medigraphic.com
ISSN 0185-3325 (Impreso)
Órgano Oficial del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz

2008, Número 4

<< Anterior Siguiente >>

Salud Mental 2008; 31 (4)


Los antidepresivos inhibidores selectivos de recaptura de serotonina (ISRS, ISR-5HT)

Chávez- León E, Ontiveros UMP, Serrano GC

Idioma: Español
Referencias bibliográficas: 116
Paginas: 307-319
Archivo PDF: 221.12 Kb.


RESUMEN

La depresión es un trastorno mental que afecta a 3.7 % de la población. Los antidepresivos inhibidores selectivos de la recaptura de serotonina (ISRS) resultan útiles en el tratamiento de éste y otros trastornos mentales. El citalopram, escitalopram, fluoxetina, fluvoxamina, paroxetina y sertralina constituyen este grupo de fácil administración y con un amplio perfil de seguridad.
Objetivos: 1) Establecer las indicaciones actuales de los antidepresivos ISRS. 2) Describir los mecanismos que explican su acción antidepresiva. 3) Describir los efectos secundarios frecuentes y aquéllos específicamente relacionados con este grupo antidepresivo.
Resultados: Los antidepresivos ISRS son el tratamiento de elección para la depresión, los trastornos de angustia, de ansiedad generalizada, obsesivo-compulsivo, de estrés postraumático, disfórico premenstrual y la bulimia nervosa. Los pacientes deprimidos muestran una actividad menor a la normal del neurotransmisor serotonina. La inhibición de la recaptura de la serotonina sobre los receptores serotoninérgicos presinápticos 5HT1A, 5HT2C y 5HT3C aumenta la neurotransmisión en este sistema. La desensibilización de los autorreceptores 5HT1A y la regulación hacia abajo (downregulation) de los receptores 5HT2 acoplados a la proteína G, efecto tardío de los ISRS, dan por resultado la mejoría de los síntomas depresivos. El mecanismo que explica el efecto antidepresivo relativamente tardío parece ser distinto al efecto serotoninérgico agudo y rápido responsable de la mejoría en el caso del trastorno disfórico premenstrual. Estos antidepresivos, como los estabilizadores del ánimo y la terapia electroconvulsiva, incrementan los niveles séricos del factor de crecimiento neuronal cerebral, así como de otros factores neurotróficos. Aunque las dosis de los ISRS son variables, en la mayoría de los casos es posible iniciar el tratamiento antidepresivo con dosis terapéuticas e incrementarlas paulatinamente hasta las dosis máximas con seguridad. Sus efectos secundarios más frecuentes son gastrointestinales, en la respuesta sexual y sobre la densidad ósea. Los efectos secundarios específicamente relacionados con el uso de estos antidepresivos son: 1. El síndrome serotoninérgico, caracterizado por cambios en el estado mental, hiperactividad autonómica y anomalías neuromusculares. 2. El síndrome de secreción inapropiada de hormona antidiurética, que se caracteriza por osmolaridad sérica alta, urinaria baja e hiponatremia, así como por mialgias, letargo, cefalea e incluso confusión, convulsiones y coma. 3. El sangrado, principalmente de tubo digestivo y cutáneo. El uso de los ISRS aumenta el riesgo de sangrar entre dos y cuatro veces. Cuando el paciente usa aspirina, el riesgo aumenta hasta siete veces y con el uso concomitante de antiinflamatorios, cerca de 16 veces. La edad, el antecedente de sangrado y la capacidad de inhibir la recaptura constituyen también factores de riesgo. 4. El síndrome de descontinuación, menor con la fluoxetina, mayor con la paroxetina y sertralina, aparece a partir del segundo día y su duración es de dos semanas. Manifestaciones como náusea, cefalea, parestesias, congestión nasal y malestar general se deben a la disminución de los niveles de serotonina en la sinapsis. 5. Los efectos sobre el producto cuando los ISRS se utilizan durante la gestación consisten en malformaciones congénitas específicas. La sertralina se ha asociado a onfalocele, defectos del septum cardíaco y anencefalia. A su vez, la fluoxetina se ha asociado a craneosinostosis y defectos cardíacos. Y la paroxetina a defectos cardíacos, gastrosquisis, defectos del tubo neural y también a onfalocele y anencefalia. Su uso también aumenta la tasa de abortos espontáneos hasta 1.45 veces, parto prematuro y bajo peso al nacer, problemas en el neonato inmediato (problemas respiratorios e hipotonía), hipoglucemia, cianosis, inquietud, convulsiones y Apgar bajo. Su uso durante el tercer trimestre puede ocasionar hipertensión pulmonar persistente que, aunque es rara, se asocia a una mortalidad de 10- 20 %. 6) De los efectos por el uso de ISRS durante la lactancia se conoce poco. En el caso de la sertralina y la paroxetina no se detectan estos antidepresivos en el suero del niño; en cambio, los niveles séricos de citalopram fueron de 1.9 nmol/L, de fluoxetina 47 nmol/L y de venlafaxina de 91 nmol/L. En los estudios disponibles no se observaron efectos conductuales o en el desarrollo del recién nacido. 7) Suicidalidad o riego suicida. Aunque el tratamiento antidepresivo disminuye tanto la ideación y la frecuencia de suicidios en los pacientes tratados, la FDA ha establecido una serie de recomendaciones para el manejo de pacientes que inician el tratamiento con antidepresivos ISRS: Iniciar con la dosis más baja, citar semanalmente a los pacientes durante 6 semanas consecutivas, recomendar y facilitar el contacto telefónico, prohibir el uso de alcohol y drogas, interrogar en cada ocasión sobre pensamientos y comportamientos suicidas o autolesivos, documentar en el expediente la información y usar psicoterapia de apoyo, cognitivo-conductual o interpersonal en el tratamiento.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Medina-Mora ME, Borges G, Lara C, Benjet C, Blanco J. Prevalence, service use, and demographic correlates of 12-month DSM- IV psychiatric disorders in Mexico: results from the Mexican National Comorbidity Survey. Psychol Med 2005;35:1773-1783.

