Vilazodone Hydrochloride

FRIDAY, May 26, 2023 -- You've been diagnosed with depression. What's next? The cornerstone of treatment remains antidepressants, so it's likely your doctor will prescribe one for you, but which one might be best? You will join millions around the world who struggle with how to treat the mental health disorder. An estimated 3.8% of the global population experiences depression, according to the World Health Organization . The numbers are staggering, but when depression is left untreated, it can impair daily functioning, raise the risk of suicide and lower quality of life. Fortunately, there are many different types of antidepressants available, each with unique mechanisms of action, benefits and potential side effects. Here, experts will explore the most commonly prescribed depression medications, how they work and their common side effects. Depression medications Dr. Abid Nazeer, founder, chief medical officer and medical director of Advanced Psych Solutions in Naperville, Ill., stated, “If you don’t treat depression, there’s a risk that you may get through the day, but it will feel like a struggle. If it’s been adequately treated, you can have a much better day.” Meanwhile, Pardis Khosravi , a psychologist and clinical director at Children’s Health Council in California, said, “Depression is not something you can 'power through' or think your way out of with positive thoughts. It is a medical illness that left untreated can have a profound impact on your health, quality of life and daily functioning. Untreated depression increases the likelihood of risky behaviors such as substance use, self-harm and suicidal ideation and/or behaviors.” Although alternative therapies can be successful in treating depression, medication might become necessary in certain situations when other treatments have failed, depression symptoms interfere considerably with daily life, there is a history of mental health issues, or when a person feels too exhausted to pursue non-medication treatments. Here are some of the most common depression medications: Selective serotonin reuptake inhibitors (SSRIs) SSRIs are a class of medications used to treat depression by elevating serotonin levels in the brain, a crucial neurotransmitter that facilitates communication between nerve cells. The Mayo Clinic indicates that SSRIs prevent serotonin reabsorption into neurons, ensuring that more of the chemical messenger remains available to enhance signaling between brain cells. Additionally, SSRIs are known as selective agents because they primarily impact serotonin rather than other neurotransmitters. These SSRIs have received approval from the U.S. Food and Drug Administration for the treatment of depression: Citalopram (Celexa) Escitalopram (Lexapro) Fluoxetine (Prozac) Paroxetine (Paxil, Pexeva) Sertraline (Zoloft) While SSRIs effectively treat depression, they may also cause various side effects. Per an article published in the Primary Care Companion to the Journal of Clinic Psychology , SSRIs' most common side effects include gastrointestinal problems, sexual dysfunction, weight gain and sleep disturbances. Gastrointestinal side effects include nausea, diarrhea and abdominal pain, while sexual dysfunction includes decreased libido, erectile dysfunction and difficulty achieving orgasm. In rare cases, SSRIs may increase the risk of suicidal ideation, particularly in young people, some research has shown. Antidepressant medications SSRIs are not the only medications for depression: Tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs) work by affecting other neurotransmitters. SSRIs generally have fewer side effects than these older antidepressants and are typically the first-line treatment for depression. However, the choice of medication depends on individual needs, and health care providers may recommend different types of antidepressants based on the patient's specific symptoms and medical history. Monoamine oxidase inhibitors (MAOIs) MAOIs are another type of antidepressant medication that blocks the enzyme monoamine oxidase, which breaks down neurotransmitters such as serotonin, norepinephrine and dopamine. By increasing the levels of these neurotransmitters, MAOIs can alleviate symptoms of depression. Some of the most common MAOIs include: Phenelzine (Nardil) Tranylcypromine (Parnate) Isocarboxazid (Marplan) Selegiline (Emsam) — available as a transdermal patch These medications can be effective in treating depression. However, the Mayo Clinic states that they are generally not considered first-line therapy due to their potential for serious side effects and interactions with certain foods and medications. Atypical antidepressants According to Mental Health America , atypical antidepressants are a diverse class of medications used to treat depression that do not fit neatly into other categories of antidepressants. They work by targeting multiple neurotransmitters in the brain, including serotonin, norepinephrine and dopamine, to improve mood and ease symptoms of depression. Some of the most commonly used atypical antidepressants include: Bupropion (Wellbutrin) Mirtazapine (Remeron) Trazodone (Desyrel) Vilazodone (Viibryd) Vortioxetine (Trintellix) Bupropion is known for its unique mechanism of action, which involves increasing the levels of norepinephrine and dopamine in the brain. Mirtazapine works by increasing the release of both serotonin and norepinephrine, while trazodone primarily affects serotonin levels. Vilazodone and vortioxetine are newer medications that target multiple neurotransmitters and effectively treat depression. These medications may be useful for individuals who have not responded to other types of antidepressants or who experience side effects from other medications. SOURCES: Abid Nazeer, MD, founder, chief medical officer and medical director, Advanced Psych Solutions, Naperville, Ill.; Pardis Khosravi, psychologist and clinical director, Children’s Health Council, Palo Alto, Calif. Posted May 2023

