Search

Based on a clinical case, the authors consider the problem of the optimal choice of an antidepressant, taking into account not only the psychopathological structure of depression, the severity and characteristics of its triad, but also the presence of somatic symptoms. This determines the need for a comprehensive analysis of the pharmacological profile of prescribed antidepressants, their psychotropic and somatotropic effects. The switch of the patient to brintellix, which has polymodal neuroreceptor activity, at a dose of 20 mg per day, made it possible to achieve remission and reduce adverse reactions caused by SSRIs.В статье на основе анализа клинического случая рассматривается проблема оптимального выбора антидепрессанта с учетом не только психопатологической структуры депрессии, степени выраженности и особенностей ее триады, но также наличия соматических симптомов. Это определяет необходимость комплексного анализа фармакологического профиля назначаемых антидепрессантов, их психотропных и соматотропных эффектов. Перевод пациента на вортиоксетин (Бринтелликс), обладающий полимодальной нейрорецепторной активностью, в дозе 20 мг в сутки позволил добиться достижения ремиссии и редукции наблюдавшихся на терапии селективными ингибиторами обратного захвата серотонина нежелательных побочных эффектов.

*President, Institute for Safe Medication Practices, 200 Lakeside Drive, Suite 200, Horsham, PA 19044; phone: 215-947-7797; fax: 215-914-1492; e-mail: mcohen@ismp.org; Web site: www.ismp.org. †Vice President, Institute for Safe Medication Practices, Horsham, Pennsylvania. These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program. Any reports published by ISMP will be anonymous. Comments are also invited; the writers’ names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported directly to ISMP through the ISMP Web site (www.ismp.org), by calling 800-FAIL-SAFE, or via e-mail at ismpinfo@ismp.org. ISMP guarantees the confidentiality and security of the information received and respects reporters’ wishes as to the level of detail included in publications.

Generalized Anxiety Disorder (GAD) is a persistent condition characterized by chronic anxiety, exaggerated worry and tension, mainly comorbid with Major Depressive Disorder (MDD). Currently, selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are recommended as first-line treatment of GAD. However, some patients may not respond to the treatment or discontinue due to adverse effects. Vortioxetine (VRX) is a multimodal antidepressant with a unique mechanism of action, by acting as 5-HT3A, 5-HT1D and 5-HT7 receptor antagonist, partial agonist at the 5-HT1A and 5-HT1B receptors and inhibitor at the 5-HT transporter. Preliminary clinical trials showed contrasting findings in terms of improvement of the anxiety symptomatology and/or cognitive impairment. Here, we aim to systematically review the evidence currently available on the efficacy, safety and tolerability of VRX in the treatment of GAD. The generalizability of results on the efficacy of VRX in patients with anxiety symptomatology and GAD is limited due to few and contrasting RCTs so far available. Only two studies, of which one prevention relapse trial, reported a significant improvement in anxiety symptomatology compared to three with negative findings.

In the final months of 2013, the US Food and Drug Administration approved two new antidepressant formulations. This column presents a review of the pertinent literature on both: vortioxetine (Brintellix(®)) and levomilnacipran (Fetzima(®)).

This article presents a brief review and summarizes current therapies for the treatment of chronic obstructive pulmonary disease, major depression, and rheumatoid arthritis. One new pharmaceutical agent is highlighted for each of the topics.

Vortioxetine (Brintellix) is a new antidepressant recently recommended by NICE as third-line therapy for the treatment of major depressive episodes in adults. This article describes the drug's properties, clinical trial evidence for its efficacy and its adverse effects.