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标题: 抗抑郁药物的其他作用， [打印本页]
作者: 晔阳    时间: 07-5-25 23:17
标题: 抗抑郁药物的其他作用，
抗抑郁药物处了抗抑郁外，还有其他作用。这些作用可以看作是副作用，也可看作是另外的治疗作用。比如，抗抑郁药的减肥作用。由于多种SSRI （selective serotonin re-uptake inhibitor), 就是选择性 五-羟色胺(5-HT,or serotonin) 受体重摄取抑制剂减缓5-HT 的清楚，延长了它的作用。他的作用之一就是增加体内能量代谢率。因此而减肥。可是有的药物，如维斯通是5-HT 和多巴胺受体抑制剂。这两种受体都有增加能量代谢的作用。抑制了他们的作用，当然，吃进去的用不完，怎么办。只好，陈挖洞，广集量，存起来了。
作者: starlamb    时间: 07-5-25 23:43
标题: 回复 #1 晔阳 的帖子
我的药物
Luvox, clonazepam 及 seroquel是属于SSRI 还是5-HT?
会有增胖的副作用吗？
还有Lamictal是属于哪一类型呢？

请大哥指点！
作者: 晔阳    时间: 07-5-26 00:42
标题: LUVOX 是SSRI
ATTACHMENT


NDA 20-243/S-021



[Note: Below is the labeling for Luvox. This labeling was agreed upon bySolvay and the Agency in a series of faxes dated September 21, 24, and 26,2000. The labeling is identical to your last approved labeling supplement, S-022, which was approved in anAgency letter dated August 9, 2000, except for the highlighted revisions. Theserevisions to labeling are based on the labeling changes proposed in yourDecember 2, 1999 submission (S-021) as well as labeling revisions requested in an Agency letter datedJune 1, 2000 (S-017).
Double underlinefont denotes additions to the labeling, and strikeout font denotes deletions tothe labeling.]

LUVOX®(FluvoxamineMaleate) Tablets
25 mg, 50 mg and100 mg

DESCRIPTION
Fluvoxamine maleate is a selective serotonin (5-HT) reuptake inhibitor(SSRI) belonging to a new chemical series, the 2-aminoethyl oxime ethers ofaralkylketones. It is chemically unrelated to other SSRIs andclomipramine.
It is chemicallydesignated as 5-methoxy-4’-(trifluoromethyl)valerophenone-(E)-O-(2-aminoethyl)oximemaleate (1:1) and has the empirical formula C15H21O2N2F3C4H4O4.
Its molecular weight is 434.4.

The structural formula is:



file:///C:/DOCUME%7E1/pfeng/LOCALS%7E1/Temp/msohtml1/01/clip_image002.gif






Fluvoxamine maleateis a white or off white, odorless, crystalline powder which is sparinglysoluble in water, freely soluble in ethanol and chloroform and practicallyinsoluble in diethyl ether.

LUVOX® (Fluvoxamine Maleate) Tablets are available in 25mg, 50 mg and 100 mg strengths for oral administration.
In addition to the active ingredient,fluvoxamine maleate, each tablet contains the following inactiveingredients:
carnauba wax, hydroxypropylmethylcellulose, mannitol, polyethylene glycol, polysorbate 80, pregelatinizedstarch (potato), silicon dioxide, sodium stearyl fumarate, starch (corn), andtitanium dioxide.
The 50 mg and 100 mgtablets also contain synthetic iron oxides.

CLINICALPHARMACOLOGY
Pharmacodynamics
The mechanism of action of fluvoxamine maleate inObsessive Compulsive Disorder is presumed to be linked to its specificserotonin reuptake inhibition in brain neurons. In preclinical studies, it wasfound that fluvoxamine inhibited neuronal uptake of serotonin.

In in vitrostudies fluvoxamine maleate had no significant affinity for histaminergic,alpha or beta adrenergic, muscarinic, or dopaminergic receptors.
Antagonism of some of these receptors isthought to be associated with various sedative, cardiovascular,anticholinergic, and extrapyramidal effects of some psychotropic drugs.



原帖由 dorcasliu80 于 07-5-25 23:43 发表
我的药物
Luvox, clonazepam 及 seroquel是属于SSRI 还是5-HT?
会有增胖的副作用吗？
还有Lamictal是属于哪一类型呢？

请大哥指点！

[ 本帖最后由 晔阳 于 07-5-26 00:57 编辑 ]
作者: 晔阳    时间: 07-5-26 00:45
Clonazepam 是安定类，作用于GABA 能受体，与上述话题无关。
Clonazepam's pharmacological profile is similar to other anxiolytic/sedative  benzodiazepines.

