ABSTRACT
Selective serotonin reuptake inhibitors (SSRIs) have become the agents of first choice in the treatment of depression because of their safe side effect profile. This paper reviews the current literature on the use of SSRIs in pregnancy and lactation concerning their safety. There are human studies that only used fluoxetine in pregnancy, which established its safety. SSRIs are excreted in breast milk, and their long-term effects on the newborn are unknown at this time. The decision to use SSRIs in pregnancy should be made on a case by case basis with active involvement of the patient in the informed consent process during which the risks and benefits are discussed and documented.
Subject(s)
Depression/drug therapy , Fluoxetine/therapeutic use , Pregnancy Complications/drug therapy , Selective Serotonin Reuptake Inhibitors/therapeutic use , Animals , Breast Feeding , Depression, Postpartum/drug therapy , Female , Humans , PregnancySubject(s)
Depressive Disorder/drug therapy , Pregnancy Complications/drug therapy , Selective Serotonin Reuptake Inhibitors/adverse effects , Abnormalities, Drug-Induced/etiology , Abnormalities, Drug-Induced/prevention & control , Animals , Female , Fluoxetine/adverse effects , Fluoxetine/therapeutic use , Humans , Infant, Newborn , Pregnancy , Risk Factors , Selective Serotonin Reuptake Inhibitors/therapeutic useABSTRACT
We report on the occurrence of galactorrhea associated with a prolactin elevation within weeks of treatment with risperidone. One of our patients was switched to a typical antipsychotic, with an improvement in the galactorrhea. The other patient was continued on risperidone due to a robust response, while her galactorrhea was partially treated with bromocriptine. The mechanism of prolactin elevation with risperidone is unclear. These cases suggest the need for further studies.
Subject(s)
Antipsychotic Agents/adverse effects , Galactorrhea/chemically induced , Prolactin/drug effects , Psychotic Disorders/drug therapy , Risperidone/adverse effects , Adult , Antipsychotic Agents/administration & dosage , Dose-Response Relationship, Drug , Female , Galactorrhea/blood , Humans , Prolactin/blood , Risperidone/administration & dosageABSTRACT
OBJECTIVE: To prospectively evaluate the reliability and validity of the Collateral Source Geriatric Depression Scale (CS-GDS) administered by telephone (T-CS-GDS) in patients undergoing outpatient comprehensive geriatric assessment. SUBJECTS: Eighty-three geriatric patients evaluated in a 1-year period at the outpatient Geriatric Assessment Center of the University of Nebraska Medical Center. METHODS: The 30-item CS-GDS was completed by the collateral source of all patients on three occasions: by telephone several days before their assessment, face-to-face during their assessment visit and several days later, again by phone. During their assessment, all patients were evaluated by one of three geriatric psychiatrists who were blinded to CS-GDS results. The test retest reliability of the T-CS-GDS was measured by comparing the results of the two phone interviews. The construct validity of the T-CS-GDS was estimated by comparing the results of the initial T-CS-GDS with the CS-GDS obtained during the comprehensive assessment. The criterion validity of the T-CS-GDS was estimated by comparing the results of the T-CS-GDS with the clinical diagnosis of depression assigned by the psychiatrists. RESULTS: The individual items of the initial T-CS-GDS showed substantial concordance with the second T-CS-GDS (kappa range 0.41-0.8, mean = 0.61) and with the assessment GDS (kappa range 0.33-0.85, mean = 0.61). Twelve items showed evidence of bias when comparing the two T-CS-GDSs and four items when comparing the initial T-CS-GDS with the CS-GDS done during the assessment. The mean number of symptomatic responses was not significantly different for the T-CS-GDS vs assessment administration but did decline slightly when comparing the two T-CS-GDSs. ROC curve analysis showed good agreement between the clinical diagnosis and the T-CS-GDS. CONCLUSION: The CS-GDS appears to maintain its reliability and validity when administered via telephone and thus may be useful for a variety of epidemiologic and clinical purposes.
Subject(s)
Depressive Disorder/diagnosis , Personality Assessment/statistics & numerical data , Telephone , Aged , Aged, 80 and over , Depressive Disorder/psychology , Female , Geriatric Assessment/statistics & numerical data , Humans , Male , Prospective Studies , Psychometrics , Reproducibility of ResultsABSTRACT
This case vignette illustrates dramatic improvement of tardive dyskinesia (TD) in an elderly female with a long history of neuroleptic exposure, following treatment with low-dose risperidone. The TD continued to be in remission at 1-year follow-up. This observation calls for well-designed randomized studies to evaluate the efficacy of risperidone in treating TD.
