tailieunhanh - Báo cáo y học: "The opposite effects of fluvoxamine and sertraline in the treatment of psychotic major depression: a case report"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: The opposite effects of fluvoxamine and sertraline in the treatment of psychotic major depression: a case report. | Kishimoto et al. Annals of General Psychiatry 2010 9 23 http content 9 1 23 ANNALS OF GENERAL PSYCHIATRY CASE REPORT Open Access Thefcpposite effects of fluvoxamine and sertraline in the treatment of psychotic major depression a case report Akira Kishimoto 1 AyakoTodani2 Junko Miura1 Tetsuno Kitagaki1 and Kenji Hashimoto3 Abstract Background Psychotic major depression is a clinical subtype of major depressive disorder. A number of clinical studies have demonstrated the efficacy of the combination of an antidepressant for example a tricyclic antidepressant or selective serotonin reuptake inhibitor SSRI and an atypical antipsychotic or electroconvulsive therapy ECT in treating psychotic major depression. In several studies monotherapy of SSRIs such as fluvoxamine has been shown to be effective in the treatment of psychotic major depression. Methods We report on a 36-year-old Japanese woman in whom fluvoxamine a SSRI with sigma-1 receptor agonist and sertraline a SSRI with sigma-1 receptor antagonist showed the opposite effects on psychotic symptoms in the treatment of psychotic major depression. Results Symptoms of depression and psychosis in the patient who was non-respondent to antipsychotic drugs improved after fluvoxamine monotherapy. At 3 years later a switch to sertraline from fluvoxamine dramatically worsened the psychotic symptoms in the patient. Then a switch back to fluvoxamine from sertraline improved these symptoms 1 week after fluvoxamine treatment. Conclusion Doctors should consider the monotherapy of sigma-1 receptor agonist fluvoxamine as an alternative approach to treating psychotic major depression. Background Psychotic major depression is a clinical subtype of major depressive disorder and is characterized by psychosis accompanied by relatively severe depressive symptoms. Unfortunately psychotic major depression frequently proves difficult to treat. A number of clinical studies have demonstrated the efficacy of the