SSRI Doses and Effectiveness – High Dose vs Low Dose, Is There a Difference?

adminBest Practices, Major Depression, Treatments of Depression Leave a Comment

One of the questions that has bedevilled clinicians ever since the introduction of the first SSRI (Prozac, fluoxetine) is whether there is any relationship between SSRI doses and effectiveness. In other words, do higher doses result in greater effectiveness. I can recall about 20 years ago reading the first clinical trial looking at this question. It was an article published …

SSRI and Other Antidepressants and Pregnancy – 2020

Peter ForsterMajor Depression, Physical Conditions and Health, Treatments of Depression Leave a Comment

We have several other posts on this topic which trace the evolution of our thinking about the risks of using antidepressants during pregnancy. Generally, the data continues to support our view that the risks of depression during pregnancy, both in terms of effects on the mother and effects on the child, usually outweigh the risks of antidepressant use. Another large …

Maternal SSRI Use and Autism

Peter ForsterPhysical Conditions and Health, Treatments of Depression

The CBS Evening News (4/18, story 9, 1:15, Pelley) reported, “Studies have shown that pregnant women who take antidepressants are more likely to have children with autism.” Newly published studies examine whether the medication is causing this. TIME (4/18, Park) reports that in two studies, investigators “found that other factors, including genes linked to mental illness, may be more strongly …

SSRI Antidepressants and Pregnancy – 2016

Peter ForsterPhysical Conditions and Health, Treatments of Depression

Several recent articles provide additional information about the effects on the infant of exposure to SSRI antidepressants during pregnancy. A large study published in Pediatrics adds to information that suggests that exposure to SSRI antidepressants, particularly late in pregnancy, may be associated with birth complications. As with other studies, one major limitation in the design of the study is that it …

Why SSRIs May Increase Anxiety Short Term

Peter ForsterPsychobiology, Treatments of Depression

SSRIs are among the most commonly prescribed medications for chronic anxiety, but not infrequently these medications may be associated with a short term increase in symptoms that precedes the long term benefit. In an elegant series of studies published online in late August 2016 in the premier scientific journal, Nature, researchers from the NIH and the University of North Carolina at …

Functional Brain Imaging and Antidepressant Response

Peter ForsterBasic Science, Testing, Treatments of Depression

One of the most exciting initiatives currently in the important area of  the treatment of depression is the International Study to Predict Optimized Treatment in Depression (iSPOT-D). This large multi-center initiative is based on a private industry and academic partnership that is designed to both identify best practices in the treatment of depression and also commercialize them. The most recent publication from this …

SSRI Dose Response

Peter ForsterMajor Depression, Treatments of Depression

It has long been unclear whether higher doses of SSRIs are associated with greater response. What has been clear is that higher doses are associated with significantly increased side effects. In fact previous research, whether individual studies or meta-analyses have failed to find a significant dose response with the result that many have felt that there is a flat dose response …

Escitalopram Reduces Inflammation in Depression

Peter ForsterMajor Depression, Physical Conditions and Health, Psychobiology, Treatments of Depression

Escitalopram reduces inflammation in depression and potentially reduces neurotoxicity according to an article just published in the Journal of Psychiatric Research. A pro-inflammatory tendence has previously been noted in patients with depression, and this seems to be associated strongly with increases in kynurenine (see below for more information on how exercise counteracts this tendency). Kynurenine is the first step in …

SSRI Antidepressants and Pregnancy – 2015

Peter ForsterMajor Depression, Physical Conditions and Health, Treatments of Depression

A recent study concludes that there may be some good news about the impact of SSRI antidepressants on the fetus in women who are pregnant. The authors used national registry data to examine the relationship between pre-birth SSRI treatment and pregnancy complications while controlling for the effects of the psychiatric diagnoses related to SSRI use. Some previous studies had just compared people who took …