Evidence suggests that selective serotonin reuptake inhibitors (SSRIs, a class of antidepressant medications) may contribute to increased breast cancer risk by stimulating the secretion of prolactin, a potential tumour promoter. The main objective of this study was to determine breast cancer risk associated with the duration, dosage and timing of SSRI use among women, with control for a limited set of confounders. This thesis project, conducted within the context of a population-based two-stage case-control study, consisted of a record linkage study utilizing three Saskatchewan health services databases. Cases included 1,273 women with primary breast cancer diagnosed between January 1, 2003 and December 31, 2005, and controls consisted of 12,730 subjects randomly selected from the province’s population registry. Data on SSRI use was compiled from the Saskatchewan prescription drug plan database. Information on a limited set of established risk factors for breast cancer that may confound this relationship was ascertained from the population registry and the prescription database. Cases and controls were similar in terms of age, total number of consecutive years eligible for prescription coverage and indicators of socioeconomic status. Compared to controls, cases were more likely to be married and to have used hormone therapy and/or oral contraceptives. Compared to nonusers, results indicated that the use of SSRIs for three or more years (as estimated by having filled 36 or more prescriptions for all SSRIs combined during the main exposure window more than two years prior to index date) was not associated with an increased risk of breast cancer (OR= 1.08, 95% CI: 0.74-1.58), controlling for age, marital status, oral contraceptive and hormone therapy use. In addition, no suggestion of increased risk was detected for long-term exposures to individual SSRIs (24 or more prescriptions filled during the main exposure window) and in relation to total combined SSRI use 2-7 years and more than seven years prior to index date. However, these risk estimates may have been affected by potential sources of information bias and confounding. In summary, these results do not provide evidence to suggest that the risk of breast cancer is increased with the use of SSRIs. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2008-01-08 13:51:38.74

In der Pathophysiologie der Depression könnte das Zusammenspiel von Immun- und Nervensystem eine zentrale Rolle spielen. In den Krankheitsepisoden zeigen depressive Patienten eine gesteigerte Produktion pro-inflammatorischer Zytokine wie z. B. Interleukin (IL)-1β und dem Tumornekrosefaktor (TNF)-α. Es gibt nur begrenzte Informationen bezüglich der Effekte von Antidepressiva auf Zytokine. Die meisten Studien berichten nur über die Veränderungen einzelner Zytokine und keine hat bis jetzt über Effekte von Antidepressiva auf IL-22 berichtet. Wir haben systematisch die Wirkung von drei Antidepressiva, nämlich Citalopram, Escitalopram und Mirtazapin auf die Sekretion der Zytokine IL-1β, IL-2, IL-4, IL-6, IL-17, IL-22 und TNF-α in einem Vollblutverfahren in-vitro untersucht. Als Immunstimulanzien wurden der gegen humanes CD3 gerichtete monoklonale Antikörper OKT3 und der gegen CD40 gerichtete monoklonale Antikörper 5C3 verwendet. Es zeigte sich, dass es unter Citalopram zu einer erhöhten IL-1β, I-6, IL-22 und TNF-α-Produktion und unter Mirtazapin zu einer erhöhten Produktion von IL-1β, IL-22 und TNF-α gegenüber der Kontrollbedingung, in der keine Antidepressiva zugesetzt wurden, kam. Unter Escitalopram kam es zu einer gegenüber der Kontrollbedingung verringerten IL-17-Produktion. Der Einfluss der Antidepressiva auf IL-2 und IL-4 war für alle drei Psychopharmaka nicht signifikant. Verglichen mit Escitalopram führte Citalopram zu höheren IL-1β-, IL-6-, IL-17- und IL-22-Konzentrationen und Mirtazapin führte zu einer höheren IL-1β-, IL-17-, IL-22- und TNF-α-Produktion. Möglicherweise besteht ein Bezug zwischen dem Profil der Zytokinproduktion eines Antidepressivums und seinen therapeutischen Effekten, Nebenwirkungen und seinem Rückfallrisiko. Zur Überprüfung dieser Hypothese sind jedoch in-vivo Studien notwendig. / The interplay between immune and nervous systems plays a pivotal role in the pathophysiology of depression. In depressive episodes, patients show increased production of pro-inflammatory cytokines such as interleukin (IL)-1β and tumor necrosis factor (TNF)-α. There is limited information on the effect of antidepressant drugs on cytokines, most studies report on a limited sample of cytokines and none have reported effects on IL-22. We systematically investigated the effect of three antidepressant drugs, citalopram, escitalopram and mirtazapine, on secretion of cytokines IL-1β, IL-2, IL-4, IL-6, IL-17, IL-22 and TNF-α in a whole blood assay in vitro, using murine anti-human CD3 monoclonal antibody OKT3, and 5C3 monoclonal antibody against CD40, to stimulate T and B cells respectively.Citalopram increased production of IL-1β, IL-6, TNF-α and IL-22. Mirtazapine increased IL-1β, TNF-α and IL-22. Escitalopram decreased IL-17 levels. The influence of antidepressants on IL-2 and IL-4 levels was not significant for all three drugs. Compared to escitalopram, citalopram led to higher levels of IL-1β, IL-6, IL-17 and IL-22; and mirtazapine to higher levels of IL-1β, IL-17, IL-22 and TNF-α. Mirtazapine and citalopram increased IL-22 production. The differing profile of cytokine production may relate to differences in therapeutic effects, risk of relapse and side effects.

