QUESTION I have read that fluoxetine is the drug of choice for treating depression during pregnancy. One of my patients, who did not respond to the "old" selective serotonin reuptake inhibitors, is doing well on venlafaxine and is now 6 weeks pregnant. What advice should I give her? ANSWER Fluoxetine is recommended because to date it has the most evidence of its safety. It is important that w...

Serotonin is a naturally occurring “messenger” protein that is found primarily in the gastrointestinal system, certain blood cells (platelets) and the central nervous system (brain and brain stem). Abnormal activity of this messenger protein has been implicated in both migraine and depression, and medications that modify serotonin can be effective in treating both disorders. Such medications in...

(Letter to the Editor) SIR, Erythromelalgia is an unusual disorder characterized by the triad of red, hot and painful extremities. The symptoms are exacerbated by heat and improved by cold. Its aetiology is not fully understood. Numerous different medications including aspirin, gabapentin, amitriptyline, benzodiazepines and opiates have been used in attempts to treat the symptoms of erythromela...

This case describes a 31-year-old female Caucasian patient with complaints of ongoing depression, agitation, and severe panic attacks. The patient was untreated until a recent unsuccessful trial of citalopram followed by venlafaxine which produced a partial response. Genetic testing was performed to assist in treatment decisions and revealed the patient to be heterozygous for polymorphisms in 5...

Dra. Lívia Almeida Dutra – Rua Borges Lagoa 512 / 61C 04038-000 São Paulo SP Brasil. E-mail: [email protected] Myoclonus is a clinical sign defined as sudden, brief, shock like, involuntary movements caused by muscular contractions or inhibitions. Certain commonly prescribed drugs cause movements disorders as myoclonic jerks and polymyoclonus in the absence of other signs of toxicity. Ven...

This review provides an overview of 59 randomized placebo-controlled trials that examined the analgesic effect of antidepressants. To summarize, there is significant evidence that the tricyclic group of antidepressants is analgesic and that trazodone is not; the data regarding selective serotonin reuptake inhibitors are conflicting. To date, there are no randomized controlled trials examining t...