Concomitant treatment with safinamide and antidepressant drugs: Safety data from real clinical practice

array:23 ["pii" => "S0213485321001298" "issn" => "02134853" "doi" => "10.1016/j.nrl.2021.08.004" "estado" => "S300" "fechaPublicacion" => "2024-05-01" "aid" => "1660" "copyright" => "Sociedad Española de Neurología" "copyrightAnyo" => "2021" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Neurologia. 2024;39:340-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S0213485321001304" "issn" => "02134853" "doi" => "10.1016/j.nrl.2021.08.005" "estado" => "S300" "fechaPublicacion" => "2024-05-01" "aid" => "1661" "copyright" => "Sociedad Española de Neurología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Neurologia. 2024;39:345-52" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Intra and inter-rater remote assessment of bradykinesia in Parkinson's disease" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "345" "paginaFinal" => "352" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Evaluación remota de la bradicinesia en la enfermedad de Parkinson mediante análisis intra e inter evaluadores" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1173 "Ancho" => 1667 "Tamanyo" => 81845 ] ] "descripcion" => array:1 [ "en" => "Scenario description. (a) Camera, (b) patient location and (c) physiotherapist." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "L.M.D. Luiz, I.A. Marques, J.P. Folador, A.O. Andrade" "autores" => array:4 [ 0 => array:2 [ "nombre" => "L.M.D." "apellidos" => "Luiz" ] 1 => array:2 [ "nombre" => "I.A." "apellidos" => "Marques" ] 2 => array:2 [ "nombre" => "J.P." "apellidos" => "Folador" ] 3 => array:2 [ "nombre" => "A.O." "apellidos" => "Andrade" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213485321001304?idApp=UINPBA00004N" "url" => "/02134853/0000003900000004/v1_202404170527/S0213485321001304/v1_202404170527/en/main.assets" ] "itemAnterior" => array:17 [ "pii" => "S0213485321001286" "issn" => "02134853" "doi" => "10.1016/j.nrl.2021.08.003" "estado" => "S300" "fechaPublicacion" => "2024-05-01" "aid" => "1659" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Neurologia. 2024;39:329-39" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Anticonvulsant effects of Paeonia daurica subsp. macrophylla root extracts in pentylenetetrazol-induced seizure models in mice" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "329" "paginaFinal" => "339" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Efectos anticonvulsivos de Paeonia daurica subsp. macrophylla extractos de raíz en modelos de convulsiones inducidas por pentilentetrazol en ratones" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3825 "Ancho" => 2667 "Tamanyo" => 627899 ] ] "descripcion" => array:1 [ "en" => "Schematic diagram for anticonvulsant experiment of P. daurica subsp. macrophylla root extracts in PTZ models in mice." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "E. Tahmasebi, H. Monsef-Esfahani, M. Vazirian, P. Sharafi-Badr, M. Sharifzadeh, S.N. Sadati Lamardi" "autores" => array:6 [ 0 => array:2 [ "nombre" => "E." "apellidos" => "Tahmasebi" ] 1 => array:2 [ "nombre" => "H." "apellidos" => "Monsef-Esfahani" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Vazirian" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Sharafi-Badr" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Sharifzadeh" ] 5 => array:2 [ "nombre" => "S.N." "apellidos" => "Sadati Lamardi" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213485321001286?idApp=UINPBA00004N" "url" => "/02134853/0000003900000004/v1_202404170527/S0213485321001286/v1_202404170527/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Concomitant treatment with safinamide and antidepressant drugs: Safety data from real clinical practice" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "340" "paginaFinal" => "344" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "P. Pérez-Torre, J.L. López-Sendón, V. Mañanes Barral, I. Parees, S. Fanjul-Arbós, E. Monreal, A. Alonso-Canovas, J.C. Martínez Castrillo" "autores" => array:8 [ 0 => array:4 [ "nombre" => "P." "apellidos" => "Pérez-Torre" "email" => array:1 [ 0 => "paulaptorre@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "J.L." "apellidos" => "López-Sendón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "V." "apellidos" => "Mañanes Barral" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "I." "apellidos" => "Parees" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "S." "apellidos" => "Fanjul-Arbós" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "E." "apellidos" => "Monreal" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 6 => array:3 [ "nombre" => "A." "apellidos" => "Alonso-Canovas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 7 => array:3 [ "nombre" => "J.C." "apellidos" => "Martínez Castrillo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Movement Disorders Unit, Neurology Department, Ramón y Cajal Hospital, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Neuropsychology, Movement Disorders Unit, Neurology Department, IRYCIS, Hospital Ramón y Cajal, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tratamiento concomitante de safinamida y antidepresivos: Datos de seguridad sobre la práctica en la vida real" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 585 "Ancho" => 1500 "Tamanyo" => 60429 ] ] "descripcion" => array:1 [ "en" => "(1) 3 patients were taking safinamide+tramadol+duloxetine. (2) 3 patients were taking safinamide+tramadol+mirtazapine. (3) 3 patients were taking safinamide+tramadol+escitalopram. 2 patients were taking 2 antidepressants+safinamide+tramadol." ] ] ] "textoCompleto" => "IntroductionDepressive disturbances are common in patients with Parkinson's disease (PD) and may influence many other clinical aspects of the disease.<a class="elsevierStyleCrossRef" href="#bib0125">1</a> Frequently, affective disorders predate the onset of motor symptoms, on average, 4–6 years before the diagnosis of PD.<a class="elsevierStyleCrossRef" href="#bib0130">2</a> In several studies, treated or untreated mild depression has been associated with greater disability and it can sometimes precipitate the initiation of dopaminergic therapy. Antidepressants as a drug class have shown utility in depression and anxiety in PD.<a class="elsevierStyleCrossRefs" href="#bib0135">3,4</a> Serotonin syndrome is a measure of central nervous system (CNS) hyperexcitability in relation to an excess of serotonin.<a class="elsevierStyleCrossRef" href="#bib0145">5</a> It includes a combination of mental status changes, neuromuscular and autonomic hyperactivity. Symptoms can range from mild to life-threatening. Serotonin syndrome can occur via therapeutic use of serotonergic drugs alone, an intentional overdose of serotonergic drugs, or classically, as a result of a complex drug interaction between two serotonergic drugs that work by different mechanisms.<a class="elsevierStyleCrossRef" href="#bib0150">6</a> MAO-B inhibitors were introduced for the treatment of PD over 40 years ago and remain a popular mainstay of treatment. Monoamine oxidase (MAO) is a mitochondrial enzyme that oxidatively deaminates monoamines and it exists as 2 isoforms, MAO-A and MAO-B. Inhibition of MAO-B, the major isoform in the human brain, prevents the breakdown of extracellular levels of dopamine in the striatum. Inhibition of MAO-B can also be reversible or irreversible.<a class="elsevierStyleCrossRef" href="#bib0155">7</a> Safinamide is a MAO-B inhibitor and glutamate modulator. Unlike other MAO-B inhibitors, the inhibition of safinamide is reversible and more selective compared with that of selegiline and rasagiline, minimizing the risk of hypertensive crises or serotonergic syndrome, and preventing dietary restrictions.<a class="elsevierStyleCrossRefs" href="#bib0160">8–10</a> According to the summary of product characteristics, a washout period of five half-lives of the selective serotonin reuptake inhibitors (SSRI) used previously should be considered before safinamide treatment initiation. However, as it has been mentioned above most of the times the patient manifest symptoms of depression and it is not possible to stop antidepressant medication. Then we may consider to start safinamide anyway, and we must always warn the patient about alarm symptoms that indicate he should look for immediate medical help such as vomiting or diarrhea.<a class="elsevierStyleCrossRefs" href="#bib0175">11,12</a> Concomitant use of safinamide and fluvoxamine is not recommended and also special care must be taken in those receiving high doses of antidepressants.<a class="elsevierStyleCrossRef" href="#bib0185">13</a> The aim of this study was to assess the possible pharmacological interactions between safinamide and antidepressants, and in particular the appearance of serotonin syndrome.Materials and methodsWe conducted a retrospective observational study of patients with Parkinson's disease from our Movement Disorders Unit, who were under treatment with any antidepressant drug and safinamide. PD was defined according to UK PD Brain Bank criteria.