Hostname: page-component-8448b6f56d-xtgtn Total loading time: 0 Render date: 2024-04-19T11:19:38.687Z Has data issue: false hasContentIssue false
  • English
  • Français

Do Dual-Action Neurotransmitter Agents Offer an Advantage in Psychiatric Treatment?

Published online by Cambridge University Press:  07 November 2014

Richard C. Shelton ,
Dennis S. Charney  and
Madhukar Trivedi
Get access Rights & Permissions [Opens in a new window]

Abstract

Antidepressant treatments have evolved over the last 20 years, and many new drugs with complex mechanisms of action are available. It has become apparent that mechanism of action is significant in terms of treatment impact. We may have some capacity to predict the potential outcomes of treatment based on what drugs we use. Depression management requires elaborate assessment in order to keep track of treatment progress and know how to move through the sequences of therapy. Many patients with depression who are treated with antidepressants do not experience full remission, and a large number of patients who do recover eventually relapse. Remission as a treatment goal is difficult to achieve. One of the reasons why remission rates are low is that the currently available treatment choices are implemented improperly. Also, our understanding of the neurobiology of depression is still in the early stages. As we gain more knowledge about what this disorder truly entails, we will be able to achieve better treatment outcomes, and we can hope that remission will become the standard of care in treating patients with depression.

