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Introducción: La fluoxetina es un fármaco utilizado para la depresión especialmente en deportistas ya que parece no alterar el rendimiento deportivo. Algunos atletas combinan este fármaco con cafeína, sin embargo, el efecto combinado de ambas drogas se desconoce. Este estudio tuvo por objetivo explorar el efecto combinado de fluoxetina y cafeína sobre el rendimiento de fuerza, potencia y resistencia muscular. Metodología: En este estudio de caso, una mujer entrenada en fuerza realizó cuatro condiciones experimentales: a) placebo (PLA); b) placebo y fluoxetina (PLA+FLU); c) cafeina (CAF); d) cafeína y fluoxetina (CAF+FLU). La participante ingirió 20 mg/día de fluoxetina y 3 g/kg de masa corporal de cafeína o placebo (maltodextrina), 60 minutos antes de realizar los test. La participante realizó un test de fuerza y potencia muscular al 25%, 50%, 75% y 90% de 1-repetición-máxima (1RM), seguido de un test de resistencia muscular al 65% y 85% de 1RM, en ambos casos para los ejercicios de press de banca y sentadilla. Resultados: CAF+FLU redujo la velocidad y potencia media en press de banca y sentadilla al 75% y 90% de 1RM en el test de fuerza y potencia muscular, y al 85% en el test de resistencia muscular. Mientras que la administración de PLA+FLU y CAF+FLU redujo el pico de velocidad y potencia al 25% de 1RM en fuerza y potencia muscular y al 65% de 1RM en resistencia muscular. Conclusiones: La fluoxetina contrarresta el efecto ergogénico de la cafeína sobre la fuerza, potencia y resistencia muscular. Por tanto, aunque más estudios son necesarios, los atletas diagnosticados con depresión bajo tratamiento de fluoxetina debería reconsiderar el uso de cafeína como suplemento nutricional para mejorar el rendimiento.

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To report a unique case of a patient who developed simultaneous bilateral maculopathy presumed from intake of fluoxetine. The optic coherence tomography (OCT) macular showed a subfoveal disruption in the outer retinal layer in both eyes (OU), higher in the left one (OS). Although reported cases of serotonin recapture inhibitors (SSRIs) Maculopathy so far have been caused by sertraline, fluoxetine shares the biological mechanism, and OCT findings and ocular symptoms are the same as published. We should be aware with ocular symptoms in patients that take fluoxetine., (Copyright © 2024 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.)

The main objective of this paper is to establish the potency range and the action mechanism of selective serotonin reuptake inhibition (SSRI) fluoxetine on female CD-1 mice (25-39 kg). Our results indicated that fluoxetine's antidepressant doses of 16 mg/kg (i.p.), 32 mg/kg (i.p.), and 64 mg/kg (i.p.) had an analgesic and anxiolytic effect without significant results on the spatial memory test. Reduced activity on memory work on specific activities was only observed with a dose of 64 mg/kg (i.p.). This is evidence to suggest that fluoxetine can be more effective with doses that showed an antidepressant effect. It also indicates that fluoxetine can have an analgesic and anxiolytic effect without reducing motor activity on mice. The maximum dose tested on this study showed variations on motor activity of mice suggesting that SSRI fluoxetine can have sedative effects. [ABSTRACT FROM AUTHOR]

Introduction. currently the treatment of mental illness by antidepressants is very frequent. Selective serotonin reuptake inhibitors are the most prescribed antidepressants worldwide and have been associated with alterations in accommodation or pupil. The objective of this study is to evaluate the effects of fluoxetine on the pupillary reflex and the accommodation in young population. Methodology. The study group included seven patients diagnosed with depression and treated with fluoxetine; 22 subjects were included as a control group. The pupillary reflexes and the accommodative state were evaluated using the Power Refractor II pupilometer. Five phases of 3 seconds each were measured. In phase 2 there was a glare with a white light. Results. For the pupil diameter, maximum and minimum values were obtained in the group of patients treated with fluoxetine than in the control in all the measurement phases. For the control group, a maximum pupillary contraction is observed in the glare phase, however, in the study group it is observed in the phase after glare. As for the accommodation, there are no significant differences between the two groups. Conclusions. In patients treated with fluoxetine there are pupillary alterations like a bigger pupillary diameters and slower pupillary contraction. The lack of conclusive results in terms of accommodation does not mean that there are no changes related to it, whose detection requires future studies with different methodologies and with a larger sample size. [ABSTRACT FROM AUTHOR]

Neste trabalho, foram avaliadas 14 amostras de fluoxetina comercializadas por 13 estabelecimentos diferentes da rede de farmácias magistrais em Belo Horizonte/MG. A amostragem obtida representa 47,0% do total de 30 unidades de preparação distintas na cidade e corresponde a cerca de 180 pontos de venda. Foram realizadas análises de determinação de peso, identificação, teor de princípio ativo e uniformidade de doses unitárias. As análises foram realizadas pela Fundação Estadual Ezequiel Dias (Funed/MG) com base nas metodologias descritas nas farmacopeias de referência. Foram observadas irregularidades em algumas amostras como na rotulagem e ensaio de teor. Foi também investigada a presença e concentração de metais e outras impurezas inorgânicas através da técnica de análise por ativação neutrônica (AAN). Os resultados mostraram também a presença de elementos como As, Br, Co, Cr e Hf que, mesmo em baixas concentrações, podem ser prejudiciais à saúde humana se consumidos de forma constante durante longo prazo. ==================================== In this study, fourteen samples of fluoxetine being commercialized by thirteen different establishments of the network of magistral pharmacies in the City of Belo Horizonte/MG were assessed. The sampling corresponds to 47,0% of the total 30 different units of preparation of the city, which corresponds to about 180 points of sale. Analyses for determining weight, identification, active ingredient content and uniformity of dosage units were performed by the State Foundation Ezequiel Dias (FUNED /MG) based on methodologies described by reference pharmacopoeias. Irregularities, on the labeling and the content testing, were observed in some samples. It was also investigated, through the technique of neutron activation analysis (NAA), the presence and concentrations of metals and other inorganic impurities. The results showed the presence of elements such as As, Br, Cr Co, Cr, Hf and others, that even at low concentrations, may be harmful to human health if consumed steadily for a long term.

