BACKGROUND Depression is a widespread mental health condition that requires effective treatment.In the treatment of depression,traditional Chinese medicine(TCM)offers obvious advantages,fewer adverse reactions,and a l...BACKGROUND Depression is a widespread mental health condition that requires effective treatment.In the treatment of depression,traditional Chinese medicine(TCM)offers obvious advantages,fewer adverse reactions,and a lower recurrence rate.AIM To evaluate the clinical benefits of Guipi decoction combined with escitalopram oxalate tablets for individuals with depression.METHODS In total,80 patients diagnosed as having depression were enrolled in the study and divided into either an experimental group or a control group.All of the patients were orally administered escitalopram oxalate tablets.Additionally,the experimental group received Jiajian Guipi decoction and reduced Governor vessel fumigation over 4 wk.TCM syndrome scores,Hamilton depression rating scale(HAM-D)scores,self-rating depression scale(SDS)scores,and Pittsburgh sleep quality index scores were measured for the two groups and compared before and after the treatment.The two groups were monitored for any adverse reactions.RESULTS After 4 wk of treatment,both groups exhibited a significant reduction in TCM syndrome scores compared with their pre-treatment scores(P<0.05).However,the experimental group exhibited significantly lower TCM syndrome scores than the control group(P<0.05).Similarly,the post-treatment SDS and HAM-D-24 scores were significantly lower in both groups than the pre-treatment scores(P<0.05),with the experimental group exhibiting lower scores than the control group(P<0.05).The total treatment efficiency was significantly better in the experimental group(97.14%)than in the control group(77.78%)(P<0.05).Furthermore,after 4 wk of treatment,the Pittsburgh sleep quality index scores for both groups were significantly lower than those before the treatment(P<0.05),with the experimental group exhibiting lower scores than the control group(P<0.05).The incidence of adverse reactions was significantly lower in the experimental group than in the control group(P<0.05).CONCLUSION The combination of Guipi decoction and escitalopram oxalate tablets was found to be an effective and safe treatment for depression.This combination could reduce TCM syndrome scores,improve depressive symptoms,and enhance sleep quality.展开更多
Objective:To investigate the protective role of pumpkin seed ethanolic extract against escitalopram-induced reproductive toxicity in male mice.Methods:Swiss albino male mice were randomly divided into five groups with...Objective:To investigate the protective role of pumpkin seed ethanolic extract against escitalopram-induced reproductive toxicity in male mice.Methods:Swiss albino male mice were randomly divided into five groups with six mice in each group.Group Ⅰreceived normal water orally,Group Ⅱ,Ⅲ,Ⅳand Ⅴreceived escitalopram oxalate(10 mg/kg),pumpkin seed extract(300 mg/kg)plus escitalopram oxalate(10 mg/kg),escitalopram oxalate(20 mg/kg),and pumpkin seed extract(300 mg/kg)plus escitalopram oxalate(20 mg/kg),respectively.All test doses were continuously administered orally once daily per animal body weight for 30 days and 60 days.Body weight and sexual organ weight were evaluated on day 31 and 61.Effects of pumpkin seed extract on sperm parameters,biochemical parameters and histology of testis were also investigated.Results:Escitalopram 10 or 20 mg/kg caused reproductive toxicity in male mice after 30 and 60 days of treatment.However,simultaneous administration of escitalopram oxalate(10 or 20 mg/kg)with pumpkin seed extract(300 mg/kg)attenuated escitalopram-induced testicular toxicity.Significant increase in the body weight and relative organ weight was observed.Sperm count,sperm motility and viability significantly increased(P<0.05).The histopathological alterations caused by escitalopram was also ameliorated.Conclusions:Ethanolic extract of pumpkin seeds(300 mg/kg body weight)protects again reproductive toxicity induced by escitalopram.Therefore,dietary intake of pumpkin seed extract might be useful for male patients who expose to antidepressant drug due to depression.展开更多
BACKGROUND Antidepressants,particularly selective serotonin reuptake inhibitors,are currently considered the first-line treatment for panic disorder(PD).However,little is known about the relationship between the bioma...BACKGROUND Antidepressants,particularly selective serotonin reuptake inhibitors,are currently considered the first-line treatment for panic disorder(PD).However,little is known about the relationship between the biomarkers that may predict better treatment.AIM To compare genome-wide methylation and gene expression patterns between responsive and non-responsive patients with PD after 4 wk of escitalopram treatment.METHODS Thirty patients with PD were enrolled in this study(responders=13;nonresponders=17).All patients were assessed using the PD Severity Scale-Chinese version before and after treatment.The Illumina Infinium