Background Yueju Pill,a classic traditional Chinese medicine,shows antidepressant effects rapidly.However,biomarkers that can predict its treatment outcomes in major depressive disorder(MDD)are still lacking.Multimoda...Background Yueju Pill,a classic traditional Chinese medicine,shows antidepressant effects rapidly.However,biomarkers that can predict its treatment outcomes in major depressive disorder(MDD)are still lacking.Multimodal magnetic resonance imaging(MRI)offers a promising avenue to identify such biomarkers.Aims This pilot study aimed to explore whether therapeutic responses to Yueju Pill could be predicted by MRI-derived brain networks and to identify drug-specific biomarkers in comparison to escitalopram,a mainstream antidepressant.Methods We collected multimodal MRI data and blood samples from 28 outpatients with MDD from the Fourth People's Hospital of Taizhou,who were randomly divided into two groups to receive either Yueju Pill(23 g/time/day)or escitalopram(10 mg,two times a day)for 4 days.Morphological and functional brain networks were constructed and used to predict individual changes in symptoms quantified by the 24-item Hamilton Depression Scale(HAMD-24)scores and serum brain-derived neurotrophic factor(BDNF)levels.Results After the treatment,both groups exhibited significant reductions in the HAMD-24 scores,while only the Yueju Pill group showed significant increases in the BDNF levels.Gyrification Index-based morphological networks predicted change rates of the HAMD-24 scores in both groups,but sulcus depth-based and cortical thickness-based morphological networks predicted change rates of the HAMD-24 scores and BDNF levels,respectively,only in the Yueju Pill group.Subnetwork analyses revealed that the visual network independently predicted the changes in both the HAMD-24 scores(sulcus depth-based networks)and BDNF levels(cortical thickness-based networks)following Yueju Pill treatment.Conclusions Morphological but not functional brain networks can predict symptom improvement and BDNF changes of patients with MDD after Yueju Pill treatment.Sulcus depth-based and cortical thickness-based morphological brain networks,particularly their visual subnetworks,might serve as Yueju Pill-specific biomarkers for predicting the therapeutic responses.These findings have the potential to guide personalised therapy for patients with MDD early in the therapeutic process.展开更多
Summary： The neuroproteetive effects of escitalopram oxalate in rats with chronic hypoperfusion and the possible mechanism were explored. Chronic hypoperfusion （2-VO） model was prepared and given escitalopram oxala...Summary： The neuroproteetive effects of escitalopram oxalate in rats with chronic hypoperfusion and the possible mechanism were explored. Chronic hypoperfusion （2-VO） model was prepared and given escitalopram oxalate （experimental group） or PBS （control group） after 6 weeks. Eight weeks after the operation, Morris water maze test was carried out to evaluate the learning and memory ability of the rats. The cell proliferation, three-dimensional vascular distribution, cell morphological changes in ischemic area and the plasma vascular endothelial growth factor （VEGF） were detected to explore the possible mechanisms. （1） Morris water maze test showed that the escape latency in the experimental group was significantly shorter than in the control group, while the first quadrant swimming time in the experi- mental group was significantly longer than the control group （both P〈0.01）. （2） Cerebrovascular confo- cal detection results showed that the inside diameter of capillaries was significantly less in the experi- mental group than in the control group; the vascular density was significantly increased in the experi- mental group and the total area of capillaries was also significantly increased in the experimental group as compared with the control group. （3） There was statistically significant difference in BrdU-positive cells in the ischemic brain tissue between the experimental group and the control group （P=0.003〈0.01）. （4） VEGF concentrations in the plasma and the ischemic area were higher in the experimental group than in the control group （P〈0.05）. It was concluded that escitalopram oxalate could significantly im- prove the learning and memory ability of the rats with chronic cerebral ischemia probably by the VEGF-mediated angiogenesis.展开更多
Objective:This study is conducted to investigate the effects differences of escitalopram with or without combined electroacupuncture(EA)among male inpatients with a diagnosis of alcohol dependence and comorbid protrac...Objective:This study is conducted to investigate the effects differences of escitalopram with or without combined electroacupuncture(EA)among male inpatients with a diagnosis of alcohol dependence and comorbid protracted alcohol withdrawal symptoms(PAWS).Methods:A total of 62 participants who met the inclusion criteria were enrolled in a two-arm randomized,placebo controlled,patients-blind trial and allocated to an escitalopram with real-EA group(realEA group,patients=31)and an escitalopram with sham-EA group(sham-EA group,patients=31),respectively.In addition to the oral administration of escitalopram for total four weeks,patients in each group received corresponding EA treatment five days per week and two days off for consecutive four weeks.Both serum homocysteine(Hcy)test and electrophysiological tests,including event-related potentials(ERPs)and exploratory eye movement(EEM)were performed at pre-and post-treatment.Additionally,the global scores of Penn Alcohol Craving Scale(PACS),17-items Hamilton Depression Rating Scale(HAMD-17),and Hamilton Anxiety Scale(HAMA)were used for assessing the subjective emotion experience of patients,respectively.Meanwhile,adverse effects were monitored and recorded.Results:After four-week treatment,the global scores of PACS and HAMD-17 declined significantly in both groups(both P<0.05).Furthermore,the decline in the real-EA group was superior to that in the shamEA group(P<0.05).Meanwhile,the total scores of HAMA only decreased in the real-EA group(P<0.05)but not in the sham-EA group(P>0.05).According to the parameters of ERPs,significant declines for N2PL,P3PL,and P3amp were observed in both two groups(all P<0.05),and the decreases for P3PL and P3amp in the real-EA group was much superior to that in the sham-EA group(both P<0.05).According to the parameters of EEM,significant increase for NEF was observed only in the real-EA group(P<0.05).Besides,there was a dramatic decline for serum Hcy level only in the real-EA group(P<0.05).One case in the sham-EA group withdrew from the trial due to self-reported nausea and bitter taste,and outcomes of the remaining 61 patients were adopted for analysis.Conclusion:(1)Escitalopram with EA may be a potential alternative therapy for mitigating PAWS among male inpatients with alcohol dependence.(2)Escitalopram with EA might improve the alcoholdependence induced cognitive dysfunctions via upregulating the expression of Hcy.展开更多