No description available.

Darbo tikslas Ištirti kserostomijos klinikos ypatumus ir juos lemiančius veiksnius sergant Šegreno sindromu, po radioterapijos kaklo ir galvos srityje bei vartojant triciklius antidepresantus ir pasiūlyti burnos sveikatos pagerinimo būdą. Darbo uždaviniai 1. Ištirti pagrindinius kserostomijos klinikos simptomus ir nustatyti juos įtakojančių veiksnių reikšmingumą. 2. Nustatyti kai kurių etiologinių kserostomijos veiksnių sąsają su pacientų amžiumi, lytimi ir pagrindiniais klinikos simptomais. 3. Ištirti didžiųjų ir mažųjų seilių liaukų funkcinę būklę sialometrijos ir sialoscintigrafijos metodais ir įvertinti jos įtaką klinikiniams simptomams. 4. Nustatyti kserostomijos trukmės sąsają su pagrindiniais kserostomijos simptomais. 5. Nustatyti sergančiųjų pacientų dantų, apydančio ir burnos higienos būklės sąsają su kserostomijos etiologija ir klinika. 6. Pasiūlyti kserostomijos stadijų klasifikaciją ir jos diagnostikos kriterijus. 7. Patobulinti dirbtinių seilių sudėtį ir pasiūlyti sergančiųjų kserostomija burnos sveikatos pagerinimo būdą. Medžiaga ir metodai Tyrimų medžiagą sudarė dvi grupės: I. KMU dantų ir burnos ligų klinikoje 2003 – 2005 metais 64 pacientai, pirmą kartą besikreipę konsultuotis dėl sausos burnos, buvo įtraukti į studiją. Iš jų 34 atrinkti dirbtinių seilių poveikiui tirti iš kurių 27 pacientam atliktas sialoscintigrafinis tyrimas; II. Iš KMUK archyvo atsitiktiniu būdu buvo atrinktos 481... [toliau žr. visą tekstą] / There is a continuous discussion about the basic xerostomia etiology and clinic problems in literature. Still individual authors have no unified opinion on how and to what extent the etiological factor of hyposalivation is relevant to manifestation of various aspects of xerostomia (Jensen SB et al.). There is no final objective data about the relationship of subjective patient complains with age, sex, psychological status and duration of xerostomia. There is an on-going discussion among certain authors in medical literature on when salivation should be considered as deficient, and what level of hyposalivation causes clinical xerostomia. Proper treatment of xerostomia is one of the most relevant problem. At the present, there is no unified treatment strategy that is towarded to stage or severity degree of xerostomia. However, objective criteria are not developed yet to classify xerostomia severity. Most authors, independently of absence of clear indications, recommend anticariesogenic, antibacterial treatment and to compensate the lack of saliva with artificial ones. Currently, there are not available saliva substitutes as one of the most important xerostomia treatment component on the market in our country. The study is also needed to evaluate the effectiveness of the treatment. 2. THE AIM AND THE GOALS OF THE STUDY The aim of the study was to evaluate the pecularities of xerostomia etiology and clinic and the... [to full text]