MethylationEPIC(850k)BeadChip for genome-wide methylation screening and mRNA sequencing was used in all patients with PD.RESULTS A total of 701 differentially methylated positions(DMPs)were found between responders and non-responders(|Δβ|≥0.06,q<0.05),and the hyper-and hypomethylated CpG sites were 511(72.9%)and 190(27.1%),respectively.Relative to non-responders,there were 59 differential transcripts,of which 20 were downregulated and 39 were upregulated(q<0.05).However,no differen tially expressed genes were identified by mRNA sequencing after correcting for multiple testing(|log2(FC)|>1,q>0.05).CONCLUSION This preliminary study showed that DMPs might be associated with the treatment response to escitalopram in PD;however,these DMPs need to be verified in large samples.展开更多
Summary： The neuroproteetive effects of escitalopram oxalate in rats with chronic hypoperfusion and the possible mechanism were explored. Chronic hypoperfusion （2-VO） model was prepared and given escitalopram oxala...Summary： The neuroproteetive effects of escitalopram oxalate in rats with chronic hypoperfusion and the possible mechanism were explored. Chronic hypoperfusion （2-VO） model was prepared and given escitalopram oxalate （experimental group） or PBS （control group） after 6 weeks. Eight weeks after the operation, Morris water maze test was carried out to evaluate the learning and memory ability of the rats. The cell proliferation, three-dimensional vascular distribution, cell morphological changes in ischemic area and the plasma vascular endothelial growth factor （VEGF） were detected to explore the possible mechanisms. （1） Morris water maze test showed that the escape latency in the experimental group was significantly shorter than in the control group, while the first quadrant swimming time in the experi- mental group was significantly longer than the control group （both P〈0.01）. （2） Cerebrovascular confo- cal detection results showed that the inside diameter of capillaries was significantly less in the experi- mental group than in the control group; the vascular density was significantly increased in the experi- mental group and the total area of capillaries was also significantly increased in the experimental group as compared with the control group. （3） There was statistically significant difference in BrdU-positive cells in the ischemic brain tissue between the experimental group and the control group （P=0.003〈0.01）. （4） VEGF concentrations in the plasma and the ischemic area were higher in the experimental group than in the control group （P〈0.05）. It was concluded that escitalopram oxalate could significantly im- prove the learning and memory ability of the rats with chronic cerebral ischemia probably by the VEGF-mediated angiogenesis.展开更多
BACKGROUND Depression is a growing public health problem that affects over 350 million people globally and accounts for approximately 7.5%of healthy years lost due to disability.Escitalopram,one of the first-line medi...BACKGROUND Depression is a growing public health problem that affects over 350 million people globally and accounts for approximately 7.5%of healthy years lost due to disability.Escitalopram,one of the first-line medications for the treatment of depression,is a selective serotonin reuptake inhibitor and one of the most commonly prescribed antidepressant medications worldwide.Although thought to be generally safe and with minimal drug-drug interactions,we herein present an unusual case of cholestatic liver injury,likely secondary to escitalopram initiation.CASE SUMMARY A 56-year-old Chinese lady presented with fever and cholestatic liver injury two weeks after initiation of escitalopram for the treatment of psychotic depression.Physical examination was unremarkable.Further investigations,including a computed tomography scan of the abdomen and pelvis and tests for hepatitis A,B and C and for autoimmune liver disease were unyielding.Hence,a diagnosis of escitalopram-induced liver injury was made.Upon stopping escitalopram,repeat liver function tests showed downtrending liver enzymes with eventual normalization of serum aspartate aminotransferase and alanine aminotransferase one-week post-discharge.CONCLUSION Clinicians should be aware of the possibility of escitalopram-induced liver injury when initiating depressed patients on antidepressant treatment.This requires extra vigilance as most patients may remain asymptomatic.Measurement of liver function tests could be considered after initiation of antidepressant treatment,especially in patients with pre-existing liver disease.展开更多
We detected the event-related potential mismatch negativity （MMN） of 30 depression patients and compared to 30 age,gender,and education-matched healthy controls.Results showed that amplitudes of frequency and durati...We detected the event-related potential mismatch negativity （MMN） of 30 depression patients and compared to 30 age,gender,and education-matched healthy controls.Results showed that amplitudes of frequency and duration MMN were lower in depression patients compared with control patients,indicating abnormality in auditory processing （i.e.,cognitive impairment）.Following escitalopram treatment for 8 weeks,the amplitudes of frequency and duration MMN were significantly increased and Hamilton Rating Scale for Depression scores were significantly decreased in depression patients.These data suggest that escitalopram can improve cognitive function of patients with depression.Further,MMN may be a useful tool for evaluating cognitive function and treatment effects.展开更多