原帖由 dorcasliu80 于 07-5-25 23:43 发表
我的药物
Luvox, clonazepam 及 seroquel是属于SSRI 还是5-HT?
会有增胖的副作用吗？
还有Lamictal是属于哪一类型呢？

请大哥指点！
作者: 晔阳    时间: 07-5-26 00:56
标题: Seroquel 是5-HT 受体阻断剂。
Seroquel 是5-HT 受体阻断剂。它的副作用列于下表。注意这是短程，大批量(七百多人人群治疗的副作用。

Seroquel                        
        
CLINICAL PHARMACOLOGYPharmacodynamicsSEROQUEL is an antagonist at multiple neurotransmitter receptors in the brain:  serotonin 5HT1A and 5HT2 (IC50s=717 & 148nM  respectively), dopamine D1 and D2 (IC50s=1268  & 329nM respectively), histamine H1 (IC50=30nM), and adrenergic α 1  and α 2 receptors (IC50s=94 & 271nM, respectively).  SEROQUEL has no appreciable affinity at cholinergic muscarinic and benzodiazepine  receptors (IC50s>5000 nM).
The mechanism of action of SEROQUEL, as with other drugs having efficacy in  the treatment of schizophrenia and bipolar disorder, is unknown. However, it  has been proposed that the efficacy of SEROQUEL in schizophrenia and its mood  stabilizing properties in bipolar depression and mania are mediated through  a combination of dopamine type 2 (D2) and serotonin type 2 (5HT2)  antagonism. Antagonism at receptors other than dopamine and 5HT2  with similar receptor affinities may explain some of the other effects of SEROQUEL.  SEROQUEL’s antagonism of histamine H1 receptors may explain the somnolence  observed with this drug.
SEROQUEL’s antagonism of adrenergic α 1 receptors may explain  the orthostatic hypotension observed with this drug.


Clinical Efficacy DataBipolar DisorderDepression The efficacy of SEROQUEL for the treatment of depressive episodes associated  with bipolar disorder was established in 2 identical 8-week, randomized, double-blind,  placebo-controlled studies (N=1045). These studies included patients with either  bipolar I or II disorder and those with or without a rapid cycling course. Patients  randomized to SEROQUEL were administered fixed doses of either 300 mg or 600  mg once daily.
The primary rating instrument used to assess depressive symptoms in these studies  was the Montgomery-Asberg Depression Rating Scale (MADRS), a 10 item clinician-rated  scale with scores ranging from 0 to 60. The primary endpoint in both studies  was the change from baseline in MADRS score at week 8. In both studies, SEROQUEL  was superior to placebo in reduction of MADRS score. Improvement in symptoms,  as measured by change in MADRS score relative to placebo, was seen in both studies  at Day 8 (Week 1) and onwards. In these studies, no additional benefit was seen  with the 600 mg dose. For the 300 mg dose group, statistically significant improvements  over placebo were seen in overall quality of life and satisfaction related to  various areas of functioning, as measured using the Q-LES-Q(SF).
Mania The efficacy of SEROQUEL in the treatment of acute manic episodes was established  in 3 placebo-controlled trials in patients who met DSM-IV criteria for Bipolar  I disorder with manic episodes. These trials included patients with or without  psychotic features and excluded patients with rapid cycling and mixed episodes.  Of these trials, 2 were monotherapy (12 weeks) and 1 was adjunct therapy (3  weeks) to either lithium or divalproex. Key outcomes in these trials were change  from baseline in the Young Mania Rating Scale (YMRS) score at 3 and 12 weeks  for monotherapy and at 3 weeks for adjunct therapy. Adjunct therapy is defined  as the simultaneous initiation or subsequent administration of SEROQUEL with  lithium or divalproex.
The primary rating instrument used for assessing manic symptoms in these trials  was YMRS, an 11-item clinician-rated scale traditionally used to assess the  degree of manic symptomatology (irritability, disruptive/aggressive behavior,  sleep, elevated mood, speech, increased activity, sexual interest, language/thought  disorder, thought content, appearance, and insight) in a range from 0 (no manic  features) to 60 (maximum score).
The results of the trials follow:
MonotherapyIn two 12-week trials (n=300, n=299) comparing SEROQUEL to placebo, SEROQUEL  was superior to placebo in the reduction of the YMRS total score at weeks 3  and 12. The majority of patients in these trials taking SEROQUEL were dosed  in a range between 400 and 800 mg per day.
Adjunct TherapyIn this 3-week placebo-controlled trial, 170 patients with acute bipolar mania  (YMRS ≥20) were randomized to receive SEROQUEL or placebo as adjunct treatment  to lithium or divalproex. Patients may or may not have received an adequate  treatment course of lithium or divalproex prior to randomization. SEROQUEL was  superior to placebo when added to lithium or divalproex alone in the reduction  of YMRS total score.
The majority of patients in this trial taking SEROQUEL were dosed in a range  between 400 and 800 mg per day. In a similarly designed trial (n=200), SEROQUEL  was associated with an improvement in YMRS scores but did not demonstrate superiority  to placebo, possibly due to a higher placebo effect.
SchizophreniaThe efficacy of SEROQUEL in the treatment of schizophrenia was established  in 3 short-term (6-week) controlled trials of inpatients with schizophrenia  who met DSM III-R criteria for schizophrenia. Although a single fixed dose haloperidol  arm was included as a comparative treatment in one of the three trials, this  single haloperidol dose group was inadequate to provide a reliable and valid  comparison of SEROQUEL and haloperidol.
Several instruments were used for assessing psychiatric signs and symptoms  in these studies, among them the Brief Psychiatric Rating Scale (BPRS), a multi-item  inventory of general psychopathology traditionally used to evaluate the effects  of drug treatment in schizophrenia. The BPRS psychosis cluster (conceptual disorganization,  hallucinatory behavior, suspiciousness, and unusual thought content) is considered  a particularly useful subset for assessing actively psychotic schizophrenic  patients. A second traditional assessment, the Clinical Global Impression (CGI),  reflects the impression of a skilled observer, fully familiar with the manifestations  of schizophrenia, about the overall clinical state of the patient. In addition,  the Scale for Assessing Negative Symptoms (SANS), a more recently developed  but less well evaluated scale, was employed for assessing negative symptoms.


