Fatemi et al., 1999). Finally, in a recent report (Thase et al., 2001),... 

A larger set of placebo-controlled studies show conclusively that imipramine is also effective for the treatment of panic disorders. Other agents shown to be effective in panic disorders include the SSRIs paroxetine, sertraline, fluvoxamine, fluoxetine and citalopram. Generally, initial treatment of moderate to severe panic disorders may require the initiation of a short course of benzodiazepines e.g. clonazepam (0.5 1 mg twice daily), and an SSRI. The patient will obtain immediate relief from panic attacks with the benzodiazepine whereas the SSRI may take 1 6 weeks to become effective. Once a patient is relieved of initial panic attacks, clonazepam should be tapered and discontinued over several weeks and SSRI therapy continued thereafter. There are no pharmacological treatments available for specific phobias, however controlled trials have shown efficacy for several agents, e.g. phenelzine, moclobemide. clonazepam, alprazolam, fluvoxamine. sertraline and paroxetine in the treatment of social phobia (Roy-Byrne and Cowlev, 2002). 

Moderate to low tertiary TCAs fluoxetine paroxetine sertraline fluoxetine secondary TCAs sertraline TCAs paroxetine... 

Cyt 2D6 metabolizes haloperidol, risperidone, thioridazine, sertindole, olanzapine and clozapine common substrates - fluoxetine, paroxetine, sertraline, venlafaxine, amitriptyline, clomipramine, desipramine, imipramine, nortriptyline, propranolol, metoprolol, timolol, codeine, encainide, flecanide. Common inhibitors - paroxetine, sertraline, fluoxetine. 

Imipramine, desipramine, amitriptyline, nortriptyline, trimipramine, clomipramine, lofepramine, amoxapine, dosulepin, maprotiline, mianserin, setiptiline, trazodone, fluvoxamine, paroxetine, milnacipram, sulpiride, tandspirone, methylpheni-date, melitracen Amitriptyline, imipramine, trimipramine, clomipramine, citalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, venlafaxine, reboxetine, viloxazine, doxepin, maprotiline, mianserine, mirtazapine, moclobemide, trazodone, opipramol (and some metabolites)... 

Castaing et al., 2007 [109] Fluoxetine, paroxetine, sertraline, fluvoxamine, citalopram, milnacipram, venlafaxine, mirtazapine (and some metabolites) M ethy lr isp eri do ne... 

Eap CB, Bouchoux G, Amey M et al (1998) Simultaneous determination of human plasma levels of citalopram, paroxetine, sertraline, and their metabolites by gas chromatography-mass spectrometry. J Chromatogr Sci 36 365-371... 

Fluoxetine Fluvoxamine Nefazodone Paroxetine Sertraline - Trazodone Venlafaxine... 

However, the agency s conclusions were based on a limited number of new antidepressants, including bupropion, citalopram, fluoxetine, flu-voxamine, mirtazapine, nefazodone, paroxetine, sertraline, escitalopram, and venlafaxine, according to an FDA Talk Paper (2004a). These were the drugs most often cited by the public at the two FDA hearings. 

Grimsley, S., 8c Jann, M. (1992). Paroxetine, sertraline, and fluvoxamine New selective serotonin reuptake inhibitors. Clinical Pharmacy, 11, 930—957. 

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