<a class="elsevierStyleCrossRef" href="#bib0190">14</a> Baseline characteristics of patients were collected (age, sex, Hoehn Yahr stage (H&Y)), as well as safinamide dose, antidepressant and other concomitant opioid-type medications, and side effects related to treatment. Specifically, symptoms suggestive of serotonin syndrome (high body temperature, agitation, increased reflexes, tremor, sweating, dilated pupils, diarrhea) were screened for. Also, we collected time of simultaneous use, doses of levodopa and other antiparkinsonian drugs. Descriptive statistics have been used to summarize and organize the study data. Quantitative variables were described by mean±standard deviation if normally distributed, or by median (first quartile; third quartile) if not normally distributed.ResultsClinical records were reviewed for the study period of September 2018 to September 2019. Seventy-eight PD patients who were treated with safinamide of which 25 (32.05%) had a concomitant treatment with an antidepressant drug, being sertraline and escitalopram the most frequent [<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>]. Eight patients were on safinamide 50mg and 17 on safinamide 100mg. Mean age was 80 years±8.43 and H&Y stage was 3.<a class="elsevierStyleCrossRefs" href="#bib0130">2–4</a> Mean dose of levodopa used was 703.75mg±233.15. Eight patients were also under treatment with dopaminergic agonists, 4 with opicapone and 6 patients were simultaneously taking opioid medications. Median duration of concomitant treatment with safinamide and antidepressant drug was 6 months (IQR 20.5), and over eighteen months in 5 cases. No case of serotonin syndrome was recorded, neither was any of its typical manifestations combined or in isolation. As for adverse events leading to discontinuation of safinamide, it was registered only in one case, who discontinued the drug due to worsening hallucinations. Nine (12%) patients reported improvement in non-motor symptoms such as sleep (4), pain (2), mood (1), or urinary symptoms (2).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>DiscussionTreatment of motor and non-motor symptoms of PD is complex, and commonly leads to regimens of combination therapy with possibility of interactions. This is especially important when we combine antidepressant and pain treatments with MAOIs, due to the potential risk of serotonin syndrome, especially if combined with other drugs that are frequently used in patients with PD, such as opioids. Data suggest that safinamide may have a lower risk of serotonin syndrome.<a class="elsevierStyleCrossRefs" href="#bib0195">15–18</a> Only real clinical experience can corroborate these data, since polypharmacy tends to be avoided for safety in clinical trials. In our study we have found frequent concomitant use of antidepressants and safinamide, with very favorable safety data. No serotonin syndrome was recorded, either minor manifestations, not even in the opioid treatment subgroup. Adherence to safinamide was very good, with only one case of suspension of treatment due to collateral effects (hallucinations), probably due to its dopaminergic properties and to the combination with other drugs with similar mechanism. Although the retrospective registry does not allow evaluating efficacy, in terms of non-motor symptoms control, in a subgroup of patients the use of safinamide was beneficial for the control of several non-motor symptoms, as has been suggested in other real-life clinical studies.<a class="elsevierStyleCrossRef" href="#bib0215">19</a> Pain occurs two or three times more frequently in patients with PD than in individuals of similar age without PD. Prevalence of pain in PD may vary from 34% to 83%, depending on methodological evaluations. It can be considered as a non-motor symptom but also related to concomitant osteoarticular pathology, so is very frequent that patients with Parkinson disease have opioid medications among their treatments.<a class="elsevierStyleCrossRefs" href="#bib0210">18,19</a> While SSRIs are the most commonly reported drug associated with serotonin syndrome, physicians should be aware of tramadol as a potential single agent cause for serotonin syndrome.<a class="elsevierStyleCrossRef" href="#bib0220">20</a> The concurrent use of SSRIs with tramadol has been shown to induce serotonin syndrome through synergistic serotonergic action, along with the inhibition of CYP2D6, resulting in higher levels of tramadol enantiomer associated with serotonergic activity.<a class="elsevierStyleCrossRefs" href="#bib0225">21–24</a> We found a small group of patients that were taking together antidepressants, tramadol and safinamide [<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>]. Any of them had symptoms suggestive of serotonergic hyperactivity, but we must monitor closely for the possible occurrence of adverse effects. We are aware that this observational study has several limitations due to the small number of patients included and its retrospective design.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>ConclusionOur real clinical practice study suggests that concomitant use of safinamide with antidepressant drugs in PD patients seemed to be safe and well tolerated, even in the long term. However, caution is warranted, individualizing treatment regimens and monitoring the potential appearance of adverse effects.Ethical standardThe study was approved by the local Ethics Committee.FundingThere are no financial disclosures. Full other financial disclosures of all authors for the previous 12 months. P. Pérez Torre: Hospital Ramón y Cajal, Madrid. IRYCIS, Madrid. V. Mañanes: Hospital Ramón y Cajal, Madrid. IRYCIS, Madrid. E. Monreal: Hospital Ramón y Cajal, Madrid. I Parees: Hospital Ramón y Cajal, Madrid Spain. IRYCIS, Madrid. S. Fanjul: Hospital Ramón y Cajal, Madrid. A Alonso: Hospital Ramon y Cajal, Madrid. J. Martinez: Hospital Ramon y Cajal, Madrid. IRYCIS, Madrid. J. López-Sendón: Hospital Ramón y Cajal. IRYCIS, Madrid, Spain.Authors’ contributionP. Pérez Torre – research project: conception, organization, execution; statistical analysis: design, execution; manuscript: writing of the first draft.E. Monreal – research project: organization; statistical analysis: review and critique; manuscript: review and critique.V. Mañanes – research project: organization; statistical analysis: review and critique, Manuscript: review and critique.I Parees – research project: organization; statistical analysis: review and critique; manuscript: review and critique.S. Fanjul – research project: organization; statistical analysis: review and critique; manuscript: review and critique.A Alonso – research project: organization; statistical analysis: review and critique; manuscript: review and critique.JC Martínez – research project: organization, execution; statistical analysis: review and critique; manuscript: review and critique.JL López-Sendón – research project: organization; statistical analysis: review and critique; manuscript: review and critique.Conflict of interestThere are no conflicts of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:14 [ 0 => array:3 [ "identificador" => "xres2130758" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background and purpose" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1809593" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres2130759" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1809594" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Materials and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusion" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Ethical standard" ] 10 => array:2 [ "identificador" => "sec0035" "titulo" => "Funding" ] 11 => array:2 [ "identificador" => "sec0040" "titulo" => "Authors’ contribution" ] 12 => array:2 [ "identificador" => "sec0045" "titulo" => "Conflict of interest" ] 13 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2021-05-18" "fechaAceptado" => "2021-08-04" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1809593" "palabras" => array:4 [ 0 => "Safinamide" 1 => "Depression" 2 => "Parkinson's disease" 3 => "Serotonin syndrome" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1809594" "palabras" => array:4 [ 0 => "Safinamida" 1 => "Depresión" 2 => "Enfermedad de Parkinson" 3 => "Síndrome serotoninérgico" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "Background and purposeThe aim of this study was to assess the possible pharmacological interactions between safinamide and antidepressants, and in particular the appearance of serotonin syndrome with data from real life. MethodsWe conducted a retrospective observational study of patients with Parkinson's disease from our Movement Disorders Unit, who were under treatment with any antidepressant drug and safinamide. Specifically, symptoms suggestive of serotonin syndrome were screened for. Also, we collected time of simultaneous use, doses of levodopa and other antiparkinsonian drugs. ResultsClinical records were reviewed for the study period of September 2018 to September 2019. Seventy-eight PD patients who were treated with safinamide of which 25 (32.05%) had a concomitant treatment with an antidepressant drug, being sertraline and escitalopram the most frequent. Mean age was 80 years±8.43 and H&Y stage was 3 [2–4]. Mean dose of levodopa used was 703.75mg±233.15. Median duration of concomitant treatment with safinamide and antidepressant drug was 6 months (IQR 20.5), and over eighteen months in 5 cases. No case of serotonin syndrome was recorded, neither was any of its typical manifestations combined or in isolation. ConclusionsOur real clinical practice study suggests that concomitant use of safinamide with antidepressant drugs in PD patients seemed to be safe and well tolerated, even in the long term. However, caution is warranted, individualizing treatment regimens and monitoring the potential appearance of adverse effects." