Pharmacology for GAD: Complex Choices

Topics: Cymbalta | Duloxetine | Effexor | Generalized Anxiety Disorder | Lyrica | Pharmacology | Pregabalin | Research | Research Update | SSRIs | Venlafaxine

Review of: Slee A et al, Lancet 2019;393(10173):768–777 Study Type: Network meta-analysis With over 2 dozen choices, how do we pick a medication for generalized anxiety disorder (GAD)? The authors of this network meta-analysis sought to answer this question. Network meta-analysis allows researchers to gauge treatments that haven’t been directly c

Mirtazapine Augmentation: Running Low on Rocket Fuel

Topics: Antidepressant Augmentation | Antidepressants | Depression | Depressive Disorder | Mirtazapine | Pharmacology | Pharmacology Tips | Psychopharm Myths | Psychopharmacology | Psychopharmacology Tips | SSRIs | Treatment-Resistant Depression | Venlafaxine

Adding mirtazapine (Remeron) to a serotonergic antidepressant is a popular augmentation strategy. When added to venlafaxine, the combo was thought to possess a particularly potent synergy that Stephen Stahl called “California Rocket Fuel.” However, the strategy has failed in a handful of new studies, some of them much larger than the original data.

Is Paxil the Best SSRI for Anxiety?

Topics: Antidepressants | Anxiety | Anxiety Disorder | Generalized Anxiety Disorder | Panic Disorder | Pharmaceutical Industry | Pharmacology | Pharmacology Tips | Practice Tools and Tips | Psychopharm Myths | Psychopharmacology | Psychopharmacology Tips | PTSD | Social Anxiety Disorder | SSRIs

Dear Dr. Aiken: Your review of Paxil’s risks in the May issue failed to mention a benefit that’s unique to this drug. Isn’t it the best SSRI for anxiety? Dr. Aiken: Paroxetine’s (Paxil’s) reputation as the anti-anxiety SSRI got off to a running start. It was first launched for panic disorder in 1996, two years before its approval for depres

A New Proposal for SSRI Withdrawal

Topics: Pharmacology | Pharmacology Tips | SSRIs | Withdrawal

Review of: Horowitz MA and Taylor D, Lancet Psychiatry, March 2019, published online Type of Study: Literature review and clinical guideline Withdrawal problems rank among patients’ top concerns with antidepressants. They include insomnia, flu-like symptoms, irritability, distractibility, and unusual sensory experiences such as “brain zaps.” To

SSRI withdrawal symptoms

Topics: Pharmacology | Pharmacology Tips | SSRIs | Withdrawal

Withdrawal problems rank among patients’ top concerns with antidepressants. They include insomnia, flu-like symptoms, irritability, distractibility, and unusual sensory experiences such as “brain zaps.” Use this PDF tool to check if the patient is having any SSRI withdrawal symptoms at baseline.