Biomedical engineers present a robust new method for accurately measuring and identifying eight antidepressants most commonly prescribed to women. In recent years, a mass spectrometry process that can detect the amounts of drugs in a biological sample, such as blood, has become a powerful diagnostic tool for helping medical professionals identify and monitor levels of therapeutic drugs in patients, which can cause unwanted or dangerous side effects. Holding back this technique -- which is called liquid chromatography tandem mass spectrometry or LC-MS/MS for short -- is that it often requires relatively large biological samples and a number of complicated steps that must be done by hand to prepare samples for analysis. At Brown University, a team of biomedical engineers has been working to make this time-consuming process simpler and much more automated, a key ingredient to the technique being widely adopted by clinicians. The researchers shared their results in Scientific Reports on Monday, Feb. 6. In the study, they present a robust new method for accurately measuring and identifying eight antidepressants most commonly prescribed to women: bupropion, citalopram, desipramine, imipramine, milnacipran, olanzapine, sertraline and vilazodone. The method does just what the researchers hoped. It is able to identify and monitor these drugs from small biological samples -- 20 microliters each, which is about the equivalent of blood taken from a prick. The method is also able to be done almost entirely by liquid-handling robots found in most clinical mass spectrometry labs. "We designed our method and put together kits so that once the samples have been collected, they can be put in a computer program for a robotic liquid handler, and all the user essentially has to do is take off the caps, press some buttons, and it will go start to finish," said lead author Ramisa Fariha, a Brown Ph.D. student working in a microfluidic diagnostics and biomedical engineering laboratory led by Brown professor Anubhav Tripathi. Once the samples are ready, the user puts them through the mass spectrometer, which breaks the sample down into tiny fragments that contain tell-tale signs of the drugs they are looking for. The method's accuracy is comparable to other LC-MS/MS-based techniques but has the advantage of a much smaller sample size and is able to be largely automated using the liquid handlers. These innovations set up the system's immediate potential to be widely translated to clinical settings to help monitor the impacts of drugs prescribed for patients diagnosed with depression, including women experiencing postpartum depression. "We have made a very big step," said Tripathi, a Brown engineering professor, the lab's principal investigator and an author on the study. "For clinical lab adaptation, you want to reduce the error by humans. The more you automate, the more robustness you get and the more trust there is from doctors." Depression is a growing global crisis, and women face higher rates of diagnosis than men. The percentage of patients prescribed antidepressants has tripled over the past two decades, and clinicians find themselves at a crossroad between finding the right drug to suit a patient and monitoring the abundance of it in the body, the researchers wrote in the study. Currently, there are no commercial products in the U.S. to help clinicians directly monitor how much these drugs are present in patients, the researchers noted. Clinicians often end up relying on more qualitative methods, like surveys, because of how obtrusive mass spectrometry methods are to patients in terms of sample size and the time-consuming nature of preparing the samples for the machine. Tripathi and colleagues in his lab started working on this potential solution in 2021 after they were asked to evaluate a commercial European kit that uses LC-MS/MS to detect drugs in humans. The work has largely been the result of a collaboration between Brown graduate and undergraduate students who work in the lab. The researchers, led by Fariha, decided to take a crack at designing their own kit that could be just as accurate but much simpler. They started by identifying some of the most commonly used depressants and from there worked to refine the how the LC-MS/MS technique identifies the drugs, including how much of a sample it needs and establishing a control they could run against actual samples. After running a barrage of quality control checks, tweaking and testing different methods of measuring the samples at different conditions, the researchers took their entire process for preparing the sample and broke it down so that it could be programmed into a machine that could handle the preparation of the liquids. The Brown researchers used a JANUS G3 Robotic Liquid Handler in their work but said that clinicians can use simpler or more advanced machines. The team detailed how they programmed their machine in a way that others can easily replicate with their own equipment. "Every time our lab and our team publishes a paper, we go into the nitty gritty so our results can be easily replicated by others," Fariha said. The team also created prototype kits that can be sent to clinicians so they can implement the method in their labs. The kits include the chemicals and solvents needed along with a detailed instruction booklet that calls out what clinicians should be on the lookout for based on their own experiences and the numerous tweaks they made during quality control process. The team -- known within the lab as the clinical diagnostics and automation team -- plans to work next on automation projects in oncology, such as designing a kit that could detect ovarian cancer. The automation team has a number of undergraduates who participate -- an example of how Brown students collaborate with each other and with faculty to address real-world problems. Emma Rothkopf, a senior concentrating in biomedical engineering and an author on the paper, said the experience was critical in helping her directly bridge concepts she learned in the academic setting to the lab. "I'd find myself looking at data or doing certain steps and think, 'Oh, my gosh, I learned this in class,'" Rothkopf said. In addition to Fariha, Tripathi and Rothkopf, other authors on the study include Prutha S. Deshpande, Mohannad Jabrah, Adam Spooner and Oluwanifemi David Okoh. The work was supported by PerkinElmer.