scholarly journals Repeated use of SSRIs potentially associated with an increase on serum CK and CK-MB in patients with major depressive disorder: a retrospective study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shengwei Wu ◽  
Yufang Zhou ◽  
Zhengzheng Xuan ◽  
Linghui Xiong ◽  
Xinyu Ge ◽  
...  
Keyword(s):  
Creatine Kinase ◽  
Major Depressive Disorder ◽  
Retrospective Study ◽  
Depressive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Cardiac Injury ◽  
First Episode ◽  
Cardiovascular Risks ◽  
Major Depressive ◽  
Depressive Patients

AbstractThere is a large amount of evidence that selective serotonin reuptake inhibitors (SSRIs) are related to cardiovascular toxicity, which has aroused concern regarding their safety. However, few studies have evaluated the effects of SSRIs on cardiac injury biomarkers, such as creatine kinase (CK) and creatine kinase isoenzyme (CK-MB). The purpose of our study was to determine whether SSRIs elevated CK and CK-MB levels of prior medicated depressive patients (PMDP) compared to first-episode drug-naïve depressive patients (FDDPs). We performed an observational and retrospective study involving 128 patients with major depressive disorder. Patients who had never used any type of antidepressant were designated FDDP; patients who had used only one type of SSRI but were not treated after a recent relapse were designated PMDP. Serum CK and CK-MB levels were measured before and after using SSRIs for a period of time. The duration of current treatment in the FDDP and PMDP groups was 16.200 ± 16.726 weeks and 15.618 ± 16.902 weeks, respectively. After SSRI treatment, levels of serum CK in the PMDP group were significantly higher than in the FDDP group. Univariate ANCOVA results revealed that PMDP was 22.313 times more likely to elevate CK (OR 22.313, 95% CI 9.605–35.022) and 2.615 times more likely to elevate CK-MB (OR 2.615, 95% CI 1.287–3.943) than FDDP. Multivariate ANCOVA revealed an interaction between the group and sex of CK and CK-MB. Further pairwise analysis of the interaction results showed that in female patients, the mean difference (MD) of CK and CK-MB in PMDP was significantly greater than that in FDDP (MD = 33.410, P = 0.000, 95% CI 15.935–50.886; MD = 4.613, P = 0.000, 95% CI 2.846–6.381). Our findings suggest that patients, especially females, who had previously used SSRI antidepressants were more likely to have elevated CK and CK-MB, indicators of myocardial muscle injury. Use of SSRIs should not be assumed to be completely safe and without any cardiovascular risks.

scholarly journals The Association Between Suicide Risk and Affective Temperaments in First-Episode and Neuroleptic-Naïve Major Depressive Disorder

2021 ◽  
Author(s):  
Lu Yin ◽  
Ting-Ting Wang ◽  
Yan-Yan Wei ◽  
Li-Gang Zhang ◽  
Shuang-Jiang Zhou ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
General Population ◽  
Depressive Disorder ◽  
Suicide Risk ◽  
Severe Depression ◽  
First Episode ◽  
Major Depressive ◽  
Affective Temperaments ◽  
Hamd Score ◽  
Depressive Patients

Abstract Background Suicide risk is associated with depression. Affective temperaments may play a role in this risk. We explored the relationship between affective temperaments and suicide and identified some traits that can predict suicide risk in depression. Methods We analyzed the results of Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A) in 284 participants recruited from a psychiatric clinic and the community in Beijing and compared the subscale scores (cyclothymic, dysthymic, anxious, irritable and hyperthymic) among major depressive disorder (MDD) versus the general population as well as depressive patients with versus without suicide risk, using student’s test, Chi-square test, rank sum test, multivariable regression modeling and receiver operating characteristic (ROC) analysis. Results The incidence of suicidal risk in depressive subjects was 47.62% (80/168). Being unmarried (P<0.001), unemployment (P=0.007) and temperaments of dysthymic, cyclothymic, anxious, and irritable scores (all P<0.05) were significantly more prevalent in depressive patients than in the general population. A young age (P<0.001), female sex (P=0.037), being unmarried (P=0.001), more severe depression (P<0.001), and dysthymic, anxious and cyclothymic temperament (all P<0.05) were significantly more prevalent in depressive disorder patients with suicide risk than in those without suicide risk. The logistic regression analysis showed that younger age (OR=0.937, 95% CI 0.905~0.970), female sex (OR=2.606, 95% CI 1.142~5.948), more severe depression (OR=1.145, 95% CI 1.063~1.234), cyclothymic temperament (OR=1.275, 95% CI 1.102~1.475) and dysthymic temperament (OR=1.265, 95% CI 1.037~1.542) were all independently associated with high suicidal risk in first-episode major depressive patients (P<0.05). By ROC analysis, the area under the compound factor (age, sex, HAMD score without the 3rd item, cyclothymic and dysthymic temperament) was 0.853 (95% CI 0.790~0.903). Conclusion The suicide rate in first-episode neuroleptic-naïve major depressive disorder (MDD) subjects was higher than we thought. Temperament traits differ between the general population and those with major depressive disorder. Major depressive disorder subjects with much more severe depressive symptoms and cyclothymic or dysthymic temperament were at high risk of suicide. Compound factors (age, sex, HAMD score without the 3rd item, cyclothymic and dysthymic temperament score) could be predictors of suicide risk in the clinic.

scholarly journals The Effects of Major Depressive Disorder on the Sequential Organization of Information Processing Stages: An Event-Related Potential Study

2020 ◽  
Vol 10 (12) ◽  
pp. 935
Author(s):  
Daniel Kwasi Ahorsu ◽  
Ken Chung ◽  
Ho Hon Wong ◽  
Michael Gar Chung Yiu ◽  
Yat Fung Mok ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Information Processing ◽  
Depressive Disorder ◽  
Event Related Potential ◽  
First Episode ◽  
Processing Strategy ◽  
Major Depressive ◽  
Holistic View ◽  
Community Functioning ◽  
Sequential Organization

The adverse effects of depression on patients’ life have been reported but information about its effects on the sequential organization of the information processing stages remains poorly understood as previous studies focused only on distinct stages. This study adds to existing knowledge by examining the effect of major depressive disorder (MDD) on the sequential organization of information processing, executive and community functioning. Fifty-seven participants with 19 participants each for first episode depression (FMDD), recurrent episodes depression (RMDD), and healthy controls (HCs) participated in this study. They completed assessments on executive and community functioning measures, and choice reaction time task (CRTT) for the event-related potential (ERP) data. Findings revealed no significant between-group difference in executive functioning but participants with depression (FMDD and RMDD) were found to be more depressed, with FMDD participants having worse community functioning skills compared with HCs. There was no significant between-group main effect on behavioral data. ERP data showed significantly less positive-going P3b among RMDD participants compared with HCs. FMDD participants used a different information processing strategy at P1, while HCs and RMDD participants used a different processing strategy at N2b compared with the other group(s), respectively. The results suggest the use of multifaceted assessment to get a holistic view of the health status of people with MDD in order to inform clinicians on the appropriate interventional strategies needed for the patient.

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