BACKGROUND Depression is a growing public health problem that affects over 350 million people globally and accounts for approximately 7.5%of healthy years lost due to disability.Escitalopram,one of the first-line medi...BACKGROUND Depression is a growing public health problem that affects over 350 million people globally and accounts for approximately 7.5%of healthy years lost due to disability.Escitalopram,one of the first-line medications for the treatment of depression,is a selective serotonin reuptake inhibitor and one of the most commonly prescribed antidepressant medications worldwide.Although thought to be generally safe and with minimal drug-drug interactions,we herein present an unusual case of cholestatic liver injury,likely secondary to escitalopram initiation.CASE SUMMARY A 56-year-old Chinese lady presented with fever and cholestatic liver injury two weeks after initiation of escitalopram for the treatment of psychotic depression.Physical examination was unremarkable.Further investigations,including a computed tomography scan of the abdomen and pelvis and tests for hepatitis A,B and C and for autoimmune liver disease were unyielding.Hence,a diagnosis of escitalopram-induced liver injury was made.Upon stopping escitalopram,repeat liver function tests showed downtrending liver enzymes with eventual normalization of serum aspartate aminotransferase and alanine aminotransferase one-week post-discharge.CONCLUSION Clinicians should be aware of the possibility of escitalopram-induced liver injury when initiating depressed patients on antidepressant treatment.This requires extra vigilance as most patients may remain asymptomatic.Measurement of liver function tests could be considered after initiation of antidepressant treatment,especially in patients with pre-existing liver disease.展开更多
BACKGROUND Depression is a widespread mental health condition that requires effective treatment.In the treatment of depression,traditional Chinese medicine(TCM)offers obvious advantages,fewer adverse reactions,and a l...BACKGROUND Depression is a widespread mental health condition that requires effective treatment.In the treatment of depression,traditional Chinese medicine(TCM)offers obvious advantages,fewer adverse reactions,and a lower recurrence rate.AIM To evaluate the clinical benefits of Guipi decoction combined with escitalopram oxalate tablets for individuals with depression.METHODS In total,80 patients diagnosed as having depression were enrolled in the study and divided into either an experimental group or a control group.All of the patients were orally administered escitalopram oxalate tablets.Additionally,the experimental group received Jiajian Guipi decoction and reduced Governor vessel fumigation over 4 wk.TCM syndrome scores,Hamilton depression rating scale(HAM-D)scores,self-rating depression scale(SDS)scores,and Pittsburgh sleep quality index scores were measured for the two groups and compared before and after the treatment.The two groups were monitored for any adverse reactions.RESULTS After 4 wk of treatment,both groups exhibited a significant reduction in TCM syndrome scores compared with their pre-treatment scores(P<0.05).However,the experimental group exhibited significantly lower TCM syndrome scores than the control group(P<0.05).Similarly,the post-treatment SDS and HAM-D-24 scores were significantly lower in both groups than the pre-treatment scores(P<0.05),with the experimental group exhibiting lower scores than the control group(P<0.05).The total treatment efficiency was significantly better in the experimental group(97.14%)than in the control group(77.78%)(P<0.05).Furthermore,after 4 wk of treatment,the Pittsburgh sleep quality index scores for both groups were significantly lower than those before the treatment(P<0.05),with the experimental group exhibiting lower scores than the control group(P<0.05).The incidence of adverse reactions was significantly lower in the experimental group than in the control group(P<0.05).CONCLUSION The combination of Guipi decoction and escitalopram oxalate tablets was found to be an effective and safe treatment for depression.This combination could reduce TCM syndrome scores,improve depressive symptoms,and enhance sleep quality.展开更多
BACKGROUND The antidepressant escitalopram is widely prescribed for the treatment of depression.It is generally well-tolerated,and cholestasis is not mentioned in its summary of product characteristics(Sm PC).We prese...BACKGROUND The antidepressant escitalopram is widely prescribed for the treatment of depression.It is generally well-tolerated,and cholestasis is not mentioned in its summary of product characteristics(Sm PC).We present a case of cholestatic and cytolysis liver injury due to escitalopram and a Vigi Base?study.CASE SUMMARY A 68-year-old man was admitted to our emergency unit due to clinical jaundice associated with hepatitis,pruritus and dark urine.We tested the patient for the most common etiologies of jaundice,including hemolysis,viral hepatitis,cirrhosis,carcinoma,cholangitis,cholelithiasis and intrahepatic or extrahepatic obstruction.The etiological study was negative,and an adverse drug reaction was the sole possible explanation.The patient was receiving treatment with escitalopram.Two days after its withdrawal,pruritus was resolved.Ten days after withdrawal,clinical jaundice disappeared.It took a month and three weeks after withdrawal for the patient to have normalized liver function tests.To our knowledge,this is the first reported case of cholestasis where treatment with escitalopram was the only possible cause,with a highly probable causality.In addition,we determined whether escitalopram is associated with hepatotoxicity and cholestasis by performing a disproportionality analysis.All cases of hepatobiliary disorders induced by escitalopram and reported in the World Health Organization pharmacovigilance database(Vigi Base?)were analyzed to characterize this toxicity.We found that patients treated with escitalopram had an increased risk of hepatitis[odds ratio(OR)=1.938(1.186-3.166)]and cholestasis[OR=1.866(1.279-2.724)][OR(95%confidence interval)].The median duration between the introduction of escitalopram and the occurrence of acute hepatitis and/or cholestasis was ten days+/-seven days.CONCLUSION Although extremely rare,this case report,the review of the literature and the pharmacovigilance update confirm that escitalopram can cause drug-induced hepatotoxicity and cholestasis,generally within a week after initiation.Thus,escitalopram should be withdrawn immediately if an iatrogenic cause cannot be excluded.If its responsibility is ascertained,escitalopram should be consequently contraindicated.In addition,serotoninergic antidepressants in patients with nonsevere depression are ineffective and harmful.Finally,the Sm PC of escitalopram should be updated to alert for this risk and give clear clinical guidelines.展开更多