The degradation of fluoxetine was studied by means of three advanced oxidation photochemical processes: photo Fenton (FFS), photo electro Fenton (FEFS) and photocatalysis with TiO2 (FCS), mediated by solar radiation. Experiments were run with 100 mL solutions in a reaction vessel and in the case of FEFS, the reactor was equipped with an IrO2 / RuO2 anode and an air diffusion graphite cathode for continuous peroxide production. In all cases, degradation, the mineralization of fluoxetine and toxicity were monitored. The FFS process showed the highest speed of degradation and mineralization, as well as the greater efficiencies in the degradation and mineralization. The pH in the FFS process defined the scope of the mineralization, evidencing that acidic pH achieves greater mineralization by avoiding the formation of complexes and hydroxides typical of a higher pH. The FCS process presents high efficiency, but slow kinetics. Beer yeast toxicity decreases as degradation byproducts are generated in all evaluated processes. [ABSTRACT FROM AUTHOR]

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El estudio tuvo como propósito determinar la estabilidad acelerada de cápsulas de fluoxetina 20 mg, evaluado a través del control físico y químico, basado en la directiva de estabilidades, bajo las condiciones de temperatura asignadas para la zona climática IVa. La estabilidad acelerada se realizó por 6 meses a una temperatura y humedad relativa de 40°C ± 2°C y no más de 25% respectivamente. Las características físicas y químicas y del producto se realizaron según la técnica interna del laboratorio fabricante, basada en la Farmacopea de los Estados Unidos de América, versión 38 (USP-38); tomando como puntos de análisis las características físicas de aspecto, peso promedio, uniformidad de unidades de dosificación y análisis de disolución; y como características químicas la determinación de contenido y el análisis de pureza cromatográfica. Los resultados obtenidos en este estudio demuestran que las cápsulas de fluoxetina 20 mg son conformes respecto a los parámetros físicos y químicos.

Trabalhos de diferentes autores constataram que, um aumento na concentração de serotonina (5-HT) no cérebro, durante exercício físico intenso e prolongado, está diretamente relacionado a um prejuízo na função do Sistema Nervoso Central (SNC), com correspondente desenvolvimento da fadiga e consequente diminuição do desempenho. No presente trabalho, 10 ratos Wistar foram submetidos a sessões de corrida até o esgotamento físico em esteira rolante. Os protocolos experimentais foram divididos em quatro fases: Fase 1 - avaliação do tempo médio de corrida dos animais até o esgotamento físico; Fase 2 - avaliação do tempo médio de corrida dos animais até o esgotamento físico, sob tratamento com fluoxetina; Fase 3 - "washout" de sete dias; Fase 4 - "washout" de 14 dias. Este estudo sugere que a administração crônica de fluoxetina aumenta substancialmente o tempo médio de corrida até o esgotamento físico em ratos submetidos a exercício em esteira rolante.Las obras de diferentes autores encontraron que un aumento en la concentración de la serotonina (5-HT) en el cerebro durante el ejercicio intenso y prolongado está directamente relacionado con deterioro de la función del Sistema Nervioso Central (SNC), con el correspondiente desarrollo de la fatiga y su consecuente reducción en el rendimiento. En este estudio, 10 ratas Wistar fueron sometidas a la ejecución de sesiones en una cinta hasta el agotamiento físico. Los protocolos experimentales fueron divididos en cuatro fases: Fase 1 - Evaluación de la carrera media de los animales al agotamiento físico, la Fase 2 - Evaluación de la carrera media de los animales al agotamiento físico, están en tratamiento con fluoxetina, la Fase 3 - "lavado "de siete días; Fase 4 -" lavado "de 14 días. Este estudio sugiere que la administración crónica de fluoxetina incrementa sustancialmente la tarifa media del agotamiento físico en ratas sometidas a ejercicio en una caminadora.Works of different authors have been shown that an increase in the concentration of serotonin (5-HT) in the brain during intense and long-term physical exercise, is directly associated with a harm in the function of the Central Nervous System (CNS), with corresponding development of the fatigue and consequence decrease of the performance. In the present work, 10 rats Wistar were submitted to run-sessions until the exhaustion in treadmill. The experimental protocols were splited in 4 phases: Phase 1: evaluation of the range run-time of the animals until the physical exhaustion. Phase 2: evaluation of the range run-time of the animals until the physical exhaustion on treatment with fluoxetine. Phase 3: washout seven days. Phase 4 washout 14 days. The present study suggest that chronic administration of fluoxetine increase substantially the run-time until the physical exhaustion in rats submitted to exercises in treadmill.