Background:Depression will become the second most common disease after coronary heart disease(CHD).Escitalopram and olanzapine are commonly used to treat depression.Some studies indicated that escitalopram combined wi...Background:Depression will become the second most common disease after coronary heart disease(CHD).Escitalopram and olanzapine are commonly used to treat depression.Some studies indicated that escitalopram combined with olanzapine is effective in treating depression,however,there is no evidence to support these results.Our objective was to study the efficacy of escitalopram combined with olanzapine on depression by conducting a systematic review and meta analysis,and to provide reference for doctors.Methods:Relevant evidence were searched from PubMed,SinoMed,the Cochrane Library,Web of Science,Embase,China Knowledge Resource Integrated(CNKI),Wanfang Data Knowledge Service Platform databases(WANFANG)and VIP dating from inception to July 2020.The randomized controlled trials(RCTs)of escitalopram and olanzapine for the treatment of depression was obtained.According to inclusion and exclusion criteria,two researches(Sun Wu and Wang Zhe)independently screened the literature,extracted data,and evaluated the quality of included studies.Rev Man 5.3 software was used to conduct statistical analyze.Results:A total of 39 studies involving 3,267 patients were identified.These studies were finally included into the meta-analysis.Pooled results showed that there was a significant difference in efficiency(RR=1.18,95%CI:1.14 to 1.12,P<0.00001),HAMD(MD=-4.54,95%CI:-5.09 to-3.99,P<0.00001),and HAMA(MD=-3.94,95%CI:-5.57 to-2.12,P<0.0001).There was no significant difference in adverse reactions(MD=0.07,95%CI-0.03 to 0.17,P=0.19).Heterogeneity test showed that due to the high heterogeneity of HAMD(P<0.00001,12=86%)and HAMA(P<0.00001,I2=91%),after removing the items with high heterogeneity,there were also statistically significant in HAMD(MD=-5.22,95%CI:-5.53 to-4.91,P<0.00001)and HAMA(MD=-5.46,95%CI:-6.15 to-4.77,P<0.00001).Conclusion:Based on this study,the combination of escitalopram and olanzapine was more effective in treating depression than the control group.It is suggested that clinical and scientific researchers carry out more high-quality,large-sample,multi-center RCTs to provide more evidence-based medical evidence for the future study of escitalopram combined with olanzapine in the treatment of depression.展开更多
Purpose: Hormone therapy (estrogen with or without progestin) remains the gold standard treatment for hot flashes in menopausal women, but concerns for the risk of hormone therapy have resulted in its decline and a de...Purpose: Hormone therapy (estrogen with or without progestin) remains the gold standard treatment for hot flashes in menopausal women, but concerns for the risk of hormone therapy have resulted in its decline and a demand for nonhormonal treatments with demonstrated efficacy for hot flashes. Aim of this study was to examine the efficacy of selective serotonin reuptake inhibitor escitalopram on hot flashes in a healthy sample of non-depressant menopausal women in Japan. Methods: We retrospectively analyzed the medical records of 11 menopausal patients with hot flashes, who received escitalopram (10 mg daily) for 2 weeks between March and August 2012. Hot flashes severities and scores were recorded on a scale of 0 to 10 points, at beginning and end of 2 weeks treatment. Results: At 2 weeks of therapy, 9 of 11 patients reported significant decreases in hot flash frequency and severity, but the remission of the symptom was not observed in 2 patients. Speed of relief from hot flashes was rapid (within one week). Conclusions: Escitalopram 10 mg/day may be a prompt and effective option for treating hot flashes in menopausal women who do not want to use hormone replacement therapy.展开更多