An efficient synthesis of substituted 1,3-dihydroisobenzofurans is developed. In this novel route, oaroylbenzaldehydes, as key intermediates, can be obtained by lead tetraacetate oxidation of Naroylhydrazones of salic...An efficient synthesis of substituted 1,3-dihydroisobenzofurans is developed. In this novel route, oaroylbenzaldehydes, as key intermediates, can be obtained by lead tetraacetate oxidation of Naroylhydrazones of salicylaldehydes. The mild and general strategy enables the synthesis of various substituted 1,3-dihydroisobenzofurans in high yields. Moreover, this method can be applied to efficiently synthesize escitalopram.展开更多
We detected the event-related potential mismatch negativity （MMN） of 30 depression patients and compared to 30 age,gender,and education-matched healthy controls.Results showed that amplitudes of frequency and durati...We detected the event-related potential mismatch negativity （MMN） of 30 depression patients and compared to 30 age,gender,and education-matched healthy controls.Results showed that amplitudes of frequency and duration MMN were lower in depression patients compared with control patients,indicating abnormality in auditory processing （i.e.,cognitive impairment）.Following escitalopram treatment for 8 weeks,the amplitudes of frequency and duration MMN were significantly increased and Hamilton Rating Scale for Depression scores were significantly decreased in depression patients.These data suggest that escitalopram can improve cognitive function of patients with depression.Further,MMN may be a useful tool for evaluating cognitive function and treatment effects.展开更多
Background:Depression will become the second most common disease after coronary heart disease(CHD).Escitalopram and olanzapine are commonly used to treat depression.Some studies indicated that escitalopram combined wi...Background:Depression will become the second most common disease after coronary heart disease(CHD).Escitalopram and olanzapine are commonly used to treat depression.Some studies indicated that escitalopram combined with olanzapine is effective in treating depression,however,there is no evidence to support these results.Our objective was to study the efficacy of escitalopram combined with olanzapine on depression by conducting a systematic review and meta analysis,and to provide reference for doctors.Methods:Relevant evidence were searched from PubMed,SinoMed,the Cochrane Library,Web of Science,Embase,China Knowledge Resource Integrated(CNKI),Wanfang Data Knowledge Service Platform databases(WANFANG)and VIP dating from inception to July 2020.The randomized controlled trials(RCTs)of escitalopram and olanzapine for the treatment of depression was obtained.According to inclusion and exclusion criteria,two researches(Sun Wu and Wang Zhe)independently screened the literature,extracted data,and evaluated the quality of included studies.Rev Man 5.3 software was used to conduct statistical analyze.Results:A total of 39 studies involving 3,267 patients were identified.These studies were finally included into the meta-analysis.Pooled results showed that there was a significant difference in efficiency(RR=1.18,95%CI:1.14 to 1.12,P<0.00001),HAMD(MD=-4.54,95%CI:-5.09 to-3.99,P<0.00001),and HAMA(MD=-3.94,95%CI:-5.57 to-2.12,P<0.0001).There was no significant difference in adverse reactions(MD=0.07,95%CI-0.03 to 0.17,P=0.19).Heterogeneity test showed that due to the high heterogeneity of HAMD(P<0.00001,12=86%)and HAMA(P<0.00001,I2=91%),after removing the items with high heterogeneity,there were also statistically significant in HAMD(MD=-5.22,95%CI:-5.53 to-4.91,P<0.00001)and HAMA(MD=-5.46,95%CI:-6.15 to-4.77,P<0.00001).Conclusion:Based on this study,the combination of escitalopram and olanzapine was more effective in treating depression than the control group.It is suggested that clinical and scientific researchers carry out more high-quality,large-sample,multi-center RCTs to provide more evidence-based medical evidence for the future study of escitalopram combined with olanzapine in the treatment of depression.展开更多
Purpose: Hormone therapy (estrogen with or without progestin) remains the gold standard treatment for hot flashes in menopausal women, but concerns for the risk of hormone therapy have resulted in its decline and a de...Purpose: Hormone therapy (estrogen with or without progestin) remains the gold standard treatment for hot flashes in menopausal women, but concerns for the risk of hormone therapy have resulted in its decline and a demand for nonhormonal treatments with demonstrated efficacy for hot flashes. Aim of this study was to examine the efficacy of selective serotonin reuptake inhibitor escitalopram on hot flashes in a healthy sample of non-depressant menopausal women in Japan. Methods: We retrospectively analyzed the medical records of 11 menopausal patients with hot flashes, who received escitalopram (10 mg daily) for 2 weeks between March and August 2012. Hot flashes severities and scores were recorded on a scale of 0 to 10 points, at beginning and end of 2 weeks treatment. Results: At 2 weeks of therapy, 9 of 11 patients reported significant decreases in hot flash frequency and severity, but the remission of the symptom was not observed in 2 patients. Speed of relief from hot flashes was rapid (within one week). Conclusions: Escitalopram 10 mg/day may be a prompt and effective option for treating hot flashes in menopausal women who do not want to use hormone replacement therapy.展开更多