  2. Chavez-León E. Fármacos antidepresivos. En: Chávez-León E, Del Bosque-Garza J, Ontiveros-Uribe MP (eds). Manual de psicofarmacología. Capítulo 1. México: Asociación Psiquiátrica Mexicana; 2007; 5-9.

  3. Soares CN, Joffe H, Viguera AC et al. Paroxetine versus placebo for women in midlife after hormone therapy discontinuation. Am J Med 2008;121(2):159-162.

  4. Schatzberg AF, Cole JO, Debattista C. Manual of clinical psychopharmacology. Washington: American Psychiatric Publishing, Inc.; 2007; p. 35-38.

  5. Gillman PK. Tricyclic antidepressant pharmacology and therapeutic drug interaction updated. Br J Pharmacol 2007;151:737-748.

  6. Krishnan KR. Revisiting monoamine oxidase inhibitors. J Clin Psychiatry 2007;68(supl 8):35-41.

  7. Stahl SM. Not so selective serotonin reuptake inhibitors. J Clin Psychiatry 1998;59:343-344.

  8. Hansen RA, Gartlehener G, Lohr KN, Gaynes BN, Carey T. Treatment of major depressive disorder. Ann Intern Med 2005;143:415-426.

  9. Machado M, Iskedjian M, Ruiz I, Einarson TR. Remission, dropouts, and adverse drug reaction rates in major depressive disorder: A meta- analysis of head-to-head trials. Curr Med Res Opin 2006;22(9):1825-1837.

  10. Swenson JR, Doucette S, Fergusson D. Adverse cardiovascular events in antidepressants trials involving high risk patients: A systematic review of randomized trials. Can J Psychiatry 2006;51:923-929.

  11. Nemeroff CB, Schatzberg AF. Pharmacological treatments for unipolar depression. En: Nathan PE, Gorman JM (eds). Treatments that work. New York: Oxford University Press; 2007; p. 271-288.

  12. Rubino A, Roskell N, Tennis P et al. Risk of suicide during treatment with venlafaxine, citalopram, fluoxetine, and dothiepin: Retrospective cohort study. Br Med J 2007;334(7587):242-247.

  13. Fougherty DD, Rauch SL, Jenike MA. Pharmacological treatments for obsessive-compulsive disorder. En: Nathan PE, Gorman JM (eds). Treatments that work. New York: Oxford University Press; 2007; p. 447-474.

