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SSRIs - Fluoxetine Hydrochloride (Prozac), Sertraline Hydrochloride (Zoloft), Paroxetine Hydrochloride (Paxil), Fluvoxamine Maleate (Luvox), Citalopram Hydrobromide (Celexa).

Depress Anxiety 1998;8 Suppl 1:59-63   (ISSN: 1091-4269)

Fava M; Rosenbaum JF
Depression Clinical and Research Program, Massachusetts General Hospital, Boston 02114, USA.

Anger, hostility and irritability are frequently observed among patients with unipolar depressive disorders. Approximately one-third of depressed outpatients present with "anger attacks," sudden spells of anger accompanied by symptoms of autonomic activation such as tachycardia, sweating, hot flashes, and tightness of the chest. Depressed patients with anger attacks are significantly more anxious and hostile and they are more likely to meet criteria for avoidant, dependent, borderline, narcissistic, and antisocial personality disorders than depressed patients without anger attacks. Several studies suggest that antidepressant treatment of anger attacks in depression is safe and effective. Anger attacks disappear in 53-71% of depressed outpatients treated with antidepressants such as fluoxetine, sertraline, and imipramine. In addition, the rate of emergence of anger attacks after treatment with fluoxetine (6-7%) is no different from the rates observed after treatment with sertraline (8%) and imipramine (10%), and lower than the rate with placebo (20%). Finally, since the central serotonergic neurotransmitter system is known to be involved in the modulation of aggressive behavior in animals and humans, one can hypothesize that antidepressants which affect this system may be particularly effective in depressed patients with anger attacks.

Indexing Check Tags: Human

Language: English
MEDLINE Indexing Date: 199903
Publication Type: JOURNAL ARTICLE; REVIEW (24 references); REVIEW, TUTORIAL
Unique NLM Identifier: 99026743
Journal Code: M

Ann Oncol 2000 Jan;11(1):17-22   (ISSN: 0923-7534)

Stearns V; Isaacs C; Rowland J; Crawford J; Ellis MJ; Kramer R; Lawrence W; Hanfelt JJ; Hayes DF
Breast Cancer Program, Lombardi Cancer Center, Georgetown University School of Medicine, Washington, DC, USA.

BACKGROUND: Many breast cancer survivors suffer debilitating hot flashes. Estrogen, the drug of choice in perimenopausal women, is generally not recommenced to breast cancer survivors. Nonhormonal treatments are mostly disappointing. Anecdotal reports in our institution suggested that the selective serotonin-reuptake inhibitor, paroxetine hydrochloride, might be efficacious in alleviating hot flashes. PATIENTS AND METHODS: Thirty women with prior breast cancer who were suffering at least two hot flashes a day entered a single institution pilot trial to evaluate paroxetine's efficacy in reducing the frequency and severity of hot flashes. After completing daily diaries for one week on no therapy, the women received open-label paroxetine, 10 mg daily for one week, followed by four weeks of paroxetine, 20 mg daily. The women completed hot-flash daily diaries throughout the study period, and a health-related symptom-assessment questionnaire and a quality-of-life rating scale in the first and sixth week of the study. RESULTS: Twenty-seven women completed the six-week study period. The mean reduction of hot flash frequency was 67% (95% confidence interval (95% CI): 56%-79%). The mean reduction in hot flash severity score was 75% (95% CI: 66%-85%). There was a statistically significant improvement in depression, sleep, anxiety, and quality of life scores. Furthermore, 25 (83%) of the study participants chose to continue paroxetine therapy at the end of study. The most common adverse effect was somnolence, resulting in drug discontinuation in two women, and dose reduction in two women. One woman discontinued drug due to anxiety. CONCLUSIONS: Paroxetine hydrochloride is a promising new treatment for hot flashes in breast cancer survivors, and warrants further evaluation in a double-blind randomized placebo-controlled trial.

Comment in: Ann Oncol 2000 Jan; 11(1):9

Indexing Check Tags: Female; Human; Support, Non-U.S. Gov't

Language: English
MEDLINE Indexing Date: 200005
Publication Type: CLINICAL TRIAL; JOURNAL ARTICLE
Unique NLM Identifier: 20154972
Journal Code: M

Psychooncology 1998 Mar-Apr;7(2):129-32   (ISSN: 1057-9249)

Roth AJ; Scher HI
Department of Psychiatry, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.

Indexing Check Tags: Case Report; Human; Male; Support, Non-U.S. Gov't

Language: English
MEDLINE Indexing Date: 199809
Publication Type: JOURNAL ARTICLE
Unique NLM Identifier: 98251417
Journal Code: M