Objective:To investigate the protective role of pumpkin seed ethanolic extract against escitalopram-induced reproductive toxicity in male mice.Methods:Swiss albino male mice were randomly divided into five groups with...Objective:To investigate the protective role of pumpkin seed ethanolic extract against escitalopram-induced reproductive toxicity in male mice.Methods:Swiss albino male mice were randomly divided into five groups with six mice in each group.Group Ⅰreceived normal water orally,Group Ⅱ,Ⅲ,Ⅳand Ⅴreceived escitalopram oxalate(10 mg/kg),pumpkin seed extract(300 mg/kg)plus escitalopram oxalate(10 mg/kg),escitalopram oxalate(20 mg/kg),and pumpkin seed extract(300 mg/kg)plus escitalopram oxalate(20 mg/kg),respectively.All test doses were continuously administered orally once daily per animal body weight for 30 days and 60 days.Body weight and sexual organ weight were evaluated on day 31 and 61.Effects of pumpkin seed extract on sperm parameters,biochemical parameters and histology of testis were also investigated.Results:Escitalopram 10 or 20 mg/kg caused reproductive toxicity in male mice after 30 and 60 days of treatment.However,simultaneous administration of escitalopram oxalate(10 or 20 mg/kg)with pumpkin seed extract(300 mg/kg)attenuated escitalopram-induced testicular toxicity.Significant increase in the body weight and relative organ weight was observed.Sperm count,sperm motility and viability significantly increased(P<0.05).The histopathological alterations caused by escitalopram was also ameliorated.Conclusions:Ethanolic extract of pumpkin seeds(300 mg/kg body weight)protects again reproductive toxicity induced by escitalopram.Therefore,dietary intake of pumpkin seed extract might be useful for male patients who expose to antidepressant drug due to depression.展开更多
BACKGROUND Antidepressants,particularly selective serotonin reuptake inhibitors,are currently considered the first-line treatment for panic disorder(PD).However,little is known about the relationship between the bioma...BACKGROUND Antidepressants,particularly selective serotonin reuptake inhibitors,are currently considered the first-line treatment for panic disorder(PD).However,little is known about the relationship between the biomarkers that may predict better treatment.AIM To compare genome-wide methylation and gene expression patterns between responsive and non-responsive patients with PD after 4 wk of escitalopram treatment.METHODS Thirty patients with PD were enrolled in this study(responders=13;nonresponders=17).All patients were assessed using the PD Severity Scale-Chinese version before and after treatment.The Illumina Infinium MethylationEPIC(850k)BeadChip for genome-wide methylation screening and mRNA sequencing was used in all patients with PD.RESULTS A total of 701 differentially methylated positions(DMPs)were found between responders and non-responders(|Δβ|≥0.06,q<0.05),and the hyper-and hypomethylated CpG sites were 511(72.9%)and 190(27.1%),respectively.Relative to non-responders,there were 59 differential transcripts,of which 20 were downregulated and 39 were upregulated(q<0.05).However,no differen tially expressed genes were identified by mRNA sequencing after correcting for multiple testing(|log2(FC)|>1,q>0.05).CONCLUSION This preliminary study showed that DMPs might be associated with the treatment response to escitalopram in PD;however,these DMPs need to be verified in large samples.展开更多
[Objectives] To analyze the effect of Jiaotai acupuncture combined with Escitalopram on mild depression and its influence on inflammatory factors.[Methods] Eighty patients with mild depression admitted to Shenzhen Bao...[Objectives] To analyze the effect of Jiaotai acupuncture combined with Escitalopram on mild depression and its influence on inflammatory factors.[Methods] Eighty patients with mild depression admitted to Shenzhen Baoan District Central Hospital from March 2021 to March 2023 were randomly divided into observation group (40 cases) and control group (40 cases). The control group was treated with Escitalopram, and the observation group was treated with Jiaotai acupuncture on the basis of the control group. The overall efficacy, depression score before and after treatment, and the improvement of inflammation level were compared between the two groups.[Results] The total effective rate of the observation group was significantly higher than that of the control group ( P <0.05), and the improvement of depression score and inflammation level of the observation group was significantly better than that of the control group ( P <0.05).[Conclusions] Jiaotai acupuncture combined with Escitalopram can significantly reduce inflammation and improve symptoms in patients with mild depression.展开更多
Objective: to compare the safety of escitalopram and paroxetine in the treatment of senile depression. Methods: in this study, 82 patients with senile depression from November 2018 to June 2020 were selected for analy...Objective: to compare the safety of escitalopram and paroxetine in the treatment of senile depression. Methods: in this study, 82 patients with senile depression from November 2018 to June 2020 were selected for analysis. They were divided into control group and observation group according to the order of admission, and were treated with paroxetine and escitalopram respectively. The curative effect, adverse reactions, symptom improvement and satisfaction of the two groups were compared. Results: the effective rate was 97.56%(40 cases) in the observation group and 95.12%(39 cases) in the control group, with no significant difference between the two groups (P > 0.05). The incidence of adverse reactions in the observation group was 4.88%(2 cases), which was lower than that in the control group (19.51%, 8 cases). There was significant difference between the two groups (P < 0.05). Before the treatment, the HADM scores and SDS scores of each group were counted, and the depressive symptoms were evaluated. After the scores were calculated, there was no difference between the observation group and the control group, P > 0.05. After the second and fourth weeks of treatment, the HADM scores and SDS scores of each group were counted. After evaluating the depressive symptoms, the scores in the observation group were lower than those in the control group (P < 0.05). At the eighth week of treatment, the HADM scores and SDS scores of each group were counted, and the depressive symptoms were evaluated. After the scores were calculated, there was no difference between the observation group and the control group, P > 0.05. After counting the satisfaction data of each group, it reached 92.68% in the observation group, which was higher than 75.61% in the control group, with significant differences between groups (P < 0.05). Conclusion: the treatment outcome of escitalopram and paroxetine in the treatment of senile depression patients is equivalent, and both can achieve ideal curative effect, but the former has fast effect and less adverse reactions, which can improve patient compliance, and is more feasible.展开更多
基金supported by the National Key Research and Development Program of China(No.2022YFE0201000)National Natural Science Foundation of China(Nos.82472092,82174002,81874374 and 81673625)+2 种基金a grant from the Research Center for Brain Cognition and Human Development,Guangdong,China(No.2024B0303390003)Key Realm R&D Program of Guangzhou(No.202206010109)Taizhou Science and Technology Support Program(Social Development)project(No.TS2016-12).
