Sunday, 1 December 2013

Selective serotonin re-uptake inhibitor (SSRI) discontinuation syndrome - The Phytochemicals and antioxidants

Selective serotonin re-uptake inhibitors or serotonin-specific reuptake inhibitor (SSRIs) are a types of  antidepressant medications to treat depression and certain neurological disorders, including  obsessive-compulsive disorder, panic disorder (PD), generalized anxiety disorder, post traumatic stress disorder (PTSD), and social anxiety disorder (SAD), etc..

SSRI discontinuation syndrome is defined as a condition of a syndrome as a result of interruption, reduced doses or discontinuation of any anti depressant medication, including SSRI (selective serotonin re-uptake inhibitor) and serotonin–norepinephrine reuptake inhibitor (SNRI), researchers  showed that The SSRI discontinuation syndrome is a characteristic selective serotonin reuptake inhibitor (SSRI) discontinuation syndrome appears to exist. It is usually mild, commences within 1 week of stopping treatment, resolves spontaneously within 3 weeks, and consists of diverse physical and psychological symptoms, the commonest being dizziness, nausea, lethargy and headache. SSRI reinstatement leads to resolution within 48 h(1).
Phytochemicals and antioxidants to reduce the symptoms of Selective serotonin re-uptake inhibitor (SSRI) discontinuation syndrome
1. Tangeretin
Tangeretin, a citrus flavonoid in  the oral administration resulted in significant levels of tangeretin in the brain (hypothalamus, striatum and hippocampus). Treatment of the rats with the dopaminergic neurotoxin 6-hydroxydopamine resulted in reduced levels of dopamine, an effect which was reversed by the administration of tangeretin. This study concluded that tangeretin can cross the blood-brain barrier and has a potential use as a neuroprotective agent(16).

2. Epigallocatechin-3-gallate and Polyphenols
Green tea polyphenols (GTPs and epigallocatechin-3-gallate (EGCG) modulation could improve the cognitive impairments induced by psychological stress. The related mechanisms may be involved with the changes of catecholamines, 5-hydroxytryptamine, cytokines and expressions of metallothioneins(17).

3. Furanocoumarins 
furanocoumarins found abundantly in grapefruit with CYP2D6 inhibition achieved in the range of 190-900 nM and Anthocyanins and anthocyanidins were shown to be about 1,000-fold less potent, they are unlikely to interfere with drug metabolism by CYP2D6(18).

4.  N-acetyl-cysteine and curcumin
 N-acetyl-cysteine has been shown to have a significant benefit on depressive symptoms in a randomized placebo-controlled trial. Additionally, curcumin, the yellow pigment of curry, has been shown to strongly interfere with neuronal redox homeostasis in the CNS and to possess antidepressant activity in various animal models of depression, also thanks to its ability to inhibit monoamine oxidases(19)

 5. Etc.
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