Tyrimo objektas ir metodai: tiriamieji antidepresantai: bušpirono hidrochloridas; sertralino hidrochloridas; amitriptilino hidrochloridas, fluvoksamino maleatas ir paroksetino hidrochloridas. Šių antidepresantų mišinio skirstymui ir komponentų identifikavimui plonasluoksnės chromatografijos metodu naudoti tirpikliai ir ryškinimo reagentai: metanolis, 25 proc. amonio hidroksidas, trichlormetanas, etanolis, etilacetatas, cikloheksanas, etano rūgštis, dimetilacetonas, acetonitrilas, propanolis, trifluoracto rūgštis, dichlormetanas, 1,4–dioksanas, benzenas, petrolio eteris, izoamilo spiritas, dietileteris, oktanas, metano rūgštis, N,N –dimetilanilinas, nitrobenzenas ir heksanas; Dragendorfo reagentas (modifikuotas pagal Munjė), ninhidrinas, Mandelino reagentas ir UV spinduliuotė (254 nm; 365 nm). Darbo tikslas: sukurti ir validuoti plonasluoksnės chromatografijos metodiką, tinkamą išskirstyti antidepresantų mišinio (amitriptilino hidrochloridas, paroksetino hidrochloridas, sertralino hidrochloridas, fluvoksamino maleatas ir bušpirono hidrochloridas) komponentus ir juos identifikuoti. Darbo uždaviniai: atlikti mokslinės literatūros šaltinių analizę įvertinant amitriptilino, paroksetino, sertralino, fluvoksamino ir bušpirono fizines, chemines, farmakologines savybes ir analizės metodus naudojamus jiems identifikuoti. Aprašyti skirtingas plonasluoksnės chromatografijos metodikas, tinkamas amitriptilino, paroksetino, sertralino, fluvoksamino ir bušpirono mišinio skirstymui ir... [toliau žr. visą tekstą] / Object and methods: research antidepressants: buspirone hydrochloride, sertraline hydrochloride, amitriptyline hydrochloride, fluvoxamine maleate and paroxetine hydrochloride. Used solvents and visualization reagents for those antidepressant mixture distribution and component identification by thin-layer chromatography: methanol, 25 percent. ammonium hydroxide, trichloromethane, ethanol, ethyl acetate, cyclohexane, ethane acid, dimethylketone, acetonitrile, propanol, trifluoroacetic acid, dichloromethane, 1,4-dioxane, benzene, petroleum ether, isoamyl alcohol, diethyl ether, octane, methane acid, N, N - dimethylaniline, nitrobenzene and hexane; Dragendorff reagent (modified by Munjė), ninhydrin, Mandelina reagent and UV radiation (254 nm; 365 nm). Aim: to develop and validate a thin-layer chromatographic method suitable for separating of antidepressants mixture components (amitriptyline hydrochloride, paroxetine hydrochloride, sertraline hydrochloride, fluvoxamine maleate and buspirone hydrochloride) and identify them. Objective: to perform analysis of scientific literature suporting amitriptyline, paroxetine, sertraline, fluvoxamine and buspirone physical, chemical, pharmacological properties, and analytical methods used to identify them. Describe the different thin-layer chromatographic techniques suitable for amitriptyline, paroxetine, sertraline, fluvoxamine and buspirone mixture distribution and component identification. Create a suitable thin-layer chromatographic... [to full text]