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background and purpose" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "ObjetivosEl objetivo de este estudio ha sido evaluar las posibles interacciones farmacológicas entre safinamida y antidepresivos; en particular la aparición del síndrome serotoninérgico mediante datos obtenidos en la vida real. Material y métodosRealizamos un estudio observacional retrospectivo de pacientes con enfermedad de Parkinson (EP) de nuestra unidad de trastornos del movimiento, que estaban en tratamiento con algún fármaco antidepresivo y safinamida. Específicamente, se examinaron los síntomas sugestivos de síndrome serotoninérgico. Además, se recogieron tiempos de uso simultáneo, dosis de levodopa y otros fármacos antiparkinsonianos concomitantes. ResultadosSe revisaron las historias clínicas correspondientes al período de estudio de septiembre de 2018 a septiembre de 2019. Setenta y ocho pacientes con EP se encontraban en tratamiento con safinamida, de los cuales 25 (32,05%) se encontraban recibiendo además un fármaco antidepresivo, siendo sertralina y escitalopram los más frecuentes. La edad media fue de 80 años±8,43 y el estadio H&Y fue de 3 [2-4]. La dosis media de levodopa utilizada fue de 703,75mg±233,15. La mediana de duración del tratamiento concomitante con safinamida y un fármaco antidepresivo fue de 6 meses (IQR: 20,5), y más de 18 meses en 5 casos. No se registró ningún caso de síndrome serotoninérgico, ni tampoco ninguno de sus síntomas de forma aislada. ConclusiónNuestro estudio de práctica clínica real sugiere que el uso concomitante de safinamida con fármacos antidepresivos en pacientes con EP parece ser seguro y bien tolerado, incluso a largo plazo. Sin embargo, es necesaria precaución, individualizando los regímenes de tratamiento, y controlando la posible aparición de efectos adversos." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 585 "Ancho" => 1500 "Tamanyo" => 60429 ] ] "descripcion" => array:1 [ "en" => "(1) 3 patients were taking safinamide+tramadol+duloxetine. (2) 3 patients were taking safinamide+tramadol+mirtazapine. (3) 3 patients were taking safinamide+tramadol+escitalopram. 2 patients were taking 2 antidepressants+safinamide+tramadol." ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Antidepressant type \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Name \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Dose \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Number of patients \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Selective serotonin reuptake inhibitors (SSRIs)</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sertraline \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50/100 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5/1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Escitalopram \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10/15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5/1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Paroxetine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Serotonin-norepinephrine reuptake inhibitors (SNRIs)</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Venlafaxine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Duloxetine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Norepinephrine and dopamine reuptake inhibitors (NDRIs) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bupropion \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">150 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Serotonin receptor antagonist and reuptake inhibitors (SARI) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Trazodone \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50/100 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1/1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Noradrenergic and specific serotonergic antidepressant (NaSSA) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mirtazapine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15/30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2/3 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3512585.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Antidepressant medications, dose and number of patients who were on treatment." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:24 [ 0 => array:3 [ "identificador" => "bib0125" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Depression and Parkinson's disease: current knowledge" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L. Marsh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11910-013-0409-5" "Revista" => array:5 [ "tituloSerie" => "Curr Neurol Neurosci Rep" "fecha" => "2013" "volumen" => "13" "paginaInicial" => "409" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24190780" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0130" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recognition and treatment of depression in Parkinson's disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "D. Weintraub" 1 => "P.J. Moberg" 2 => "J.E. Duda" 3 => "I.R. Katz" 4 => "M.B. Stern" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0891988703256053" "Revista" => array:6 [ "tituloSerie" => "J Geriatr Psychiatry Neurol" "fecha" => "2003" "volumen" => "16" "paginaInicial" => "178" "paginaFinal" => "183" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12967062" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0135" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A systematic review of prevalence studies of depression in Parkinson's disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.S. Reijnders" 1 => "U. Ehrt" 2 => "W.E. Weber" 3 => "D. Aarsland" 4 => "A.F. Leentjens" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/mds.21803" "Revista" => array:6 [ "tituloSerie" => "Mov Disord" "fecha" => "2008" "volumen" => "23" "paginaInicial" => "183" "paginaFinal" => "189" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17987654" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0140" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Assessment and management of neuropsychiatric symptoms in Parkinson's disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Mueller" 1 => "A.P. Rajkumar" 2 => "Y.M. Wan" 3 => "L. Velayudhan" 4 => "D. Ffytche" 5 => "K.R. Chaudhuri" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s40263-018-0540-6" "Revista" => array:6 [ "tituloSerie" => "CNS Drugs" "fecha" => "2018" "volumen" => "32" "paginaInicial" => "621" "paginaFinal" => "635" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30027401" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0145" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Serotonin syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Volpi-Abadie" 1 => "A.M. Kaye" 2 => "A.D. Kaye" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ochsner J" "fecha" => "2013" "volumen" => "13" "paginaInicial" => "533" "paginaFinal" => "540" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24358002" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0150" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The serotonin syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E.W. Boyer" 1 => "M. Shannon" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMra041867" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2005" "volumen" => "352" "paginaInicial" => "1112" "paginaFinal" => "1120" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15784664" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0155" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Interaction between monoamine oxidase B inhibitors and selective serotonin reuptake inhibitors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Aboukarr" 1 => "M. Giudice" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1017/S031716710001516X" "Revista" => array:6 [ "tituloSerie" => "Can J Hosp Pharm" "fecha" => "2018" "volumen" => "71" "paginaInicial" => "196" "paginaFinal" => "207" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29955193" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0160" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Safinamide: a review in Parkinson's disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H.A. Blair" 1 => "S. Dhillon" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "CNS