BACKGROUND The antidepressant escitalopram is widely prescribed for the treatment of depression.It is generally well-tolerated,and cholestasis is not mentioned in its summary of product characteristics(Sm PC).We prese...BACKGROUND The antidepressant escitalopram is widely prescribed for the treatment of depression.It is generally well-tolerated,and cholestasis is not mentioned in its summary of product characteristics(Sm PC).We present a case of cholestatic and cytolysis liver injury due to escitalopram and a Vigi Base?study.CASE SUMMARY A 68-year-old man was admitted to our emergency unit due to clinical jaundice associated with hepatitis,pruritus and dark urine.We tested the patient for the most common etiologies of jaundice,including hemolysis,viral hepatitis,cirrhosis,carcinoma,cholangitis,cholelithiasis and intrahepatic or extrahepatic obstruction.The etiological study was negative,and an adverse drug reaction was the sole possible explanation.The patient was receiving treatment with escitalopram.Two days after its withdrawal,pruritus was resolved.Ten days after withdrawal,clinical jaundice disappeared.It took a month and three weeks after withdrawal for the patient to have normalized liver function tests.To our knowledge,this is the first reported case of cholestasis where treatment with escitalopram was the only possible cause,with a highly probable causality.In addition,we determined whether escitalopram is associated with hepatotoxicity and cholestasis by performing a disproportionality analysis.All cases of hepatobiliary disorders induced by escitalopram and reported in the World Health Organization pharmacovigilance database(Vigi Base?)were analyzed to characterize this toxicity.We found that patients treated with escitalopram had an increased risk of hepatitis[odds ratio(OR)=1.938(1.186-3.166)]and cholestasis[OR=1.866(1.279-2.724)][OR(95%confidence interval)].The median duration between the introduction of escitalopram and the occurrence of acute hepatitis and/or cholestasis was ten days+/-seven days.CONCLUSION Although extremely rare,this case report,the review of the literature and the pharmacovigilance update confirm that escitalopram can cause drug-induced hepatotoxicity and cholestasis,generally within a week after initiation.Thus,escitalopram should be withdrawn immediately if an iatrogenic cause cannot be excluded.If its responsibility is ascertained,escitalopram should be consequently contraindicated.In addition,serotoninergic antidepressants in patients with nonsevere depression are ineffective and harmful.Finally,the Sm PC of escitalopram should be updated to alert for this risk and give clear clinical guidelines.展开更多
目的探索影响轻中度抑郁症患者对电针、药物和针药联合3种不同干预措施应答的关键因素。方法将61例轻中度抑郁症患者随机分为电针组(20例,脱落1例)、药物组(20例,脱落4例)和针药联合组(21例,脱落1例)。电针治疗选取主穴百会、印堂并接电...目的探索影响轻中度抑郁症患者对电针、药物和针药联合3种不同干预措施应答的关键因素。方法将61例轻中度抑郁症患者随机分为电针组(20例,脱落1例)、药物组(20例,脱落4例)和针药联合组(21例,脱落1例)。电针治疗选取主穴百会、印堂并接电,每次30 min,每周3次;药物治疗口服草酸艾司西酞普兰,5~10 mg/d;针药联合组的患者同时接受电针和药物治疗,治疗均持续6周。观察患者抑郁严重程度、生活质量等临床表现,ELISA法检测3组患者血清相关指标表达水平。结果治疗后,3组患者,24项汉密尔顿抑郁量在(24-item Hamilton depression scale,HAMD-24)评分均显著下降(P<0.05),3组患者,健康状况调查问卷(short form 36 health survey,SF-36)评分均显著提高(P<0.05)。3组患者的HAMD-24应答率、缓解率、SSRS、SF-36评分差异无统计学意义(P>0.05)。结合临床症状和分子生物学指标模拟的模型较为可靠。结论适合不同干预措施的轻、中度抑郁症患者人群基本特征有所不同。对伴随较严重睡眠障碍的抑郁症患者,选择针药联合治疗更有可能取得较好的临床疗效。展开更多
BACKGROUND To assess the effectiveness of Shugan Jieyu capsules on peripheral blood miR-124,miR-132,and brain-derived neurotrophic factor(BDNF)levels in patients with mild to moderate depression following coronary art...BACKGROUND To assess the effectiveness of Shugan Jieyu capsules on peripheral blood miR-124,miR-132,and brain-derived neurotrophic factor(BDNF)levels in patients with mild to moderate depression following coronary artery intervention[percuta-neous coronary intervention(PCI)]for coronary heart disease.Patients with mild-to-moderate depression of the liver-qi stagnation type after PCI for coronary heart disease at the 305th Hospital of the People’s Liberation Army were enrolled from June 2022 to November 2023 and randomly assigned to two groups:Experimental(treated with Shugan Jieyu capsules)and control(tr-eated with escitalopram oxalate tablets).This study compared the antidepressant effects of these treatments using 17-item Hamilton Rating Scale for Depression(HAMD-17)scores,metabolic equivalents,low-density lipoprotein cholesterol,BDNF,high-sensitivity C-reactive protein levels,miR-124 and miR-132 levels,distribution of immune-related lymphocyte subsets,and traditional Chinese me-dicine syndrome scores before and after 6 weeks of treatment.RESULTS No significant difference was observed in any index between the two groups before treatment(P>0.05).After treatment,the total efficacy rates were 93.33%and 90.00%in the experimental and control groups,respectively.Experimental group had significantly lower scores for the main and secondary syndromes compared to the control group(P<0.05).No significant difference was observed in the metabolic equivalents between the two groups be-fore and after treatment(P>0.05).The levels of low-density lipoprotein cholesterol,high-sensitivity C-reactive pro-tein,and miR-132 were significantly lower,whereas those of miR-124,BDNF,CD3+T lymphocytes,CD3+CD4+T helper lymphocytes,and CD3+CD4+/CD3+CD8+cells were significantly higher in the experimental group com-pared to the control group(P<0.05).The incidence of adverse reactions during experimental group was signi-ficantly lower than that in control group(P<0.05).CONCLUSION Shugan Jieyu capsules have good efficacy in patients with mild-to-moderate depression after PCI,and its me-chanism may contribute to the regulation of miR-124,miR-132,BDNF levels,and lymphoid immune cells.展开更多
基金The study was approved by the Ethics Committee of Beijing Changping Hospital of Traditional and Western Medicine.