OBJECTIVE: To evaluate morphological alterations in rat fetuses treated with fluoxetine and imipramine during the "critical" period of gestation. METHOD: Fifteen female rats were separated into three groups (n = 5) and treated with 10 mg/kg/day of test substances on the ninth, tenth and eleventh day of pregnancy: G1, fluoxetine; G2, imipramine hydrochloride; G3 (control), saline. On day 21, cesarean sections were performed to release the fetuses, whose bodies were weighed and macroscopically analyzed. The placenta was also weighed. The fetuses were then fixed and their encephala removed and weighed. Sections of the frontal lobe were taken for histological neuron counting. RESULTS: G1 and G2 showed the highest fetal body weight. Placental weight showed statistical differences (p < 0.01): G1 weighed more than G2 and G3. Otherwise, G2 exhibited the highest encephalon weight, statistically differing from G3 (control) and fluoxetine-treated G1 (p < 0.01). However, G1 did not statistically (p > 0.01) differ from the control group. G3 showed the highest number of neurons per area when compared to G1 and G2 (p < 0.01). CONCLUSION: The use of antidepressants in rats caused an increase in fetal weight and a decrease in the number of fetal frontal lobe neurons, thus suggesting that the use of antidepressants by pregnant women can induce depression in fetuses due to alterations in their neural development.OBJETIVO: Avaliar as possíveis alterações ocorridas em nível macroscópico e microscópico de fetos de ratas submetidas ao tratamento com fluoxetina e imipramina durante o período "crítico" da gestação. MÉTODO: Quinze ratas, posteriormente ao acasalamento, foram divididas em três grupos experimentais (n = 5): G1, tratadas com 10mg/kg/dia de fluoxetina; G2, tratadas com 10mg/kg/dia de cloridrato de imipramina, e G3 (controle), tratadas com 10mg/kg/dia de solução fisiológica a 0,9%, no 9º, 10º e 11º dias de prenhez das ratas. Posteriormente à cesária, no 21º dia de prenhez, analisou-se macroscopicamente o peso fetal e placentário. Os fetos foram fixados e houve a remoção do encéfalo para pesagem e preparação das lâminas do tecido neuronal para contagem de neurônios do lobo frontal. RESULTADOS: O G1 e G2 apresentaram maior peso fetal. O G1 apresentou maior peso placentário, diferindo do G2 e G3 (p < 0,01). De forma diferente, o G2 possuiu maior peso encefálico, diferindo do G3 e G1 (p < 0,01). G1 não diferiu estatisticamente do grupo controle (p > 0,01). O G3 exibiu maior número de neurônios, por área, do lobo frontal em relação a G1 e G2 (p < 0,01). CONCLUSÃO: A adoção dos antidepressivos causou, nos fetos, aumento de peso e redução da contagem de neurônios do lobo frontal, sugerindo que a indicação de antidepressivos às gestantes pode induzir a depressão nos fetos por alterações em seu neurodesenvolvimento.

OBJECTIVE: To assess fluoxetine effects on mitochondrial structure of the right ventricle in rats exposed to cold stress. METHODS: The experimental study procedures were performed in 250-300g male EPM-Wistar rats. Rats (n=40) were divided into four groups: 1) Control group (CON); 2) Fluoxetine (FLU); 3) Induced hypothermia (IH) and; 4) Induced hypothermia treated with fluoxetine (IHF). Animals of FLU group were treated by the administration of gavages containing 0.75 mg/kg/day fluoxetine during 40 days. The induced hypothermia was obtained by maintaining the groups 3 and 4 in a freezer at -8ºC for 4 hours. The animals were sacrificed and fragments of the right ventricle (RV) were removed and processed prior to performing electron microscopic analysis. RESULTS: The ultrastructural changes in cardiomyocytes were quantified through the number of mitochondrial cristae pattern (cristolysis). The CON (3.85%), FLU (4.47%) and IHF (8.4%) groups showed a normal cellular structure aspect with preserved cardiomyocytes cytoarchitecture and continuous sarcoplasmic membrane integrity. On the other hand, the IH (34.4%) group showed mitochondrial edema and lysis in cristae. CONCLUSION: The ultrastructural analysis revealed that fluoxetine strongly prevents mitochondrial cristolysis in rat heart, suggesting a protector effect under cold stress condition.OBJETIVO: Analisar os efeitos da fluoxetina sobre a estrutura mitocondrial do ventrículo direito de ratos expostos ao estresse pelo frio. MÉTODOS: Os procedimentos do estudo foram realizados em ratos Wistar-EPM (250-300g) machos. Os ratos (n=40) foram divididos em quatro grupos: 1) Controle (CON); 2) Fluoxetina (FLU); 3) Induzidos à hipotermia (IH) e; 4) Induzidos à hipotermia tratados com fluoxetina (IHF). O grupo FLU foi tratado com gavagem contendo 0,75 mg/kg/dia de fluoxetina durante 40 dias. O estresse induzido pelo frio foi realizado mantendo os grupos 3 e 4 em um freezer (-8ºC) por quatro horas. Os animais foram sacrificados e fragmentos do ventrículo direito (VD) foram removidos e processados antes de serem conduzidos para a microscopia eletrônica. RESULTADOS: As alterações ultraestruturais dos cardiomiócitos foram quantificadas pelo número padrão de cristas mitocondriais (cristólises). Os grupos CON (3,85%), FLU (4,47%) e IHF (8,4%) mostraram aspecto normal de suas estruturas celulares com a citoarquitetura dos cardiomiócitos preservada com integridade sarcoplasmática contínua. Por outro lado, o grupo IH (34,4%) apresentou edema mitocondrial e lise nas cristas. CONCLUSÃO: A análise ultraestrutural revelou que a fluoxetina previne fortemente cristólises mitocondriais em miocárdio de ratos, sugerindo possível efeito protetor na condição de estresse induzido pelo frio.

