BACKGROUND Few studies have assessed the risk of hip fracture following concurrent use of psychoactive medicines, and none has investigated combinations with selective serotonin reuptake inhibitors. OBJECTIVES To assess the risk of hip fracture in older people as a result of concurrent use of selective serotonin reuptake inhibitors and other psychoactive medicines. METHODS A matched case-co...

A common psychopharmacology between pain and depression suggests that compounds inhibiting the reuptake of serotonin and/or noradrenaline are likely to produce relief from chronic pain. Indeed tricyclic antidepressants have been a standard treatment of chronic pain for many years. In spite of their improved tolerance, selective serotonin reuptake inhibitors do not appear to be particularly effe...

Fluoxetine and its successors (Table 1) differ from the heterocyclic antidepressants in that they inhibit serotonin reuptake, with little or no effect on other receptor sites. As a result of this specificity, these agents are referred to as selective serotonin reuptake inhibitors (SSRIs). Their clinical efficacy is believed to be the result of an initial increase in serotonin concentrations (in...

Serotonin is a naturally occurring “messenger” protein that is found primarily in the gastrointestinal system, certain blood cells (platelets) and the central nervous system (brain and brain stem). Abnormal activity of this messenger protein has been implicated in both migraine and depression, and medications that modify serotonin can be effective in treating both disorders. Such medications in...

B. Understand the indications, contraindications, efficacy, use, drug interactions, and side effects of classical and newer or alternative antidepressants for treating comorbid mood or anxiety disorders in patients with pain. This would include the use of first-generation agents (e.g., tricyclics, including nortriptyline and desipramine, and monoamine oxidase inhibitors, including phenelzine), ...