Depsit (Escitalopram) is the most commonly prescribed antidepressant. It is Selective Serotonin Reuptake Inhibitor and mainly produces its effects in CNS. This short survey on Depsit (Escitalopram) was conducted during my bachelors in Physiology (2016). There isn't any valuable information available on internet regarding this brand of escitalopram. This report may serve as a useful tool for all healthcare professionals.
A description of Brivaracetam, a novel SV2A ligand, an anti-epileptic with greater potency and significantly reduced behavioural adverse effects compared to Levetiracetam .
A description of Brivaracetam, a novel SV2A ligand, an anti-epileptic with greater potency and significantly reduced behavioural adverse effects compared to Levetiracetam .
Global Medical Cures™ | Medicines for Treating Mental Health ConditionsGlobal Medical Cures™
Global Medical Cures™ | Medicines for Treating Mental Health Conditions
DISCLAIMER-
Global Medical Cures™ does not offer any medical advice, diagnosis, treatment or recommendations. Only your healthcare provider/physician can offer you information and recommendations for you to decide about your healthcare choices.
Safety Considerations in the use of Psychotropic Medication in Children and T...Stephen Grcevich, MD
This presentation for the medical staff of Child and Adolescent Behavioral Health in Canton, OH is an introduction to basic safety concerns and monitoring associated with the use of psychotropics in children and teens. The presentation was tailored to newly graduated advanced practice nurses.
Drug induced hyperprolactinaemia, do we have to treatWafaa Benjamin
During antipsychotic treatment, prolactin concentrations can rise to ten times normal levels or above.
Existing data indicate that 17-78% of female patients have amenorrhoea with or without galactorrhoea.
Survey data, however, suggest that clinicians underestimate the prevalence of these conditions.
Long-term consequences of antipsychotic-related hypo-oestrogenism require further research but are likely to include premature bone loss.
Antipsychotic-induced hyperprolactinaemia should become a focus of interest in the drug treatment of psychiatric patients.
Recomendaciones de Choosing Wisely para evitar intervenciones innecesarias en adultos mayores.
Fuente: http://www.americangeriatrics.org/files/documents/choosing_wisely_list2.pdf
Pramirol (Pramipexole Dihydrochloride Tablets) is a non-ergot dopamine agonist and is used alone or with other medicines to treat Parkinson's disease. This medication is also used to treat Moderate-to-severe primary Restless Legs Syndrome (RLS) that causes an unusual urge to move the legs.
Newer drugs for the treatment of motor symptoms of Parkinson's DiseaseSudhir Kumar
Parkinson's disease is a common movement disorder with prominent motor symptoms such as tremors, bradykinesia and rigidity. Many patients suffer from motor fluctuations including on off phenomena, and freezing. This presentation looks at the latest drugs for treating these.
Invited lecture delivered by Dr Sujoy Dasgupta in a Webinar organized by Sexual medicine Committee of FOGSI (Federation of Obstetric and Gynaecological Societies of India), held in February, 2022
Zoloft is an anti-depressant medication, used for treating major depression, panic disorder, anxiety disorders and more. GDD, put an Zoloft Generic on sale at low price. Buy Zoloft Generic and treat your depression at minimal health cost.
The man whose antidepressants stopped workingMajor depress.docxpoulterbarbara
: The man whose antidepressants stopped working
Major depressive disorder is one of the most prevalent disorders we will see in our clinical practice. Treatment options for MDD can vary greatly contingent on the appropriate psychopharmacologic interventions being adopted for our clients.
Medication nonadherence for patients with chronic diseases is extremely common, affecting as many as 40% to 50% of patients who are prescribed medications for management of chronic conditions (Kleinsinger, 2018). Nonadherence isn't a new problem. However, offering clients valuable interventions and education to overcome any potential compliance barriers will help the provider identify any challenges and decide how to achieve mutually agreed-upon goals to improve their health.
Questions
1.
Do you ever feel that taking your medications is a nuisance or inconvenience? Do you have a difficult time remembering to take your medications or forget?