OBJETIVO: Investigar o uso da fluoxetina na cidade de Santo André, SP, por meio de coleta e análise das receitas especiais (RE) prescritas por médicos e arquivadas nas farmácias e drogarias daquela cidade. MÉTODOS: Foram coletadas as receitas especiais retidas durante os meses de agosto do ano de 2005 a julho de 2006, em 13 farmácias de manipulação e em 27 drogarias em diferentes regiões de Santo André. Cada receita especial foi analisada em relação à presença de fluoxetina, em associação ou não a outros princípios ativos, e o sexo do(a) paciente foi anotado. RESULTADOS: Foram analisadas 39.782 RE - 16.124 coletadas das farmácias magistrais e 23.658 das drogarias. Desses totais, 10.919 prescrições continham fluoxetina - 9.259 provenientes das farmácias magistrais (84,8%) e apenas 1.660 (15,2%) das drogarias. As prescrições de fluoxetina eram predominantemente destinadas a mulheres (79,8%). Na imensa maioria das RE, a fluoxetina foi prescrita em associação com um grande número de outras substâncias ativas, inclusive anfetaminas anoréticas, chegando a mais de dez outras em quase a metade das prescrições. Esse tipo de prescrição múltipla, principalmente para mulheres, é comparado com as prescrições de fórmulas magistrais para emagrecer, muito utilizadas no Brasil. CONCLUSÃO: Os dados obtidos sugerem que a utilização de fluoxetina teria um fim estético (perda de peso), e não um fim terapêutico (tratamento de depressão). Discute-se a relação risco-benefício desse possível uso, que poderia ser classificado de inadequado dado as conhecidas reações adversas da fluoxetina e a sua interferência no sistema citocromo P450.OBJECTIVE: Investigate the use of fluoxetine in Santo André city, SP, by collecting and analyzing special prescriptions (SP) issued by physicians and filed in compounding pharmacies and drugstores of that city. METHODS: Special prescriptions were collected during August 2005 to July 2006 in 13 compounding pharmacies and 27 drugstores, in different regions of Santo André. Each prescription has been examined for the presence of fluoxetine, in combination or not with other active ingredients, and sex (a) patient was noted. RESULTS: We examined 39,782 SP; 16,124 of them were collected from compounding pharmacies and 23,658 from drugstores. Of these totals, 10,919 prescriptions contained fluoxetine as follows: 9,259 from the compounding pharmacies (84.8%) and only 1,660 (15.2%) from drugstores. Fluoxetine was manly prescribed for women (79.8%). In the vast majority of SP, fluoxetine was prescribed in combination with a large number of other active substances reaching more than ten others in almost half of the prescriptions. CONCLUSION: It is suggested that the large use of fluoxetine possibily aims to an aesthetic objective (to lose weight) and not as a therapeutic aim (treatment of depression). This work discusses the risk/benefit of this use which could be described as inappropriate, given the known adverse reactions of fluoxetine and its interference with the cytochrome P450 system.

The objective of this study was evaluate the anxiety and locomotor activity (LA) in 52 Wistar adult male rats, being 26 treated with fluoxetine (10 mg/Kg - sc) in the neonatal period. These same rats received foot shock (FS) (1.6-mA - 2-s) in the 90th day. The anxiety and LA were appraised by plus-maze. The time spent in the open arms was used as anxiety index and the LA was measured by number of entries in closed arms (NECA) and the total of entries (TE). T-test was used with pO objetivo deste estudo foi avaliar a ansiedade e a atividade locomotora (AL) em 52 ratos Wistar adultos machos, sendo 26 tratados no período neonatal com fluoxetina (10 mg/Kg - sc) e no 90º dia, receberam estímulos elétricos nas patas (1,6-mA-2-s). A ansiedade e a AL foram avaliadas por meio do labirinto elevado em cruz. O tempo de permanência dos animais nos braços abertos (BA) foi utilizado como índice de ansiedade e a AL medida pelo número de entradas nos braços fechados (NEBF) e pelo total de entradas (TE) nos BA e BF. O teste t foi utilizado, com (p

PURPOSE: To compare the effects of the antidepressant drugs duloxetine and fluoxetine on depressive behaviors in rodents. METHODS: Eighteen male Wistar rats were given systemic injections of duloxetine, fluoxetine, or saline prior to a Forced Swimming Test (FST). Immobility and number of stops were measured. RESULTS: Rats given injections of fluoxetine displayed significantly less immobility (p = 0.02) and fewer stops than the control group (p = 0.003). Duloxetine significanlty reduced the number of stops (p = 0.003), but did not effect immobility (p = 0.48). CONCLUSION: Duloxetine and fluoxetine reduced depressive behaviors in the Forced FST. However, our findings suggest that fluoxetine is more effective than duloxetine.OBJETIVO: Comparar o efeito antidepressivo da droga cloridrato de duloxetina com a fluoxetina. MÉTODOS: O teste do nado forçado, teste comportamental que avalia a atividade antidepressiva em ratos, foi utilizado em 18 ratos Wistar, machos adultos, divididos em três grupos iguais: duloxetina, fluoxetina e controle. RESULTADOS: Os dados do teste do nado forçado foram analisados pelo teste One-way ANOVA, Mann Whitney e Kruskall-Wallis.Houve diferença significativa (p = 0,003) entre o número de paradas dos grupos duloxetina e fluoxetina e o grupo controle. CONCLUSÃO: A duloxetina e a fluoxetina tiveram frequência de paradas similares. A fluoxetina mostrou ser mais efetiva que a duloxetina no teste do nado forçado em ratos.

Osmotic demyelination syndrome (ODS) may be precipitated by aggressive correction of a hypo or hyper-osmolar states. We describe the case of a 53-year-old woman that was started on fluoxetine 20 mg/day for depression and nine days later was found to have fluoxetine-induced syndrome of inappropriate secretion of antidiuretic hormone. After hyponatremia correction the mental status of the patient gradually improved, but subsequently she had intermittent difficulty in speaking, naming objects, memory deficits and psychomotor slowness. Magnetic resonance revealed bilateral symmetric hyperintense lesions in the basal ganglia, temporal lobe and hippocampal formation compatible with ODS. These symptoms gradually resolved and she was discharged home without any deficits. Two months later, a new image showed lesion in pons and the other lesions had disappeared. Fluoxetine therapy had never been related with a complication like that.A síndrome de desmielinização osmótica (SDO) pode ser precipitada pela correção agressiva de um estado hiper ou hipoosmolar. Nós descrevemos o caso de mulher de 53 anos que havia iniciado o uso de fluoxetina 20 mg/dia para depressão e que nove dias depois foi diagnosticada como tendo síndrome da secreção inapropriada de hormônio antidiurético induzida por fluoxetina. Depois da correção da hiponatremia o estado mental da paciente gradualmente melhorou, mas subsequentemente ela apresentou dificuldade intermitente para fala e para nomear objetos, déficits de memória recente e lentidão psicomotora. Ressonância magnética revelou lesões hiperintensas bilaterais e simétricas na região dos gânglios da base, lobo temporal e hipocampo compatíveis com SDO. Estes sintomas gradualmente se resolveram e a paciente foi de alta sem qualquer déficit. Dois meses mais tarde uma nova imagem cerebral mostrou lesão na ponte e ausência das lesões antigas. Até onde sabemos a terapia com fluoxetina nunca foi relacionada a uma complicação tardia como esta.

