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Activation syndrome induced by the antidepressant tianeptine and suicidal ideation: Evidence from a large depressed outpatient sample
- Source :
- Progress in Neuro-Psychopharmacology and Biological Psychiatry, Progress in Neuro-Psychopharmacology and Biological Psychiatry, Elsevier, 2020, 97, pp.109762. ⟨10.1016/j.pnpbp.2019.109762⟩
- Publication Year :
- 2020
- Publisher :
- HAL CCSD, 2020.
-
Abstract
- Objective To determine the characteristics of the activation syndrome (AS) that predict the emergence or worsening of suicidal ideation (SI) in the first month of antidepressant treatment with tianeptine, as well as the temporal relationship between both conditions. Method A naturalistic sample of 2422 depressed outpatients starting a new antidepressant treatment with tianeptine was assessed at 2, 4 and 6 weeks of follow-up using validated questionnaires. Four main dimensions of AS were examined: impulsivity, sleep problems, anxiety and agitation. Results The emergence of an AS was more likely in long-lasting depressive episodes, but less likely if the patient responded to the antidepressant or benzodiazepines were added as an add-on treatment. Treatment-emergent SI was strongly associated to the presence of an AS, particularly in case of sleep problems (OR = 8.42) or impulsivity upsurges (OR = 3.89), even after adjustment for all relevant confounding factors. Conclusions Our findings suggest a dose-effect mechanism modulating the relationship between treatment-related SI and AS. AS symptoms may need to be monitored closely in the weeks that follow the introduction of an antidepressant treatment.
- Subjects :
- Male
MESH: Thiazepines
Time Factors
Thiazepines
[SDV.MHEP.PSM] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health
Antidepressive Agents, Tricyclic
Anxiety
Benzodiazepines
0302 clinical medicine
Sleep Initiation and Maintenance Disorders
Outpatients
Tianeptine
MESH: Syndrome
Suicidal ideation
Psychomotor Agitation
MESH: Middle Aged
MESH: Suicidal Ideation
Confounding
MESH: Psychomotor Agitation
Syndrome
Middle Aged
3. Good health
Suicidal behavior
Activation syndrome
Antidepressant
Drug Therapy, Combination
Female
MESH: Impulsive Behavior
medicine.symptom
medicine.drug
medicine.medical_specialty
[SDV.SP.MED] Life Sciences [q-bio]/Pharmaceutical sciences/Medication
MESH: Depressive Disorder, Major
Impulsivity
Suicidal Ideation
03 medical and health sciences
[SDV.SP.MED]Life Sciences [q-bio]/Pharmaceutical sciences/Medication
MESH: Sleep Initiation and Maintenance Disorders
medicine
Humans
Psychiatry
Biological Psychiatry
Jitteriness
Pharmacology
Depressive Disorder, Major
MESH: Humans
MESH: Anxiety
business.industry
MESH: Time Factors
medicine.disease
MESH: Male
030227 psychiatry
MESH: Antidepressive Agents, Tricyclic
MESH: Outpatients
MESH: Drug Therapy, Combination
MESH: Benzodiazepines
[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health
Impulsive Behavior
business
Sleep
MESH: Female
Subjects
Details
- Language :
- English
- ISSN :
- 02785846
- Database :
- OpenAIRE
- Journal :
- Progress in Neuro-Psychopharmacology and Biological Psychiatry, Progress in Neuro-Psychopharmacology and Biological Psychiatry, Elsevier, 2020, 97, pp.109762. ⟨10.1016/j.pnpbp.2019.109762⟩
- Accession number :
- edsair.doi.dedup.....f59c9383f0f0722728706a3bdd08d9d7