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Drug-Induced Type 1 Brugada Pattern: A Case Report.
Cureus
November 2024
Internal Medicine, University Hospitals Sussex NHS Foundation Trust, St Richard's Hospital, Chichester, GBR.
Article Synopsis
- Brugada syndrome is a genetic heart disorder characterized by abnormal heart rhythms, leading to fainting and potential sudden death, even in otherwise healthy individuals.
- A 33-year-old man was diagnosed with drug-induced type 1 Brugada pattern after experiencing syncopal episodes that mimicked seizures, with no history of heart issues or epilepsy.
- The antidepressant dosulepin was identified as the likely trigger for the condition, and a psychiatry consult was recommended to evaluate medication alternatives.
Mirtazapine: An Antidepressant for Treating Chronic, Refractory Nausea and Vomiting in a Patient With Metastatic Sarcoma Receiving Palliative Care: A Case Report.
Clin Case Rep
November 2024
Cancer Research Center Cancer Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences Tehran Iran.
Managing chronic, refractory nausea and vomiting in advanced cancer patients is challenging, especially when unrelated to cancer treatment. Mirtazapine, a tetracyclic antidepressant, effectively alleviates these symptoms, improving quality of life. It offers a promising palliative care alternative, addressing multiple symptoms and reducing polypharmacy, thereby enhancing patient satisfaction.
View Article and Find Full Text PDFA Proposed Algorithm for the Pharmacological Treatment of Generalized Anxiety Disorder in the Older Patient.
J Geriatr Psychiatry Neurol
October 2024
Psychiatry Department, VA Boston Healthcare System, Brockton, MA, USA.
Article Synopsis
- A new algorithm from Harvard focuses on treating generalized anxiety disorder (GAD) specifically in older adults, reviewing relevant studies to determine medication effectiveness.
- Selective serotonin reuptake inhibitors (SSRIs), especially sertraline and escitalopram, are recommended as the first-line treatments, with alternatives like buspirone suggested for minimizing sexual side effects.
- If initial treatments don’t work, other options include different SSRIs, SNRIs, and medications like pregabalin or gabapentin, while caution is advised with benzodiazepines and hydroxyzine due to potential risks in elderly patients.
Combination of low doses of mirtazapine plus venlafaxine produces antidepressant-like effects in rats, without affecting male or female sexual behavior.
Psychopharmacology (Berl)
January 2025
Departamento de Farmacobiología, Sede sur, Cinvestav, Mexico.
Rationale: Pharmacological treatments for depression are not always effective and produce unwanted side effects. Male and female sexual dysfunction is one of these side effects, which can lead to treatment withdrawal. Combination of two antidepressants with different mechanisms of action, like mirtazapine (MTZ) and venlafaxine (VLF) have been shown to be effective for treatment-resistant depression in humans.
View Article and Find Full Text PDFDutch Pharmacogenetics Working Group (DPWG) guideline for the gene-drug interaction between CYP2D6, CYP2C19 and non-SSRI/non-TCA antidepressants.
Eur J Hum Genet
November 2024
Department of Psychiatry, Parnassia Group, Amsterdam, Netherlands.
The Dutch Pharmacogenetics Working Group (DPWG) aims to facilitate pharmacogenetics implementation in clinical practice by developing evidence-based guidelines to optimize pharmacotherapy based on pharmacogenetic test results. The current guideline describes the gene-drug interaction between CYP2D6 and venlafaxine, mirtazapine and duloxetine. In addition, the interaction between CYP2C19 and mirtazapine and moclobemide is presented.
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