Depression is a common psychiatric disorder, affecting, according to the World Health Organization (WHO), 350 million people worldwide. Despite this high prevalence in clinical populations, depression is still underdiagnosed, when properly diagnosed is treated incorrectly. Historically, since the discovery of antidepressants in 1950, most developed drugs for depression shows variable therapeutic effect, being common the occurrence of side effects and adverse effects. In the 80's, fluoxetine was discovered, which has the ability to inhibit the protein responsible for the reuptake of serotonin by the presynaptic neuron, which increases the amount of serotonin available at the synapse. An updated literature review was conducted in the databases PubMed, Scielo, Medline, BVS and academic books using articles published in Portuguese, English and Spanish in order to address the therapeutic use of fluoxetine, as ascertain its off-label use the prescription by doctors not psychiatrists and demonstrate the side effects. In short, it was observed that depression is being treated incorrectly due to underdiagnosis its off-label use for weight loss can bring health risks. [ABSTRACT FROM AUTHOR]

Introduction. Pharmacotherapy for the management of obesity is primarily aimed at weight loss, weight loss maintenance and risk reduction (reduction in body fat, risk factors for cardiovascular disease and the incidence of diabetes mellitus). Among drugs that have been evaluated for weight loss include antidepressants (fluoxetine) and antiepileptic (topiramate). Material and Methods. We analyzed eating behavior and weight loss in a sample of morbid obesity patients before bariatric surgery. The patients suffering eating disturbances symptoms were grouped into three groups: one group received 40 mg of flouxetine/day (Group A); another group received topiramate 200 mg/day (Group B); and the third group of patients were treated with fluoxetine 40 mg and 200 mg of topiramate/day (Group C). Results. Patients treated with fluoxetine plus topiramate lost more weight at 3 and 6 months before surgery. Conclusions. The use of the psychopharmaceutical drug (fluoxetine and topiramate) in morbid obese patients with eating disorders could represent a new approach to the management of eating behavior before bariatric surgery. [ABSTRACT FROM AUTHOR]

OBJETIVE: Hypericum perforatum has demonstrated antidepressant efficacy when compared to placebo, but comparisons with other antidepressants remain controversial. We assessed the efficacy and safety of Hypericum perforatum in comparison with fluoxetine, in a 8-week double-blind trial in patients with mild to moderate depression. METHOD: Seventy-two outpatients were randomly assigned to receive Hypericum perforatum 900 mg/day, fluoxetine 20 mg/day or placebo. Efficacy measures included the HAM-D21 scale, the Montgomery-Åsberg Rating Scale, and the Clinical Global Impression. Safety was assessed with the UKU Side Effect Rating Scale. RESULTS: Intention-to-treat analysis showed no differences between the mean scores of the three groups. In the analyses of observed cases, patients receiving Hypericum perforatum had the lowest remission rates (12%, p = 0.016) compared to fluoxetine (34.6%) and placebo (45%). CONCLUSIONS: Hypericum perforatum was less efficacious than both fluoxetine and placebo. Both drugs were safe and well-tolerated. Larger trials are needed for definite conclusions.OBJETIVO: Hypericum perforatum demonstrou eficácia antidepressiva em comparação ao placebo, mas comparações com outros antidepressivos permanecem controversas. Avaliamos a eficácia e a tolerabilidade do Hypericum perforatum em comparação com fluoxetina e placebo, em um estudo duplo-cego de oito semanas em pacientes com depressão leve a moderada. MÉTODO: Setenta e dois pacientes ambulatoriais receberam aleatoriamente doses fixas de Hypericum perforatum 900 mg/dia, fluoxetina 20 mg/dia ou placebo. Medidas de eficácia incluíram a HAM-D21, Escala de Montgomery-Asberg e Impressão Clínica Global. A segurança foi avaliada por meio da Escala UKU de Efeitos Colaterais. RESULTADOS: A análise por intenção de tratar não demonstrou diferenças entre os três grupos. Na análise por casos observados, os pacientes que receberam Hypericum perforatum tiveram as menores taxas de remissão (12%, p = 0,016), em comparação à fluoxetina (34,6%) e ao placebo (45%). CONCLUSÕES: Hypericum perforatum foi menos eficaz que fluoxetina e placebo. Ambas as drogas foram seguras e bem toleradas. Estudos conclusivos com uma maior amostra são necessários.

The fluoxetine, commercially named Prozac, is efficient against depression and anxiety, with lower risk of collateral effects. However, the possible genotoxic effects are still unknown. The use of vitamins as protectors against damages on cells and DNA has been evaluated, mainly for vitamins A and C. Furthermore, the associative effect of vitamins with several medicines demands studies. The evaluations of genotoxic effect of Prozac and vitamins A and C protective effect were carried out in culture of Chinese hamster ovary cells, CHO-K1, by means of the comet test. The Prozac was used, in liquid formulation, diluted in 5µg, 1µg and 0.2 µg/mL of culture medium. The vitamins were used, in liquid formulation, at the concentrations of 3µg and 880,5 µg/mL of culture medium to vitamins A and C, respectively. The treatments were carried out during 1 hour. The obtained data demonstrated that only the highest concentration of Prozac (5 µg) is genotoxic and both vitamins A and C reduced such genotoxicity. The data suggest a follow-up on patients who use Prozac and the possibility of vitamins A and C association in order to minimize the collateral genotoxic effects.

