Tolerance to desvenlafaxine in rapid metabolizing depressed patients.

The terms 'tolerance' and 'poop out' are commonly applied to describe the progressive loss of effectiveness of a previously effective antidepressant and where the individual may be a rapid metabolizer of those drugs as a consequence of possessing certain polymorphisms of P450 (CYP) liver enzymes, especially CYP2D6 and CYP2C19. As the antidepressant desvenlafaxine is not metabolized by those enzymes, it might be hypothesized that it would be less likely to be associated with tolerance or poop out, even for patients whose genotyping pattern is indicative of rapid metabolizing. In this study, we report on five patients who had a historical pattern suggestive of tolerance to other antidepressant drugs, whose genotyping test indicated that they were CYP2C19 rapid metabolizers, and who experienced 'poop out' again when commenced on desvenlafaxine.

The impact of differing anxiety disorders on outcome following an acute coronary syndrome: time to start worrying?

Background: Both depression and anxiety have been implicated as influencing survival following an acute coronary syndrome (ACS). Studies evaluating the contribution of anxiety have produced varying results, perhaps reflecting the use of dimensional self-report measures of state anxiety and failure to control for co-morbid depression. We sought to assess the impact of anxiety on outcome in ACS patients using DSM-IV diagnoses, in addition to self-report measures, controlling for effects of concurrent depressive diagnosis as well as medical and socio-demographic variables.

From diathesis to dimorphism: the biology of gender differences in depression.

Unipolar depression is more common in women than men. We pursue a unifying explanation for the sex difference in the incidence of depression that emerges at puberty and is unlikely to be fully explained as an artifact or as a result of socialization or contemporary sex roles. Because symptomatic anxiety disorders show a similar female preponderance in women, we consider the biology of anxiety disorders and their links to depression.