文摘Background Yueju Pill,a classic traditional Chinese medicine,shows antidepressant effects rapidly.However,biomarkers that can predict its treatment outcomes in major depressive disorder(MDD)are still lacking.Multimodal magnetic resonance imaging(MRI)offers a promising avenue to identify such biomarkers.Aims This pilot study aimed to explore whether therapeutic responses to Yueju Pill could be predicted by MRI-derived brain networks and to identify drug-specific biomarkers in comparison to escitalopram,a mainstream antidepressant.Methods We collected multimodal MRI data and blood samples from 28 outpatients with MDD from the Fourth People's Hospital of Taizhou,who were randomly divided into two groups to receive either Yueju Pill(23 g/time/day)or escitalopram(10 mg,two times a day)for 4 days.Morphological and functional brain networks were constructed and used to predict individual changes in symptoms quantified by the 24-item Hamilton Depression Scale(HAMD-24)scores and serum brain-derived neurotrophic factor(BDNF)levels.Results After the treatment,both groups exhibited significant reductions in the HAMD-24 scores,while only the Yueju Pill group showed significant increases in the BDNF levels.Gyrification Index-based morphological networks predicted change rates of the HAMD-24 scores in both groups,but sulcus depth-based and cortical thickness-based morphological networks predicted change rates of the HAMD-24 scores and BDNF levels,respectively,only in the Yueju Pill group.Subnetwork analyses revealed that the visual network independently predicted the changes in both the HAMD-24 scores(sulcus depth-based networks)and BDNF levels(cortical thickness-based networks)following Yueju Pill treatment.Conclusions Morphological but not functional brain networks can predict symptom improvement and BDNF changes of patients with MDD after Yueju Pill treatment.Sulcus depth-based and cortical thickness-based morphological brain networks,particularly their visual subnetworks,might serve as Yueju Pill-specific biomarkers for predicting the therapeutic responses.These findings have the potential to guide personalised therapy for patients with MDD early in the therapeutic process.
文摘Summary： The neuroproteetive effects of escitalopram oxalate in rats with chronic hypoperfusion and the possible mechanism were explored. Chronic hypoperfusion （2-VO） model was prepared and given escitalopram oxalate （experimental group） or PBS （control group） after 6 weeks. Eight weeks after the operation, Morris water maze test was carried out to evaluate the learning and memory ability of the rats. The cell proliferation, three-dimensional vascular distribution, cell morphological changes in ischemic area and the plasma vascular endothelial growth factor （VEGF） were detected to explore the possible mechanisms. （1） Morris water maze test showed that the escape latency in the experimental group was significantly shorter than in the control group, while the first quadrant swimming time in the experi- mental group was significantly longer than the control group （both P〈0.01）. （2） Cerebrovascular confo- cal detection results showed that the inside diameter of capillaries was significantly less in the experi- mental group than in the control group; the vascular density was significantly increased in the experi- mental group and the total area of capillaries was also significantly increased in the experimental group as compared with the control group. （3） There was statistically significant difference in BrdU-positive cells in the ischemic brain tissue between the experimental group and the control group （P=0.003〈0.01）. （4） VEGF concentrations in the plasma and the ischemic area were higher in the experimental group than in the control group （P〈0.05）. It was concluded that escitalopram oxalate could significantly im- prove the learning and memory ability of the rats with chronic cerebral ischemia probably by the VEGF-mediated angiogenesis.