Thirty-two children (21 female and 11 male), between 7 and 14 years old, with chronic daily headache (CDH) were consecutively included in a prospective, randomized, double blind, placebo controlled crossover study. The patients were divided in group I (fluoxetine vs. placebo), with 17 patients and group II (placebo vs. fluoxetine), with 15 patients. After one month of baseline headache frequency recording, the patients received fluoxetine in dosages from 0.25 to 0.50 mg/kg for three months. A wash out period of one month was followed by another three months treatment period. Results showed a significant decrease in headache frequency in the study period [78% reduction in group I (pTrinta e duas crianças (21 feminino, 11 masculino), com idades entre 7 e 14 anos, com cefaléia crônica diária (CCD) foram incluídos consecutivamente no estudo prospectivo, randomizado, duplo-cego, cruzado com placebo. Os pacientes foram divididos em grupo I (fluoxetina vs. placebo), com 17 pacientes, e grupo II (placebo vs. fluoxetina) , com 15 pacientes. Após um mês de registro da freqüência da cefaléia, os pacientes receberam fluoxetina em doses de 0,25-0,5 mg/kg por três meses. Após período de interrupção da droga de um mês, seguiu-se novo período de três meses de tratamento. Os resultados mostraram diminuição estatisticamente significativa da freqüência da cefaléia [78% de redução no grupo I (p

Depression is one of the most common mental disorders in the population and can occur in all age groups. It is responsible for high processing costs, causing great harm to the individual and hence to society. The aim of this study is to evaluate the prescription of fluoxetine treatment for depression in Pelotas city. This work was carried out through the documentary analysis of control recipes especially for the fluoxetine substance, belonging to the list of substances subject to special control of the decree 344/98 of Agência Nacional de Vigilância Sanitária ANVISA, list C1, which is retained in pharmacies or drugstores for future control of the Health Surveillance. The following data were collected: patient's sex, prescribed medication, and medical speciality of the prescriber. The results were analyzed and submitted to quantitative analysis. 300 prescriptions were analyzed. Through the analysis of the results and the literature it can be unified that women, once again received more prescriptions of antidepressants when compared to men. [ABSTRACT FROM AUTHOR]

The pharmacological manipulation with selective inhibitor of serotonin reuptake (SSRIs) can modify the operation of the serotonergic system and may facilitate or inhibit the action of this system, inducing changes in the morphology of the skeletal muscle of rats. The objective of this study was to evaluate the action of the treatment with fluoxetine during the critical period of the animal´s life on development of the soleus and lateral gastrocnemius muscles, under the aspects of weight, the number of nuclei of myocyte cells and cross-sectional area of muscle fibers. Twenty four (30 and 90-day-old) male Wistar rats were used. They were treated with saline solution (NaCl 0.9%; 1 ml/100 g of body weight) or fluoxetine (10 mg; 1 ml/100g of body weight). The animals were divided in Saline Group (GS-30 and GS-90) and Fluoxetine Group (GF-30 and GF-90). The fluoxetine group showed a reduction on weight (g) of soleus (p=0.046) and lateral gastrocnemius (p=0.02) muscles in rats with 90 days. A lesser number of myonuclei was observed in fluoxetine group than saline group of 30 days (soleus, p<0.001; lateral gastrocnemius, p£0.007) and 90 days (soleus, p=0.002; lateral gastrocnemius, p£0.038). The cross section area of fluoxetine groups is also smaller than the saline groups with 30 days (soleus, p=0.03; lateral gastrocnemius, p=0.041) and 90 days (soleus, p=0.042; lateral gastrocnemius, p=0.012). The treatment of fluoxetine during the critical period of development of the nervous system of rats, causes early changes in the structure of muscle fibers that seem to be related to reducing the weight of the soleus and gastrocnemius muscles only in late stage of the animal's life. Thus, the dosage used ISRS, suggests an inhibitory effect of 5-HT in relation to variables on the development of the skeletal muscle tissue of rats. [ABSTRACT FROM AUTHOR]

Objective: To present the main advances and projections related with ischemic stroke management. Development: This article look at some recent aspects considered in specialized journals about: 1) Definition of stroke types, 2) Genetic risk factors of ischemic stroke, 3) Neuroimaging paradigm in ischemic stroke, 4) Telemedicine for stroke (telestroke), 5) Antithrombotic use (oral dual antiagregante therapy, periprocedural management of antithrombotic, prevention with direct action oral anticoagulants, extension of thrombolytic time to 4.5 hours after onset), 6) Evolution of approach regarding endovascular techniques, 7) Stem cells administration for brain infarction, 8) Therapies for malignant hemispheric brain edema, 9) Blood pressure levels regulation in stroke, and 10) Identification of pharmacological intervention (Selective serotonin reuptake inhibitors) for aid in motor recovery. Conclusions: A review was carried out about main advances and trends for research and clinical practice of ischemic stroke. The consideration of implementation limiting factors is vital for perfection of stroke patient management. For the implementation of this advances are required an increase consciousness and public education about stroke, protocols improvement for stroke centers, development of stroke certification process and stroke capabilities, and economic and legislative support. [ABSTRACT FROM AUTHOR]

