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uicscience · 7 years

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Antidepressant side effects reported more by patients with co-occurring panic disorder

Patients who take medication for depression report more side effects if they also suffer from panic disorder, according to a new study led by researchers from the University of Illinois at Chicago published in the Journal of Clinical Psychiatry.

The researchers looked at data from 808 patients with chronic depression who were given antidepressants as part of the Research Evaluating the Value of Augmenting Medication with Psychotherapy (REVAMP) trial. Of those patients, 85 also had diagnoses of panic disorder.

Among all participants, 88 percent reported at least one side effect during the 12 week trial, which ran from 2002 through 2006. Every two weeks, antidepressant side effects were assessed, and categorized as gastrointestinal, cardiovascular, dermatological, neurological, genitourinary, sleep, or sexual functioning.

The researchers found that patients with depression and panic disorder were more likely than those with only depression to self-report gastrointestinal (47 percent vs. 32 percent), cardiovascular (26 percent vs. 14 percent), neurological (59 percent vs. 33 percent), and genital/urinary side effects (24 percent vs. 8 percent). Co-occurring panic disorder was not associated with eye or ear issues or dermatological, sleep or sexual functioning side effects compared to participants without panic disorder.

“People with panic disorder are especially sensitive to changes in their bodies,” said Stewart Shankman, professor of psychology and psychiatry at UIC and corresponding author on the paper. “It’s called ‘interoceptive awareness.’

“Because these patients experience panic attacks — which are sudden, out-of-nowhere symptoms that include heart racing, shortness of breath, and feeling like you’re going to die — they are acutely attuned to changes in their bodies that may signal another panic attack coming on. So it does make sense that these tuned-in patients report more physiological side effects with antidepressant treatment.”

Response to antidepressants varies greatly, and side effects are common. Many patients who experience side effects switch medication or change dosage. Some discontinue therapy altogether.

Participants with co-occurring panic disorder were also more likely to report a worsening of their depressive symptoms over the 12 weeks if they reported multiple side effects.

“In patients with panic disorder, the more side effects they reported, the more depressed they got,” said Shankman. “Whether the side effects are real or not doesn’t matter, but what was real was that their depression worsened as a function of their side effects.”

Shankman cautions that physicians and therapists should be aware that their patients with panic disorder may report more side effects, and they should “do a thorough assessment of these side effects to try to tease out what might be the result of hypersensitivity, or what might be a side effect worth switching doses or medications for.”

Co-authors on the paper are Stephanie Gorka, and Andrea Katz of UIC; Daniel Klein of Stony Brook University; Dr. John Markowitz of Columbia University College of Physicians and Surgeons; Bruce Arnow, Rachel Manber and Alan Schatzberg of the Stanford University School of Medicine; Barbara Rothbaum of Emory University School of Medicine; Dr. Michael Thase of the University of Pennsylvania School of Medicine; Dr. Martin Keller of Brown University School of Medicine; Dr. Madhukar Trivedi of University of Texas Southwestern Medical Center; and Dr. James Kocsis of Weill-Cornell Medical College.

This research was supported by grants U01 MH62475, U01 MH61587, U01 MH62546, U01 MH61562, U01 MH63481, U01 MH62465, U01 MH61590, U01 MH61504 and U01 MH62491 from the National Institute of Mental Health.

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blogcertaincollectorpatrol · 6 years

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Assignment 1

I chose the NESARC dataset. In the NESARC study, I am interested in major depression, as depression is a complex mental disorder that affected people of all range of ages. I will be looking into the the variables indicating the symptoms, onset age, age ranges and number of episode of major depression so I copied all the relevant variables in the codebook into my subset of NESARC codebook.

It seems that there has not been a consensus about the causes of depression and that depression is viewed more a biological illness than psychological condition, therefore I am interested in seeing whether there are any correlations between major depression and family history. I will look at all the variables I mentioned above, such as the diagnosis, onset age, episodes age range, number of episodes and all the variables in the family history of major depression. I added all the variables in the family history of depression into my codebook.

I searched Google Scholar for the genetic influences of major depression articles and I am summarizing what I found in the following.

Age of onset in chronic major depression: relation to demographic and clinical variables, family history, and treatment response

Daniel N Klein

Correspondence information about the author Daniel N Klein

Email the author Daniel N Klein

, Alan F Schatzberg, James P McCullough, Frank Dowling, Daniel Goodman, Robert H Howland, John C Markowitz, Christine Smith, Michael E Thase, A.John Rush, Lisa LaVange, Wilma M Harrison, Martin B Keller

This above research found that early-onset chronic major depression was associated with higher rates of recurrent major depressive episodes and that more early-onset patients tended to have a family history of mood disorders.

Genetic Epidemiology of Major Depression: Review and Meta-Analysis

Patrick F. Sullivan, M.D., F.R.A.N.Z.C.P., Michael C. Neale, Ph.D., and Kenneth S. Kendler, M.D.

Published online: October 01, 2000 | https://doi.org/10.1176/appi.ajp.157.10.1552

The above research concluded that major depression is a familial disorder resulting from genetic influences, but not alone. The finding supported that major depression was the result of both genetic and environmental influences.

From the above references, I expect to see some correlation between the family history of major depression with some of the variables I chose for the major depression, such as onset age, age range, number of episodes, the diagnosis or some combinations of these variables.

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