Drugs" "fecha" => "2017" "volumen" => "31" "paginaInicial" => "169" "paginaFinal" => "176" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0165" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A European observational study to evaluate the safety and the effectiveness of safinamide in routine clinical practice: the SYNAPSES trial" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "SYNAPSES Study Investigators Group" "etal" => true "autores" => array:6 [ 0 => "G. Abbruzzese" 1 => "J. Kulisevsky" 2 => "B. Bergmans" 3 => "J.C. Gomez-Esteban" 4 => "G. Kägi" 5 => "J. Raw" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "J Parkinsons Dis" "fecha" => "2020" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0170" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Serotonin toxicity association with concomitant antidepressants and rasagiline treatment: retrospective study (STACCATO)" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "STACCATO study investigators" "etal" => false "autores" => array:5 [ 0 => "M. Panisset" 1 => "J.J. Chen" 2 => "S.H. Rhyee" 3 => "J. Conner" 4 => "J. Mathena" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Pharmacotherapy" "fecha" => "2014" "volumen" => "34" "paginaInicial" => "1250" "paginaFinal" => "1258" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0175" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A Spanish consensus on the use of safinamide for parkinson's disease in clinical practice" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Pagonabarraga" 1 => "J.M. Arbelo" 2 => "F. Grandas" 3 => "M.R. Luquin" 4 => "P. Martínez Martín" 5 => "M.C. Rodríguez-Oroz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3390/brainsci10030176" "Revista" => array:5 [ "tituloSerie" => "Brain Sci" "fecha" => "2020" "volumen" => "10" "paginaInicial" => "176" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32197462" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0180" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Serotonin syndrome: a complex but easily avoidable condition" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Y. Dvir" 1 => "P. Smallwood" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.genhosppsych.2007.09.007" "Revista" => array:6 [ "tituloSerie" => "Gen Hosp Psychiatry" "fecha" => "2008" "volumen" => "30" "paginaInicial" => "284" "paginaFinal" => "287" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18433663" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0185" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spanish expert consensus on the use of safinamide in Parkinson's disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Valldeoriola" 1 => "F. Grandas" 2 => "J.M. Arbelo" 3 => "M. Blázquez Estrada" 4 => "M. Calopa Garriga" 5 => "V.M. Campos-Arillo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Neurologia" "fecha" => "2018" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0190" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.J. Hughes" 1 => "S.E. Daniel" 2 => "L. Kilford" 3 => "A.J. Lees" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/jnnp.55.3.181" "Revista" => array:6 [ "tituloSerie" => "J Neurol Neurosurg Psychiatry" "fecha" => "1992" "volumen" => "55" "paginaInicial" => "181" "paginaFinal" => "184" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1564476" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0195" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Safinamide in the management of patients with Parkinson's disease not stabilized on levodopa: a review of the current clinical evidence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Bette" 1 => "D.S. Shpiner" 2 => "C. Singer" 3 => "H. Moore" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2147/TCRM.S139545" "Revista" => array:6 [ "tituloSerie" => "Ther Clin Risk Manag" "fecha" => "2018" "volumen" => "14" "paginaInicial" => "1737" "paginaFinal" => "1745" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30271159" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0200" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Study 016 Investigators Randomized trial of safinamide add-on to levodopa in Parkinson's disease with motor fluctuations" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Borgohain" 1 => "J. Szasz" 2 => "P. Stanzione" 3 => "C. Meshram" 4 => "M. Bhatt" 5 => "D. Chirilineau" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/mds.25751" "Revista" => array:6 [ "tituloSerie" => "Mov Disord" "fecha" => "2014" "volumen" => "29" "paginaInicial" => "229" "paginaFinal" => "237" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24323641" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0205" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E.J. Dunkley" 1 => "G.K. Isbister" 2 => "D. Sibbritt" 3 => "A.H. Dawson" 4 => "I.M. Whyte" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/qjmed/hcg109" "Revista" => array:6 [ "tituloSerie" => "QJM" "fecha" => "2003" "volumen" => "96" "paginaInicial" => "635" "paginaFinal" => "642" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12925718" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0210" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pharmacokinetic–pharmacodynamic relationship of the selective serotonin reuptake inhibitors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P. Baumann" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Pharmacokinet" "fecha" => "1996" "volumen" => "31" "paginaInicial" => "444" "paginaFinal" => "469" ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0215" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Emergencies and critical issues in Parkinson's disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C. Simonet" 1 => "E. Tolosa" 2 => "A. Camara" 3 => "F. Valldeoriola" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/practneurol-2018-002075" "Revista" => array:6 [ "tituloSerie" => "Pract Neurol" "fecha" => "2020" "volumen" => "20" "paginaInicial" => "15" "paginaFinal" => "25" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31427383" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0220" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Real life evaluation of safinamide effectiveness in Parkinson's disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Mancini" 1 => "A. Di Fonzo" 2 => "G. Lazzeri" 3 => "L. Borellini" 4 => "V. Silani" 5 => "M. Lacerenza" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10072-018-3272-y" "Revista" => array:6 [ "tituloSerie" => "Neurol Sci" "fecha" => "2018" "volumen" => "39" "paginaInicial" => "733" "paginaFinal" => "739" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29441484" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0225" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tramadol, pharmacology, side effects, and serotonin syndrome: a review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "B.D. Beakley" 1 => "A.M. Kaye" 2 => "A.D. Kaye" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pain Physician" "fecha" => "2015" "volumen" => "18" "paginaInicial" => "395" "paginaFinal" => "400" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26218943" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0230" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Avoiding serotonin syndrome: the nature of the interaction between tramadol and selective serotonin reuptake inhibitors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E.M. Nelson" 1 => "A.M. Philbrick" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1345/aph.1Q748" "Revista" => array:6 [ "tituloSerie" => "Ann Pharmacother" "fecha" => "2012" "volumen" => "46" "paginaInicial" => "1712" "paginaFinal" => "1716" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23212934" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0235" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Serotonin syndrome resulting from coadministration of tramadol, venlafaxine, and mirtazapine" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "D.J. Houlihan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1345/aph.1D344" "Revista" => array:6 [ "tituloSerie" => "Ann Pharmacother" "fecha" => "2004" "volumen" => "38" "paginaInicial" => "411" "paginaFinal" => "413" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14970364" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0240" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tramadol: understanding the risk of serotonin syndrome and seizures" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Hassamal" 1 => "K. Miotto" 2 => "W. Dale" 3 => "I. Danovitch" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Am J Med" "fecha" => "2018" "volumen" => "131" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/02134853/0000003900000004/v1_202404170527/S0213485321001298/v1_202404170527/en/main.assets" "Apartado" => array:4 [ "identificador" => "9397" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Originales" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/02134853/0000003900000004/v1_202404170527/S0213485321001298/v1_202404170527/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213485321001298?idApp=UINPBA00004N"]