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In the present study, behavioral and immunomodulatory effects of fluoxetine were evaluated with the forced swim test, an animal model of depression. In this model, floating behavior is responsive to antidepressants and is used as a behavioral index of despair. During 12 days, three times a day, two groups were treated intraperitoneally with saline or fluoxetine. Additionally, the humoral immune response to immunostimulation (sheep red blood cells) was evaluated. The animals treated with fluoxetine floated longer, showed decreases in body mass and had lower total production of antibodies. The results indicate simultaneous modulation of behavior and antibody production by fluoxetine [ABSTRACT FROM AUTHOR]

Objective. Determine patterns of antidepressive drug prescription in a group of patients affiliated with the General Social Security Health System in Colombia. Methods. Observational descriptive study of 9 881 patients, of both sexes and older than 5 years of age, medicated with antidepressants and continuously treated from August to October 2009. The patients include residents from 56 Colombian cities. A database was designed based on the consumption of medicines obtained from the company that distributes them to the patients. Results. The average age was 59.1 ± 16.1 years; 73.7% of the participants were women. Of the total number of patients, 83.3% were treated with monotherapy and 16.7% with two or more antidepressants. The order of the prescription of the medicines was: selective serotonin reuptake inhibitors, 47.0%; atypical, 37.8%; tricyclical, 31.8%; selective serotonin reuptake inhibitors and norepinephrine, 1.8%; and selective norepinephrine reuptake inhibitors, 0.03%. The combinations most used were fluoxetine + trazodone (n = 1 029); amitriptyline + fluoxetine (n = 265); amitriptyline + trazodone (n = 122); fluoxetine + imipramine (n = 106); and imipramine + trazodone (n = 71). The most prescribed co-medications were anti-hypertensives (52.3%); thyroid hormones (23.3%); anti-inflammatories (19.6%); anti-epileptics (15.4%); anti-diabetics (13.8%); anti-anxiety and hypnotics (12.4%); antipsychotics (7.4%); anti-Parkinsons (4.3%); and anti-neoplastics (2.2%). Conclusions. The practice of prescribing medicines with a high therapeutic value predominates, mainly for antidepressive monotherapy. Most of the antidepressants are prescribed at dosages lower than those recommended. There is a need to design educational strategies to correct some prescription practices and to conduct research [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the plasma levels of clozapine in mexican patients, and its possible relationship to dose, body weight, age, gender, smoking habits as well to establish the possible interaction with valproate and fluoxetine. Methods: steady state plasma concentrations of clozapine were evaluated in 36 patients under treatment with clozapine. Drug plasma concentrations were measured by high performance liquid chromatography with ultraviolet detection. Results: the mean plasma level of clozapine was 397 ± 260 ng/mL. Due to a considerable interindividual variation, daily doses do not correlate with levels of clozapine. No significant differences were found in plasma levels due to age and weight; however a slight trend in plasma levels due to gender and smoking habit was observed. A significant difference on plasma levels was observed between patients under monotherapy versus patients with simultaneous treatment with fluoxetine; in contrast patients under valproate treatment did not show an increase in clozapine plasma levels. The most common side effects were sialorrhea and somnolence. [ABSTRACT FROM AUTHOR]

In order to study the effect of behavioral or pharmacologically enhanced anxiety on the acquisition of contextual fear conditioning, thirty two Wistar rats (275±25 gm) were divided in two groups (behavioral restriction and control). Half of each group received saline solution (ig.; 0.9%) or fluoxetine (ig.; 4mg/Kg) before the fear conditioning procedure. The two way ANOVA showed significant differences for treatment (F[1,28] = 25.261; P < 0.001). Student Newman-Keuls showed that subjects treated with fluoxetine had lower freezing times. There were no significant differences nor for restriction neither for the interaction between the factors (F[1,28] = 0.115; P = 0.737 y F[1,28] = 0.016; P = 0.899). Thus, the restriction procedure used did not modify the acquisition of the conditioned fear response suggesting that the putative 5-HT enhancement induced is not comparable to that induced by fluoxetine. Acute fluoxetine disrupted the acquisition of the conditioned fear response, suggesting that the mechanism by means of which anxiety disrupts learning could be serotonergic in nature. [ABSTRACT FROM AUTHOR]

Objective: To evaluate morphological alterations in rat fetuses treated with fluoxetine and imipramine during the "critical" period of gestation. Method: fifteen female rats were separated into three groups (n = 5) and treated with 10 mg/kg/day of test substances on the ninth, tenth and eleventh day of pregnancy: G1, fluoxetine; G2, imipramine hydrochloride; G3 (control), saline. On day 21, cesarean sections were performed to release the fetuses, whose bodies were weighed and macroscopically analyzed. The placenta was also weighed. The fetuses were then fixed and their encephala removed and weighed. Sections of the frontal lobe were taken for histological neuron counting. Results: G1 and G2 showed the highest fetal body weight. Placental weight showed statistical differences (p ≤ 0.01): G1 weighed more than G2 and G3. Otherwise, G2 exhibited the highest encephalon weight, statistically differing from G3 (control) and fluoxetine-treated G1 (p ≤ 0.01). However, G1 did not statistically (p > 0.01) differ from the control group. G3 showed the highest number of neurons per area when compared to G1 and G2 (p ≤ 0.01). Conclusion: The use of antidepressants in rats caused an increase in fetal weight and a decrease in the number of fetal frontal lobe neurons, thus suggesting that the use of antidepressants by pregnant women can induce depression in fetuses due to alterations in their neural development. [ABSTRACT FROM AUTHOR]

