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Cardiovascular Effects of Combining Subcutaneous or Intravenous Esketamine and the MAO Inhibitor Tranylcypromine for the Treatment of Depression: A Retrospective Cohort Study
- Source :
- CNS Drugs
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- Background (Es)ketamine and monoamine oxidase inhibitors (MAOIs), e.g., tranylcypromine, are therapeutic options for treatment-resistant major depression. Simultaneous administration is currently not recommended because of concern about hypertensive crises. Objective Our objective was to evaluate whether changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) during esketamine administration differed between patients who concomitantly received tranylcypromine and those who did not. Methods This was a retrospective cohort study utilizing cardiovascular monitoring data from inpatients treated for severe depression in unipolar, bipolar, and schizoaffective disorder. Primary outcomes were change in mean BP and HR during the first hour after intravenous or subcutaneous esketamine administration compared with baseline, controlled for confounders. Secondary analyses quantify differences in absolute BP during esketamine treatment and comparisons of BP peaks, temporal effects, and intraindividual comparisons before and after tranylcypromine initiation. Results Our analysis included 509 esketamine administrations in 43 patients, 14 of whom concomitantly received tranylcypromine. Controlling for creatinine and age, mean ± standard deviation (SD) BP changes were significantly increased by concomitant tranylcypromine treatment (ΔSBP: F[1,503] = 86.73, p
- Subjects :
- Adult
Male
medicine.medical_specialty
Monoamine Oxidase Inhibitors
Injections, Subcutaneous
Blood Pressure
Cohort Studies
Depressive Disorder, Treatment-Resistant
Young Adult
chemistry.chemical_compound
Heart Rate
Internal medicine
Heart rate
medicine
Humans
Drug Interactions
Pharmacology (medical)
Ketamine
Original Research Article
Aged
Retrospective Studies
Depressive Disorder, Major
Creatinine
Dose-Response Relationship, Drug
business.industry
Tranylcypromine
Retrospective cohort study
Middle Aged
Antidepressive Agents
Confidence interval
Psychiatry and Mental health
Esketamine
Blood pressure
chemistry
Cardiology
Administration, Intravenous
Female
Neurology (clinical)
business
medicine.drug
Subjects
Details
- ISSN :
- 11791934 and 11727047
- Volume :
- 35
- Database :
- OpenAIRE
- Journal :
- CNS Drugs
- Accession number :
- edsair.doi.dedup.....1e7d001813c5ff43129efc2d7fda1ed8