•&νβσπ;&νβσπ;&νβσπ;&νβσπ;&νβσπ;&νβσπ;Developing a medication schedule, It is difficult to come up with a schedule to take medications every day for some patients. Collaboratively we need to come up with a convenient time to take the antidepressant and the other prescribed medication for them to be effective.
2.
Does your prescribed medications and treatment regimen still leave you feeling depressed? Do you have a difficult time adhering to a prescribed regimen?
•&νβσπ;&νβσπ;&νβσπ;&νβσπ;&νβσπ;&νβσπ;The patient discontinued his Effexor although it appeared to be effective. It is essential to find out the patient’s reason for not following the prescribed regimen and come up with a solution together.
•&νβσπ;&νβσπ;&νβσπ;&νβσπ;&νβσπ;&νβσπ;It is crucial for the patient to take his antidepressants accordingly, as well as not skip or alter the dosage, nor terminate the medication once you start feeling better.
3.
Have the side effects of your medications been difficult to cope with or manage? Do you sometimes stop taking your medications because of the adverse effects?
Sertraline has been prescribed in the past and discontinued several times. The patient experienced side effects of sexual dysfunction and stopped taking. Encourage the patient to monitor any side effects, physical and emotional changes or occurrences.
Stopping medications and treatment regimens prematurely or abruptly have been associated with high relapse rates and can cause serious withdrawal symptoms (Henssler, Heinz, Brandt, & Bschor, 2019).
Important People
Family members and other caregivers bring personal knowledge on the suitability or lack thereof regarding different treatments for the patient's circumstances and preferences (Smith, 2013). The patient is married, so I would address additional questions to his wife. After getting permission to discuss his medical records with his family members, I would ask the wife if she knew what medications her husband was taking? If she knew why he was taking them? Informed and en.
Global Medical Cures™ | Medicines for Treating Mental Health ConditionsGlobal Medical Cures™
Global Medical Cures™ | Medicines for Treating Mental Health Conditions
DISCLAIMER-
Global Medical Cures™ does not offer any medical advice, diagnosis, treatment or recommendations. Only your healthcare provider/physician can offer you information and recommendations for you to decide about your healthcare choices.
Safety Considerations in the use of Psychotropic Medication in Children and T...Stephen Grcevich, MD
This presentation for the medical staff of Child and Adolescent Behavioral Health in Canton, OH is an introduction to basic safety concerns and monitoring associated with the use of psychotropics in children and teens. The presentation was tailored to newly graduated advanced practice nurses.
Drug induced hyperprolactinaemia, do we have to treatWafaa Benjamin
During antipsychotic treatment, prolactin concentrations can rise to ten times normal levels or above.
Existing data indicate that 17-78% of female patients have amenorrhoea with or without galactorrhoea.
Survey data, however, suggest that clinicians underestimate the prevalence of these conditions.
Long-term consequences of antipsychotic-related hypo-oestrogenism require further research but are likely to include premature bone loss.
Antipsychotic-induced hyperprolactinaemia should become a focus of interest in the drug treatment of psychiatric patients.
Recomendaciones de Choosing Wisely para evitar intervenciones innecesarias en adultos mayores.
Fuente: http://www.americangeriatrics.org/files/documents/choosing_wisely_list2.pdf
Pramirol (Pramipexole Dihydrochloride Tablets) is a non-ergot dopamine agonist and is used alone or with other medicines to treat Parkinson's disease. This medication is also used to treat Moderate-to-severe primary Restless Legs Syndrome (RLS) that causes an unusual urge to move the legs.
Newer drugs for the treatment of motor symptoms of Parkinson's DiseaseSudhir Kumar
Parkinson's disease is a common movement disorder with prominent motor symptoms such as tremors, bradykinesia and rigidity. Many patients suffer from motor fluctuations including on off phenomena, and freezing. This presentation looks at the latest drugs for treating these.
