Volume 22, Issue 1, March 2020
Selective Inhibition of the Serotonin Transporter in the Treatment of Depression: Sertraline, Fluoxetine and Citalopram
Zsombor Szoke-Kovacs, Csaba More, Rita Szoke-Kovacs, Endre Mathe and Ede Frecska
Discovery and development of the selective serotonin reuptake inhibitors mark a milestone in neuropharmacology. Drugs from this class alter the functioning of the serotonin system by the potentiation of serotonin through the negative allosteric modulation of its neuronal uptake by the human serotonin transporter. Selective serotonin reuptake inhibitors show few side effects compared to those caused by traditional antidepressants and they vary in the binding interactions formed during binding. Generally, their binding involves three specific regions of the drug structures, each participating in vital interactions, such as salt bridge formation and additional hydrophobic interactions with conserved residues in the central binding site of the target protein. Side effects, however, such as the initial lack of response to treatment, or drowsiness, nausea, and sexual dysfunction occasionally may arise. Additional binding studies, furthermore, highlighted the importance of enantioselectivity in the binding of these compounds, raising concerns about the beneficial application of racemate mixtures of some of these compounds. Therefore, additional characterisation of binding and further structural improvement of this class of drugs is necessary. The recently synthesized sertraline salts, and functional derivatives of fluoxetine and citalopram show promising results in delivering antidepressant activity as well as in effectively overcoming anorexigenic side-effects in rodent models. Hence, despite certain non-desired eff ects associated with selective serotonin reuptake inhibitor applications, this class of drugs is considered as first-line medication in the management of major depression, and is carrying an excellent potential for the development and refinement of the currently available and novel antidepressant therapies.
Mohammad Tahan, Tamkeen Saleem, Photis Zygoulis, Lucas Vieira Lacerda Pires, Majid Pakdaman, Hamid Taheri and Majid E Brahimpour
Background: Depression is a common mental health disorder which has become a global public health issue. It constitutes around 35 to 45 % of mental health problems in Iran and covers 8 % to 20 % of population of Iran. Therefore, the present study aimed to determine the prevalence of depression among the Iranian patients through systematic review and meta-analysis. Method: For the present study information were searched in Web of Science, Scopus, PubMed, Google Scholar, and in Iranian databases including Iran Medex, SID, MedLib, Scientific Information Database, MagIran, using the following keywords: “depression”, “prevalence” and Iran. The data from these databases were analyzed through meta-analysis (random effects model). Heterogeneity among the results of the studies was examined by I2 index. Beck Depression Inventory (BDI), Depression Anxiety and Stress Scale-21 (DASS-21), General Health Questionnaire-28 (GHQ-28), and Geriatric Depression Scale (GDS) were used in this study, and statistical analyses were performed using STATA Ver.16. Results: A total of 46 studies conducted in Iran based on a sample size of 2960 individuals was found during the time period of 2010 and 2018. Prevalence of depression among Iranian patients was estimated to be 34.26 (95 % CI, 24.12 % – 44.10 %). Thus, the findings indicated that there exists a moderate prevalence of depression which is continuously growing. Conclusion: The prevalence of depression in Iran is moderate and growing which is alarming as it may turn out to be a massive increase in incidence rate of depression in coming years. This indicates a greater risk for Iranian population and calls for effective measures to be taken to control the mental health problems among Iranian patients.
Karoly Bozsonyi, David Lester, Andrea Fulop, Tamas Zonda and Lajos Balint
Background: A couple of studies suggest that sunshine duration and ambient temperature contribute to suicide. Few studies have happened in East-Central European area. Objective: We scrutinized the daily suicide rates and other measured meteorological parameters spanning from 1971 to 2013 in the region of Hungary exhibiting the highest suicide rate. Methods: The meteorological parameters measured in the area signified the independent variables of the statistical model, while the observed suicide rate connoted the dependent variable. Dynamic Regression, a time series analytical method was employed for creating the model. Results: Three meteorological parameters displayed a weak, yet statistically significant relationship with suicide rates. 1/ Daily sunshine duration has shown an immediate, significant positive correlation, 2/ daily changes in temperature at ground level also exhibited a significant relationship, albeit it followed a complex transient profile overarching three days. Tropopause height was also significant in the model: an immediate positive effect was followed by a negative effect six days later. Conclusions: We estimated consistent and immediate positive associations between daily suicide and daily change of elevated ambient temperature and duration of sunshine in a high rated area of Hungary.
Estimating and managing the changing methodological parameters of self-report surveys of addictive behavior – based on the waves of the National Survey on Addiction Problems in Hungary (NSAPH) in 2007 and 2015
Borbala Paksi, Zsolt Demetrovics, Mark D. Griffiths, Anna Magi and Katalin Felvinczi
The standard nature of the procedures and tools of sampling and data collection cannot guarantee the stability of data reliability and validity because non-sampling errors are highly sensitive to social conditions. The present study provides a post-hoc attempt to estimate and manage the changing methodological parameters of self-report surveys of addictive behaviours (being highly subjected to changes in social conditions) to make data interpretation easier. The analysis is based on the data of two national Hungarian representative surveys assessing addiction problems in 2007 and 2015 (National Survey on Addiction Problems in Hungary [NSAPH]). Both surveys were conducted using a Hungarian nationwide representative sample aged 18-64 years applying similar procedures in data collection and -processing. Regarding data concerning substance use, both surveys included variables to estimate non-sampling errors in line with current international practices. The methodological parameters of NSAPH2015 showed an increase in non-sampling errors regarding substance use behaviour compared to NSAPH2007. The present paper elaborates an estimation procedure based on the assumption that when following a population, the proportion of people who have ever engaged in a specific type of addictive behaviour cannot be reduced in the given population over time. This also applies to cohorts followed by cross-sectional surveys among national representative samples, as far as lifetime prevalence and data on the age of first use/activity is available. To identify valid trends in different behaviours in epidemiological research assessing addictive behaviours or other sensitive data, researchers should provide the required conditions for controlling or correcting data by cohort analysis.