  14. Golier JA, Legge JA, Yehuda R. Pharmacological treatment of posttraumatic stress disorder. En: Nathan PE, Gorman JM (eds). Treatments that work. New York: Oxford University Press; 2007; p. 475-512.

  15. Wilson GT, Fairburn CG. Treatments for eating disorders. En: Nathan PE, Gorman JM (eds). Treatments that work. New York: Oxford University Press; 2007; p. 579-610.

  16. Landén M, Nissbrandt H, Allgulander C, Sörvik K, Ysander C et al. Placebo-controlled trial comparing intermittent and continuous paroxetine in premenstrual dysphoric disorder. Neuropsychopharmacol 2007;32:153-161.

  17. Chavez-León E, Ng B, Ontiveros-Uribe MP. Tratamiento farmacológico del trastorno límite de personalidad. Salud Mental 2006;29(5):16-24.

  18. Davidson JRT: Pharmacotherapy of social anxiety disorder: What does the evidence tell us? J Clin Psychiatry (supl) 2006;67 12:20-26.

  19. Hoyer D, Clarke DE, Fozard JR et al. International Union of Pharmacology classification of receptors for 5-hydroxytryptamine (serotonin). Pharmacol Rev 1994;46:157-203.

  20. Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med 2005;352:1112-1120.

  21. Holmans P, Weissman MM, Zubenko GS et al. Genetics of early-onset major depression (GenRED): final genome scan report. Am J Psychiatry 2007;64:248-258.

  22. Kendler KS, Gats M, Gardner CO, Pedersen NL. A Swedish national twin study of lifetime major depression. Am J Psychiatry 2006;163:109-114.

  23. Landén M, Thase ME. A model to explain the therapeutic effects of serotonin reuptake inhibitors: the role of 5-HT2 receptors. Psychopharmacol Bull 2006;39(1):147-166.

  24. Belmaker RH, Agam G. Mechanisms of disease. Major depressive disorder. N Engl J Med 2008;358(1):55-68.

  25. Kerege F, Vaudan G, Schwald M et al. Neurotrophin levels in postmortem brains of suicide victims and the effects of antemortem diagnosis and psychotropic drugs. Brain Res Mol 2005;136:29-37.

  26. Monteleone P, Serritella C, Martiadis V, Maj M. Decreased levels of serum brain-derived neurotrophic factor in both depressed and euthymic patients with unipolar depression and in euthymic depressed and euthymic patients with bipolar I and II disorders. Bipolar Disord 2008;10:95-100.

  27. Chen B, Dowlatshahi D, Macqueen GM et al. Increased hippocampal BDNF immunoreactivity in subjects treated with antidepressant medication. Biol Psychiatry 2001;50:260-265.

  28. Clayton AH, Pradko JF, Croft HA et al. Prevalence of sexual dysfunction among newer antidepressants. J Clin Psychiatry 2002;63:357-366.

  29. Williams VSL, Baldwin DS, Hogue SL et al. Estimating the prevalence and impact of antidepressant- induced sexual dysfunction in 2 European countries: a cross sectional patient survey. J Clin Psychiatry 2006;67:204-210.

  30. Balon R. Disfunción sexual asociada a los ISRS. Am J Psychiatry (Ed Esp) 2006;9(10):39-64.

  31. Diem SJ, Blackwell TL, Stone KL, Yaffe K, Haney EM et al. Use of antidepressants and rates of hip bone loss in older women. Arch Intern Med 2007;167:1240-1245.

  32. Richards JB, Papaioannou A, Adachi JD, Joseph L, Whitson HE. For the Canadian Multicenter Osteoporosis Study (CAMOS) Research Group: Effect of selective serotonin reuptake inhibitors on the risk of fracture. Arch Intern Med 2007;167:188-194.

  33. Looper KL. Potential medical and surgical complications of serotonergic antidepressant medications. Psychosom 2007;48(1):1-9.

  34. Birmes P, Coppin D, Schmitt I et al. Serotonin syndrome: a brief review. Can Med Assoc J 2003;168(11):1439-1442.

  35. Ng BKW, Cameron AJD, Liang R, Rahman H Serotonin syndrome following methylene blue infusion during parathyroidectomy: a case report and literature review. Can J Anesthesiol 2008;55:36-41.