Type
Teaching Monograph
Information
CNS Spectrums , Volume 6 , Issue 9: Epilepsy: Diagnosis and Treatment in the 21st Century , September 2001 , pp. 1 - 8
Copyright
Copyright © Cambridge University Press 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Wallace, H, Shorvon, S, Tallis, R. Age-specific incidence and prevalence rates of treated epilepsy in an unselected population of 2,052,922 and age-specific fertility rates of women with epilepsy. Lancet. 1998; 352: 1970–1973.CrossRefGoogle Scholar
2. Webber, MP, Hauser, WA, Ottman, R, Annegers, JF. Fertility in persons with epilepsy. Epilepsia. 1986; 27: 746–752.CrossRefGoogle ScholarPubMed
3. Schupf, N, Ottman, R. Reproduction among individuals with idiopathic/cryptogenic epilepsy: risk factors for reduced fertility in marriage. Epilepsia. 1996; 37: 833–840.CrossRefGoogle ScholarPubMed
4. Schupf, N, Ottman, R. Likelihood of pregnancy in individuals with idiopathic/cryptogenic epilepsy: social and biologic influence. Epilepsia. 1994; 35: 750–756.CrossRefGoogle Scholar
5. Dansky, LV, Andermann, E, Andermann, F. Marriage and fertility in epileptic patients. Epilepsia. 1980; 21: 261–271.CrossRefGoogle ScholarPubMed
6. Fisher, RS, Vickrey, BG, Gibson, P et al. , The impact of epilepsy from the patient's perspective I: descriptions and subjective perceptions. Epilepsy Res. 2000; 41: 39–51.CrossRefGoogle ScholarPubMed
7. Herzog, AG, Seibel, MM, Schomer, DL, Vaitukaitis, JL, Geschwind, N. Reproductive endocrine disorders in women with partial seizures of temporal lobe origin. Arch Neurol. 1986; 43: 341–346.CrossRefGoogle ScholarPubMed
8. Morrell, MJ. Catamenial epilepsy and issues of fertility, sexuality, and reproduction. In: Wyllie, E, ed. The Treatment of Epilepsy: Principles and Practice. 3rd ed. Baltimore, Md: Lippincott Williams and Wilkins; 2001: 671–680.Google Scholar
9. Drislane, FW, Coleman, AE, Schomer, DL et al. , Altered pulsatile secretion of luteinizing hormone in women with epilepsy. Neurology. 1994; 44: 306–310.CrossRefGoogle ScholarPubMed
10. Meo, R, Bilo, L, Nappi, C et al. , Derangement of the hypothalamic GnRH pulse generator in women with epilepsy. Seizure. 1993; 2: 241–252.CrossRefGoogle ScholarPubMed
11. Dana-Haeri, J, Oxley, J, Richens, A. Pituitary responsiveness to gonadotrophin-releasing and thyrotrophin-releasing hormones in epileptic patients receiving carbamazepine or phenytoin. Clin Endocrinol (Oxf). 1984; 20: 163–168.CrossRefGoogle ScholarPubMed
12. Pritchard, PB, Wannamaker, BB, Sagel, J, Nair, R, DeVillier, C. Endocrine function following complex partial seizures. Ann Neurol. 1983; 14: 27–32.CrossRefGoogle ScholarPubMed
13. Sperling, MR, Pritchard, PB, Engel, J, Daniel, C, Sagel, J. Prolactin in partial epilepsy: an indicator of limbic seizures. Ann Neurol. 1986; 20: 716–722CrossRefGoogle ScholarPubMed
14. Dana-Haeri, J, Trimble, MR, Oxley, J. Prolactin and gonadotrophin changes following generalized and partial seizures. J Neurol Nenrosurg Psychiatry. 1983; 46: 331–335.CrossRefGoogle ScholarPubMed
15. Bilo, L, Meo, R, Valentino, R, Buscaino, GA, Straino, S, Nappi, C. Abnormal pattern of luteinizing hormone pulsatility in women with epilepsy. Fertil Steril. 1991;55:705–711.CrossRefGoogle ScholarPubMed
16. Bilo, L, Meo, R, Nappi, et al. , Reproductive endocrine disorders in women with primary generalized epilepsy. Epilepsia. 1988;29:612–619.CrossRefGoogle ScholarPubMed
17. Murialdo, G, Galimberti, CA, Magri, F et al. , Menstrual cycle and ovary alterations in women with epilepsy on antiepileptic therapy. J Endocrinol Invest. 1997;20:519–526.CrossRefGoogle ScholarPubMed
18. Murialdo, G, Galimberti, CA, Gianelli, MV et al. , Effects of valproate, phenobarbital and carbamazepine on sex-steroid setup in women with epilepsy. Clin Neuropharmacol. 1998;21:52–58.Google ScholarPubMed
19. Cummings, LN, Giudice, L, Morrell, MJ. Ovulatory function in epilepsy. Epilepsia. 1995;36:355–359.CrossRefGoogle ScholarPubMed
20. Stoffel-Wagner, B, Bauer, J, Flugel, D, Brennemann, W, Lingmuller, D, Elger, CE. Serum sex hormones are altered in patients with chronic temporal lobe epilepsy receiving anticonvulsant medication. Epilepsia. 1998;39:1164–1173.CrossRefGoogle ScholarPubMed
21. MacPhee, GJ, Larkin, JG, Butler, E, Beatsall, GH, Brodie, MJ. Circulating hormones and pituitary responsiveness in young epileptic men receiving long-term antiepileptic medication. Epilepsia. 1988;29:468–475.CrossRefGoogle ScholarPubMed
22. Luhdorf, K. Endocrine function and antiepileptic treatment. Acta Neurol Scand. 1983;67(suppl 94):15–19.Google Scholar
23. Levesque, LA, Herzog, AG, Seibel, MM. The effect of phenytoin and carbamazepine on serum dehydroepiandrosterone sulfate in men and women who have partial seizures with temporal lobe involvement. J Clin Endocrinol Metab. 1986;63:243–245.CrossRefGoogle ScholarPubMed
