Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of the present 6-week multicenter dose finding study was to compare the efficacy and tolerability of mirtazapine (preferentially presynaptic alpha 2-adrenergic receptor blocker) to placebo in hospitalized patients with major depression. The clinical efficacy was evaluated with the Hamilton Depression Scale (HAM-D), Montgomery-Asberg Depression Rating Scale (MADRS), Beck Self-Rating Depression Scale, Global Assessment Scale (GAS), and Brief Psychiatric Rating Scale (BPRS). The side effects were recorded on a checklist of emergent symptoms (ROSE) and physical examinations, ECG, clinical chemistry, and hematology tests were carried out. The dosages of mirtazapine were gradually raised from 15 mg to 50 mg. One hundred and fourteen patients were included. Twenty-two patients (37%) in mirtazapine group and 24 (44%) in the placebo group were prematurely withdrawn from the study mainly due to inadequate efficacy. The decrease in HAM-D and MADRS was generally more pronounced in the mirtazapine group than in the placebo group. Minor side effects were reported in less than 15% of the patients in both groups. Only fatigue and faintness were slightly more pronounced in the mirtazapine group than in the placebo group. No significant changes were found in laboratory parameters. Because of methodological flaws like combining a dose finding study with a placebo controlled study, further conclusions should not be made on the efficacy of mirtazapine when treating depressive patients.
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PMID:Double-blind study of mirtazapine and placebo in hospitalized patients with major depression. 791 44

Forty patients of typical major depression (DSM-III-R) have been adopted for the present study. Hamilton Rating Scale for Depression (HAM-D) was used for the clinical assessment of depressive symptoms, and the patients were followed up at least for four weeks. All the patients were confirmed to be right-handed. The baseline EEGs were compared with age-matched normal subjects (N = 38; all right handed). The differences between depressive patients and normal subjects were less theta activity, more fast activity in anterior part of both hemispheres and in posterior part of the right hemisphere in the depressive patients than in the normal subjects. As a preliminary study, amitriptyline 25 mg was single dose administered and EEGs were recorded before and 1, 3 and 6 hours after the first drug administration in normal male volunteers (N = 6; right-handed). EEG changes of after the medication from the baseline were significant increase of theta and decrease of alpha activity, increase of beta activity was not significant changes. Particularly EEG changes of after 3 hour's administration showed the typical thymoleptic reaction type. EEG changes in patients from the baseline EEG after the first medication were similar to normal subjects. The patients (N = 21) were divided into two groups based on the changes of HAM-D score during four-weeks' treatment; therapy-responsive and therapy-resistant groups. EEG changes after the first single dose administrations in the former were compared with the latter of two patients' groups. Both groups have shown an increase of theta and a decrease of alpha activity. There was more evident alpha increase in therapy-responsive patients than in therapy-resistant ones. However, there were significant differences in amitriptyline-induced EEG changes particularly in beta frequency band; therapy-responsive group showed an increase of beta activity, while therapy-resistant showed no or little change. Using discriminant analysis, the overall hitting ratio of the EEG prediction for therapy-responsive and therapy-resistant group was calculated as 85% at 3 hours after the initiation of antidepressant medication. If EEG mapping, particularly the mapping of differences between pre- and post-drug EEGs, is used to illustrate the EEG responses against antidepressant medication, it will be quite useful to discriminate therapy-resistant patients from therapy-responsive ones in very early stage of the drug treatment.
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PMID:[The baseline EEG traits and the induced EEG changes by chronic antidepressant medication in patients with major depression. Early prediction of clinical outcomes solely based on quantification and mapping of EEG]. 793 9

1. The present study evaluated the safety and efficacy of two dosages of SC 48,274 (1mg and 25mg) as compared to placebo in subjects with Generalized Anxiety Disorder (GAD). 2. This was a randomized, double-blind, placebo-controlled, parallel-group study which was part of one of three large multicenter trials which evaluated a total of 5 doses of SC 48,274 (.25, 1, 5, 25, and 100mg bid). Following a 7-day placebo baseline period, patients entered 4 weeks of double-blind treatment and a 7-day placebo follow-up period. 3. Efficacy was assessed weekly throughout the study with the Hamilton Anxiety Rating Scale (HAM-A), and Clinical Global Impression (CGI), and at treatment endpoint with the Covi Anxiety Scale, Raskin Depression Scale and Hamilton Depression Rating Scale (HAM-D). A diagnosis of GAD according to DSM-III-R criteria (with the exception that a GAD minimum duration of 3 months was allowed), a HAM-A score > or = 20 (anxious mood and tension items > or = 2), HAM-D less than HAM-A, Covi Anxiety Score > or = 8, Raskin Depression Scale less than the Covi Anxiety, and age of 18 to 65 years were necessary for inclusion in the study. 4. Patients received one of two dosages of SC 48,274, either 1mg (n = 28), 25mg (n = 9), or placebo (n = 28) bid, during the 4-week randomized portion of the trial. 5. Mean changes from baseline in HAM-A scores for the 1mg, 25mg, and placebo groups after 4 weeks treatment were -5.1, -4.2, and -1.9, respectively. Changes were significant for the 1mg group vs. placebo (F = 8.93, p = 0.004), but not for the 25mg group (F = 2.26, p = 0.138). 6. CGI severity of illness scores were also significant for the 1mg group versus placebo at the end of treatment (X2 = 3.8, p = 0.05), but not for the 25mg group (X2 = 0.90, p = 0.343). Neither group showed significant CGI improvement scores by end of treatment. 7. The most frequent adverse events associated with the study drug (n = 37) were headache (n = 7), nausea (n = 3), palpitations (n = 4) and chest pains (n = 2). There was, however, no apparent pattern of adverse events distinguishing SC 48,274 from placebo.
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PMID:An evaluation of the anxiolytic SC 48,274 in generalized anxiety disorder (GAD) 793 70

