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3 results

  • Combining nefazodone and midazolam during ECT

  • A. Conca, Z. Al-Dubai, P. König, W. Beraus
  • Journal:
    European Psychiatry / Volume 14 / Issue 6 / October 1999
    Published online by Cambridge University Press:
    16 April 2020, pp. 360-362

  • We report the case of a patient suffering from dysthymia. He underwent successful ECT treatment and was medicated with nefazodone and midazolam. Comparing the EEG and motor seizure duration in the periods with and without midazolam, no significant differences were recorded, but the dosage of thiopental and of succinylcholine had to be increased markedly after midazolam was discontinued (P < 0.05; ANOVA). This case indicates a substantial pharmacodynamic interaction between nefazodone, midazolam, thiopental, and succinylcholine.

  • A meta-analysis of clinical trials comparing the serotonin (5HT)-2 receptor antagonists trazodone and nefazodone with selective serotonin reuptake inhibitors for the treatment of major depressive disorder

  • George I. Papakostas, Maurizio Fava
  • Journal:
    European Psychiatry / Volume 22 / Issue 7 / October 2007
    Published online by Cambridge University Press:
    05 April 2007, pp. 444-447
  • Objective

    To compare response rates among patients with major depressive disorder (MDD) treated with either a serotonin-2 (5HT2-) receptor antagonist or a selective serotonin reuptake inhibitor (SSRI).

    Methods

    Medline and PubMed were searched for double-blind, randomized clinical trials comparing either trazodone or nefazodone with an SSRI for the treatment of MDD. Data from 9 reports involving a total 988 patients were identified and combined using a random-effects model.

    Results

    Patients randomized to treatment with a 5HT2 antagonist were as likely to experience clinical response as patients randomized to treatment with an SSRI (RR = 1.002, 95% CI: 0.85–1.17, P = 0.978). Pooled response rates for trazodone/nefazodone and the SSRis were 61.1% and 61.7%, respectively. There was also no difference in overall discontinuation rates (P = 0.334), discontinuation due to adverse events (P = 0.676), or discontinuation due to inefficacy (P = 0.289) between the two groups.

    Conclusions

    These results suggest that the 5HT2-receptor antagonists trazodone and nefazodone and the SSRis do not differ with respect to their overall efficacy and tolerability in the treatment of MDD. Although the sample size was relatively large and conveyed sufficient statistical power to test for differences in the overall sample, depression is a heterogeneous condition and differences may exist between treatments in particular subgroups of patients.

  • 19 - Antiepileptic drug interactions in patients requiring psychiatric drug treatment

  • from Part IV - Drug interactions in specific patient populations and special conditions
    • By Michael R. Trimble, The National Hospital for Neurology and Neurosurgery, Institute of Neurology, Queen, Square, London, UK, Marco Mula, Amadeo Avogadro University, Novara, Italy
  • Edited by Jerzy Majkowski, Blaise F. D. Bourgeois, Harvard University, Massachusetts, Philip N. Patsalos, Institute of Neurology, London, Richard H. Mattson, Yale University, Connecticut
  • Book:
    Antiepileptic Drugs
    Published online:
    07 September 2009
    Print publication:
    26 May 2005, pp 350-368

  • Summary

    In recent years a number of newer antidepressant drugs have been introduced into clinical practice. The new generation of antipsychotic drugs essentially fall into two categories; those that are clozapine related, which included olanzapine and quetiapine, and others such as risperidone. It is also known that many patients with epilepsy receive psychotropic drugs, sometimes but not always on account of psychiatric symptoms. Neuroleptics, such as phenothiazines, are metabolized by intestinal sulfoxidases, although CYP2D6 plays an important role in chlorpromazine and thioridazine metabolism. Antidepressants have been extensively evaluated in relation to the general problem of their proconvulsant activity. Historically, antipsychotic drugs have been considered proconvulsants possibly because of their D2-receptor blocking activity. As far as antidepressant drugs are concerned, fluoxetine and nefazodone interactions are probably the most relevant in epilepsy from a clinical point of view.