Invited lecture delivered by Dr Sujoy Dasgupta in a Webinar organized by Sexual medicine Committee of FOGSI (Federation of Obstetric and Gynaecological Societies of India), held in February, 2022
Zoloft is an anti-depressant medication, used for treating major depression, panic disorder, anxiety disorders and more. GDD, put an Zoloft Generic on sale at low price. Buy Zoloft Generic and treat your depression at minimal health cost.
The man whose antidepressants stopped workingMajor depress.docxpoulterbarbara
: The man whose antidepressants stopped working
Major depressive disorder is one of the most prevalent disorders we will see in our clinical practice. Treatment options for MDD can vary greatly contingent on the appropriate psychopharmacologic interventions being adopted for our clients.
Medication nonadherence for patients with chronic diseases is extremely common, affecting as many as 40% to 50% of patients who are prescribed medications for management of chronic conditions (Kleinsinger, 2018). Nonadherence isn't a new problem. However, offering clients valuable interventions and education to overcome any potential compliance barriers will help the provider identify any challenges and decide how to achieve mutually agreed-upon goals to improve their health.
Questions
1.
Do you ever feel that taking your medications is a nuisance or inconvenience? Do you have a difficult time remembering to take your medications or forget?
•&νβσπ;&νβσπ;&νβσπ;&νβσπ;&νβσπ;&νβσπ;Developing a medication schedule, It is difficult to come up with a schedule to take medications every day for some patients. Collaboratively we need to come up with a convenient time to take the antidepressant and the other prescribed medication for them to be effective.
2.
Does your prescribed medications and treatment regimen still leave you feeling depressed? Do you have a difficult time adhering to a prescribed regimen?
•&νβσπ;&νβσπ;&νβσπ;&νβσπ;&νβσπ;&νβσπ;The patient discontinued his Effexor although it appeared to be effective. It is essential to find out the patient’s reason for not following the prescribed regimen and come up with a solution together.
•&νβσπ;&νβσπ;&νβσπ;&νβσπ;&νβσπ;&νβσπ;It is crucial for the patient to take his antidepressants accordingly, as well as not skip or alter the dosage, nor terminate the medication once you start feeling better.
3.
Have the side effects of your medications been difficult to cope with or manage? Do you sometimes stop taking your medications because of the adverse effects?
Sertraline has been prescribed in the past and discontinued several times. The patient experienced side effects of sexual dysfunction and stopped taking. Encourage the patient to monitor any side effects, physical and emotional changes or occurrences.
Stopping medications and treatment regimens prematurely or abruptly have been associated with high relapse rates and can cause serious withdrawal symptoms (Henssler, Heinz, Brandt, & Bschor, 2019).
Important People
Family members and other caregivers bring personal knowledge on the suitability or lack thereof regarding different treatments for the patient's circumstances and preferences (Smith, 2013). The patient is married, so I would address additional questions to his wife. After getting permission to discuss his medical records with his family members, I would ask the wife if she knew what medications her husband was taking? If she knew why he was taking them? Informed and en.
Short educational powerpoint presenation on the need for metabolic monitoring for patients prescribed atypical antipsychotic drugs for entire staff in psychiatric setting. Linked to Master's Capstone Project- Creating a Metabolic Monitoring Protocol for Patients Prescribed Atypical Antipsychotic Drugs
Because of such a high consumption level, any risky impact of these pills on public health would be important. The present study aimed to determine the relationship between consumption of OCPs and hypertension. Method: In this retrospective, cross-sectional study, 165women below 40 years of age who used OCPs were selected by convenience sampling. Necessary information was obtained by a checklist containing demographic information, obstetric history, and OCPs use history based on the subjects’ medical records. Besides, blood pressure and weight were measured at the beginning of OCPs consumption as well as 6 months and one year after that. Results: The results showed a significant difference between the subjects’ mean systolic blood pressure one year after OCPs consumption compared to the beginning (P=0.03). Moreover, this difference was related to the type of pills, such a way that it was significant in the patients who took Low Dose (LD) OCPs compared to those who used Triphasic pills (P=0.01). Conclusion: Consuming the currently available OCPs that contain lower estrogen content had an insignificant effect on blood pressure. However, it is recommended to take care of blood pressure in order to identify the unique occasional responses.
