Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sertraline is a highly specific, potent inhibitor of serotonin reuptake. It exerts no clinically significant effects on norepinephrine and dopamine uptake and possess negligible binding affinity for histaminergic, muscarinic, dopaminergic, and adrenergic receptors. Its pharmacologic profile permits once-daily dosing while allowing plasma drug levels to equilibrate within 1 week. In multicenter, double-blind trials, sertraline proved superior to placebo and comparable to amitriptyline in ameliorating acute depression. Moreover, the drug has been shown to be effective in preventing relapses of the index episode and recurrence of further episodes over the long term. Sertraline has not been associated with sedating or anticholinergic effects, psychomotor impairment, or cardiovascular toxicity. Its principal side effects are generally transient and include mild-to-moderate nausea or diarrhea and sexual dysfunction (ejaculatory delay) in males. The safety margin of sertraline is wider than that of the tricyclic antidepressants. This serotonin reuptake inhibitor shows promise as an important therapeutic and prophylactic alternative in the pharmacologic management of depression.
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PMID:The role of sertraline in the management of depression. 785 36

This paper reports the results of two studies of depressed patients, evaluating the efficacy and toleration of the selective serotonin reuptake inhibitor (SSRI) sertraline in a general practice setting in the UK. In the first of these studies, 308 patients, with a DSM-III-R diagnosis of major depressive episode, were treated for 6 weeks with either sertraline 50-100 mg/day or the tricyclic antidepressant dothiepin 75-150 mg/day, or placebo. Seventy-six per cent of sertraline-treated patients were maintained on the lower dose (50 mg/day), whereas 81% of dothiepin-treated patients required the higher dose (150 mg/day). Sertraline-treated patients demonstrated a significant improvement in the Montgomery-Asberg Depression Rating Scale (MADRS) and the Clinical Global Impression (CGI) severity scores compared with placebo-treated patients, while dothiepin-treated patients did not show significant improvement compared with placebo. The active drugs were well tolerated, and there were no significant differences in adverse events between the groups. The second study, "Sertraline in General Practice, A Multicenter Assessment", or SIGMA, was a large, multicentre trial with a cohort of 3396 patients recruited to receive 6 weeks of treatment. Patients started on sertraline 50 mg/day, and for 59% of patients this was the final dose; less than 10% of patients reached final doses of more than 100 mg/day. A 50% or greater reduction in MADRS scores was seen in 69% of patients across a wide range of severity of symptoms at baseline, and 87% of patients demonstrated excellent or good toleration of the drug.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Management of depression in real-life settings: knowledge gained from large-scale clinical trials. 796 47

The socioeconomic impact of major depression is considerable, due to poor patient functioning and increased social impairment, bed disability days, and use of health care resources. Major depression and the side effects of antidepressants medication also adversely affect patients' quality of life (QOL). However, few clinical trials of major depression examine QOL as a measure of treatment outcome. A comprehensive, quantitative QOL instrument for depression was recently tested and validated as conforming to accepted psychometric standards. The sertraline quality of life battery (SQOLB) consists of nine domains measuring health perceptions: energy/vitality, cognitive function, social interaction, alertness behavior, work behavior, home management, life satisfaction, and bed disability days. The SQOLB has been used in two open-label trials of sertraline. In the first study, the SQOLB was administered to 400 patients with major depression at baseline and final visit in a 6 week, open-label, general practice study. At endpoint, mean Montgomery-Asberg Depression Rating Scale (MADRS) and Clinical Global Impression (CGI) scores were significantly improved. The QOL battery also showed significant (p < 0.001) positive changes from baseline to final visit in all nine domains measured. In the second study, the SQOLB was used as part of an 8 week, open-label trial of sertraline in 308 UK hospital outpatients being treated for depression by psychiatrists. Sertraline was effective in managing the depression and caused statistically significant improvements (p < 0.001) in all QOL domains measured. The QOL scales give a better indication of the effect of pervasive depressive symptoms on a patient's life than rating scales of depressive symptomatology.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Quality of life: experience with sertraline. 796 48

Depression is a widespread and serious disorder inflicting an immeasurable toll on the lives of millions of people and affecting their families and colleagues. It is the cause of countless suicides especially in those whose illness has not been detected or given appropriate care. Until recently, effective pharmacotherapeutic management of depression was hampered by the troublesome side effects associated with traditional methods of treatment. In an attempt to circumvent these adverse effects, many antidepressants were prescribed at less than therapeutic doses, resulting in a high probability of inadequate treatment, relapse, or recurrence. The development of the selective serotonin reuptake inhibitors (SSRIs) was guided by the need for an antidepressant that provided both safe and effective therapeutic benefit. Sertraline's potent and highly selective inhibition of serotonin accounts both for its efficacy in a broad spectrum of depression and for its high tolerability and ease of use. Its safety and tolerability have been demonstrated in acute and maintenance phases of treatment and establishes that sertraline provides a viable clinical alternative for acute and long-term care of depressed patients.
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PMID:Striking a balance between safety and efficacy: experience with the SSRI sertraline. 796 50

Sertraline is a potent inhibitor of serotonin reuptake in the central nervous system and is used clinically to treat depression and obsessive-compulsive behavior. Over the course of one year, there were seven cases investigated by the Office of the Chief Medical Examiner, State of Maryland, in which sertraline was identified in postmortem specimens. Heart blood concentrations in the seven cases ranged from 0.23 to 0.46 mg/L; desmethylsertraline concentrations ranged from 0.08 to 0.99 mg/L. One similarity with tricyclic antidepressants is the high liver concentrations of drug and metabolite relative to the blood. One unusual finding is the small concentrations of drug and metabolite in the urine relative to other specimens. In none of these cases was the cause of death related to sertraline intoxication.
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PMID:Distribution of sertraline in postmortem cases. 799 Apr 46

