Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0344232 (blurred vision)
 2,072 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Symptoms of behavioral activation in children and adolescents have been reported as possible adverse effects of treatment with fluoxetine and sertraline. A 15-year-old with a single major depressive episode, dissociative periods, and anxious hyperventilation attacks was started on sertraline 50 mg (1 mg/kg) daily and, within 4 days, raised to 100 mg daily. All major symptoms resolved by 4 weeks with no apparent side effects or adverse behavioral changes. Ratings of Global Assessment of Functioning and Clinical Global Impression Severity of Illness ratings reflected marked clinical improvement. The adolescent remained euthymic for 6 months but then experienced a return of some depressive symptoms. Within 3 days of raising the dose to 150 mg daily, the patient began to exhibit difficulty in falling asleep, hypermotoric behavior, and hypertalkativeness (in association with tremor and blurred vision). This episode was not of sufficient duration and did not fulfill a sufficient number of DSM-IV criteria to qualify as hypomania. The symptoms of behavioral activation lasted for 3 days and disappeared when sertraline was discontinued, but depressive and hyperventilation symptoms returned quickly. Reinstatement of 100 mg produced enduring recovery without the adverse effects. This case appears to suggest that rapid dose elevation may not be as important as dose quantity in eliciting adverse behavioral effects from sertraline. Judging from the few cases now in the medical literature, it appears that sertraline-induced behavioral activation may emerge at doses that vary considerably among individual youths (25-200 mg daily). In short, this drug-induced behavioral activation appears to be dose-dependent, but dose threshold varies widely among patients.
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PMID:Sertraline-induced behavioral activation during the treatment of an adolescent with major depression. 923 21

The efficacy and tolerability of reboxetine, a unique selective noradrenaline reuptake inhibitor, were compared with those of placebo in a 6-week, randomized, double-blind study of hospitalized patients with a DSM-III-R diagnosis of major depressive disorder. Fifty-two patients (25 in the placebo group, 27 in the reboxetine group) were included in the efficacy analysis. Sixteen (64%) of those in the placebo group and four (15%) in the reboxetine group were withdrawn during the study because of lack of efficacy. Improvement in the mean Hamilton Rating Scale for Depression (HAM-D) total score at last assessment was significantly greater in the reboxetine group than in the placebo group (p < 0.001). Similarly, the response rate to treatment, defined as > or =50% reduction in HAM-D total score, was 74% for patients who received reboxetine compared with 20% for those who received placebo (p < 0.001). A significantly greater response with reboxetine than with placebo was seen as early as day 10 of treatment (p = 0.006). The therapeutic efficacy of reboxetine was substantiated by improvement in mean scores on the Zung Self-Rating Scale and on the Clinical Global Impression Severity of Illness and Global Improvement scales. Reboxetine was well tolerated, and only one patient in each group withdrew because of adverse events. Dry mouth, insomnia, blurred vision, sweating, and constipation were recorded more frequently in the reboxetine group than in the placebo group. There was a tendency toward orthostatic changes in the systolic blood pressure, but this was not clinically significant. This study demonstrated that reboxetine is significantly more effective than placebo in the treatment of hospitalized patients with severe major depressive disorder and is well tolerated.
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PMID:Double-blind, placebo-controlled study with reboxetine in inpatients with severe major depressive disorder. 1065 5