Cardiovascular Effects of Combining Subcutaneous or Intravenous Esketamine and the MAO Inhibitor Tranylcypromine for the Treatment of Depression: A Retrospective Cohort Study
| Autor: | Cathrin Sauer, Hannelore Findeis, James Rucker, Michael Bauer, Allan H. Young, Philipp Ritter, Vera M Ludwig |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Monoamine Oxidase Inhibitors Injections Subcutaneous Blood Pressure Cohort Studies Depressive Disorder Treatment-Resistant Young Adult chemistry.chemical_compound Heart Rate Internal medicine Heart rate medicine Humans Drug Interactions Pharmacology (medical) Ketamine Original Research Article Aged Retrospective Studies Depressive Disorder Major Creatinine Dose-Response Relationship Drug business.industry Tranylcypromine Retrospective cohort study Middle Aged Antidepressive Agents Confidence interval Psychiatry and Mental health Esketamine Blood pressure chemistry Cardiology Administration Intravenous Female Neurology (clinical) business medicine.drug |
| Zdroj: | CNS Drugs |
| ISSN: | 1179-1934 1172-7047 |
| DOI: | 10.1007/s40263-021-00837-6 |
| Popis: | Background (Es)ketamine and monoamine oxidase inhibitors (MAOIs), e.g., tranylcypromine, are therapeutic options for treatment-resistant major depression. Simultaneous administration is currently not recommended because of concern about hypertensive crises. Objective Our objective was to evaluate whether changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) during esketamine administration differed between patients who concomitantly received tranylcypromine and those who did not. Methods This was a retrospective cohort study utilizing cardiovascular monitoring data from inpatients treated for severe depression in unipolar, bipolar, and schizoaffective disorder. Primary outcomes were change in mean BP and HR during the first hour after intravenous or subcutaneous esketamine administration compared with baseline, controlled for confounders. Secondary analyses quantify differences in absolute BP during esketamine treatment and comparisons of BP peaks, temporal effects, and intraindividual comparisons before and after tranylcypromine initiation. Results Our analysis included 509 esketamine administrations in 43 patients, 14 of whom concomitantly received tranylcypromine. Controlling for creatinine and age, mean ± standard deviation (SD) BP changes were significantly increased by concomitant tranylcypromine treatment (ΔSBP: F[1,503] = 86.73, p |
| Databáze: | OpenAIRE |
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