基金Sponsored by Scientific Research Project,Shanghai Science and Technology Committee:No.16401902600Special Project for Clinical Research,Shanghai Municipal Health Commission:No.20174Y0009。
文摘Objective:This study is conducted to investigate the effects differences of escitalopram with or without combined electroacupuncture(EA)among male inpatients with a diagnosis of alcohol dependence and comorbid protracted alcohol withdrawal symptoms(PAWS).Methods:A total of 62 participants who met the inclusion criteria were enrolled in a two-arm randomized,placebo controlled,patients-blind trial and allocated to an escitalopram with real-EA group(realEA group,patients=31)and an escitalopram with sham-EA group(sham-EA group,patients=31),respectively.In addition to the oral administration of escitalopram for total four weeks,patients in each group received corresponding EA treatment five days per week and two days off for consecutive four weeks.Both serum homocysteine(Hcy)test and electrophysiological tests,including event-related potentials(ERPs)and exploratory eye movement(EEM)were performed at pre-and post-treatment.Additionally,the global scores of Penn Alcohol Craving Scale(PACS),17-items Hamilton Depression Rating Scale(HAMD-17),and Hamilton Anxiety Scale(HAMA)were used for assessing the subjective emotion experience of patients,respectively.Meanwhile,adverse effects were monitored and recorded.Results:After four-week treatment,the global scores of PACS and HAMD-17 declined significantly in both groups(both P<0.05).Furthermore,the decline in the real-EA group was superior to that in the shamEA group(P<0.05).Meanwhile,the total scores of HAMA only decreased in the real-EA group(P<0.05)but not in the sham-EA group(P>0.05).According to the parameters of ERPs,significant declines for N2PL,P3PL,and P3amp were observed in both two groups(all P<0.05),and the decreases for P3PL and P3amp in the real-EA group was much superior to that in the sham-EA group(both P<0.05).According to the parameters of EEM,significant increase for NEF was observed only in the real-EA group(P<0.05).Besides,there was a dramatic decline for serum Hcy level only in the real-EA group(P<0.05).One case in the sham-EA group withdrew from the trial due to self-reported nausea and bitter taste,and outcomes of the remaining 61 patients were adopted for analysis.Conclusion:(1)Escitalopram with EA may be a potential alternative therapy for mitigating PAWS among male inpatients with alcohol dependence.(2)Escitalopram with EA might improve the alcoholdependence induced cognitive dysfunctions via upregulating the expression of Hcy.
文摘BACKGROUND Depression is a growing public health problem that affects over 350 million people globally and accounts for approximately 7.5%of healthy years lost due to disability.Escitalopram,one of the first-line medications for the treatment of depression,is a selective serotonin reuptake inhibitor and one of the most commonly prescribed antidepressant medications worldwide.Although thought to be generally safe and with minimal drug-drug interactions,we herein present an unusual case of cholestatic liver injury,likely secondary to escitalopram initiation.CASE SUMMARY A 56-year-old Chinese lady presented with fever and cholestatic liver injury two weeks after initiation of escitalopram for the treatment of psychotic depression.Physical examination was unremarkable.Further investigations,including a computed tomography scan of the abdomen and pelvis and tests for hepatitis A,B and C and for autoimmune liver disease were unyielding.Hence,a diagnosis of escitalopram-induced liver injury was made.Upon stopping escitalopram,repeat liver function tests showed downtrending liver enzymes with eventual normalization of serum aspartate aminotransferase and alanine aminotransferase one-week post-discharge.CONCLUSION Clinicians should be aware of the possibility of escitalopram-induced liver injury when initiating depressed patients on antidepressant treatment.This requires extra vigilance as most patients may remain asymptomatic.Measurement of liver function tests could be considered after initiation of antidepressant treatment,especially in patients with pre-existing liver disease.
基金The study was approved by the Ethics Committee of Beijing Changping Hospital of Traditional and Western Medicine.
文摘BACKGROUND Depression is a widespread mental health condition that requires effective treatment.In the treatment of depression,traditional Chinese medicine(TCM)offers obvious advantages,fewer adverse reactions,and a lower recurrence rate.AIM To evaluate the clinical benefits of Guipi decoction combined with escitalopram oxalate tablets for individuals with depression.METHODS In total,80 patients diagnosed as having depression were enrolled in the study and divided into either an experimental group or a control group.All of the patients were orally administered escitalopram oxalate tablets.Additionally,the experimental group received Jiajian Guipi decoction and reduced Governor vessel fumigation over 4 wk.TCM syndrome scores,Hamilton depression rating scale(HAM-D)scores,self-rating depression scale(SDS)scores,and Pittsburgh sleep quality index scores were measured for the two groups and compared before and after the treatment.The two groups were monitored for any adverse reactions.RESULTS After 4 wk of treatment,both groups exhibited a significant reduction in TCM syndrome scores compared with their pre-treatment scores(P<0.05).However,the experimental group exhibited significantly lower TCM syndrome scores than the control group(P<0.05).Similarly,the post-treatment SDS and HAM-D-24 scores were significantly lower in both groups than the pre-treatment scores(P<0.05),with the experimental group exhibiting lower scores than the control group(P<0.05).The total treatment efficiency was significantly better in the experimental group(97.14%)than in the control group(77.78%)(P<0.05).Furthermore,after 4 wk of treatment,the Pittsburgh sleep quality index scores for both groups were significantly lower than those before the treatment(P<0.05),with the experimental group exhibiting lower scores than the control group(P<0.05).The incidence of adverse reactions was significantly lower in the experimental group than in the control group(P<0.05).CONCLUSION The combination of Guipi decoction and escitalopram oxalate tablets was found to be an effective and safe treatment for depression.This combination could reduce TCM syndrome scores,improve depressive symptoms,and enhance sleep quality.
