Relapse Prevention With Gepirone ER in Outpatients With Major Depression

@article{Keller2005RelapsePW,
  title={Relapse Prevention With Gepirone ER in Outpatients With Major Depression},
  author={Martin Keller and Frank Ruwe and Cecile J. W. Janssens and J. M. Ad Sitsen and Riitta Jokinen and Janusz Janczewski},
  journal={Journal of Clinical Psychopharmacology},
  year={2005},
  volume={25},
  pages={79-84}
}
Abstract: To evaluate long-term efficacy and tolerability of the serotonin 5-HT1A receptor agonist, gepirone extended release (ER), a multicenter, randomized, placebo-controlled relapse prevention study was performed in patients with recurrent major depression (DSM-IV criteria). Patients 18 to 70 years, with a primary diagnosis of recurrent major depression (DSM-IV; 296.3) and a screening and baseline HAMD-17 total score ≥20 were eligible. After a 3- to 14-day (dependent on pretrial medication… 

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References

SHOWING 1-10 OF 13 REFERENCES

Gepirone extended-release: new evidence for efficacy in the treatment of major depressive disorder.

TLDR
Preliminary evidence suggested that gepirone-ER may not be associated with sexual dysfunction and is effective for the short-term treatment of major depressive disorder and is well tolerated.

Long-term drug treatment of unipolar depression.

  • R. Hirschfeld
  • Psychology, Medicine
    International clinical psychopharmacology
  • 1996
TLDR
There is growing evidence to support the use of a full therapeutic dose of antidepressant in maintenance treatment, and SSRIs are better tolerated than TCAs or MAOIs and display similar efficacy in acute, continuation and maintenance treatment.

Relapse prevention with antidepressant drug treatment in depressive disorders: a systematic review

Serotonin 5-HT1a Receptor Agonists as Antidepressants

TLDR
For 20 years serotonin 5-HT1A receptor agonists have been evaluated for effectiveness in treating depressive disorders and depressive symptoms occurring in a range of diagnostic categories, including major and minor depression, mixed states of anxiety and depression, and mixed syndromes of depression and alcohol dependence.

Is there a role for 5-HT1A agonists in the treatment of depression?

Serotonin 5-HT1A Agonists

TLDR
The balance of evidence suggests that the azapirones act as partial agonists postsynaptically, but as full agonists presynaptically in the dorsal raphé, which indicates that buspirone, gepirone and ipsapirone may be more effective in this disorder.

Long-Term Antidepressant Treatments Result in a Tonic Activation of Forebrain 5-HT1A Receptors

TLDR
Data indicate that such antidepressant treatments, acting on entirely different primary targets, might alleviate depression by enhancing the tonic activation of forebrain postsynaptic 5-HT1Areceptors.

Electrophysiological Investigation of the Adaptive Response of the 5‐HT System to the Administration of 5‐HT1A Receptor Agonists

TLDR
It is concluded that the sustained administration of a 5-HT1A agonist results in an enhanced tonic activation of postsynaptic 5- HT1A receptors in the forebrain, which can be presumed that the recovery of the firing activity of 4-HT neurons restores a normal release of endogenous5-HT.