OBJECTIVETo synthesize venlafaxine with an improved novel method.

METHODSp-methoxypheny lethyl-acid was reacted with SOCl(2) to produce acyl chloride which was reacted with N,N-dimethylamine solution to get amide; then through Ivanov reaction and reduction by KBH(4)/BF(3).Et(2)O to yield venlafaxine.

RESULTVenlafaxine was successfully synthesized by using this method with an yield rate of 50.3%.

CONCLUSIONThe improved method is suitable for industrial production of venlafaxine.

Antidepressive Agents, Second-Generation ; chemical synthesis ; Cyclohexanols ; chemical synthesis ; Venlafaxine Hydrochloride

Depressive illness is a major public health problem with important medical, social and economic implications. The efficacy of various antidepressants in treating depression has been demonstrated in randomized controlled trials (RCTs). However, these studies do not adequately address the complexities of clinical practice. Although most of RCTs assumed there was no difference in efficacy between the tricyclic antidepressants (TCAs) and serotonin specific reuptake inhibitors (SSRIs), naturalistic studies show that patients who take TCAs often receive subtherapeutic doses for inadequate duration than those with SSRIs. Because the benefits of the implementation of current guidelines are limited, the optimal choice of medication must be guided by detailed history and careful consideration of the real-world efficacy of antidepressants and long-term health care costs.
Antidepressive Agents ; Antidepressive Agents, Tricyclic ; Depression ; Health Care Costs ; Humans ; Public Health ; Serotonin

New antidepressants have become available for clinical use in the 1990s. Before this decade, the drugs available to treat depression consisted essentially of monoamine oxidase inhibitors, tricyclic antidepressants, and lithium. Following the introduction of SSRIs, the options have expanded and now include SSRIs nefazodone, venlafaxine, mirtazapine, reboxetine, tianeptine. Newer antidepressants possess a variety of pharmacological characteristics that are relevant to the choice of an antidepressant for clinical use. This review summarizes some of the major pharmacological characteristics among the drugs.
Antidepressive Agents ; Antidepressive Agents, Tricyclic ; Depression ; Lithium ; Monoamine Oxidase Inhibitors ; Venlafaxine Hydrochloride

Acute Disease ; Antidepressive Agents, Second-Generation ; adverse effects ; Glaucoma, Angle-Closure ; chemically induced ; Humans ; Intraocular Pressure ; Venlafaxine Hydrochloride ; adverse effects

Prostatitis is a common syndrome that is confusing and frustrating for urologists. Chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS) is the most common form of prostatitis. The etiology of CP/CPPS is unknown, but possibilities include infectious, autoimmune, neurological and psychiatric causes. Clinical, laboratory, and imaging evaluations for the patient presenting prostatitis can be categorized as basic or mandatory evaluations, further or recommended evaluations, and optional evaluations in selected patients. Evaluation can aid in diagnosis and follow-up of the patient's response to therapy. Treatment for CP/CPPS is empiric and limited by a lack of randomized, placebo-controlled clinical trials. Antimicrobials are commonly used to treat patients with prostatitis. Other commonly used drugs include alpha-adrenoceptor antagonists, anti-inflammatory drugs, tricyclic antidepressants, and anticholinergic agents. Also, minimally invasive procedures are considered in patients with CP/CPPS. Although much progress has been made in therapy, there is no distinct treatment for patients with CP/CPPS. It is possible to treat intractable patients with 'care' not 'cure'.
Antidepressive Agents, Tricyclic ; Cholinergic Antagonists ; Diagnosis ; Humans ; Pelvic Pain ; Prostatitis*

OBJECTIVES: The diagnosis of depression is based on a highly variable set of symptoms. Therefore, depression should not be viewed as a single disease, but a heterogenous syndrome comprised of different pathophysiologies. There are several subtypes of depression which were already incorporated in DSM-IV. This article provides a systematic review of pharmacological treatments of two recognized subtypes of depression-dysthymic disorder and atypical depression. METHODS: Systematic search of relevant literatures on dysthymic disorder and atypical depression was performed by proposed search strategy of the Clinical Research Center for Depression of Korean Health 21 R&D Project. All identified literatures were carefully reviewed and classified according to SIGN grading system and summarized in a narrative manner. RESULT: For the treatment of dysthymic disorder and atypical depression, selective serotonin reuptake inhibitors(SSRIs) and moclobemide have more evidence than the other antidepressants. SSRIs and moclobemide showed superior tolerability than tricyclic antidepressants. CONCLUSION: The authors proposed treatment recommendations for dysthymic disorder and atypical depression by the methods of evidence-based medicine(EBM). However, guideline developing methods of EBM also have several inevitable limitations. Therefore, in the absence of clear and significant differences in efficacy, the choice of medication must be individualized for a particular patient based on psychiatrist's own clinical decision.
Antidepressive Agents ; Antidepressive Agents, Tricyclic ; Depression* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Dysthymic Disorder* ; Evidence-Based Medicine ; Humans ; Moclobemide ; Serotonin

OBJECTIVETo investigate the clinical efficacy, adverse reaction and safety of Jieyu pill (JYP) in treating depression.