文摘BACKGROUND The antidepressant escitalopram is widely prescribed for the treatment of depression.It is generally well-tolerated,and cholestasis is not mentioned in its summary of product characteristics(Sm PC).We present a case of cholestatic and cytolysis liver injury due to escitalopram and a Vigi Base?study.CASE SUMMARY A 68-year-old man was admitted to our emergency unit due to clinical jaundice associated with hepatitis,pruritus and dark urine.We tested the patient for the most common etiologies of jaundice,including hemolysis,viral hepatitis,cirrhosis,carcinoma,cholangitis,cholelithiasis and intrahepatic or extrahepatic obstruction.The etiological study was negative,and an adverse drug reaction was the sole possible explanation.The patient was receiving treatment with escitalopram.Two days after its withdrawal,pruritus was resolved.Ten days after withdrawal,clinical jaundice disappeared.It took a month and three weeks after withdrawal for the patient to have normalized liver function tests.To our knowledge,this is the first reported case of cholestasis where treatment with escitalopram was the only possible cause,with a highly probable causality.In addition,we determined whether escitalopram is associated with hepatotoxicity and cholestasis by performing a disproportionality analysis.All cases of hepatobiliary disorders induced by escitalopram and reported in the World Health Organization pharmacovigilance database(Vigi Base?)were analyzed to characterize this toxicity.We found that patients treated with escitalopram had an increased risk of hepatitis[odds ratio(OR)=1.938(1.186-3.166)]and cholestasis[OR=1.866(1.279-2.724)][OR(95%confidence interval)].The median duration between the introduction of escitalopram and the occurrence of acute hepatitis and/or cholestasis was ten days+/-seven days.CONCLUSION Although extremely rare,this case report,the review of the literature and the pharmacovigilance update confirm that escitalopram can cause drug-induced hepatotoxicity and cholestasis,generally within a week after initiation.Thus,escitalopram should be withdrawn immediately if an iatrogenic cause cannot be excluded.If its responsibility is ascertained,escitalopram should be consequently contraindicated.In addition,serotoninergic antidepressants in patients with nonsevere depression are ineffective and harmful.Finally,the Sm PC of escitalopram should be updated to alert for this risk and give clear clinical guidelines.
基金supported by the National Basic Research Program of China(No.2011CB933503)Technology Supporting Program of Jiangsu Province(Nos.BE2009639 and BE2012657)
文摘An efficient synthesis of substituted 1,3-dihydroisobenzofurans is developed. In this novel route, oaroylbenzaldehydes, as key intermediates, can be obtained by lead tetraacetate oxidation of Naroylhydrazones of salicylaldehydes. The mild and general strategy enables the synthesis of various substituted 1,3-dihydroisobenzofurans in high yields. Moreover, this method can be applied to efficiently synthesize escitalopram.
基金the Medical Research Foundation of Jiangsu Provincial Department of Public Health,No.H201043
文摘We detected the event-related potential mismatch negativity （MMN） of 30 depression patients and compared to 30 age,gender,and education-matched healthy controls.Results showed that amplitudes of frequency and duration MMN were lower in depression patients compared with control patients,indicating abnormality in auditory processing （i.e.,cognitive impairment）.Following escitalopram treatment for 8 weeks,the amplitudes of frequency and duration MMN were significantly increased and Hamilton Rating Scale for Depression scores were significantly decreased in depression patients.These data suggest that escitalopram can improve cognitive function of patients with depression.Further,MMN may be a useful tool for evaluating cognitive function and treatment effects.
文摘Background:Depression will become the second most common disease after coronary heart disease(CHD).Escitalopram and olanzapine are commonly used to treat depression.Some studies indicated that escitalopram combined with olanzapine is effective in treating depression,however,there is no evidence to support these results.Our objective was to study the efficacy of escitalopram combined with olanzapine on depression by conducting a systematic review and meta analysis,and to provide reference for doctors.Methods:Relevant evidence were searched from PubMed,SinoMed,the Cochrane Library,Web of Science,Embase,China Knowledge Resource Integrated(CNKI),Wanfang Data Knowledge Service Platform databases(WANFANG)and VIP dating from inception to July 2020.The randomized controlled trials(RCTs)of escitalopram and olanzapine for the treatment of depression was obtained.According to inclusion and exclusion criteria,two researches(Sun Wu and Wang Zhe)independently screened the literature,extracted data,and evaluated the quality of included studies.Rev Man 5.3 software was used to conduct statistical analyze.Results:A total of 39 studies involving 3,267 patients were identified.These studies were finally included into the meta-analysis.Pooled results showed that there was a significant difference in efficiency(RR=1.18,95%CI:1.14 to 1.12,P<0.00001),HAMD(MD=-4.54,95%CI:-5.09 to-3.99,P<0.00001),and HAMA(MD=-3.94,95%CI:-5.57 to-2.12,P<0.0001).There was no significant difference in adverse reactions(MD=0.07,95%CI-0.03 to 0.17,P=0.19).Heterogeneity test showed that due to the high heterogeneity of HAMD(P<0.00001,12=86%)and HAMA(P<0.00001,I2=91%),after removing the items with high heterogeneity,there were also statistically significant in HAMD(MD=-5.22,95%CI:-5.53 to-4.91,P<0.00001)and HAMA(MD=-5.46,95%CI:-6.15 to-4.77,P<0.00001).Conclusion:Based on this study,the combination of escitalopram and olanzapine was more effective in treating depression than the control group.It is suggested that clinical and scientific researchers carry out more high-quality,large-sample,multi-center RCTs to provide more evidence-based medical evidence for the future study of escitalopram combined with olanzapine in the treatment of depression.
文摘Purpose: Hormone therapy (estrogen with or without progestin) remains the gold standard treatment for hot flashes in menopausal women, but concerns for the risk of hormone therapy have resulted in its decline and a demand for nonhormonal treatments with demonstrated efficacy for hot flashes. Aim of this study was to examine the efficacy of selective serotonin reuptake inhibitor escitalopram on hot flashes in a healthy sample of non-depressant menopausal women in Japan. Methods: We retrospectively analyzed the medical records of 11 menopausal patients with hot flashes, who received escitalopram (10 mg daily) for 2 weeks between March and August 2012. Hot flashes severities and scores were recorded on a scale of 0 to 10 points, at beginning and end of 2 weeks treatment. Results: At 2 weeks of therapy, 9 of 11 patients reported significant decreases in hot flash frequency and severity, but the remission of the symptom was not observed in 2 patients. Speed of relief from hot flashes was rapid (within one week). Conclusions: Escitalopram 10 mg/day may be a prompt and effective option for treating hot flashes in menopausal women who do not want to use hormone replacement therapy.
