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Article Synopsis
  • Antidepressants, particularly Tricyclics (TCAs) and some new treatments, may increase the risk of cataracts, while others like Tetracyclics (TeCAs) and Monoamine Oxidase Inhibitors (MAOIs) appear to lower that risk.
  • Several types of antidepressants, including SSRIs and SNRIs, have been linked to an increased risk of glaucoma, with risk ratios (RORs) showing significant associations.
  • However, the study is limited by potential duplicate reports in the FDA database, and causality can't be definitively established. Overall, most antidepressants investigated were linked to lower cataract risk, but caution is needed in interpreting these findings
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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.

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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.

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Adequacy of treatment in outpatients with obsessive-compulsive disorder.

Compr 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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