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Related Concept Videos

Antidepressant Drugs: MAOIs and Other Agents01:23

Antidepressant Drugs: MAOIs and Other Agents

Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

Oral Hypoglycemic Agents: Biguanides and Glitazones

Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood glucose levels...
Antidepressant Drugs: Tricyclics, SSRIs, and SNRIs01:28

Antidepressant Drugs: Tricyclics, SSRIs, and SNRIs

Tricyclic Antidepressants (TCAs), including Desipramine (Norpramin), Imipramine (Tofranil), Clomipramine (Anafranil), and Amitriptyline (Elavil), inhibit serotonin and norepinephrine reuptake and also block other receptors. They are used for depression, pain conditions, and insomnia. Common adverse effects include anticholinergic effects, sedation, orthostatic hypotension, and weight gain. They have a narrow therapeutic window and so require plasma-level monitoring. Abrupt discontinuation can...
Dipeptidyl Peptidase 4 Inhibitors01:23

Dipeptidyl Peptidase 4 Inhibitors

Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a significant...
Antidepressant Drugs: Overview01:25

Antidepressant Drugs: Overview

Antidepressant drugs are a class of medications primarily used for treating various mood disorders, including major depression, anxiety disorders, and other related conditions. These medicines work by modulating the neurotransmitter balance within the brain, alleviating depressive symptoms. Antidepressants can be broadly categorized into several groups according to their mechanism of action and chemical structure: Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin-Norepinephrine...
Oral Hypoglycemic Agents: α-Glucosidase Inhibitors01:19

Oral Hypoglycemic Agents: α-Glucosidase Inhibitors

α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are typically...

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Related Experiment Videos

Does antidepressant medication use affect persistence with diabetes medicines?

Gillian E Caughey, Adrian K Preiss, Agnes I Vitry

    Pharmacoepidemiology and Drug Safety
    |March 1, 2013
    PubMed
    Summary

    Older adults using antidepressants were 42% more likely to discontinue their newly prescribed oral diabetes medications. This suggests depression impacts medication adherence, requiring targeted support for these patients.

    Related Experiment Videos

    Area of Science:

    • Geriatric Medicine
    • Pharmacology
    • Public Health

    Background:

    • Adherence to oral antidiabetic medicines (OAMs) is crucial for managing type 2 diabetes in older adults.
    • Depression is a common comorbidity in older adults and can affect treatment adherence.
    • Understanding the impact of antidepressants on OAM persistence is vital for optimizing diabetes care.

    Purpose of the Study:

    • To investigate the association between antidepressant use and persistence with newly initiated oral antidiabetic medicines in an elderly population.
    • To determine if antidepressant use influences the likelihood of discontinuing metformin or sulfonylurea therapy.

    Main Methods:

    • Retrospective analysis of administrative claims data from Australian veterans (2000-2008).
    • Identified new users of metformin or sulfonylurea, assessing antidepressant use in the preceding six months.
    • Employed competing risks regression to analyze time to discontinuation of diabetes medication.

    Main Results:

    • 29,710 new OAM users were analyzed; 24.2% used antidepressants.
    • Median OAM duration was significantly shorter for antidepressant users (1.81 years) versus non-users (3.23 years).
    • Antidepressant use was associated with a 42% increased likelihood of discontinuing diabetes medications (SHR 1.42, p < 0.001).

    Conclusions:

    • Depression, indicated by antidepressant use, is linked to poorer adherence to oral diabetes medications in older adults.
    • Findings underscore the need for enhanced support services for elderly patients with diabetes and co-morbid depression initiating OAMs.
    • Interventions addressing depression may improve medication persistence and diabetes management outcomes.