Statistics

Original article

Tratamiento concomitante de safinamida y antidepresivos: Datos de seguridad sobre la práctica en la vida real

P. Pérez-Torrea,

Corresponding author

paulaptorre@gmail.com

Corresponding author.

, J.L. López-Sendóna, V. Mañanes Barralb, I. Pareesa, S. Fanjul-Arbósa, E. Monreala, A. Alonso-Canovasa, J.C. Martínez Castrilloa

a Movement Disorders Unit, Neurology Department, Ramón y Cajal Hospital, Madrid, Spain

b Neuropsychology, Movement Disorders Unit, Neurology Department, IRYCIS, Hospital Ramón y Cajal, Madrid, Spain

Read

2812

Times
was read the article

686

Total PDF

2126

Total HTML

Share statistics

 array:23 [
  "pii" => "S0213485321001298"
  "issn" => "02134853"
  "doi" => "10.1016/j.nrl.2021.08.004"
  "estado" => "S300"
  "fechaPublicacion" => "2024-05-01"
  "aid" => "1660"
  "copyright" => "Sociedad Espa&#241;ola de Neurolog&#237;a"
  "copyrightAnyo" => "2021"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Neurologia. 2024;39:340-4"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S0213485321001304"
    "issn" => "02134853"
    "doi" => "10.1016/j.nrl.2021.08.005"
    "estado" => "S300"
    "fechaPublicacion" => "2024-05-01"
    "aid" => "1661"
    "copyright" => "Sociedad Espa&#241;ola de Neurolog&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Neurologia. 2024;39:345-52"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Intra and inter-rater remote assessment of bradykinesia in Parkinson&#39;s disease"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "345"
          "paginaFinal" => "352"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Evaluaci&#243;n remota de la bradicinesia en la enfermedad de Parkinson mediante an&#225;lisis intra e inter evaluadores"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1173
              "Ancho" => 1667
              "Tamanyo" => 81845
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Scenario description&#46; &#40;a&#41; Camera&#44; &#40;b&#41; patient location and &#40;c&#41; physiotherapist&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "L&#46;M&#46;D&#46; Luiz, I&#46;A&#46; Marques, J&#46;P&#46; Folador, A&#46;O&#46; Andrade"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "L&#46;M&#46;D&#46;"
              "apellidos" => "Luiz"
            ]
            1 => array:2 [
              "nombre" => "I&#46;A&#46;"
              "apellidos" => "Marques"
            ]
            2 => array:2 [
              "nombre" => "J&#46;P&#46;"
              "apellidos" => "Folador"
            ]
            3 => array:2 [
              "nombre" => "A&#46;O&#46;"
              "apellidos" => "Andrade"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213485321001304?idApp=UINPBA00004N"
    "url" => "/02134853/0000003900000004/v1_202404170527/S0213485321001304/v1_202404170527/en/main.assets"
  ]
  "itemAnterior" => array:17 [
    "pii" => "S0213485321001286"
    "issn" => "02134853"
    "doi" => "10.1016/j.nrl.2021.08.003"
    "estado" => "S300"
    "fechaPublicacion" => "2024-05-01"
    "aid" => "1659"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Neurologia. 2024;39:329-39"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Anticonvulsant effects of <span class="elsevierStyleItalic">Paeonia daurica</span> subsp&#46; <span class="elsevierStyleItalic">macrophylla</span> root extracts in pentylenetetrazol-induced seizure models in mice"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "329"
          "paginaFinal" => "339"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Efectos anticonvulsivos de <span class="elsevierStyleItalic">Paeonia daurica</span> subsp&#46; <span class="elsevierStyleItalic">macrophylla</span> extractos de ra&#237;z en modelos de convulsiones inducidas por pentilentetrazol en ratones"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 3825
              "Ancho" => 2667
              "Tamanyo" => 627899
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Schematic diagram for anticonvulsant experiment of <span class="elsevierStyleItalic">P&#46; daurica</span> subsp&#46; <span class="elsevierStyleItalic">macrophylla</span> root extracts in PTZ models in mice&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "E&#46; Tahmasebi, H&#46; Monsef-Esfahani, M&#46; Vazirian, P&#46; Sharafi-Badr, M&#46; Sharifzadeh, S&#46;N&#46; Sadati Lamardi"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Tahmasebi"
            ]
            1 => array:2 [
              "nombre" => "H&#46;"
              "apellidos" => "Monsef-Esfahani"
            ]
            2 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Vazirian"
            ]
            3 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Sharafi-Badr"
            ]
            4 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Sharifzadeh"
            ]
            5 => array:2 [
              "nombre" => "S&#46;N&#46;"
              "apellidos" => "Sadati Lamardi"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213485321001286?idApp=UINPBA00004N"
    "url" => "/02134853/0000003900000004/v1_202404170527/S0213485321001286/v1_202404170527/en/main.assets"
  ]
  "en" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
    "titulo" => "Concomitant treatment with safinamide and antidepressant drugs&#58; Safety data from real clinical practice"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "340"
        "paginaFinal" => "344"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "P&#46; P&#233;rez-Torre, J&#46;L&#46; L&#243;pez-Send&#243;n, V&#46; Ma&#241;anes Barral, I&#46; Parees, S&#46; Fanjul-Arb&#243;s, E&#46; Monreal, A&#46; Alonso-Canovas, J&#46;C&#46; Mart&#237;nez Castrillo"
        "autores" => array:8 [
          0 => array:4 [
            "nombre" => "P&#46;"
            "apellidos" => "P&#233;rez-Torre"
            "email" => array:1 [
              0 => "paulaptorre@gmail.com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "J&#46;L&#46;"
            "apellidos" => "L&#243;pez-Send&#243;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "V&#46;"
            "apellidos" => "Ma&#241;anes Barral"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "I&#46;"
            "apellidos" => "Parees"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "S&#46;"
            "apellidos" => "Fanjul-Arb&#243;s"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "E&#46;"
            "apellidos" => "Monreal"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Alonso-Canovas"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "J&#46;C&#46;"
            "apellidos" => "Mart&#237;nez Castrillo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Movement Disorders Unit&#44; Neurology Department&#44; Ram&#243;n y Cajal Hospital&#44; Madrid&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Neuropsychology&#44; Movement Disorders Unit&#44; Neurology Department&#44; IRYCIS&#44; Hospital Ram&#243;n y Cajal&#44; Madrid&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Tratamiento concomitante de safinamida y antidepresivos&#58; Datos de seguridad sobre la pr&#225;ctica en la vida real"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 585
            "Ancho" => 1500
            "Tamanyo" => 60429
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">&#40;1&#41; 3 patients were taking safinamide<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>tramadol<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>duloxetine&#46; &#40;2&#41; 3 patients were taking safinamide<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>tramadol<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>mirtazapine&#46; &#40;3&#41; 3 patients were taking safinamide<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>tramadol<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>escitalopram&#46; <span class="elsevierStyleItalic">2 patients were taking 2 antidepressants</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#43;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">safinamide</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#43;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">tramadol</span>&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Depressive disturbances are common in patients with Parkinson&#39;s disease &#40;PD&#41; and may influence many other clinical aspects of the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">1</span></a> Frequently&#44; affective disorders predate the onset of motor symptoms&#44; on average&#44; 4&#8211;6 years before the diagnosis of PD&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">2</span></a> In several studies&#44; treated or untreated mild depression has been associated with greater disability and it can sometimes precipitate the initiation of dopaminergic therapy&#46; Antidepressants as a drug class have shown utility in depression and anxiety in PD&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">3&#44;4</span></a> Serotonin syndrome is a measure of central nervous system &#40;CNS&#41; hyperexcitability in relation to an excess of serotonin&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">5</span></a> It includes a combination of mental status changes&#44; neuromuscular and autonomic hyperactivity&#46; Symptoms can range from mild to life-threatening&#46; Serotonin syndrome can occur via therapeutic use of serotonergic drugs alone&#44; an intentional overdose of serotonergic drugs&#44; or classically&#44; as a result of a complex drug interaction between two serotonergic drugs that work by different mechanisms&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">6</span></a> MAO-B inhibitors were introduced for the treatment of PD over 40 years ago and remain a popular mainstay of treatment&#46; Monoamine oxidase &#40;MAO&#41; is a mitochondrial enzyme that oxidatively deaminates monoamines and it exists as 2 isoforms&#44; MAO-A and MAO-B&#46; Inhibition of MAO-B&#44; the major isoform in the human brain&#44; prevents the breakdown of extracellular levels of dopamine in the striatum&#46; Inhibition of MAO-B can also be reversible or irreversible&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">7</span></a> Safinamide is a MAO-B inhibitor and glutamate modulator&#46; Unlike other MAO-B inhibitors&#44; the inhibition of safinamide is reversible and more selective compared with that of selegiline and rasagiline&#44; minimizing the risk of hypertensive crises or serotonergic syndrome&#44; and preventing dietary restrictions&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">8&#8211;10</span></a> According to the summary of product characteristics&#44; a washout period of five half-lives of the selective serotonin reuptake inhibitors &#40;SSRI&#41; used previously should be considered before safinamide treatment initiation&#46; However&#44; as it has been mentioned above most of the times the patient manifest symptoms of depression and it is not possible to stop antidepressant medication&#46; Then we may consider to start safinamide anyway&#44; and we must always warn the patient about alarm symptoms that indicate he should look for immediate medical help such as vomiting or diarrhea&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">11&#44;12</span></a> Concomitant use of safinamide and fluvoxamine is not recommended and also special care must be taken in those receiving high doses of antidepressants&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">13</span></a> The aim of this study was to assess the possible pharmacological interactions between safinamide and antidepressants&#44; and in particular the appearance of serotonin syndrome&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0010" class="elsevierStylePara elsevierViewall">We conducted a retrospective observational study of patients with Parkinson&#39;s disease from our Movement Disorders Unit&#44; who were under treatment with any antidepressant drug and safinamide&#46; PD was defined according to UK PD Brain Bank criteria&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">14</span></a> Baseline characteristics of patients were collected &#40;age&#44; sex&#44; Hoehn Yahr stage &#40;H&#38;Y&#41;&#41;&#44; as well as safinamide dose&#44; antidepressant and other concomitant opioid-type medications&#44; and side effects related