  36. Isbister GK, Bowe SJ, Dawson A, Whyte IM. Relative toxicity of selective serotonin reuptake inhibitors (SSRIs) in overdose. J Toxicol Clin Toxicol 2004;42:277-285.

  37. Watson WA, Litovitz TL, Rodgers GC Jr. 2002 annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med 2003;21:353-421.

  38. Gill M, Lovecchio F, Selden B. Serotonin syndrome in a child after a single dose of fluvoxamina. Ann Emerg Med 1999;33:457-459.

  39. Isbister GK, Dawson A, Whyte IM et al. Neonatal paroxetine withdrawal syndrome or actually serotonin syndrome? Arch Dis Child Fetal Neonatal Ed 2001;F147-F148.

  40. Laine K, Heikkinen T, Ekblad U, Kero P. Effects of exposure to selective reuptake serotonin inhibitors during pregnancy on serotoninérgico symptoms in newborns and cord blood monoamine and prolactin concentrations. Arch Gen Psychiatry 2003;60:720-726.

  41. U.S. Food and Drug Administration. Selective serotonin reuptake inhibitors (SSRIs), selective serotonin- norepinephrin reuptake inhibitors (SNRIs), 5-hydroxytryptamine receptor agonists (triptans). http://www.fda.gov/CDER/DRUG/InfoSheets/HCP/triptansHCP.htm Accesada en enero de 2008.

  42. Rosenbaum JF, Fava M, Hoog SL, Ascroft RC, Krebs WB. Selective serotonin reuptake inhibitor discontinuation syndrome: a randomized clinical trial. Biol Psychiatry 1998;44:77-87.

  43. Verre M, Bossio A, Mammone M et al. Serotonin syndrome caused by olanzapine and clomipramine. Minerva Anestesiol 2007;73:1-5.

  44. Lee A, Woo J, Ito S. Frequency of infant adverse events that are associated with citalopram use during breast- feeding. Am J Obstet Gynecol 2004;190:218-221.

  45. Palmer BF, Gates JR, Lader M. Causes and management of hiponatremia. Ann Pharmacother 2003; 37:1694-1702.

  46. Bouman WP, Pinner G, Johnson H. Incidence of selective serotonin-reuptake inhibitor (SSRI)- induced hyponatraemia due to the syndrome of inappropriate antidiuretic hormone (SIADH) secretion in the elderly. Int J Geriatr Psychiatry 1998;13:12-15.

  47. Fabian TJ, Amico JA, Kroboth PD et al. Paroxetine-induced hyponatremia in older adults: a 12- week prospective study. Arch Intern Med 2004;164:327-332.

  48. Kirby D, Ames D. Hyponatraemia and selective serotonin-reuptake inhibitors in elderly patients. Int J Geriatr Psychiatry 2001;16:484-493.

  49. Meijer WE, Heerdink ER, Nolen WA et al. Association of risk of abnormal bleeding with degree of serotonin-reuptake inhibition by antidepressants. Arch Intern Med 2004;164:2367-2370.

  50. Dalton SO, Johansen C, Mellemkjaer L et al. Use of selective serotonin reuptake- inhibitors and risk of upper gastrointestinal tract bleeding: a population-based cohort study. Arch Intern Med 2003;163:59-64.

  51. De Abajo FJ, Rodriguez LA, Montero D. Association between selective serotonin reuptake- inhibitors and upper gastrointestinal bleeding: population-based, case-control study. Br Med J 1999;319(7217):1106-1109.

  52. Kurdiak PA, Juurlink DN, Kopp A et al. Antidepressants, warfarin, and the risk of hemorrhage. J Clin Psychopharmacol 2005;25:561-564.

  53. Tata LJ, West J, Smith C et al. General population based-study of the impact of tricyclic and selective serotonin reuptake-inhibitor antidepressants on the risk of acute myocardial infarction. Heart 2005;91:465-471.

  54. Van Walraven C, Mamdani MM, Wells PS et al. Inhibition of serotonin reuptake by antidepressants and upper gastrointestinal bleeding in elderly patients: retrospective cohort study. Br Med J 2001;323(7314):655-658.

