P. Pancheri, S. Bonaccorso, P. Maselli, G.D. Kotzalidis - Vol. 5, Giugno 1999, num.2
Testo Immagini Bibliografia Summary Riassunto Indice
Effetti attivanti vs. effetti
inibenti dei farmaci antidepressivi
Activating vs. sedative effects of
antidepressant drugs
Background: psychomotor retardation and agitation are features of depression, but they are also commonly found during the course of antidepressant medication. Several mechanisms linked to bioaminergic effects of these drugs have been hypothesised to underlie these side effects.Aim and methods: to clarify these mechanisms we recorded activating (agitation, restlessness, anxiety, activation [CNS stimulation], hyperarousal, nervousness-irritability, excitation, hyperkinesia, insomnia) and sedative side (anergy, asthenia-weakness, avolition, somnolence, sedation, psychomotor retardation) effects of antidepressant drugs reported in double-blind trials, and compared them with those emerged with placebo, using the chi-square test. Results: most drugs differed significantly from placebo, which proved to be activating. There were no clearcut relationships between the ability of drugs to inhibit any monoamine transporter or to induce changes to any particular monoamine receptor and the emergence of either activating or sedative effects. The most reliable measure that predicted induction of sedative effects was histaminergic H1 blockade; the induction of somnolence accounted for most of this effect.Conclusions: the emergence of activating or sedative side effects during antidepressant treatment depends on the combination of the pharmacological properties of antidepressant drugs; the influence of these drugs on other transmitter and/or transporter systems might give another clue as to the mechanisms of induction of these effects. However, literature review is not a sensitive method to evaluate psychomotor drug effects.