Vilazodone, a new antidepressant introduced in the US, which combines SERT in...Dikshya upreti
How is vilazodone different from other SSRIs?
A unique mechanistic approach is that of vilazodone, an agent that combines two mechanisms in a single drug, namely that of the SSRIs with 5HT1A receptor partial agonist actions, or a serotonin partial agonist reuptake inhibitor (SPARI).
Silodosin versus tamsulosin in symptomatic benign prostatic hyperplasia-Our e...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Polypharmacy appropriate and inappropriate based on risk and benefit assessment case study, negative consequences of polypharmacy, deprescribing tools,
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
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Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
1. U n i v e r s i t y O f K a r a c h i
2016
Brand Name:
Depsit
Generic Name:
Escitalopram Oxalate
Chemical Name:
Escitalopram (S-Citalopram)
DRUG SURVEY
REPORT
By: Asifa Nisar Bhutto
B.Sc. (H) Physiology
H-1323007
Fundamentals Of Pharmacology
2. 1
ABSTRACT:
Introduction: Depsit (Escitalopram) is the most commonly prescribed antidepressant. It is S-
enantiomer of citalopram, and has better effect. Depsit is highly selective SRI and produces its
effects in CNS by inhibiting serotonin reuptake by binding to serotonin transport protein.
Object: This study was designed to find out the most commonly experienced side effects,
efficacy and major causes of using depsit. Methodology: A questionnaire based cross-sectional
survey was conducted among the local residents of Karachi, Pakistan. The questionnaire was
composed of 14 basic questions filled by a total of 20 respondents. Conclusion: This study
shows that the use of this medicine is strictly under prescription, and no malpractice was found.
Most of the people have gastro-psychiatric over lapse, are and chronic users (using since 4-5
years). No prominent side effects are found except increase in appetite leading to weight gain,
sleepiness and lethargy.
4. 3
OBJECT:
To find out the frequency and causes of use, side effects, and effectiveness of tab. Depsit.
INTRODUCTION:
Tab. Depsit is composed of Escitalopram oxalate. Escitalopram is a selective serotonin (5-
hydroxytryptamine, 5-HT) reuptake inhibitor (SSRI) and it is FDA approved drug for the treatment of
adults and children over 12 years of age with major depressive disorder (MDD) and certain anxiety
disorders: general anxiety disorder (GAD), social anxiety disorder (SAD), obsessive-compulsive disorder
(OCD), and panic disorder. SSRIs are also effective in reducing the symptoms of PMS (Premenstrual
syndrome) and for treating tension headaches and migraine.
Pharmacodynamics:
All SSRIs inhibit reuptake of serotonin (5-HT) into presynaptic serotonergic neurons, an action that
increases the availability of serotonin at the synapse and, ultimately, enhances serotonergic function in
the central nervous system. This mechanism of action depends on the binding of drug to the serotonin
transporter protein. It has minimal effects on norepinephrine and dopamine neuronal reuptake.
Escitalopram has no or very low affinity for serotonergic (5-HT1-7) or other receptors including alpha-
and beta-adrenergic, dopamine (D1-5), histamine (H1-3), muscarinic (M1-5), and benzodiazepine
receptors. Escitalopram also does not bind to, or has low affinity for, various ion channels including Na+ ,
K+ , Cl- , and Ca++ channels. Antagonism of muscarinic, histaminergic, and adrenergic receptors has
been hypothesized to be associated with various anticholinergic, sedative, and cardiovascular side
effects of other psychotropic drugs.
5. 4
Pharmacokinetics:
Biotransformation of escitalopram is mainly hepatic. Maximum concentration of escitalopram is
achieved after 3-4 hours of administration. Its half-life is about 27-33 hours and bioavailability is 80%.
