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CNS Spectr
January 2025
Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
Nervenarzt
December 2024
Klinik für Psychiatrie und Psychotherapie, Universität zu Köln, Köln, Deutschland.
Background: Antidepressant pharmacotherapy often does not result in the desired effect despite adequate duration and dose. Better evidence on second-step strategies is needed.
Objective: Overview of the current evidence for various pharmacological second-step strategies after nonresponse to antidepressant monotherapy.
Neuropsychopharmacology
December 2024
Department of Physiology and Biophysics, University of Illinois at Chicago, Chicago, IL, 60612, USA.
EClinicalMedicine
November 2024
Department of Pharmacology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Background: In an influential network meta-analysis, the tricyclic antidepressant (TCA) amitriptyline was found to be the most efficacious of 21 antidepressants, hence outranking selective serotonin reuptake inhibitors (SSRIs) and serotonin and noradrenaline reuptake inhibitors (SNRIs). The alpha/5HT///H antagonist mirtazapine was ranked as the second most effective and appeared at least as effective as the SSRIs and SNRIs that followed next. Since the most common effect parameter in depression trials-the sum score of the Hamilton Depression Rating Scale (HDRS-17-sum)-includes three items measuring sleep and two measuring appetite and weight, this outcome could be the result of amitriptyline and mirtazapine being more sedative and orexigenic.
View Article and Find Full Text PDFCompr Psychiatry
January 2025
Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands; Amsterdam Neuroscience Research Institute, Amsterdam, The Netherlands; Arkin Institute for Mental Health, Amsterdam, The Netherlands.
Objective: To examine whether patients with obsessive-compulsive disorder (OCD) are adequately treated with pharmacotherapy before referral to a specialized center for OCD.
Methods: We performed a retrospective chart review of patients with OCD who were seen for intake at an academic outpatient center in The Netherlands between 2016 and 2023. We collected data on age, gender, illness severity using the Yale-Brown Obsessive-Compulsive Scale, duration of illness, comorbidity and past pharmacotherapy and psychotherapy.
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