Table 1. 副作用试验Treatment-Emergent Adverse Experience
  Incidence in 3- to 12-Week Placebo-Controlled Clinical
  Trials for the Treatment of Schizophrenia and Bipolar
  Mania (monotherapy)

                                                                                                                           



Body System/
        Preferred Term		SEROQUEL
        (人数n=719)		PLACEBO
        (n=404)
Body as a Whole
Headache21%14%
Pain7%5%
Asthenia5%3%
Abdominal4%1%
Back Pain3%1%
Fever2%1%
Cardiovascular
Tachycardia6%4%
Postural Hypotension4%1%
Digestive
Dry Mouth9%3%
Constipation8%3%
Vomiting6%5%
Dyspepsia5%1%
Gastroenteritis2%0%
Gamma Glutamy 1 Transpeptidase Increased1%0%
Metabolic and Nutritional
Weight Gain Nervous5%1%
Agitation20%17%
Somnolence18%8%
Dizziness11%5%
Anxiety4%3%
Respirator
Pharyngitis4%3%
Rhinitis3%1%
Skin and Appendages
Rash4%2%
Special Senses
Amblyopia2%1%
        1Events for which the SEROQUEL incidence          was equal to or less than placebo are not listed in the table, but included          the following: accidental injury, akathisia, chest pain, cough increased,          depression, diarrhea, extrapyramidal syndrome, hostility, hypertension,          hypertonia, hypotension, increased appetite, infection, insomnia, leukopenia,          malaise, nausea, nervousness, paresthesia, peripheral edema, sweating,          tremor, and weight loss.




原帖由 dorcasliu80 于 07-5-25 23:43 发表
我的药物
Luvox, clonazepam 及 seroquel是属于SSRI 还是5-HT?
会有增胖的副作用吗？
还有Lamictal是属于哪一类型呢？

请大哥指点！

[ 本帖最后由 晔阳 于 07-5-26 01:01 编辑 ]
作者: wzhp    时间: 07-5-26 07:13
学习。
作者: starlamb    时间: 07-5-26 12:04
标题: 回复 #5 晔阳 的帖子
大哥。。。哇！全都是英文。。。
不过很多医学名称。。。真的要好好研究一下。
要不然真的看不懂。。。。。
作者: 晔阳    时间: 07-5-26 21:03
你不要都看，只看中文字和你认识的药名就是了。中文的没有，为了增加可靠性，把原文有用的东西转了过来。相信会有人看得懂。


原帖由 dorcasliu80 于 07-5-26 12:04 发表
大哥。。。哇！全都是英文。。。
不过很多医学名称。。。真的要好好研究一下。
要不然真的看不懂。。。。。

[ 本帖最后由 晔阳 于 07-5-26 21:04 编辑 ]
作者: lovelycat14    时间: 07-5-26 22:49
哦，我吃的百优解等于是增加了我的新陈代谢，所以我瘦了，谢谢晔阳，辛苦了。
那左洛复呢，也有同样的减轻体重的作用吗？

[ 本帖最后由 lovelycat14 于 07-5-26 22:55 编辑 ]
作者: 晔阳    时间: 07-5-27 12:00
左洛复也是SSRI, 所以不必担心肥胖。
作者: 晔阳    时间: 07-5-27 12:01
另外，抗抑郁药物，可能据有抗癌作用。
作者: 琴川杨    时间: 07-5-29 20:12
Luvox（氟伏沙明）：SSRI类药物
lonazepam（氯硝西泮）：安定类药物
seroquel（奎硫平）：非典型抗精神病药物，其导致肥胖作用和维思通差不多。
作者: 梦恬    时间: 07-5-29 20:41
标题: 回复 #12 琴川杨 的帖子
杨医生谢谢你的回复，治疗医生还没通过话，他说我在忙，他来我家看过女儿2次，用车去接他的，当地没好的医生，应该对女儿比较了解的，他以前说女儿：只能挑100斤，但她要挑120斤，那就给她吃点药，所以剂量不足。由于头颈的因数，他说女儿是癔症，这我也有点怀疑，现吃1片西普妙情绪上是好多了，但对头颈还是很关注，做作业时老是感到难过，弄的眼睛也累，对成绩看的很重，总至学习还是太累，杨医生这些残余症状要是能通过心理辅导解决那有多好啊，要是不行还是要加量的是吗



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