In recent years, there has been much debate regarding the rationality of consumption and cost effectiveness of antidepressants. The economic aspects of treating depression are becoming more frequently evaluated as newer antidepressants become available and as healthcare entities attempt to address increasing costs. The aim of the research. To investigate and assess the possibilities of a more rational use of the public and private funds of the Lithuanian population in the cases of medicament depression treatment. The tasks of the research: 1. To perform a comparative analysis of the antidepressant consumption in the years 2004 to 2009 in Lithuania. 2. To evaluate depression diagnosis and treatment effectiveness and depression diagnosis dynamics in Lithuania from 2004 to 2009. 3. To perform antidepressant cost analysis from 2004 to 2009 in Lithuania. 4. To perform the cost-effectiveness analysis of depression treatment and propose the possible ways for costs rationalization. Scientific novelty of the research. For the first time, depression relapse rate was used as a medicament depression treatment effectiveness evaluation indicator in assessing the rationality of the costs of treatment with antidepressants. The survey data can be used in practice when dealing with antidepressants consumption and the improvement of the effectiveness of evaluation and reimbursement systems in Lithuania. / Pastaraisiais metais kyla daug diskusijų dėl antidepresantų panaudojimo racionalumo bei sąnaudų efektyvumo. Rinkoje atsirandant naujiems antidepresantams vis dažniau analizuojami ekonominiai depresijos gydymo aspektai, o sveikatos priežiūros sektoriaus valdymo institucijos bando spręsti išlaidų didėjimo problemą. Darbo tikslas. Ištirti ir įvertinti galimybes racionaliau naudoti viešąsias ir privačias Lietuvos gyventojų lėšas vaistams, skiriamiems medikamentiniam depresijos atvejų gydymui. Darbo uždaviniai. 1. Atlikti lyginamąją antidepresantų sunaudojimo 2004–2009 m. Lietuvoje analizę. 2. Įvertinti depresijos diagnozavimo ir gydymo efektyvumą bei depresijos diagnozavimo dinamiką Lietuvoje 2004–2009 m. 3. Atlikti išlaidų antidepresantams per 2004–2009 m. Lietuvoje analizę. 4. Atlikti depresijos gydymo sąnaudų efektyvumo analizę ir pateikti galimus išlaidų racionalizavimo būdus. Darbo mokslinis naujumas ir praktinė reikšmė. Vertinant gydymo antidepresantais išlaidų racionalumą, pirmą kartą kaip medikamentinio depresijos atvejų efektyvaus gydymo vertinimo indikatorius buvo panaudotas depresijos pasikartojimo rodiklis. Tyrimo rezultatai gali būti naudojami praktikoje, nagrinėjant antidepresantų panaudojimą, sąnaudų efektyvumo vertinimą ir kompensavimo sistemos tobulinimą Lietuvoje.

Certain electrophysiological markers hold promise in distinguishing individuals with major depressive disorder (MDD) and in predicting antidepressant response, thereby assisting with assessment and optimizing treatment, respectively. This thesis examined resting brain activity via electroencephalographic (EEG) recordings, as well as EEG-derived event-related potentials (ERPs) to auditory stimuli and facial expression presentations in individuals with MDD and controls. Additionally, the utility of resting EEG as well as auditory ERPs (AEPs), and the associated loudness-dependence of AEPs (LDAEP) slope, were assessed in predicating outcome to chronic treatment with one of three antidepressant regimens [escitalopram (ESC); bupropion (BUP); ESC+BUP]. Relative to controls, depressed adults had lower pretreatment cortical activity in regions implicated in approach motives/positive processing. Increased anterior cingulate cortex (ACC)-localized theta was observed, possibly reflecting emotion/cognitive regulation disturbances in the disorder. AEPs and LDAEPs, putative indices of serotonin activity (implicated in MDD etiology), were largely unaltered in MDD. Assessment of ERPs to facial expression processing indicated slightly blunted late preconscious perceptual processing of expressions, and prolonged processing of intensely sad faces in MDD. Faces were rated as sadder overall in MDD, indicating a negative processing bias. Treatment responders (vs. non-responders) exhibited baseline cortical hypoactivity; after a week of treatment, cortical arousal emerged in responders. Increased baseline left fronto-cortical activity and early shifts towards this profile were noted in responders (vs. non-responders). Responders exhibited a steep, and non-responders shallow, baseline N1 LDAEP derived from primary auditory cortex activity. P2 LDAEP slopes (primary auditory cortex-derived) increased after a week of treatment in responders and decreased in non-responders. Consistent with overall findings, ESC responders displayed baseline cortical hypoactivity and steep LDAEP-sLORETA slopes (vs. non-responders). BUP responders also exhibited steep baseline slopes and high ACC theta. These results indicate that specific resting brain activity profiles appear to distinguish depressed from non-depressed individuals. Subtle ERP modulations to simple auditory and emotive processing also existed in MDD. Resting alpha power, ACC theta activity and LDAEP slopes predicted antidepressant response in general, but were limited in predicting outcome to a particular treatment, which may be associated with limited sample sizes.

Thesis (Ph. D.)--West Virginia University, 2009. / Title from document title page. Document formatted into pages; contains x, 202 p. : ill. Includes abstract. Includes bibliographical references (p. 172-182).

Thesis (M.Sc.)--Memorial University of Newfoundland, Faculty of Medicine, 1997. / Typescript. Bibliography: leaves 154-161.

Thesis (M. Sc.)--Memorial University of Newfoundland, Faculty of Medicine, 1998. / Typescript. Bibliography: leaves 68-81.