24. Dana-Haeri, J, Oxley, J. Reduction of free testosterone by antiepileptic drugs. Br Med J. 1982;284:85–86.CrossRefGoogle ScholarPubMed
25. Commission on Classification and Terminology of the International League Against Epilepsy. Proposal for a revised classification of epilepsies and epileptic syndromes. Epilepsia. 1989;30:389–399.CrossRefGoogle Scholar
26. Reutens, DC, Howell, RA, Gebert, KE, Berkovic, SF. Validation of a questionnaire for clinical seizure diagnosis. Epilepsia. 1992;33:1065–1071.CrossRefGoogle ScholarPubMed
27. Coulam, CB, Annegers, JF. Do oral anticonvulsants reduce the efficacy of oral contraceptives? Epilepsia. 1979;20:519–526.CrossRefGoogle ScholarPubMed
28. Mattson, RH, Cramer, JA, Darney, PD, Naftolin, F. Use of oral contraceptives by women with epilepsy. JAMA. 1986;256:238–240.CrossRefGoogle ScholarPubMed
29. Haukkamaa, M. Contraception by norplant Norplant subdermal capsules is not reliable in epileptic patients on anticonvulsant treatment. Contraception. 1986;33:559–565CrossRefGoogle Scholar
30. Odlind, V, Olsson, SE. Enhanced metabolism of levonorgestrel during phenytoin treatment in a woman with Norplant implants. Contraception. 1986;33:257–261.CrossRefGoogle Scholar
31. Krauss, GL, Brandt, J, Campbell, M, Plate, C, Summerfield, M. Antiepileptic medication and oral contraceptive interactions: a national survey of neurologists and obstetricians. Neurology. 1996;46:1534–1539.CrossRefGoogle ScholarPubMed
32. Morrell, MJ, Sarto, GE, Osborne Shafer, P, Borda, EA, Herzog, A, Callanan, M. Health issues for women with epilepsy: a descriptive survey to assess knowledge and awareness among healthcare providers. J Women's Health Gend Based Med. 2000;9:959–965.CrossRefGoogle ScholarPubMed
33. Zahn, CA, Morrell, MJ, Collins, SD, Collins, SD, Labiner, DM, Yerby, MS. Management issues for women with epilepsy: a review of the literature. American Academy of Neurology Practice Guidelines. Neurology. 1998;51:949–956.CrossRefGoogle Scholar
34. Isojarvi, JIT, Laatikainen, TJ, Pakarinen, AJ, Juntunen, KTS, Myllyla, VV. Polycystic ovaries and hyperandrogenism in women taking valproate for epilepsy. N Engl J Med. 1993;329:1383–1388.CrossRefGoogle ScholarPubMed
35. Poison, DW, Wadsworth, J, Adams, J, Franks, S. Polycystic ovaries—common finding in normal women. Lancet. 1988;870–872.Google Scholar
36. Isojarvi, JIT, Laatikainen, TJ, Knip, M, Pakarinen, AJ, Juntunen, KTS, Myllyla, VV. Obesity and endocrine disorders in women taking valproate for epilepsy. Ann Neurol. 1996;39:597–584.CrossRefGoogle ScholarPubMed
37. Ben-Shlomo, I, Franks, S, Adashi, EY. The polycystic ovary syndrome: nature or nurture? Fertil Steril. 1995;63:953–954.CrossRefGoogle ScholarPubMed
38. Lobo, RA. A disorder without identity: “HCA,” “PCO,” “PCOD,” “PCOS,” and “SLS”: what are we to call it?! Fertil Steril. 1995;63:1158–1160.CrossRefGoogle Scholar
39. Clayton, RN, Ogden, V, Hodgkinson, J et al. , How common are polycystic ovaries in normal women and what is their significance for the fertility of the population? Clin Endocrinol. 1992;37:127–134.CrossRefGoogle ScholarPubMed
40. Isojarvi, JIT, Rattya, J, Myllyla, VV et al. , Valproate, lamotrigine and insulin mediated risks in women with epilepsy. Ann Neurol. 1998;43:446–451.CrossRefGoogle ScholarPubMed
41. Isojarvi, JIT, Parakinen, AJ, Ylipalosaari, PJ, Myllyla, VV. Serum hormones in male epileptic patients receiving anticonvulsant medication. Arch Neurol. 1990;47:670–676.CrossRefGoogle ScholarPubMed
42. Fenwick, PBC, Mercer, C, Grant, R et al. , Nocturnal penile tumescence and serum testosterone levels. Arch Sex Behav. 1986;15:13–21.CrossRefGoogle ScholarPubMed
43. Rattya, J, Turkka, J, Pakarinen, AJ et al. , Reproductive effects of valproate, carbamazepine, and oxcarbazapine in men with epilepsy. Neurology. 2001;56:31–36.CrossRefGoogle Scholar
44. Isojarvi, JIT, Pakarinen, AJ, Rattya, A, Pelkonen, O, Myllyla, VV. Serum sex hormone levels after replacing carbamazepine with oxcarbazepine. Eur J Clin Pharmacol. 1995;47:461–464.CrossRefGoogle ScholarPubMed
45. Morrell, MJ, Guldner, GT. Self-reported sexual function and sexual arousability in women with epilepsy. Epilepsia. 1996;37:1204–1210.CrossRefGoogle ScholarPubMed
46. Morrell, MJ, Sperling, MR, Stecker, M, Dichter, MA. Sexual dysfunction in partial epilepsy: a deficit in physiological sexual arousal. Neurology. 1994;44:243–247.CrossRefGoogle Scholar
47. Morrell, MJ. Sexuality in epilepsy. In: Engel, J, Pedley, TA, eds. Epilepsy: A Comprehensive Textbook. New York, NY: Lippincott-Raven Publishers; 1997:2021–2026.Google Scholar