Data on a twice-daily dosage schedule with moclobemide in the treatment of depression is limited. In this study, moclobemide 150 mg twice daily (b.i.d.) was compared to two different three-times-daily (t.i.d.) regimens with total daily dosages of 300 and 450 mg, respectively, over a 6-week period. The study was randomized, double-blind, and conducted at three university centers. Efficacy was measured on the Hamilton Depression and Anxiety Rating Scales, on the Zung Scale, and on clinical global impression. Tolerability and safety were assessed through adverse events and vital signs and on clinical global impression. One hundred seventy-eight depressed outpatients were included, and 158 completed the study. The treatment groups were comparable at baseline. No clear differences between the treatment groups could be shown with respect to efficacy. There was, however, a slightly larger decrease in the total HAM-A score in the groups receiving 150 mg b.i.d. and t.i.d. than in the third group. There were no marked differences between the groups with respect to tolerability and safety. Tolerability was rated "good" or "excellent" in 94% of patients, and there was no appreciable change in vital signs in any of the treatment groups. Moclobemide 150 mg b.i.d. is the optimal initial schedule for treatment of depression.
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PMID:Moclobemide twice daily in the treatment of major depressive episode: a double-blind, multicenter comparison with different three-times-daily dosage schedules. 795 80

Safety aspects [adverse events, blood pressure and heart rate, weight, and laboratory tests (liver parameters, hemoglobin, leukocytes)] of long-term treatment in 1,120 patients are discussed. Adverse events during this long-term treatment were also compared with those of a subgroup of these patients who, before long-term treatment, were treated on a short-term basis (n = 706). Efficacy [Hamilton Depression Rating Scale (HAM-D), Clinical Global Impression of Efficacy (CGI), and occurrence of relapses and recurrences] in a homogeneous sample of 485 patients is also discussed. The adverse events most frequently observed during long-term treatment were insomnia, headache, and dizziness. Insomnia and headache were also most often occurring in the compared sample of patients with short-term treatment, whereas dizziness during this treatment period ranked at the fifth position. Supine and standing mean blood pressure did not consistently change during long-term treatment, the most prominent increases in comparison with baseline were seen in the period > 1 year of treatment (6.3 mm Hg supine/7.2 mm Hg standing). Comparison of blood pressure values in the hypertensive range at baseline and during long-term treatment revealed no statistical difference (McNemar test p = 0.07829). Mean heart rate slightly decreased during long-term treatment (by a maximum of 6.3 beats/min supine, 8.2 beats/min standing). Mean weight did not change between baseline and treatment end point. There were 23 patients with a weight loss of 10 kg or more and 16 patients with a weight gain of 10 kg or more. For none of the laboratory parameters tested was there a statistical significance regarding shifts from normal to pathological values. HAM-D mean total scores in the above-mentioned subgroup of patients decreased from 25.05 points at baseline (n = 485) to 7.88 points after 1 year of treatment (n = 139). Seventy-five patients who had favorably responded to treatment (total responders n = 300) relapsed during the first 6 months of treatment. During the second half-year of treatment the recurrence rate was 14.8%, and during the third 6 months the recurrence rate was 12.2%. CGI in the same subsample of patients in whom HAMD was evaluated (n = 485) compared with those patients who did not drop out during the short-term period up to 44 days and entered long-term treatment (n = 401) showed that the percentage of the ratings "no change/worse" was higher in the sample that also included patients who withdrew from treatment during the short-term period.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Safety and efficacy during long-term treatment with moclobemide. 795 86

Several studies have reported on comorbidity between depression and anxiety. The present study investigates the occurrence of anxiety symptoms during an episode of unipolar depression. The authors administered the 15-item Rating Scale for Anxiety States of Hamilton (HAM-A) to 73 depressed inpatients categorized according to DSM-III criteria into minor (300.40, 309.00), major depression without (296.X2) and with (296.X3) melancholia. Principal-component (PC) analysis revealed three interpretable PCs: a somatic anxiety, a depression-anxiety overlap, and an anxious mood-behavior factor. Subjects with major depression showed significantly higher ratings on total HAM-A score, the three above PCs, and on all HAM-A items (except general somatic muscular and genitourinary symptoms) than subjects with minor depression. A cluster analysis generated two stable, qualitatively distinct clusters: i.e. one with severe anxiety and one with no or minimal anxiety; the six most discriminating symptoms were: tension, behavior at interview (general or physiological), respiratory, genitourinary and autonomic symptoms. Up to 95.4% of patients allocated to the severe anxiety cluster were major depressives. The results suggest that major depression may be divided into two qualitatively distinct classes, i.e. major depression with and without anxiety features.
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PMID:Evidence for the existence of major depression with and without anxiety features. 797 33