Escitalopram is metabolized by the cytochrome P450 (CYP) isoenzymes CYP2C19, CYP2D6 and CYP3A4.
The principle metabolite is S-demethylcitalopram (S-DCT) that is eliminated in urine. The
pharmacokinetics of this drug is not affected by concurrent intake of food.
*Depsit (Escitalopram Oxalate) is contraindicated for patients taking Monoamine Oxidase Inhibitors
(MAOIs) due to its potent interactions with this drug (serotonin syndrome).
SIDE EFFECTS:
Gastrointestinal- Nausea, diarrhea, increased appetite, taste disturbances.
Central Nervous System- Sleeplessness, fatigue, drowsiness, unusual excitement, confusion.
Heart- Fast or irregular heartbeat, postural hypotension
Psychiatric: Increased appetite, lethargy, anxiety, suicidal thoughts.
Genitourinary- Impotence, ejaculation disorder.
Eye and ENT- Inflammation of the Para nasal sinuses, seeing things or hearing voices that do not exist
(hallucinating). Miscellaneous- Increased sweating, weight gain, fever, and severe muscle stiffness.
Methodology:
A short survey was conducted to find out the uses, effectiveness and side effects of Depsit. The sample
size catered was 20 and data was collected by distributing a Performa (based on 14 basic questions)from
local residents of Karachi, specifically, patients from DUHS (Ojha campus) OPD, sub department of:
Neurology, and from Jinnah Postgraduate Medical Centre (JPMC) medical unit 4 (M4) and medical unit 7
(M7), after informed verbal consent. Patients who were interested in giving their psychiatric problems
history were given preference, whereas, those who had serious hepatic/renal impairment were
excluded from the study.
6. 5
Result:
Data was analyzed in MS Excel version 14. Following results are obtained:
Fig 1: Most of the subjects using depsit are young. Fig. 2: Showing that no. of female users is greater.
Figure 1 this figure is showing the level of education of participants. The minimal qualification noted was
matriculation, and maximal was graduation, including two doctors. The qualification was found to be
independent of age.
12
8
Age
18-25 years
26-35 years
5
15
Gender
Male
Female
5
9
6
Matric
Intermediate
Graduation
0 2 4 6 8 10
Qualification
7. 6
Figure 2 This figure shows the duration for which depsit was used. Minimum time of usage found in this study is 1
week, while most of the patients were taking this drug for 4-5 years.
Figure 3 This pie chart shows the major complains for which this drug was prescribed, and it reveals that most of
the patients were having GIT problems.
5
9
6
Complain
Headache
GIT Problems
Multiple Complains
1
6
4
9
Less than 1
month
1-6 months Till 1 year More than 1
year
0
1
2
3
4
5
6
7
8
9
10
Duration
Numberofpeople Duration Of Use
8. 7
Figure 4 This chart highly supports the effectiveness of depsit. 19 out of 20 patients found this drug very effective
for their problem.
Figure 5 This chart shows the effect of this drug on the body weight of user. 12 patients noticed an increase in
their weight, 8 patients had no fluctuation in weight, while nobody noticed the decrease in weight after using
this medicine
1
19
Effectiveness
Not effective
Vey Effective
8
12
Effect On Weight
No effect
Increase in weight
9. 8
Figure 6 Awareness regarding the actual use of depsit was independent of patient’s level of education. However,
12 out of 20 patients were well aware of its uses.
Figure 7 This figure shows the daily dosage of medicine taken by the patients. Majority of the patients
were given the minimum dose (5mg/day).
8
12
Knowledge regarding actual
use of this drug
Don't know
Well aware
11
9
Daily Dosage
5 mg
10 mg
10. 9
Figure 10; chart showing other drugs used by the patients along with depsit.
Figure 8 This chart shows that most of the patients think that this drug is addictive.