The TMJ has been to the Dental community a key point in the search of knowledge, being it part of the temporomandibular joint complex and of the estomatognathic system which are in charge of the mastication, speech, swallowing, as well as participation in breathing and taste perception. For the majority of the women in serious state of depression, which do not respond psychotherapeutic treatment, pharmacological treatment it's applied. The antidepressants serotonin selective reuptake inhibitors (SSRIs) are the most recommended in these cases. The teratogenic effect of the SSRIs is considered controversial, studies done with women who used these drugs during the pregnancy showed that the respiratory and central nervous systems are the most affected, was also recorded a deficit of body growth and the decrease of the encephalon and skull measures. In the present study, our goal was to assess whether the administration of Fluoxetine during the pregnancy modified the embryology and morphology of the TMJ of rats. For that, 16 Wistar female rats from the Nutrition Department of the UFPE vivarium were selected; 8 for the control group, which received daily 0.9% of saline in subcutaneous dose of 10ml/g, with schedules previously established after daily weighing and 8 for the experimental one that were treated with fluoxetine hydrochloride with the dose of 10mg/Kg in a volume 10ml/g of weight, were injected subcutaneously with the same standards established for the control group. It was observed, with this dose that the embryological development of the TMJ, especially of the mandibular condyle, does not present any difference between the degree of maturation of the tissue that forms the TMJ, especially of the condyle between the treated and control groups. [ABSTRACT FROM AUTHOR]

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The aim of the present study was to test the hypothesis that the application of fluoxetine - a highly selective serotonin reuptake inhibitor (SSRI) - in rats during the suckling period induces changes in testicular development. Groups of newborn male rats were randomly assigned with different doses of fluoxetine 24 hours after birth. Each litter stayed with its respective mother during 21 days. Body weight (BW) was measured daily from the 1st -2Pst day to calculate daily doses of fluoxetine. 5mg (TI), 10mg (T2) 20 mg (T3) or deionized water, were injected intraperitoneally. On the 2Pst day, animals were heparinized, anesthetized and blood was collected by cardiac puncture to determine by radioimmunoassay the follicle stimulating hormone (FSH) levels. Testis were removed, weighed, and processed for morphometric analysis. Fluoxetine groups presented decreased body and testicular weight when compared with the control group on the 21st day. Our findings show that the manipulation of the serotoninergic system with fluoxetine during the critical period of testicular development alters the Sertoli cell population and all testicular parameters related to this cell. [ABSTRACT FROM AUTHOR]

Introduction. Impulsiveness and aggressiveness are characteristics of borderline personality disorder and are associated to a serotoninergic system dysfunction. Serotonin transporter polymorphisms have been linked to aggressive and impulsive behaviors. The short allele (S) in depression is associated to a worse response to selective serotonin reuptake inhibitors (SSRI). This study aims to study these polymorphisms to predict the response of aggressive and impulsive behaviors to SSRIs in borderline personality disorder. Method. Fifty-nine patients with DSM-IV borderline personality disorder in accordance with the International Personality Disorder Examination (IPDE) and without axis 1 disease were treated with flexible doses of fluoxetine for 12 weeks. The patients were evaluated with the Overt Aggression Scale Modified (OAS-M) at the beginning and at 2, 4, 8 and 12 weeks of treatment. Polymorphisms L and S of the serotonin transporter promoter region were determined. Response to fluoxetine of the LL carriers versus the S carriers (LS+SS) was compared. Results. LL carriers had a better response than S carriers in the reduction of total OAS-M scores and on the aggressiveness and irritability components of the OAS-M. Conclusions. L-allele carriers responded better to fluoxetine than S carriers, in a similar way as in depression. The S allele may represent a common factor of bad response to SSRI in diseases associated to serotoninergic system dysfunction. [ABSTRACT FROM AUTHOR]

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Temperament and character are terms utilized to delineate the participation of biologic and psychosocial factors in the development of normal and disordered personality. At times, biological factors, and in others rearing, education, psychological and social events at an early age are the main determinants. The American Psychiatric Association describes Borderline Personality Disorder (BPD) as characterized by a pattern of interpersonal, self-image and affective instability, as well as notable impulsivity. In this disorder, temperament as an inherited factor plays an important role, as demonstrated by familial studies in which the disorder is more frequently present in the families of probands than non-probands. Other disorders where impulsivity is an outstanding feature, such as antisocial personality disorder and substance abuse, are also frequent in first degree relatives of patients with BPD. [ABSTRACT FROM AUTHOR]

The attributes that characterize a molecule as neurotransmitter at CNS are: i. neuronal synthesis, ii. being present at presynapsis, iii. Ca2+-dependent release, iv. postsynaptic actions mediated by receptors, v. an elimination mechanism at synapse. Since 1964, 5-hydroxytryptamine (5-HT) was included as a neurotransmitter anti is part of a set of neurotransmitters named biogenic amines. In rodents, the 5-hydroxytryptaminergic system is constituted by nine nuclei at brainstem, and divided in two groups, rostral and caudal by thor localization. The rostral group projects mainly to the telencephalon and diencephalon, while the caudal group docs it to the spinal cord. 5-HT innervation to brainstem and cerebellar nuclei have been also described. [ABSTRACT FROM AUTHOR]

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Objectives: To determine the possible drugs interactions with antidepressive agents in data bases of patients in the Health Insurance System of Colombia., Methods: From data bases of about 4 million users in Colombia, a systematic review of drugs dispensation statistics was made to identify drug interactions between antidepressive agents, cholinergic antagonists and tramadol in 2010., Results: We identified 114,465 monthly users of antidepressive agents. Of these, 5776 (5.0%) received two, and 178 (0.2%) received three antidepressive agents simultaneously. The most frequent combination was fluoxetine+trazodone (n=3235; 56.9% of cases). About 1127 (1.0%) patients were prescribed a cholinergic antagonist simultaneously; 2523 (2.1%) users were dispensed tramadol at the same time, while raising the risk of serotonin syndrome., Conclusions: Drug interactions represent a potential risk that is often underestimated by physicians. Pharmacovigilance is a useful tool to optimize resources and prevent negative outcomes associated with medication. It is recommended that systematic search is made to enhance surveillance programs for the rational use of medicines in this country., (Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.)