  55. Wessinger S, Kaplan M, Choi L et al. Increased use of selective-serotonin reuptake inhibitors in patients admitted with gastrointestinal haemorrhage: a multicentre retrospective analysis. Aliment Pharmacol Ther 2006;23:937-944.

  56. Loke YK, Trivedi AN, Singh S. Meta-analysis: gastrointestinal bleeding due to interaction between selective serotonin uptake inhibitors and non-steroidal anti-inflammatory drugs. Aliment Pharmacol Ther 2008;27:31-40.

  57. De Abajo FJ, Jick H, Derby L et al. Intracraneal haemorrhage and use of selective serotonin reuptake inhibitors. Br J Clin Pharmacol 2003;50:43-47.

  58. Hougardy DM, Egberts TC, Van Der Graaf F et al. Serotonin transporter polymorphism and bleeding time during SSRI therapy. Br J Clin Pharmacol (en prensa) 2008.

  59. Bogetto F, Bellino S, Revello RB, Patria L. Discontinuation syndrome in dysthymic patients treated with selective serotonin reuptake inhibitor: a clinical investigation. CNS Drugs 2002;16:273-283.

  60. Rothschild AJ, Locke CA. Reexposure to fluoxetine alter serious suicide attempts by three patients: the role of acatisia. J Clin Psychiatry 1991;52:491-493.

  61. Lane RM. Withdrawal symptoms after discontinuation of selective serotonin reuptake inhibitors (SSRIs). J Serotonin Res 1996;3(2):75-83.

  62. Judge R, Parry MG, Quail D, Jacobson JG. Discontinuation symptoms: comparison of brief interruption in fluoxetine and paroxetine treatment. Int Clin Psychopharmacol 2002;17:217-225.

  63. Gavin NI, Gaynes BN, Lohr KN et al. Perinatal depression. Obstet Gynecol 2005;106:1071-1083.

  64. Dietz PM, Williams SB, Callaghan WM rt al. Clinically identified maternal depression before, during, and alter pregnancies ending in live births. Am J Psychiatry 2007;164:1515-1520.

  65. Cooper WO, Willy ME, Pont SJ et al. Increasing use of antidepressants in pregnancy. Am J Obstet Gynecol 2007;196:544.e1-544.e5.

  66. Hendrick V, Stowe ZN, Altshuler LL et al. Placental passage of antidepressant medications. Am J Psychiatry 2003;160:993-996.

  67. Alwan S, Reefhuis J, Rasmussen S. Use of selective serotonin-reuptake inhibitors in pregnancy and the risk of birth defects. N Engl J Med 2007;356(26):2684-2692.

  68. Louik C, Lin AE, Werler MM et al. First-trimester use of selective serotonin-reuptake inhibitors and the risk of birth defects. N Engl J Med 2007;356(26):2675-2683.

  69. Rahimi R, Shekoufen N, Abdollahi M et al. Pregnancy outcomes following exposure to serotonin reuptake inhibitors: a meta-analysis of clinical trials. Reprod Toxicol 2005;22(4):571-575.

  70. Kallen B. Neonate characteristics alter maternal use of antidepressants in late pregnancy. Arch Pediatr Adolesc Med 2004;158:312-316.

  71. Simon GE, Cunningham ML, Davis RL. Outcomes of prenatal antidepressant exposure. Am J Psychiatry 2002;159:2055-2061.

  72. Oberlander TF, Misri S, Fitzgerald CE et al. Pharmacologic factors associated with transient neonatal symptoms following prenatal psychotropic medication exposure. J Clin Psychiatry 2004;65:230-237.

  73. Sivojelezova A, Shuhaiber S, Sarkissian L et al. Citalopram use in pregnancy: prospective comparative evaluation of pregnancy and fetal outcome. Am J Obstet Gynecol 2005;193:2004-2009.

  74. Bairy KL, Madhyastha S, Ashok KP et al. Developmental and behavioral consequences of prenatal fluoxetine. Pharmacol 2007;79:1-11.

  75. Levinson-Castiel R, Merlob P, Linder N et al. Neonatal abstinence syndrome after in- utero exposure to selective serotonin- reuptake inhibitors in term infants. Arch Pediatr Adolesc Med 2006;160:173-176.

