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Biomedical subjects

R M Lane

Publications and source records attributed to R M Lane.

23 records · Page 2Linked to original sources
PubMedDate not supplied

Pharmacotherapy of the depressed patient with cardiovascular and/or cerebrovascular illness.

Cardiovascular and cerebrovascular disease are associated with a high incidence of depressive disorder. Despite this high level of co-morbidity, depressive disorders appear to go largely unrecognised and remain untreated. This may have serious consequences, as concomitant depression worsens the prognosis in patients with cardiovascular or cerebrovascular disease, increases medical costs, and delays return to work. Treatment with traditional tricyclic antidepressants is difficult in these patients because of the known cardiac effects. The favourable side-effect profiles of the 5-HT reuptake inhibitors suggest that they may offer therapeutic advantages, as they have little or no effect on cardiac conduction, do not cause orthostatic hypotension, and lack serious sequelae in overdose. The pharmacological profiles and the reduced potential of these newer antidepressant drugs to cause drug interaction show important differences that may be of clinical relevance in this patient population.

Antidepressive Agents, Tricyclic↗
PubMedDate not supplied

SSRIs and hyponatraemia.

Increasing age, certain medications such as diuretics, disease processes such as malignant neoplasm and schizophrenia, and a history of hyponatraemia or polydipsia may predispose patients to the development of hyponatraemia. In addition, certain psychotropic medications, including TCAs, MAOIs, carbamazepine, trazodone and neuroleptics, may predispose to hyponatraemia, yet a causative role for most has not been firmly established and the effect is most likely to be more idiosyncratic. The SSRIs have been associated with hyponatraemia in a small number of case reports. The mean age and sex of patients in reported cases is over 70 years and predominantly female, and patients were often receiving concomitant diuretic therapy. The frequency of hyponatraemia in elderly female patients receiving fluoxetine has been estimated to be as high as eight per 1000. The risk of developing hyponatraemia appears to be highest during the first few weeks of treatment. Because of the potential seriousness of hyponatraemia, if an elderly patient receiving an SSRI develops unexplained symptoms during the first few weeks of therapy, it is necessary to measure the serum sodium level.

Age Factors↗