7
12
1
No GIT Drugs Migraine Drugs
0
2
4
6
8
10
12
14
Use of other drugs
Numberofpeople
Other Drugs
4
16
Addiction
Not Addictive
Addictive
11. 10
Figure 9 This figure shows the effect of depsit on the overall mood of patient, and it reveals that most of the
patients felt a positive change in their mood.
Figure 10 This chart shows that 19 out of 20 patients experienced hypersomnia induced by this medicine.
No effect
Positive
Negative
0
5
10
15
20
2
17
1
Effect
Numberofpeople
Effect On Mood
1
19
Do you feel sleepy after taking
Depsit?
No Yes
12. 11
Figure 11 This figure shows the number of people that experienced side effects related to Central Nervous
System.
Figure 12 This pie chart shows that only a small number of patients encountered Gastrointestinal Tract Problems
after taking depsit.
14
6
CNS Side Effects
No
Yes
18
2
GIT Side Effects
No
Yes
13. 12
Figure 13 This figure shows the number of patients (15) that reported an increase in appetite during the course of
this medicine.
5
15
Increase in Appetite
No Yes
14. 13
Discussion: Out of 20 subjects that took part in study, only 5 were male and 15 female which gives
a rough idea about higher prevalence of depression in females as compared to males. Most of the
patients were young. Minimum age recorded is 18 years and maximum is 34 years. The least
qualification found is matric (5 subjects), and highest is graduation (6 Subjects), while 9 subjects were
intermediate pass. The level of education of subjects was independent of their age. Only 1 participant
used this medicine for a duration of 1 week (minimum time recorded) while 2 participants (female) were
using this medicine for almost 4 years, and 1 male participant was on this drug for last 5 years (highest
duration recorded). 5 patients complained of problems related to headache, dizziness & vision, 6
patients were having GI upsets (bloating, diarrhea, constipation, epigastric pain), and majority of
patients (9) reported multiple problems (like, abdominal pain, breathlessness, excessive sweating etc.)
due to which this drug was prescribed to them. Depression may give rise to several other problems like
IBS, Panic attacks (misinterpreted as acute asthma), and several other health issues. So, in order to cure
these conditions, underlying cause (depression) must be treated and eliminated. 19 out of 20 patients
rated this drug as an excellent remedy for their problem. A large number of people (12/20) noticed a
rapid elevation in their weight as they continued using this medicine, while 8 patients had no effect. This
might be due to increased appetite as a result of calmness. Hypersomnia may also contribute to this
factor. Nobody reported a decrease in weight related to this drug. 8/20 patients showed no significant
knowledge regarding the actual cause for which depsit is prescribed, while 12 were well aware about its
use. The knowledge of patients was independent of their age and qualification. Daily dosage prescribed
was found to be 5mg/day and 10mg/day, a maximum dosage of 20mg/day was not taken by any subject.
Majority of the participants were also prescribed omeprazole (risek), husk, and other GIT drugs, 7
patients were not using any other drug with depsit, while only 1 patient (female) was taking muscle
relaxant (Nuberol fort), and migraine drugs (miral, epival). With the exception of 3 patients, all the
participants noticed a positive, stabilizing effect of depsit on their mood. 16/20 patients reported
addiction of this medicine, and 19/20 said that they felt extreme sleepiness after taking depsit. Side
effects related to CNS (shaking, restlessness, coordination problem) were faced by only 6 patients.
Gastrointestinal upset (bloating, increased stool frequency) was noticed only in 2 patients. Increased
appetite and lethargy are two most common side effect of depsit experienced by 15 and 16 patients
respectively. 2 /20 patients reported sleepiness and bloating as severe side effects due to which the
therapy was not continued.
Conclusion:
The use of depsit (escitalopram) is highly controlled among the patients included in this study.
Almost all the participants were well aware of its use and reported this medicine as a highly
effective antidepressant. Depsit is not only prescribed in Neurology or Psychiatry departments,
it is frequently given to IBS patients and those having random episodes of panic attacks. The
use of this medicine is safe. No severe side effects were observed.
15. 14
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