  76. Sanz EJ, De las Cuevas C, Kiuru A et al. Selective serotonin-reuptake inhibitors in pregnant women and neonatal withdrawal syndrome: a database analysis. Lancet 2005;365(9458):482-487.

  77. Chambers CD, Hernandez Diaz S, Van Marter LJ, Werler MM. Selective serotonin-reuptake inhibitors and risk of persistent pulmonary hypertension of the newborn. N Engl J Med 2006;354(6):579-587.

  78. Misri S, Reebye P, Kendrick K et al. Internalizing behaviors in 4-yearold children exposed in-utero to psychotropic medications. Am J Psychiatry 2006;163:1026-1032.

  79. Nulman I, Rovet J, Stewart DE et al. Neurodevelopment of children exposed in utero to antidepressant drugs. N Engl J Med 1997;336:258-262.

  80. Nulman I, Rovet J, Stewart DE et al. Child development following exposure to tricyclic antidepressants or fluoxetine throughout fetal life: a prospective, controlled study. Am J Psychiatry 2002;159:1889-1895.

  81. Casper RC, Fleisher BE, Lee-Ancajas JC et al. Follow-up of children of depressed mothers exposed or not exposed to antidepressant drugs during pregnancy. J Pediatr 2003;142:402-408.

  82. Cohen LS, Altshuler LL, Harlow Bl et al. Relapse of major depression during pregnancy in women who maintain or discontinue antidepressant treatment. J Am Med Assoc 2006;295:499-507.

  83. Andersson L, Sundstrom-Poromaa I, Wulff M et al. Implications of antenatal depression and anxiety for obstetric outcome. Obstet Gynecol 2004;104:467-476.

  84. Misri S, Oberlander TF, Fairbrother N et al. Relation between prenatal maternal mood and anxiety and neonatal health. Can J Psychiatry 2004;49:684-689.

  85. Murray L. The impact of posnatal depression on infant development. J Child Psicol Psychiatry 1992;33:543-561.

  86. Spinelli MG, Endicott J. Controlled clinical trial of interpersonal psychotherapy versus parenting education program for depressed pregnant women. Am J Psychiatry 2003;160:555-562.

  87. Eberhard-Gran M, Eskild A, Opjordsmoen S. Use of psychotropic medications in treating mood disorders during lactation. CNS Drugs 2006;20(3):187-198.

  88. Van Odijk J, Kull I, Borres M et al. Breast feeding and allergic disease: a multidisciplinary review of the literature (1996- 2001) on the mode of early feeding in infancy and its impact on later atopic manifestations. Allergy 2003;58:833-843.

  89. Anderson PO, Pochop SL, Manoguerra AS. Adverse drug reactions in breastfed infants: less than imagined. Clin Pediatr 2003;42:325-340.

  90. Rampono J, Proud S, Hackett LP et al. A pilot study of newer antidepressant concentrations in cord and maternal serum and possible effects in the neonate. Int J Neuropsychopharmacol 2004;7:329-334.

  91. Weissman AM, Levy BT, Hartz AJ et al. Pooled analysis of antidepressant levels in lactating mothers, breast milk, and nursing infants. Am J Psychiatry 2004;161:1066-1078.

  92. Berle JO, Steen VD, Aamo TO et al. Breastfeeding during maternal antidepressant treatment with serotonin reuptake inhibitors: infant exposure, clinical symptoms, and cytochrome P450 genotypes. J Clin Psychiatry 2004;65:1228-1234.

  93. Merlob P, Stahl B, Sulkes J. Paroxetine during breast- feeding: infant weight gain and maternal adherence to counsel. Eur J Pediatr 2004;163:135-139.

  94. Grunebaum MF, Ellis SP, Shuhua L, Oquendo MA, Mann J. Antidepressants and suicide risk in the United States, 1985-1999. J Clin Psychiatry 2004;65(11):1456-1462.

  95. Teicher MH, Glod C, Cole JO. Emergence of intense suicidal preoccupation during fluoxetine treatment. Am J Psychiatry 1990;147:207-210.

  96. Beasley CM, Dornseif BE, Bosomworth JC et al. Fluoxetine and suicide: A meta-analysis of controlled trials of treatment for depression. Br Med J 1991;303:685-692.