文摘BACKGROUND Depression is a widespread mental health condition that requires effective treatment.In the treatment of depression,traditional Chinese medicine(TCM)offers obvious advantages,fewer adverse reactions,and a lower recurrence rate.AIM To evaluate the clinical benefits of Guipi decoction combined with escitalopram oxalate tablets for individuals with depression.METHODS In total,80 patients diagnosed as having depression were enrolled in the study and divided into either an experimental group or a control group.All of the patients were orally administered escitalopram oxalate tablets.Additionally,the experimental group received Jiajian Guipi decoction and reduced Governor vessel fumigation over 4 wk.TCM syndrome scores,Hamilton depression rating scale(HAM-D)scores,self-rating depression scale(SDS)scores,and Pittsburgh sleep quality index scores were measured for the two groups and compared before and after the treatment.The two groups were monitored for any adverse reactions.RESULTS After 4 wk of treatment,both groups exhibited a significant reduction in TCM syndrome scores compared with their pre-treatment scores(P<0.05).However,the experimental group exhibited significantly lower TCM syndrome scores than the control group(P<0.05).Similarly,the post-treatment SDS and HAM-D-24 scores were significantly lower in both groups than the pre-treatment scores(P<0.05),with the experimental group exhibiting lower scores than the control group(P<0.05).The total treatment efficiency was significantly better in the experimental group(97.14%)than in the control group(77.78%)(P<0.05).Furthermore,after 4 wk of treatment,the Pittsburgh sleep quality index scores for both groups were significantly lower than those before the treatment(P<0.05),with the experimental group exhibiting lower scores than the control group(P<0.05).The incidence of adverse reactions was significantly lower in the experimental group than in the control group(P<0.05).CONCLUSION The combination of Guipi decoction and escitalopram oxalate tablets was found to be an effective and safe treatment for depression.This combination could reduce TCM syndrome scores,improve depressive symptoms,and enhance sleep quality.
文摘Objective:To investigate the protective role of pumpkin seed ethanolic extract against escitalopram-induced reproductive toxicity in male mice.Methods:Swiss albino male mice were randomly divided into five groups with six mice in each group.Group Ⅰreceived normal water orally,Group Ⅱ,Ⅲ,Ⅳand Ⅴreceived escitalopram oxalate(10 mg/kg),pumpkin seed extract(300 mg/kg)plus escitalopram oxalate(10 mg/kg),escitalopram oxalate(20 mg/kg),and pumpkin seed extract(300 mg/kg)plus escitalopram oxalate(20 mg/kg),respectively.All test doses were continuously administered orally once daily per animal body weight for 30 days and 60 days.Body weight and sexual organ weight were evaluated on day 31 and 61.Effects of pumpkin seed extract on sperm parameters,biochemical parameters and histology of testis were also investigated.Results:Escitalopram 10 or 20 mg/kg caused reproductive toxicity in male mice after 30 and 60 days of treatment.However,simultaneous administration of escitalopram oxalate(10 or 20 mg/kg)with pumpkin seed extract(300 mg/kg)attenuated escitalopram-induced testicular toxicity.Significant increase in the body weight and relative organ weight was observed.Sperm count,sperm motility and viability significantly increased(P<0.05).The histopathological alterations caused by escitalopram was also ameliorated.Conclusions:Ethanolic extract of pumpkin seeds(300 mg/kg body weight)protects again reproductive toxicity induced by escitalopram.Therefore,dietary intake of pumpkin seed extract might be useful for male patients who expose to antidepressant drug due to depression.