36 elderly outpatients (mean age 68.6 years) with depression and increased blood urea level were treated with mianserin (60 mg every evening). All patients were ordered to drink additionally 11 of mineral water per day, which only 30 patients complied with. The patients who complied with the ordered increase in fluid intake (responder, n = 30) showed in comparison to those who did not comply (non-responder, n = 6) a significant improvement in depression (i.e., HAM-D, p < 0.001) after a four week period of treatment (t2). The responders' blood urea level normalized whereas the non-responders' level, although lowered, still remained in the pathological range.
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PMID:[Effect of mianserin and additional fluid intake on depression and blood urea concentration in elderly patients]. 805 11

Recurrent unipolar depression is a common, but undertreated disorder. Many patients require long-term maintenance therapy, and full doses of antidepressant agents may be preferred for the prevention of relapse. We report results of a 1-year, multicenter, open-label study of paroxetine (10 to 50 mg/day) in 433 patients with major depressive disorder, with additional data from 110 patients who entered a long-term extension of the study. The primary measures of efficacy were the Hamilton Rating Scale for Depression (HAM-D) total and Clinical Global Impression (CGI) severity of illness scores. During the first 6 weeks of therapy, the mean HAM-D total declined approximately 50% (from 27.9 to 13.5), with continued improvement, at an attenuated rate, throughout the first year. At the end of 1 year, the mean HAM-D total was 6.9. Similarly, the CGI severity of illness score declined from 4.6 at baseline to 2.8 at week 6 and to 1.7 at the end of 1 year. Remission was maintained in the population that entered the long-term extension, with mean HAM-D total and CGI severity of illness scores of 6.4 and 1.8, respectively, after 2.5 years, and 4.2 and 1.3 after 4 years. The most common adverse events reported during long-term treatment with paroxetine were somnolence, nausea, headache, and sweating. Pharmacokinetic analysis showed no clear correlation between the concentrations of paroxetine in plasma and either clinical efficacy or tolerability. There was no increased drug accumulation during long-term treatment. Side effects tended to occur early during therapy; and no new side effects emerged during the long-term extension. These results suggest that paroxetine is effective and well tolerated in the long-term treatment of depression.
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PMID:Long-term treatment of major depressive disorder with paroxetine. 810 53

A 6-week, double-blind, parallel group study compared the efficacy and tolerability of paroxetine and fluoxetine in 106 depressed geriatric outpatients (age, > or = 65 years). Patients with an acute major depressive episode were randomized to receive either paroxetine (20 to 40 mg; N = 54) or fluoxetine (20 to 60 mg; N = 52) after a 3- to 7-day washout. Efficacy evaluations at weeks 1, 3, and 6 used the 21-item Hamilton Rating Scale for Depression (HAM-D). Cognitive function was assessed by use of the Mini-Mental State Examination (MMSE) and the Sandoz Clinical Assessment Geriatric Scale (SCAG). Tolerability was assessed by response to a nonleading question concerning adverse events. There were no significant differences between treatments at week 6 on the HAM-D total, change from baseline. However, there was a statistically significant difference (p < 0.05) at week 3 in favor of paroxetine. Results from the MMSE and SCAG showed that, during treatment, patients in the paroxetine group were characterized by greater improvement in cognitive function than were those in the fluoxetine group. This result was statistically significant at week 3 for both scales (p < 0.05). Adverse events occurred most frequently within the gastrointestinal and nervous systems for both drugs, with no significant differences between treatments.
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PMID:A double-blind study of paroxetine compared with fluoxetine in geriatric patients with major depression. 810 54

Forty-three out-patients with depression of a moderate degree were enrolled in a randomized, double-blind parallel group study comparing amitriptyline and alprazolam for 6 weeks of treatment. Patients were evaluated at the end of placebo washout and at Weeks 1, 2, 3 and 6 of drug therapy using the Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Beck Depression Inventory (BDI) and Clinical Global Impression (CGI). Drug dosage was determined in a fixed-flexible design resulting in mean final doses of alprazolam 3.2 mg/day and of amitriptyline 115 mg/day. Although both drug groups improved there were statistically significant differences in favour of amitriptyline at the end of the study on the HAM-D, BDI and HAM-A scales. Patients on amitriptyline reported more side effects overall than patients taking alprazolam with significantly more reports of dry mouth in the amitriptyline group.
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PMID:Alprazolam and amitriptyline in the treatment of moderate depression. 819 82


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