  97. Libby AM, Brent DA, Morrato EH et al. Decline in treatment of pediatric depression after FDA advisory on risk of suicidality with SSRIs. Am J Psychiatry 2007;164:884-891.

  98. Gibbons RD, Hendricks Brown C, Hur K et al. Early evidence on the effects of regulators’ suicidality warnings on SSRI prescriptions and suicide in children and adolescents. Am J Psychiatry 2007;164:1356-1363.

  99. US Department of Health and Human Services. Centers for Disease Control and Prevention. Fatal Injury Report: Web based injury statistics query and reporting system, www.cdc.gov/NCIPC/wisqars. Accesada en enero de 2008.

  100. US Food and Drug Administration: Briefing Document for Psychopharmacologic Drugs Advisory Committee, December 13, 2006, http://www.fda.gov/ohrms/dockets/ac/06/briefing/ 2006-4272b1-01-FDA.pdf. Accesada en enero de 2008.

  101. Nemeroff CB, Kalali A, Keller MB et al. Impact of publicity concerning pediatric suicidality data on physician practice patterns in the United States. Arch Gen Psychiatry 2007;64:466-472.

  102. The Tads Team: The Treatment for Adolescents with Depression Study (TADS): Long-term effectiveness and safety outcomes. Arch Gen Psychiatry 64(10):1132-1143.

  103. Juurlink DN, Mamdani MM, Koop A, Redelmeier DA. The risk of suicide with selective serotonin reuptake inhibitors in the elderly. Am J Psychiatry 2006;163:813-821.

  104. Nutt DJ. Death and dependence: current controversies over the selective serotonin reuptake inhibitors. J Psychopharmacol 2003;17:355-364.

  105. Baldassano CF, Trumen CJ, Nierenberg A et al. Akathisia: a review and case report following paroxetine treatment. Compr Psychiatry 1996;37:122-124.

  106. Lipinski JF Jr, Mallya G, Zimmerman P, Pope HG Jr. Fluoxetine-induced akathisia: clinical and theoretical implications. J Clin Psychiatry 1989;50:339-342.

  107. Roy-Byrne P, Cowley DS. Pharmacological treatments for panic disorder, generalized anxiety disorder, specific phobia, and social anxiety. En: Nathan PE, Gorman JM (eds). Treatments that work. New York: Oxford University Press; 2007; p.395-430.

  108. Mann JJ, Kapur S. The emergence of suicidal ideation and behavior during antidepressant pharmacotherapy. Arch Gen Psychiatry 1991;48:1027-1033.

  109. Charlier C, Broly F, Lhermitte M et al. Polymorphisms in the CYP 2D6 gene: association with plasma concentrations of fluoxetine and paroxetine. Ther Drug Monit 2003;25:738-742.

  110. Murphy GM Jr, Kremer C, Rodrigues HE, Schatzberg AF. Pharmacogenetics of antidepressant medication intolerance. Am J Psychiatry 2003;160:1830-1835.

  111. Perlis RH, Purcell S, Fava M et al. Association between treatment-emergent suicidal ideation with citalopram and polymorphisms near cyclic adenosine monophosphate response element binding protein in the STAR*D study. Arch Gen Psychiatry 2007;64:689-697.

  112. Bridge JA, Iyengar S. Salary CB et al. Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment. JAMA 2007;297(15):1683-1696.

  113. Gibbons RD, Brown CH, Hur K et al. Relationship between antidepressants and suicide attempts: An analysis of the Veterans Health Administration Data Set. Am J Psychiatry 2007;164:1044-1049.

  114. Beasley CM Jr, Ball SG, Nilsson ME et al. Fluoxetine and adult suicidality revisited: An updated meta-analysis using expanded data sources from placebo-controlled trials. J Clin Psychopharmacol 2007;27 (6):682-686.

  115. Rosebush PI, Margetts P. Serotonin syndrome as a result of clomipramine monotherapy. J Clin Psychopharmacol 1999;19:285-287.

  116. Friedman RA, Leon AC. Expanding the Black Box-Depression, antidepressants, and the risk of suicide. N Engl J Med 2007;356(23):2345-2346.




2020     |     www.medigraphic.com