METHODSThe randomized controlled trial was conducted in 28 patients in the treated group and 29 patients in the control group treated with maprotiline (Map). The efficacy of treatment was evaluated before treatment and 14, 28 and 42 days after treatment, with Hamilton depression rating scale (HAMD), self-rating scale for depression (SDS), self-rating scale for anxiety (SAS) and clinical global impression (CGI), the adverse reaction was assessed by Asberg Rating Scale (ARS).

RESULTSJYP was effective in treating depression, the markedly effective rate being 78.8%, corresponded to that of Map (82.8%, P > 0.05). After treatment, the scores assessed by HAMD, SDS and SAS were all lower than those before treatment (P < 0.01) respectively, but comparison between the two groups showed insignificant difference (P > 0.05). However, scores of ARS were significantly lower in the treated group than that in the control group, and the efficacy index of JYP was significantly higher than that of Map (P < 0.01).

CONCLUSIONJYP in treating depression shows the efficacy corresponded to that of Map and with less adverse reaction.

Adolescent ; Adult ; Aged ; Antidepressive Agents ; therapeutic use ; Antidepressive Agents, Second-Generation ; therapeutic use ; Depressive Disorder ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Maprotiline ; therapeutic use ; Middle Aged ; Phytotherapy ; Psychiatric Status Rating Scales

The aging process makes the changes of pharmacokinetics and pharmacodynamics of psychotropic drugs. The author discussed the biological treatment of geriatric mood disorders in this review. In the acute treatment of geriatric mood disorder, there are some different considerations about the biological treatment, such as the poor physical health, the high suicidal risk, the impaired judgment and reality testing, the likelihood of poor compliance, the impaired cognitive functioning, and the lack of social supports. Psychiatrists who prescribe for the mood disorder of the elderly must bear in mind the risks and benifits of pharmacotherpy in a view of pharmacokinetic and pharmacodynamics. The author reviewed the properties and cautions of the classical antidepressant TCAs and newer atypical antidepressants, such as trazodone and venlafaxine. And also the author reviewed the special situations in geriatric mood disorders, which are the delusional depression, the treatment-resistent depression, and the neuropsychiatric disorder.
Aged ; Aging ; Antidepressive Agents, Second-Generation ; Compliance ; Delusions ; Depression ; Humans ; Judgment ; Mood Disorders* ; Pharmacokinetics ; Psychiatry ; Psychotropic Drugs ; Reality Testing ; Trazodone ; Venlafaxine Hydrochloride

The aging process makes the changes of pharmacokinetics and pharmacodynamics of psychotropic drugs. The author discussed the biological treatment of geriatric mood disorders in this review. In the acute treatment of geriatric mood disorder, there are some different considerations about the biological treatment, such as the poor physical health, the high suicidal risk, the impaired judgment and reality testing, the likelihood of poor compliance, the impaired cognitive functioning, and the lack of social supports. Psychiatrists who prescribe for the mood disorder of the elderly must bear in mind the risks and benifits of pharmacotherpy in a view of pharmacokinetic and pharmacodynamics. The author reviewed the properties and cautions of the classical antidepressant TCAs and newer atypical antidepressants, such as trazodone and venlafaxine. And also the author reviewed the special situations in geriatric mood disorders, which are the delusional depression, the treatment-resistent depression, and the neuropsychiatric disorder.
Aged ; Aging ; Antidepressive Agents, Second-Generation ; Compliance ; Delusions ; Depression ; Humans ; Judgment ; Mood Disorders* ; Pharmacokinetics ; Psychiatry ; Psychotropic Drugs ; Reality Testing ; Trazodone ; Venlafaxine Hydrochloride

OBJECTIVETo establish an liquid chromatography-mass spectrometry (HPLC-MS/MS)-based method for determining escitalopram in human plasma.

METHODSA liquid-liquid ether extraction approach was adopted using dextromethorphan as the internal standard. The Agilent ZORBAX SB-C18 (3.5 microm,2.1 x 150 mm) was used as the analytical column with acetonitrile-NH4AC buffer (70:30, V/V) as the mobile phase at the flow rate of 0.3 ml/min. The sample was ionized by electrospray ionization source in the triple quadruple tandem mass spectrometer, and the plasma escitalopram determined with a multiple reaction monitoring mode of m/z325.4-->109.4.

RESULTSThe linear range was 0.0866-64.13 microg/L (r=0.9965) for escitalopram in human plasma, with the absolute recovery between 64.98% and 78.72% and the within-day and between-day deviations less than 10%.

CONCLUSIONThe method is sensitive, accurate, rapid, specific and well applicable for clinical pharmacokinetics study of escitalopram.

Antidepressive Agents, Second-Generation ; blood ; pharmacokinetics ; Chromatography, High Pressure Liquid ; methods ; Citalopram ; blood ; pharmacokinetics ; Humans ; Sensitivity and Specificity ; Tandem Mass Spectrometry ; methods