基金Supported by The Sichuan Provincial People’s Hospital Translational Medicine Fund,No.2021LY02.
文摘BACKGROUND Antidepressants,particularly selective serotonin reuptake inhibitors,are currently considered the first-line treatment for panic disorder(PD).However,little is known about the relationship between the biomarkers that may predict better treatment.AIM To compare genome-wide methylation and gene expression patterns between responsive and non-responsive patients with PD after 4 wk of escitalopram treatment.METHODS Thirty patients with PD were enrolled in this study(responders=13;nonresponders=17).All patients were assessed using the PD Severity Scale-Chinese version before and after treatment.The Illumina Infinium MethylationEPIC(850k)BeadChip for genome-wide methylation screening and mRNA sequencing was used in all patients with PD.RESULTS A total of 701 differentially methylated positions(DMPs)were found between responders and non-responders(|Δβ|≥0.06,q<0.05),and the hyper-and hypomethylated CpG sites were 511(72.9%)and 190(27.1%),respectively.Relative to non-responders,there were 59 differential transcripts,of which 20 were downregulated and 39 were upregulated(q<0.05).However,no differen tially expressed genes were identified by mRNA sequencing after correcting for multiple testing(|log2(FC)|>1,q>0.05).CONCLUSION This preliminary study showed that DMPs might be associated with the treatment response to escitalopram in PD;however,these DMPs need to be verified in large samples.
文摘Summary： The neuroproteetive effects of escitalopram oxalate in rats with chronic hypoperfusion and the possible mechanism were explored. Chronic hypoperfusion （2-VO） model was prepared and given escitalopram oxalate （experimental group） or PBS （control group） after 6 weeks. Eight weeks after the operation, Morris water maze test was carried out to evaluate the learning and memory ability of the rats. The cell proliferation, three-dimensional vascular distribution, cell morphological changes in ischemic area and the plasma vascular endothelial growth factor （VEGF） were detected to explore the possible mechanisms. （1） Morris water maze test showed that the escape latency in the experimental group was significantly shorter than in the control group, while the first quadrant swimming time in the experi- mental group was significantly longer than the control group （both P〈0.01）. （2） Cerebrovascular confo- cal detection results showed that the inside diameter of capillaries was significantly less in the experi- mental group than in the control group; the vascular density was significantly increased in the experi- mental group and the total area of capillaries was also significantly increased in the experimental group as compared with the control group. （3） There was statistically significant difference in BrdU-positive cells in the ischemic brain tissue between the experimental group and the control group （P=0.003〈0.01）. （4） VEGF concentrations in the plasma and the ischemic area were higher in the experimental group than in the control group （P〈0.05）. It was concluded that escitalopram oxalate could significantly im- prove the learning and memory ability of the rats with chronic cerebral ischemia probably by the VEGF-mediated angiogenesis.
文摘BACKGROUND Depression is a growing public health problem that affects over 350 million people globally and accounts for approximately 7.5%of healthy years lost due to disability.Escitalopram,one of the first-line medications for the treatment of depression,is a selective serotonin reuptake inhibitor and one of the most commonly prescribed antidepressant medications worldwide.Although thought to be generally safe and with minimal drug-drug interactions,we herein present an unusual case of cholestatic liver injury,likely secondary to escitalopram initiation.CASE SUMMARY A 56-year-old Chinese lady presented with fever and cholestatic liver injury two weeks after initiation of escitalopram for the treatment of psychotic depression.Physical examination was unremarkable.Further investigations,including a computed tomography scan of the abdomen and pelvis and tests for hepatitis A,B and C and for autoimmune liver disease were unyielding.Hence,a diagnosis of escitalopram-induced liver injury was made.Upon stopping escitalopram,repeat liver function tests showed downtrending liver enzymes with eventual normalization of serum aspartate aminotransferase and alanine aminotransferase one-week post-discharge.CONCLUSION Clinicians should be aware of the possibility of escitalopram-induced liver injury when initiating depressed patients on antidepressant treatment.This requires extra vigilance as most patients may remain asymptomatic.Measurement of liver function tests could be considered after initiation of antidepressant treatment,especially in patients with pre-existing liver disease.
基金the Medical Research Foundation of Jiangsu Provincial Department of Public Health,No.H201043
文摘We detected the event-related potential mismatch negativity （MMN） of 30 depression patients and compared to 30 age,gender,and education-matched healthy controls.Results showed that amplitudes of frequency and duration MMN were lower in depression patients compared with control patients,indicating abnormality in auditory processing （i.e.,cognitive impairment）.Following escitalopram treatment for 8 weeks,the amplitudes of frequency and duration MMN were significantly increased and Hamilton Rating Scale for Depression scores were significantly decreased in depression patients.These data suggest that escitalopram can improve cognitive function of patients with depression.Further,MMN may be a useful tool for evaluating cognitive function and treatment effects.
