Antidepressant drug selection: Criteria and options

S. H. Preskorn, E. Richelson, J. P. Feighner, L. A. Cunningham, S. P. Roose, M. B. Keller

Research output: Contribution to journalArticle

120 Citations (Scopus)

Abstract

The dilemma of developing new medications rationally-as opposed to discovering them through serendipity-is to create an optimal balance between the number of mechanisms of action needed for the widest spectrum of antidepressant activity while maximizing safety and tolerability. Newer antidepressants, such as serotonin selective reuptake inhibitors (SSRIs) and venlafaxine, have a wider therapeutic index than the older tricyclic antidepressants. Fewer types of adverse effects and a reduction in the potential for pharmacodynamic interactions are the distinct benefits of all the newer targeted antidepressants, such as venlafaxine, SSRIs, and bupropion, in comparison with older drugs. However, there are important differences among the newer antidepressants in terms of effects of P450 enzymes, dose-response curves for antidepressant response and adverse effects, and dosing schedules. One of the main benefits of having a wide array of options is the evidence that there may be different forms of the illness, which respond to different mechanisms of action. More research is needed to test this concept and to develop predictors of differential responsiveness.

Original languageEnglish (US)
Pages (from-to)6-24
Number of pages19
JournalJournal of Clinical Psychiatry
Volume55
Issue number9 SUPPL. A
StatePublished - 1994
Externally publishedYes

Fingerprint

Patient Selection
Antidepressive Agents
Serotonin Uptake Inhibitors
Bupropion
Tricyclic Antidepressive Agents
Cytochrome P-450 Enzyme System
Appointments and Schedules
Safety
Research
Pharmaceutical Preparations
Venlafaxine Hydrochloride
Therapeutics

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Preskorn, S. H., Richelson, E., Feighner, J. P., Cunningham, L. A., Roose, S. P., & Keller, M. B. (1994). Antidepressant drug selection: Criteria and options. Journal of Clinical Psychiatry, 55(9 SUPPL. A), 6-24.

Antidepressant drug selection : Criteria and options. / Preskorn, S. H.; Richelson, E.; Feighner, J. P.; Cunningham, L. A.; Roose, S. P.; Keller, M. B.

In: Journal of Clinical Psychiatry, Vol. 55, No. 9 SUPPL. A, 1994, p. 6-24.

Research output: Contribution to journalArticle

Preskorn, SH, Richelson, E, Feighner, JP, Cunningham, LA, Roose, SP & Keller, MB 1994, 'Antidepressant drug selection: Criteria and options', Journal of Clinical Psychiatry, vol. 55, no. 9 SUPPL. A, pp. 6-24.
Preskorn SH, Richelson E, Feighner JP, Cunningham LA, Roose SP, Keller MB. Antidepressant drug selection: Criteria and options. Journal of Clinical Psychiatry. 1994;55(9 SUPPL. A):6-24.
Preskorn, S. H. ; Richelson, E. ; Feighner, J. P. ; Cunningham, L. A. ; Roose, S. P. ; Keller, M. B. / Antidepressant drug selection : Criteria and options. In: Journal of Clinical Psychiatry. 1994 ; Vol. 55, No. 9 SUPPL. A. pp. 6-24.
@article{e73e7c10d27140c3b479237d1c1e53ac,
title = "Antidepressant drug selection: Criteria and options",
abstract = "The dilemma of developing new medications rationally-as opposed to discovering them through serendipity-is to create an optimal balance between the number of mechanisms of action needed for the widest spectrum of antidepressant activity while maximizing safety and tolerability. Newer antidepressants, such as serotonin selective reuptake inhibitors (SSRIs) and venlafaxine, have a wider therapeutic index than the older tricyclic antidepressants. Fewer types of adverse effects and a reduction in the potential for pharmacodynamic interactions are the distinct benefits of all the newer targeted antidepressants, such as venlafaxine, SSRIs, and bupropion, in comparison with older drugs. However, there are important differences among the newer antidepressants in terms of effects of P450 enzymes, dose-response curves for antidepressant response and adverse effects, and dosing schedules. One of the main benefits of having a wide array of options is the evidence that there may be different forms of the illness, which respond to different mechanisms of action. More research is needed to test this concept and to develop predictors of differential responsiveness.",
author = "Preskorn, {S. H.} and E. Richelson and Feighner, {J. P.} and Cunningham, {L. A.} and Roose, {S. P.} and Keller, {M. B.}",
year = "1994",
language = "English (US)",
volume = "55",
pages = "6--24",
journal = "Journal of Clinical Psychiatry",
issn = "0160-6689",
publisher = "Physicians Postgraduate Press Inc.",
number = "9 SUPPL. A",

}

TY - JOUR

T1 - Antidepressant drug selection

T2 - Criteria and options

AU - Preskorn, S. H.

AU - Richelson, E.

AU - Feighner, J. P.

AU - Cunningham, L. A.

AU - Roose, S. P.

AU - Keller, M. B.

PY - 1994

Y1 - 1994

N2 - The dilemma of developing new medications rationally-as opposed to discovering them through serendipity-is to create an optimal balance between the number of mechanisms of action needed for the widest spectrum of antidepressant activity while maximizing safety and tolerability. Newer antidepressants, such as serotonin selective reuptake inhibitors (SSRIs) and venlafaxine, have a wider therapeutic index than the older tricyclic antidepressants. Fewer types of adverse effects and a reduction in the potential for pharmacodynamic interactions are the distinct benefits of all the newer targeted antidepressants, such as venlafaxine, SSRIs, and bupropion, in comparison with older drugs. However, there are important differences among the newer antidepressants in terms of effects of P450 enzymes, dose-response curves for antidepressant response and adverse effects, and dosing schedules. One of the main benefits of having a wide array of options is the evidence that there may be different forms of the illness, which respond to different mechanisms of action. More research is needed to test this concept and to develop predictors of differential responsiveness.

AB - The dilemma of developing new medications rationally-as opposed to discovering them through serendipity-is to create an optimal balance between the number of mechanisms of action needed for the widest spectrum of antidepressant activity while maximizing safety and tolerability. Newer antidepressants, such as serotonin selective reuptake inhibitors (SSRIs) and venlafaxine, have a wider therapeutic index than the older tricyclic antidepressants. Fewer types of adverse effects and a reduction in the potential for pharmacodynamic interactions are the distinct benefits of all the newer targeted antidepressants, such as venlafaxine, SSRIs, and bupropion, in comparison with older drugs. However, there are important differences among the newer antidepressants in terms of effects of P450 enzymes, dose-response curves for antidepressant response and adverse effects, and dosing schedules. One of the main benefits of having a wide array of options is the evidence that there may be different forms of the illness, which respond to different mechanisms of action. More research is needed to test this concept and to develop predictors of differential responsiveness.

UR - http://www.scopus.com/inward/record.url?scp=0027996472&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027996472&partnerID=8YFLogxK

M3 - Article

C2 - 7961544

AN - SCOPUS:0027996472

VL - 55

SP - 6

EP - 24

JO - Journal of Clinical Psychiatry

JF - Journal of Clinical Psychiatry

SN - 0160-6689

IS - 9 SUPPL. A

ER -