to treatment&#46; Specifically&#44; symptoms suggestive of serotonin syndrome &#40;high body temperature&#44; agitation&#44; increased reflexes&#44; tremor&#44; sweating&#44; dilated pupils&#44; diarrhea&#41; were screened for&#46; Also&#44; we collected time of simultaneous use&#44; doses of levodopa and other antiparkinsonian drugs&#46; Descriptive statistics have been used to summarize and organize the study data&#46; Quantitative variables were described by mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation if normally distributed&#44; or by median &#40;first quartile&#59; third quartile&#41; if not normally distributed&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0015" class="elsevierStylePara elsevierViewall">Clinical records were reviewed for the study period of September 2018 to September 2019&#46; Seventy-eight PD patients who were treated with safinamide of which 25 &#40;32&#46;05&#37;&#41; had a concomitant treatment with an antidepressant drug&#44; being sertraline and escitalopram the most frequent &#91;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#93;&#46; Eight patients were on safinamide 50<span class="elsevierStyleHsp" style=""></span>mg and 17 on safinamide 100<span class="elsevierStyleHsp" style=""></span>mg&#46; Mean age was 80 years<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;43 and H&#38;Y stage was 3&#46;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">2&#8211;4</span></a> Mean dose of levodopa used was 703&#46;75<span class="elsevierStyleHsp" style=""></span>mg<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>233&#46;15&#46; Eight patients were also under treatment with dopaminergic agonists&#44; 4 with opicapone and 6 patients were simultaneously taking opioid medications&#46; Median duration of concomitant treatment with safinamide and antidepressant drug was 6 months &#40;IQR 20&#46;5&#41;&#44; and over eighteen months in 5 cases&#46; No case of serotonin syndrome was recorded&#44; neither was any of its typical manifestations combined or in isolation&#46; As for adverse events leading to discontinuation of safinamide&#44; it was registered only in one case&#44; who discontinued the drug due to worsening hallucinations&#46; Nine &#40;12&#37;&#41; patients reported improvement in non-motor symptoms such as sleep &#40;4&#41;&#44; pain &#40;2&#41;&#44; mood &#40;1&#41;&#44; or urinary symptoms &#40;2&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0020" class="elsevierStylePara elsevierViewall">Treatment of motor and non-motor symptoms of PD is complex&#44; and commonly leads to regimens of combination therapy with possibility of interactions&#46; This is especially important when we combine antidepressant and pain treatments with MAOIs&#44; due to the potential risk of serotonin syndrome&#44; especially if combined with other drugs that are frequently used in patients with PD&#44; such as opioids&#46; Data suggest that safinamide may have a lower risk of serotonin syndrome&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">15&#8211;18</span></a> Only real clinical experience can corroborate these data&#44; since polypharmacy tends to be avoided for safety in clinical trials&#46; In our study we have found frequent concomitant use of antidepressants and safinamide&#44; with very favorable safety data&#46; No serotonin syndrome was recorded&#44; either minor manifestations&#44; not even in the opioid treatment subgroup&#46; Adherence to safinamide was very good&#44; with only one case of suspension of treatment due to collateral effects &#40;hallucinations&#41;&#44; probably due to its dopaminergic properties and to the combination with other drugs with similar mechanism&#46; Although the retrospective registry does not allow evaluating efficacy&#44; in terms of non-motor symptoms control&#44; in a subgroup of patients the use of safinamide was beneficial for the control of several non-motor symptoms&#44; as has been suggested in other real-life clinical studies&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">19</span></a> Pain occurs two or three times more frequently in patients with PD than in individuals of similar age without PD&#46; Prevalence of pain in PD may vary from 34&#37; to 83&#37;&#44; depending on methodological evaluations&#46; It can be considered as a non-motor symptom but also related to concomitant osteoarticular pathology&#44; so is very frequent that patients with Parkinson disease have opioid medications among their treatments&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">18&#44;19</span></a> While SSRIs are the most commonly reported drug associated with serotonin syndrome&#44; physicians should be aware of tramadol as a potential single agent cause for serotonin syndrome&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">20</span></a> The concurrent use of SSRIs with tramadol has been shown to induce serotonin syndrome through synergistic serotonergic action&#44; along with the inhibition of CYP2D6&#44; resulting in higher levels of tramadol enantiomer associated with serotonergic activity&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">21&#8211;24</span></a> We found a small group of patients that were taking together antidepressants&#44; tramadol and safinamide &#91;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#93;&#46; Any of them had symptoms suggestive of serotonergic hyperactivity&#44; but we must monitor closely for the possible occurrence of adverse effects&#46; We are aware that this observational study has several limitations due to the small number of patients included and its retrospective design&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusion</span><p id="par0025" class="elsevierStylePara elsevierViewall">Our real clinical practice study suggests that concomitant use of safinamide with antidepressant drugs in PD patients seemed to be safe and well tolerated&#44; even in the long term&#46; However&#44; caution is warranted&#44; individualizing treatment regimens and monitoring the potential appearance of adverse effects&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Ethical standard</span><p id="par0030" class="elsevierStylePara elsevierViewall">The study was approved by the local Ethics Committee&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Funding</span><p id="par0035" class="elsevierStylePara elsevierViewall">There are no financial disclosures&#46; Full other financial disclosures of all authors for the previous 12 months&#46; P&#46; P&#233;rez Torre&#58; Hospital Ram&#243;n y Cajal&#44; Madrid&#46; IRYCIS&#44; Madrid&#46; V&#46; Ma&#241;anes&#58; Hospital Ram&#243;n y Cajal&#44; Madrid&#46; IRYCIS&#44; Madrid&#46; E&#46; Monreal&#58; Hospital Ram&#243;n y Cajal&#44; Madrid&#46; I Parees&#58; Hospital Ram&#243;n y Cajal&#44; Madrid Spain&#46; IRYCIS&#44; Madrid&#46; S&#46; Fanjul&#58; Hospital Ram&#243;n y Cajal&#44; Madrid&#46; A Alonso&#58; Hospital Ramon y Cajal&#44; Madrid&#46; J&#46; Martinez&#58; Hospital Ramon y Cajal&#44; Madrid&#46; IRYCIS&#44; Madrid&#46; J&#46; L&#243;pez-Send&#243;n&#58; Hospital Ram&#243;n y Cajal&#46; IRYCIS&#44; Madrid&#44; Spain&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Authors&#8217; contribution</span><p id="par0040" class="elsevierStylePara elsevierViewall">P&#46; P&#233;rez Torre &#8211; research project&#58; conception&#44; organization&#44; execution&#59; statistical analysis&#58; design&#44; execution&#59; manuscript&#58; writing of the first draft&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">E&#46; Monreal &#8211; research project&#58; organization&#59; statistical analysis&#58; review and critique&#59; manuscript&#58; review and critique&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">V&#46; Ma&#241;anes &#8211; research project&#58; organization&#59; statistical analysis&#58; review and critique&#44; Manuscript&#58; review and critique&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">I Parees &#8211; research project&#58; organization&#59; statistical analysis&#58; review and critique&#59; manuscript&#58; review and critique&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">S&#46; Fanjul &#8211; research project&#58; organization&#59; statistical analysis&#58; review and critique&#59; manuscript&#58; review and critique&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">A Alonso &#8211; research project&#58; organization&#59; statistical analysis&#58; review and critique&#59; manuscript&#58; review and critique&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">JC Mart&#237;nez &#8211; research project&#58; organization&#44; execution&#59; statistical analysis&#58; review and critique&#59; manuscript&#58; review and critique&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">JL L&#243;pez-Send&#243;n &#8211; research project&#58; organization&#59; statistical analysis&#58; review and critique&#59; manuscript&#58; review and critique&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflict of interest</span><p id="par0080" class="elsevierStylePara elsevierViewall">There are no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:14 [
        0 => array:3 [
          "identificador" => "xres2130758"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Background and purpose"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1809593"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres2130759"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Objetivos"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Material y m&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusi&#243;n"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1809594"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Materials and methods"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Results"
        ]
        7 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Conclusion"
        ]
        9 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Ethical standard"
        ]
        10 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Funding"
        ]
        11 => array:2 [
          "identificador" => "sec0040"
          "titulo" => "Authors&#8217; contribution"
        ]
        12 => array:2 [
          "identificador" => "sec0045"
          "titulo" => "Conflict of interest"
        ]
        13 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2021-05-18"
    "fechaAceptado" => "2021-08-04"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1809593"
          "palabras" => array:4 [
            0 => "Safinamide"
            1 => "Depression"
            2 => "Parkinson&#39;s disease"
            3 => "Serotonin syndrome"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1809594"
          "palabras" => array:4 [
            0 => "Safinamida"
            1 => "Depresi&#243;n"
            2 => "Enfermedad de Parkinson"