文摘Objective:To investigate the protective role of pumpkin seed ethanolic extract against escitalopram-induced reproductive toxicity in male mice.Methods:Swiss albino male mice were randomly divided into five groups with six mice in each group.Group Ⅰreceived normal water orally,Group Ⅱ,Ⅲ,Ⅳand Ⅴreceived escitalopram oxalate(10 mg/kg),pumpkin seed extract(300 mg/kg)plus escitalopram oxalate(10 mg/kg),escitalopram oxalate(20 mg/kg),and pumpkin seed extract(300 mg/kg)plus escitalopram oxalate(20 mg/kg),respectively.All test doses were continuously administered orally once daily per animal body weight for 30 days and 60 days.Body weight and sexual organ weight were evaluated on day 31 and 61.Effects of pumpkin seed extract on sperm parameters,biochemical parameters and histology of testis were also investigated.Results:Escitalopram 10 or 20 mg/kg caused reproductive toxicity in male mice after 30 and 60 days of treatment.However,simultaneous administration of escitalopram oxalate(10 or 20 mg/kg)with pumpkin seed extract(300 mg/kg)attenuated escitalopram-induced testicular toxicity.Significant increase in the body weight and relative organ weight was observed.Sperm count,sperm motility and viability significantly increased(P<0.05).The histopathological alterations caused by escitalopram was also ameliorated.Conclusions:Ethanolic extract of pumpkin seeds(300 mg/kg body weight)protects again reproductive toxicity induced by escitalopram.Therefore,dietary intake of pumpkin seed extract might be useful for male patients who expose to antidepressant drug due to depression.
基金Supported by The Sichuan Provincial People’s Hospital Translational Medicine Fund,No.2021LY02.
文摘BACKGROUND Antidepressants,particularly selective serotonin reuptake inhibitors,are currently considered the first-line treatment for panic disorder(PD).However,little is known about the relationship between the biomarkers that may predict better treatment.AIM To compare genome-wide methylation and gene expression patterns between responsive and non-responsive patients with PD after 4 wk of escitalopram treatment.METHODS Thirty patients with PD were enrolled in this study(responders=13;nonresponders=17).All patients were assessed using the PD Severity Scale-Chinese version before and after treatment.The Illumina Infinium MethylationEPIC(850k)BeadChip for genome-wide methylation screening and mRNA sequencing was used in all patients with PD.RESULTS A total of 701 differentially methylated positions(DMPs)were found between responders and non-responders(|Δβ|≥0.06,q<0.05),and the hyper-and hypomethylated CpG sites were 511(72.9%)and 190(27.1%),respectively.Relative to non-responders,there were 59 differential transcripts,of which 20 were downregulated and 39 were upregulated(q<0.05).However,no differen tially expressed genes were identified by mRNA sequencing after correcting for multiple testing(|log2(FC)|>1,q>0.05).CONCLUSION This preliminary study showed that DMPs might be associated with the treatment response to escitalopram in PD;however,these DMPs need to be verified in large samples.
基金Supported by Scientific Research Project of Guangdong Provincial Administration of Traditional Chinese Medicine in 2022(20221337).
文摘[Objectives] To analyze the effect of Jiaotai acupuncture combined with Escitalopram on mild depression and its influence on inflammatory factors.[Methods] Eighty patients with mild depression admitted to Shenzhen Baoan District Central Hospital from March 2021 to March 2023 were randomly divided into observation group (40 cases) and control group (40 cases). The control group was treated with Escitalopram, and the observation group was treated with Jiaotai acupuncture on the basis of the control group. The overall efficacy, depression score before and after treatment, and the improvement of inflammation level were compared between the two groups.[Results] The total effective rate of the observation group was significantly higher than that of the control group ( P <0.05), and the improvement of depression score and inflammation level of the observation group was significantly better than that of the control group ( P <0.05).[Conclusions] Jiaotai acupuncture combined with Escitalopram can significantly reduce inflammation and improve symptoms in patients with mild depression.
文摘Objective: to compare the safety of escitalopram and paroxetine in the treatment of senile depression. Methods: in this study, 82 patients with senile depression from November 2018 to June 2020 were selected for analysis. They were divided into control group and observation group according to the order of admission, and were treated with paroxetine and escitalopram respectively. The curative effect, adverse reactions, symptom improvement and satisfaction of the two groups were compared. Results: the effective rate was 97.56%(40 cases) in the observation group and 95.12%(39 cases) in the control group, with no significant difference between the two groups (P > 0.05). The incidence of adverse reactions in the observation group was 4.88%(2 cases), which was lower than that in the control group (19.51%, 8 cases). There was significant difference between the two groups (P < 0.05). Before the treatment, the HADM scores and SDS scores of each group were counted, and the depressive symptoms were evaluated. After the scores were calculated, there was no difference between the observation group and the control group, P > 0.05. After the second and fourth weeks of treatment, the HADM scores and SDS scores of each group were counted. After evaluating the depressive symptoms, the scores in the observation group were lower than those in the control group (P < 0.05). At the eighth week of treatment, the HADM scores and SDS scores of each group were counted, and the depressive symptoms were evaluated. After the scores were calculated, there was no difference between the observation group and the control group, P > 0.05. After counting the satisfaction data of each group, it reached 92.68% in the observation group, which was higher than 75.61% in the control group, with significant differences between groups (P < 0.05). Conclusion: the treatment outcome of escitalopram and paroxetine in the treatment of senile depression patients is equivalent, and both can achieve ideal curative effect, but the former has fast effect and less adverse reactions, which can improve patient compliance, and is more feasible.