文摘Background:Depression will become the second most common disease after coronary heart disease(CHD).Escitalopram and olanzapine are commonly used to treat depression.Some studies indicated that escitalopram combined with olanzapine is effective in treating depression,however,there is no evidence to support these results.Our objective was to study the efficacy of escitalopram combined with olanzapine on depression by conducting a systematic review and meta analysis,and to provide reference for doctors.Methods:Relevant evidence were searched from PubMed,SinoMed,the Cochrane Library,Web of Science,Embase,China Knowledge Resource Integrated(CNKI),Wanfang Data Knowledge Service Platform databases(WANFANG)and VIP dating from inception to July 2020.The randomized controlled trials(RCTs)of escitalopram and olanzapine for the treatment of depression was obtained.According to inclusion and exclusion criteria,two researches(Sun Wu and Wang Zhe)independently screened the literature,extracted data,and evaluated the quality of included studies.Rev Man 5.3 software was used to conduct statistical analyze.Results:A total of 39 studies involving 3,267 patients were identified.These studies were finally included into the meta-analysis.Pooled results showed that there was a significant difference in efficiency(RR=1.18,95%CI:1.14 to 1.12,P<0.00001),HAMD(MD=-4.54,95%CI:-5.09 to-3.99,P<0.00001),and HAMA(MD=-3.94,95%CI:-5.57 to-2.12,P<0.0001).There was no significant difference in adverse reactions(MD=0.07,95%CI-0.03 to 0.17,P=0.19).Heterogeneity test showed that due to the high heterogeneity of HAMD(P<0.00001,12=86%)and HAMA(P<0.00001,I2=91%),after removing the items with high heterogeneity,there were also statistically significant in HAMD(MD=-5.22,95%CI:-5.53 to-4.91,P<0.00001)and HAMA(MD=-5.46,95%CI:-6.15 to-4.77,P<0.00001).Conclusion:Based on this study,the combination of escitalopram and olanzapine was more effective in treating depression than the control group.It is suggested that clinical and scientific researchers carry out more high-quality,large-sample,multi-center RCTs to provide more evidence-based medical evidence for the future study of escitalopram combined with olanzapine in the treatment of depression.
文摘Purpose: Hormone therapy (estrogen with or without progestin) remains the gold standard treatment for hot flashes in menopausal women, but concerns for the risk of hormone therapy have resulted in its decline and a demand for nonhormonal treatments with demonstrated efficacy for hot flashes. Aim of this study was to examine the efficacy of selective serotonin reuptake inhibitor escitalopram on hot flashes in a healthy sample of non-depressant menopausal women in Japan. Methods: We retrospectively analyzed the medical records of 11 menopausal patients with hot flashes, who received escitalopram (10 mg daily) for 2 weeks between March and August 2012. Hot flashes severities and scores were recorded on a scale of 0 to 10 points, at beginning and end of 2 weeks treatment. Results: At 2 weeks of therapy, 9 of 11 patients reported significant decreases in hot flash frequency and severity, but the remission of the symptom was not observed in 2 patients. Speed of relief from hot flashes was rapid (within one week). Conclusions: Escitalopram 10 mg/day may be a prompt and effective option for treating hot flashes in menopausal women who do not want to use hormone replacement therapy.