            3 => "S&#237;ndrome serotonin&#233;rgico"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background and purpose</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The aim of this study was to assess the possible pharmacological interactions between safinamide and antidepressants&#44; and in particular the appearance of serotonin syndrome with data from real life&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We conducted a retrospective observational study of patients with Parkinson&#39;s disease from our Movement Disorders Unit&#44; who were under treatment with any antidepressant drug and safinamide&#46; Specifically&#44; symptoms suggestive of serotonin syndrome were screened for&#46; Also&#44; we collected time of simultaneous use&#44; doses of levodopa and other antiparkinsonian drugs&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Clinical records were reviewed for the study period of September 2018 to September 2019&#46; Seventy-eight PD patients who were treated with safinamide of which 25 &#40;32&#46;05&#37;&#41; had a concomitant treatment with an antidepressant drug&#44; being sertraline and escitalopram the most frequent&#46; Mean age was 80 years<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;43 and H&#38;Y stage was 3 &#91;2&#8211;4&#93;&#46; Mean dose of levodopa used was 703&#46;75<span class="elsevierStyleHsp" style=""></span>mg<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>233&#46;15&#46; Median duration of concomitant treatment with safinamide and antidepressant drug was 6 months &#40;IQR 20&#46;5&#41;&#44; and over eighteen months in 5 cases&#46; No case of serotonin syndrome was recorded&#44; neither was any of its typical manifestations combined or in isolation&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Our real clinical practice study suggests that concomitant use of safinamide with antidepressant drugs in PD patients seemed to be safe and well tolerated&#44; even in the long term&#46; However&#44; caution is warranted&#44; individualizing treatment regimens and monitoring the potential appearance of adverse effects&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Background and purpose"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El objetivo de este estudio ha sido evaluar las posibles interacciones farmacol&#243;gicas entre safinamida y antidepresivos&#59; en particular la aparici&#243;n del s&#237;ndrome serotonin&#233;rgico mediante datos obtenidos en la vida real&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Realizamos un estudio observacional retrospectivo de pacientes con enfermedad de Parkinson &#40;EP&#41; de nuestra unidad de trastornos del movimiento&#44; que estaban en tratamiento con alg&#250;n f&#225;rmaco antidepresivo y safinamida&#46; Espec&#237;ficamente&#44; se examinaron los s&#237;ntomas sugestivos de s&#237;ndrome serotonin&#233;rgico&#46; Adem&#225;s&#44; se recogieron tiempos de uso simult&#225;neo&#44; dosis de levodopa y otros f&#225;rmacos antiparkinsonianos concomitantes&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se revisaron las historias cl&#237;nicas correspondientes al per&#237;odo de estudio de septiembre de 2018 a septiembre de 2019&#46; Setenta y ocho pacientes con EP se encontraban en tratamiento con safinamida&#44; de los cuales 25 &#40;32&#44;05&#37;&#41; se encontraban recibiendo adem&#225;s un f&#225;rmaco antidepresivo&#44; siendo sertralina y escitalopram los m&#225;s frecuentes&#46; La edad media fue de 80 a&#241;os<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;43 y el estadio H&#38;Y fue de 3 &#91;2-4&#93;&#46; La dosis media de levodopa utilizada fue de 703&#44;75<span class="elsevierStyleHsp" style=""></span>mg<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>233&#44;15&#46; La mediana de duraci&#243;n del tratamiento concomitante con safinamida y un f&#225;rmaco antidepresivo fue de 6 meses &#40;IQR&#58; 20&#44;5&#41;&#44; y m&#225;s de 18 meses en 5 casos&#46; No se registr&#243; ning&#250;n caso de s&#237;ndrome serotonin&#233;rgico&#44; ni tampoco ninguno de sus s&#237;ntomas de forma aislada&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Nuestro estudio de pr&#225;ctica cl&#237;nica real sugiere que el uso concomitante de safinamida con f&#225;rmacos antidepresivos en pacientes con EP parece ser seguro y bien tolerado&#44; incluso a largo plazo&#46; Sin embargo&#44; es necesaria precauci&#243;n&#44; individualizando los reg&#237;menes de tratamiento&#44; y controlando la posible aparici&#243;n de efectos adversos&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objetivos"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Material y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusi&#243;n"
          ]
        ]
      ]
    ]
    "multimedia" => array:2 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 585
            "Ancho" => 1500
            "Tamanyo" => 60429
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">&#40;1&#41; 3 patients were taking safinamide<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>tramadol<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>duloxetine&#46; &#40;2&#41; 3 patients were taking safinamide<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>tramadol<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>mirtazapine&#46; &#40;3&#41; 3 patients were taking safinamide<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>tramadol<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>escitalopram&#46; <span class="elsevierStyleItalic">2 patients were taking 2 antidepressants</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#43;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">safinamide</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#43;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">tramadol</span>&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Antidepressant type&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Name&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Dose&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Number of patients&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Selective serotonin reuptake inhibitors &#40;SSRIs&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sertraline&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#47;100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#47;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Escitalopram&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#47;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#47;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Paroxetine&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Serotonin-norepinephrine reuptake inhibitors &#40;SNRIs&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Venlafaxine&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Duloxetine&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Norepinephrine and dopamine reuptake inhibitors &#40;NDRIs&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Bupropion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">150&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Serotonin receptor antagonist and reuptake inhibitors &#40;SARI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Trazodone&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#47;100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#47;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Noradrenergic and specific serotonergic antidepressant &#40;NaSSA&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mirtazapine&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#47;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#47;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3512585.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Antidepressant medications&#44; dose and number of patients who were on treatment&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:24 [
            0 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Depression and Parkinson&#39;s disease&#58; current knowledge"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "L&#46; Marsh"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11910-013-0409-5"
                      "Revista" => array:5 [
                        "tituloSerie" => "Curr Neurol Neurosci Rep"
                        "fecha" => "2013"
                        "volumen" => "13"
                        "paginaInicial" => "409"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24190780"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recognition and treatment of depression in Parkinson&#39;s disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "D&#46; Weintraub"
                            1 => "P&#46;J&#46; Moberg"
                            2 => "J&#46;E&#46; Duda"
                            3 => "I&#46;R&#46; Katz"
                            4 => "M&#46;B&#46; Stern"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/0891988703256053"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Geriatr Psychiatry Neurol"
                        "fecha" => "2003"
                        "volumen" => "16"
                        "paginaInicial" => "178"
                        "paginaFinal" => "183"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12967062"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A systematic review of prevalence studies of depression in Parkinson&#39;s disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;S&#46; Reijnders"
                            1 => "U&#46; Ehrt"
                            2 => "W&#46;E&#46; Weber"
                            3 => "D&#46; Aarsland"
                            4 => "A&#46;F&#46; Leentjens"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/mds.21803"
                      "Revista" => array:6 [
                        "tituloSerie" => "Mov Disord"
                        "fecha" => "2008"
                        "volumen" => "23"
                        "paginaInicial" => "183"
                        "paginaFinal" => "189"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17987654"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessment and management of neuropsychiatric symptoms in Parkinson&#39;s disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Mueller"
                            1 => "A&#46;P&#46; Rajkumar"
                            2 => "Y&#46;M&#46; Wan"
                            3 => "L&#46; Velayudhan"
                            4 => "D&#46; Ffytche"
                            5 => "K&#46;R&#46; Chaudhuri"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s40263-018-0540-6"
                      "Revista" => array:6 [
                        "tituloSerie" => "CNS Drugs"
                        "fecha" => "2018"
                        "volumen" => "32"
                        "paginaInicial" => "621"
                        "paginaFinal" => "635"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30027401"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Serotonin syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Volpi-Abadie"
                            1 => "A&#46;M&#46; Kaye"
                            2 => "A&#46;D&#46; Kaye"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ochsner J"
                        "fecha" => "2013"
                        "volumen" => "13"
                        "paginaInicial" => "533"
                        "paginaFinal" => "540"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24358002"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The serotonin syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "E&#46;W&#46; Boyer"
                            1 => "M&#46; Shannon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMra041867"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2005"
                        "volumen" => "352"
                        "paginaInicial" => "1112"
                        "paginaFinal" => "1120"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15784664"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Interaction between monoamine oxidase B inhibitors and selective serotonin reuptake inhibitors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Aboukarr"
                            1 => "M&#46; Giudice"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1017/S031716710001516X"
                      "Revista" => array:6 [
                        "tituloSerie" => "Can J Hosp Pharm"
                        "fecha" => "2018"
                        "volumen" => "71"
                        "paginaInicial" => "196"
                        "paginaFinal" => "207"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29955193"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Safinamide&#58; a review in Parkinson&#39;s disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "H&#46;A&#46; Blair"
                            1 => "S&#46; Dhillon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "CNS Drugs"
                        "fecha" => "2017"
                        "volumen" => "31"
                        "paginaInicial" => "169"
                        "paginaFinal" => "176"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A European observational study to evaluate the safety and the effectiveness of safinamide in routine clinical practice&#58; the SYNAPSES trial"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "SYNAPSES Study Investigators Group"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Abbruzzese"
                            1 => "J&#46; Kulisevsky"
                            2 => "B&#46; Bergmans"
                            3 => "J&#46;C&#46; Gomez-Esteban"
