Drugs online research references
Br J Clin Pharmacol. 2001 Feb;51(2):181-3.
Prescribing patterns in patients using new antidepressants.
Meijer WE, Heerdink ER, Pepplinkhuizen LP, van Eijk JT, Leufkens HG.
Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht, The Netherlands.
AIMS: To study possible selective prescribing ('channelling') we compared characteristics of patients using the SSRI sertraline with patients using longer available SSRIs. METHODS: An observational cohort study in 1251 patients being prescribed an SSRI. RESULTS: In contrast to other studies, we found no evidence for channeling of sertraline. Sertraline was mainly prescribed for the labelled indication (depressive disorder), while older SSRIs were more often prescribed also for other indications. Time on the market was inversely associated to the proportion of patients treated for depressive disorder. CONCLUSIONS: We found no evidence for channeling of sertraline compared with prescribing patterns of older SSRIs.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11259993&dopt=Abstract
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Behav Brain Res. 2001 Jun;121(1-2):95-102.
Serotonin reverses dominant social status.
Larson ET, Summers CH.
Department of Biology and Neuroscience Group, University of South Dakota, 414 E. Clark Street, 57069-2390, Vermillion, SD, USA
Social stress from aggressive interaction is expressed differently in specific brain regions of dominant and subordinate male Anolis carolinensis. Prior to aggressive behavior, the outcome is predictable via the celerity of postorbital coloration: Dominant males exhibit more rapid eyespot darkening. Serotonergic activation is manifest rapidly (1 h) in hippocampus, nucleus accumbens and brainstem of subordinate males, and is expressed more rapidly in dominant males. Amygdalar serotonergic activation responds rapidly (1 h) in dominant males, but is expressed slowly (1 w) and chronically in subordinate males. We hypothesized that chronic (1 w) serotonin elevation, manipulated by the selective serotonin reuptake inhibitor sertraline, would decrease aggressiveness and result in subordinate status. Dominant status was established in pairs of male A. carolinensis. The pairs were separated and treated with sertraline or vehicle. Sertraline was given in food to either the dominant or the subordinate male, both males or neither male for 1 week. Pairs were reintroduced, and behavior and social status recorded. When both dominant and subordinate males were treated with sertraline (or vehicle), or when subordinate males alone were treated with sertraline, previously established social relationships remained unchanged or became associative. However, when dominant males alone were treated with sertraline, their social status was reversed (43%) or negated (57%). Latency to eyespot darkening was significantly retarded in dominant males treated with sertraline, and aggressive displays and attacks were reduced. Chronic 5-HT elevation is consistent with subordinate status. Social status and aggressive disposition do not appear to be immutable, but may be changed by neuroendocrine mechanisms that mediate adaptation to environmental conditions like stress.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11275287&dopt=Abstract
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camh.net
BACKGROUND: The use of selective serotonin reuptake inhibitors (SSRIs) as antidepressant therapy has increased considerably since the introduction of fluoxetine in 1989. By 1999, 3 of the 4 available SSRIs were among the top 10 most frequently used drugs in the United States. In addition, SSRIs were one of the major contributors to the growth in psychotropic medication expenditures during the past 5 years. OBJECTIVE: The purpose of this article was to examine the utilization patterns of the 4 most commonly used SSRIs and their contribution to rising antidepressant medication expenditures among claimants in a publicly funded drug program. Using the results of forecasting models, we explored possible ways to control these growing expenditures. METHODS: Cross-sectional antidepressant claims and expenditure data from the Ontario Drug Benefits program for 1992 to 1998 were examined. Five scenarios were modeled in which future SSRI expenditures and claims were predicted using exponential smoothing models. RESULTS: If the historical patterns of use continued, a 20% increase in the 1998 level of expenditures was expected to occur by the year 2000. Predicted expenditures are sensitive to the composition of the SSRI claims. Exclusive use of 1 of the 4 major SSRIs (fluvoxamine, fluoxetine, paroxetine, and sertraline) could decrease projected expenditures by 30% or increase them by 11%. An "equal shares" approach, in which each of the 4 SSRIs are used in equal proportions in the population, may reduce expenditures by approximately 8%. CONCLUSIONS: The current trends in the utilization data suggest that sertraline and paroxetine are being used as first-line treatments. The results of the forecasting models suggest that growing expenditures could be curbed if these 2 antidepressants were not used in that manner. Short of limiting the drugs available on benefit formularies, there may be a way to control costs through the use of a prescribing algorithm. Although our results support the use of fluoxetine for first-line SSRI treatment as a cost-control measure, we do not definitively recommend its adoption. These findings contribute to the discussion about using fixed versus flexible formularies as a potential cost-control mechanism.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11293562&dopt=Abstract
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