The antidepressants clomipramine hydrochloride (Anafranil), fluoxetine hydrochloride (Prozac), and sertraline hydrochloride (Zoloft) are the main choices for pharmacologic treatment of obsessive-compulsive disorder. Often, drug doses for obsessive-compulsive disorder are higher than for depression, and improvement occurs more slowly and is often only partial. Behavior therapy involving exposure to feared objects or situations and prevention of ritualistic behavior complements pharmacologic treatment. Referral to a behavioral therapist may be necessary to achieve recovery.
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PMID:Obsessive-compulsive disorder. How to free patients from intrusive thoughts and rituals. 799 73

An eight-week double-blind, multicentre study was performed to evaluate the efficacy and safety of sertraline vs. fluoxetine in the treatment of major depression (DSM-III-R). There were 108 out-patients, from nine Italian centres, entered into the study, of whom 88 were evaluable (48 sertraline, 40 fluoxetine). The final mean daily dose of sertraline was 72 mg and for fluoxetine it was 28 mg. Both treatment groups showed a statistically significant improvement from baseline at one week, and this was maintained until the end of treatment for all of the following measures: Hamilton Rating Scales for Depression and Anxiety, the Montgomery Asberg Depression Rating Scale, Clinical Global Impressions Scale, Zung Self-Rating Scale for Anxiety and the Leeds Sleep Evaluation Questionnaire. Although there was a numerical advantage for sertraline on several efficacy measures, there was no statistically significant difference found between the treatment groups. The incidence of adverse events was similar for both treatments; 40.4% for sertraline and 39.3% for fluoxetine. However, adverse events were generally rated by patients as of lower severity in the sertraline group. In addition, for the fluoxetine group, there was a higher incidence of agitation, anxiety and insomnia than for sertraline. Sertraline was considered to be better tolerated than fluoxetine overall, since only 9.6% of sertraline-treated patients discontinued treatment due to therapy failure whereas in the fluoxetine-treated group this figure was 19.6%. By contrast, 13.5% of sertraline-treated patients discontinued prematurely because of clinical improvement, compared with 10.7% of fluoxetine-treated patients.
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PMID:Double-blind study of the efficacy and safety of sertraline versus fluoxetine in major depression. 826 18

Sertraline is a serotonin reuptake inhibitor that has been approved for use in the treatment of depression. Its side-effect profile is similar to that of fluoxetine, a drug of the same class. The side effects of these drugs most often affect the gastrointestinal tract. Serotonin reuptake inhibitors are nonsedating and free of cardiac effects; they do not cause hypotension, urinary retention or blurred vision. Sertraline, like fluoxetine, appears to be safer than tricyclic antidepressants in overdose. However, no clinical studies comparing sertraline and fluoxetine have been published. The wholesale cost of a month's supply of sertraline is about $50, compared with about $5 for a generic tricyclic antidepressant. Despite their cost, serotonin uptake inhibitors may be the initial drugs of choice in depressed elderly patients, because these patients are at increased risk for suicide and have a low tolerance for the side effects of tricyclic antidepressants.
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PMID:Sertraline: a new antidepressant. 815 1

The dose regimen for sertraline in the treatment of depression has been well established. The starting dose, 50 mg/day, is the usually effective therapeutic dose, and the optimal dose when considering both efficacy and tolerability for most patients. For patients who do not show an adequate therapeutic response within 24 weeks, the dose of sertraline can be increased in 50 mg/day increments at no less than weekly intervals to a maximum of 200 mg/day. Sertraline is generally given as a single daily dose and may be administered at any time of the day. In contrast to other selective serotonin reuptake inhibitors, there is no need for altered dose recommendations in the elderly.
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PMID:Sertraline 50 mg daily: the optimal dose in the treatment of depression. 867 65

The present study was designed to compare direct health service expenditures, for the treatment of depression, among patients enrolled in a health maintenance organization, and prescribed one of three selective serotonin reuptake inhibitors, fluoxetine, paroxetine or sertraline. Information regarding depression-related health service use was derived from the computer archive of a network-model health maintenance organization system serving 700,000 beneficiaries. A total of 744 health maintenance organization beneficiaries were found to satisfy the study selection criteria. Multivariate regression analysis was used to determine the incremental influence of selected demographic, clinical, financial and provider characteristics on health service expenditures related to the treatment of depression (ICD-9-CM, or DSM-IV code 296.2) 1 year after the start of antidepressant pharmacotherapy. Multivariate findings indicate that treatment with paroxetine increases average expenditures for physician visits ($31.93; P < or = 0.05), psychiatric visits ($19.33; NS), laboratory tests ($2.35; P < or = 0.05), hospitalizations ($85.33; P < or = 0.05), psychiatric hospitalizations ($82.01; P < or = 0.05), and antidepressant pharmacotherapy ($63.72; P < or = 0.05), for a total per capita increase in health service use of $284.68 (P < or = 0.05), compared with treatment with fluoxetine. Sertraline treatment increases average expenditures for physician visits ($21.74; P < or = 0.05), psychiatric visits ($56.79; P < or = 0.05), laboratory tests ($1.21; P < or = 0.05), hospitalizations ($70.59; P < or = 0.05), psychiatric hospitalizations ($95.75; P < or = 0.05), and antidepressant pharmacotherapy ($69.85; P < or = 0.05), for a total per capita increase in health service use of $315.96 (P < or = 0.05), compared with treatment with fluoxetine. Economic comparisons between paroxetine and sertraline did not demonstrate any significant differences in expenditures for the health services examined.
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PMID:Antidepressant pharmacotherapy: economic evaluation of fluoxetine, paroxetine and sertraline in a health maintenance organization. 902 73


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