                            4 => "G&#46; K&#228;gi"
                            5 => "J&#46; Raw"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "J Parkinsons Dis"
                        "fecha" => "2020"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Serotonin toxicity association with concomitant antidepressants and rasagiline treatment&#58; retrospective study &#40;STACCATO&#41;"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "STACCATO study investigators"
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Panisset"
                            1 => "J&#46;J&#46; Chen"
                            2 => "S&#46;H&#46; Rhyee"
                            3 => "J&#46; Conner"
                            4 => "J&#46; Mathena"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Pharmacotherapy"
                        "fecha" => "2014"
                        "volumen" => "34"
                        "paginaInicial" => "1250"
                        "paginaFinal" => "1258"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A Spanish consensus on the use of safinamide for parkinson&#39;s disease in clinical practice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Pagonabarraga"
                            1 => "J&#46;M&#46; Arbelo"
                            2 => "F&#46; Grandas"
                            3 => "M&#46;R&#46; Luquin"
                            4 => "P&#46; Mart&#237;nez Mart&#237;n"
                            5 => "M&#46;C&#46; Rodr&#237;guez-Oroz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/brainsci10030176"
                      "Revista" => array:5 [
                        "tituloSerie" => "Brain Sci"
                        "fecha" => "2020"
                        "volumen" => "10"
                        "paginaInicial" => "176"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32197462"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Serotonin syndrome&#58; a complex but easily avoidable condition"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "Y&#46; Dvir"
                            1 => "P&#46; Smallwood"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.genhosppsych.2007.09.007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Gen Hosp Psychiatry"
                        "fecha" => "2008"
                        "volumen" => "30"
                        "paginaInicial" => "284"
                        "paginaFinal" => "287"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18433663"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spanish expert consensus on the use of safinamide in Parkinson&#39;s disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Valldeoriola"
                            1 => "F&#46; Grandas"
                            2 => "J&#46;M&#46; Arbelo"
                            3 => "M&#46; Bl&#225;zquez Estrada"
                            4 => "M&#46; Calopa Garriga"
                            5 => "V&#46;M&#46; Campos-Arillo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Neurologia"
                        "fecha" => "2018"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Accuracy of clinical diagnosis of idiopathic Parkinson&#39;s disease&#58; a clinico-pathological study of 100 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;J&#46; Hughes"
                            1 => "S&#46;E&#46; Daniel"
                            2 => "L&#46; Kilford"
                            3 => "A&#46;J&#46; Lees"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/jnnp.55.3.181"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurol Neurosurg Psychiatry"
                        "fecha" => "1992"
                        "volumen" => "55"
                        "paginaInicial" => "181"
                        "paginaFinal" => "184"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1564476"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Safinamide in the management of patients with Parkinson&#39;s disease not stabilized on levodopa&#58; a review of the current clinical evidence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Bette"
                            1 => "D&#46;S&#46; Shpiner"
                            2 => "C&#46; Singer"
                            3 => "H&#46; Moore"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2147/TCRM.S139545"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ther Clin Risk Manag"
                        "fecha" => "2018"
                        "volumen" => "14"
                        "paginaInicial" => "1737"
                        "paginaFinal" => "1745"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30271159"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Study 016 Investigators Randomized trial of safinamide add-on to levodopa in Parkinson&#39;s disease with motor fluctuations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Borgohain"
                            1 => "J&#46; Szasz"
                            2 => "P&#46; Stanzione"
                            3 => "C&#46; Meshram"
                            4 => "M&#46; Bhatt"
                            5 => "D&#46; Chirilineau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/mds.25751"
                      "Revista" => array:6 [
                        "tituloSerie" => "Mov Disord"
                        "fecha" => "2014"
                        "volumen" => "29"
                        "paginaInicial" => "229"
                        "paginaFinal" => "237"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24323641"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Hunter Serotonin Toxicity Criteria&#58; simple and accurate diagnostic decision rules for serotonin toxicity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "E&#46;J&#46; Dunkley"
                            1 => "G&#46;K&#46; Isbister"
                            2 => "D&#46; Sibbritt"
                            3 => "A&#46;H&#46; Dawson"
                            4 => "I&#46;M&#46; Whyte"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/qjmed/hcg109"
                      "Revista" => array:6 [
                        "tituloSerie" => "QJM"
                        "fecha" => "2003"
                        "volumen" => "96"
                        "paginaInicial" => "635"
                        "paginaFinal" => "642"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12925718"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pharmacokinetic&#8211;pharmacodynamic relationship of the selective serotonin reuptake inhibitors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46; Baumann"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Pharmacokinet"
                        "fecha" => "1996"
                        "volumen" => "31"
                        "paginaInicial" => "444"
                        "paginaFinal" => "469"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Emergencies and critical issues in Parkinson&#39;s disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46; Simonet"
                            1 => "E&#46; Tolosa"
                            2 => "A&#46; Camara"
                            3 => "F&#46; Valldeoriola"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/practneurol-2018-002075"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pract Neurol"
                        "fecha" => "2020"
                        "volumen" => "20"
                        "paginaInicial" => "15"
                        "paginaFinal" => "25"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31427383"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Real life evaluation of safinamide effectiveness in Parkinson&#39;s disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Mancini"
                            1 => "A&#46; Di Fonzo"
                            2 => "G&#46; Lazzeri"
                            3 => "L&#46; Borellini"
                            4 => "V&#46; Silani"
                            5 => "M&#46; Lacerenza"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10072-018-3272-y"
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurol Sci"
                        "fecha" => "2018"
                        "volumen" => "39"
                        "paginaInicial" => "733"
                        "paginaFinal" => "739"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29441484"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tramadol&#44; pharmacology&#44; side effects&#44; and serotonin syndrome&#58; a review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "B&#46;D&#46; Beakley"
                            1 => "A&#46;M&#46; Kaye"
                            2 => "A&#46;D&#46; Kaye"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pain Physician"
                        "fecha" => "2015"
                        "volumen" => "18"
                        "paginaInicial" => "395"
                        "paginaFinal" => "400"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26218943"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Avoiding serotonin syndrome&#58; the nature of the interaction between tramadol and selective serotonin reuptake inhibitors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "E&#46;M&#46; Nelson"
                            1 => "A&#46;M&#46; Philbrick"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1345/aph.1Q748"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Pharmacother"
                        "fecha" => "2012"
                        "volumen" => "46"
                        "paginaInicial" => "1712"
                        "paginaFinal" => "1716"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23212934"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Serotonin syndrome resulting from coadministration of tramadol&#44; venlafaxine&#44; and mirtazapine"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46;J&#46; Houlihan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1345/aph.1D344"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Pharmacother"
                        "fecha" => "2004"
                        "volumen" => "38"
                        "paginaInicial" => "411"
                        "paginaFinal" => "413"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14970364"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tramadol&#58; understanding the risk of serotonin syndrome and seizures"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Hassamal"
                            1 => "K&#46; Miotto"
                            2 => "W&#46; Dale"
                            3 => "I&#46; Danovitch"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "Am J Med"
                        "fecha" => "2018"
                        "volumen" => "131"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/02134853/0000003900000004/v1_202404170527/S0213485321001298/v1_202404170527/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9397"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Originales"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/02134853/0000003900000004/v1_202404170527/S0213485321001298/v1_202404170527/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213485321001298?idApp=UINPBA00004N"
]

Article information

ISSN: 02134853
Original language: English

DOI:10.1016/j.nrl.2021.08.004

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 October	37	14	51
2024 September	93	22	115
2024 August	79	18	97
2024 July	104	14	118
2024 June	50	12	62
2024 May	107	30	137
2024 April	154	19	173
2024 March	69	24	93
2024 February	81	47	128
2024 January	95	54	149
2023 December	63	42	105
2023 November	81	21	102
2023 October	94	9	103
2023 September	72	15	87
2023 August	39	11	50
2023 July	60	11	71
2023 June	57	17	74
2023 May	79	14	93
2023 April	74	9	83
2023 March	37	7	44
2023 February	39	16	55
2023 January	31	5	36
2022 December	29	4	33
2022 November	44	33	77
2022 October	26	10	36
2022 September	49	13	62
2022 August	26	7	33
2022 July	30	10	40
2022 June	27	8	35
2022 May	39	12	51
2022 April	49	13	62
2022 March	50	24	74
2022 February	33	12	45
2022 January	36	15	51
2021 December	36	19	55
2021 November	35	18	53
2021 October	16	20	36
2021 September	6	37	43

Show all

Indexed in:

Follow us:

Statistics

Indexed in:

Follow us:

Statistics

Subscribe to our newsletter