文摘BACKGROUND The antidepressant escitalopram is widely prescribed for the treatment of depression.It is generally well-tolerated,and cholestasis is not mentioned in its summary of product characteristics(Sm PC).We present a case of cholestatic and cytolysis liver injury due to escitalopram and a Vigi Base?study.CASE SUMMARY A 68-year-old man was admitted to our emergency unit due to clinical jaundice associated with hepatitis,pruritus and dark urine.We tested the patient for the most common etiologies of jaundice,including hemolysis,viral hepatitis,cirrhosis,carcinoma,cholangitis,cholelithiasis and intrahepatic or extrahepatic obstruction.The etiological study was negative,and an adverse drug reaction was the sole possible explanation.The patient was receiving treatment with escitalopram.Two days after its withdrawal,pruritus was resolved.Ten days after withdrawal,clinical jaundice disappeared.It took a month and three weeks after withdrawal for the patient to have normalized liver function tests.To our knowledge,this is the first reported case of cholestasis where treatment with escitalopram was the only possible cause,with a highly probable causality.In addition,we determined whether escitalopram is associated with hepatotoxicity and cholestasis by performing a disproportionality analysis.All cases of hepatobiliary disorders induced by escitalopram and reported in the World Health Organization pharmacovigilance database(Vigi Base?)were analyzed to characterize this toxicity.We found that patients treated with escitalopram had an increased risk of hepatitis[odds ratio(OR)=1.938(1.186-3.166)]and cholestasis[OR=1.866(1.279-2.724)][OR(95%confidence interval)].The median duration between the introduction of escitalopram and the occurrence of acute hepatitis and/or cholestasis was ten days+/-seven days.CONCLUSION Although extremely rare,this case report,the review of the literature and the pharmacovigilance update confirm that escitalopram can cause drug-induced hepatotoxicity and cholestasis,generally within a week after initiation.Thus,escitalopram should be withdrawn immediately if an iatrogenic cause cannot be excluded.If its responsibility is ascertained,escitalopram should be consequently contraindicated.In addition,serotoninergic antidepressants in patients with nonsevere depression are ineffective and harmful.Finally,the Sm PC of escitalopram should be updated to alert for this risk and give clear clinical guidelines.
文摘目的探索影响轻中度抑郁症患者对电针、药物和针药联合3种不同干预措施应答的关键因素。方法将61例轻中度抑郁症患者随机分为电针组(20例,脱落1例)、药物组(20例,脱落4例)和针药联合组(21例,脱落1例)。电针治疗选取主穴百会、印堂并接电,每次30 min,每周3次;药物治疗口服草酸艾司西酞普兰,5~10 mg/d;针药联合组的患者同时接受电针和药物治疗,治疗均持续6周。观察患者抑郁严重程度、生活质量等临床表现,ELISA法检测3组患者血清相关指标表达水平。结果治疗后,3组患者,24项汉密尔顿抑郁量在(24-item Hamilton depression scale,HAMD-24)评分均显著下降(P<0.05),3组患者,健康状况调查问卷(short form 36 health survey,SF-36)评分均显著提高(P<0.05)。3组患者的HAMD-24应答率、缓解率、SSRS、SF-36评分差异无统计学意义(P>0.05)。结合临床症状和分子生物学指标模拟的模型较为可靠。结论适合不同干预措施的轻、中度抑郁症患者人群基本特征有所不同。对伴随较严重睡眠障碍的抑郁症患者,选择针药联合治疗更有可能取得较好的临床疗效。
基金the 305 Hospital Independent Scientific Research Fund,2024,No.24ZZJJLW-022.
文摘BACKGROUND To assess the effectiveness of Shugan Jieyu capsules on peripheral blood miR-124,miR-132,and brain-derived neurotrophic factor(BDNF)levels in patients with mild to moderate depression following coronary artery intervention[percuta-neous coronary intervention(PCI)]for coronary heart disease.Patients with mild-to-moderate depression of the liver-qi stagnation type after PCI for coronary heart disease at the 305th Hospital of the People’s Liberation Army were enrolled from June 2022 to November 2023 and randomly assigned to two groups:Experimental(treated with Shugan Jieyu capsules)and control(tr-eated with escitalopram oxalate tablets).This study compared the antidepressant effects of these treatments using 17-item Hamilton Rating Scale for Depression(HAMD-17)scores,metabolic equivalents,low-density lipoprotein cholesterol,BDNF,high-sensitivity C-reactive protein levels,miR-124 and miR-132 levels,distribution of immune-related lymphocyte subsets,and traditional Chinese me-dicine syndrome scores before and after 6 weeks of treatment.RESULTS No significant difference was observed in any index between the two groups before treatment(P>0.05).After treatment,the total efficacy rates were 93.33%and 90.00%in the experimental and control groups,respectively.Experimental group had significantly lower scores for the main and secondary syndromes compared to the control group(P<0.05).No significant difference was observed in the metabolic equivalents between the two groups be-fore and after treatment(P>0.05).The levels of low-density lipoprotein cholesterol,high-sensitivity C-reactive pro-tein,and miR-132 were significantly lower,whereas those of miR-124,BDNF,CD3+T lymphocytes,CD3+CD4+T helper lymphocytes,and CD3+CD4+/CD3+CD8+cells were significantly higher in the experimental group com-pared to the control group(P<0.05).The incidence of adverse reactions during experimental group was signi-ficantly lower than that in control group(P<0.05).CONCLUSION Shugan Jieyu capsules have good efficacy in patients with mild-to-moderate depression after PCI,and its me-chanism may contribute to the regulation of miR-124,miR-132,BDNF levels,and lymphoid immune cells.
