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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Seventy-two private practice patients with moderate or severe anxiety-depressive neurosis received mean daily oral doses of 23.8 mg bromazepam, 94 mg amitriptyline, or 4.6 capsules of placebo in a double-blind four-week study. The patient's condition was assessed initially and at weekly intervals by using the Brief Psychiatric Rating Scale and the Hamilton Psychiatric Rating Scale for Depression. From the first through the fourth week evaluations, a larger proportion of patients improved on bromazepam than on amitriptyline. Bromazepam was also superior to amitriptyline and placebo in the degree of improvement made Statistical significance (p less than 0.05) of the changes noted after one week was even greater after four weeks, particularly in BPRS items of somatic concern, depressive mood, anxiety and tension and in nearly all representative psychic and somatic symptoms on the depression scale, confirmed by global evaluation. Compared to bromazepam patients, amitriptyline patients had significantly severer adverse reactions which were the major cause of the group's higher dropout rate (66% vs 33%). The prompt clinical response to bromazepam contributed to its superior safety and patient progress in that it was possible to carefully titrate dosage and thus help to control adverse reactions and allow patients to maintain alertness and productivity under therapy.
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PMID:Controlled comparison of bromazepam, amitriptyline, and placebo in anxiety-depressive neurosis. 1 69

Details of treatment remain imprecise in depression, as the trials of antidepressants have been more concerned with overall effectiveness than with specificity. The aetiology in depression does not provide sufficient guidance for treatment, even though drugs are preferred for endogenous depression and psychotherapy for neurotic depression. An unitary formulation of depression can be postulated on the basis of the concept of regression; endogenous and reactive depression would then stem from the nature of the depressed subject's personality. Such an approach can encompass the various possible aetiologies in depression: biochemical, psychological and social, without necessarily contrasting them. In this connection, depression is a psychobiological syndrome within which there may be different symptomatic pictures, depending notably upon the various monoamine hypotheses raised in numerous studies. In that event, possible correlations between biochemical abnormalities and certain clinical manifestations may better guide the selection of drugs.
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PMID:[Depressive symptomatology and type of treatment (author's transl)]. 4 68

The etiology of depression in the aged is discussed from the viewpoint of biologic, psychodynamic, genetic and sociocultural concepts. The chronic neurotic depression of the aged seems to differ from that of younger age groups. The understanding of geriatric depression requires a multidisciplinary approach.
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PMID:Depression in the aged: theoretical concepts. 19 53

Fifty-seven neurotically depressed outpatients with sleep disturbance were randomly assigned to treatment with either imipramine pamoate or amitriptyline given in a single dose at bedtime in a double-blind study for four weeks. The results indicate that both imipramine pamoate and amitriptyline are equally effective in treating neurotic depression. The clinical lore that imipramine is more effective for retarded depression and amitriptyline for anxious, agitated depression was not supported by this study. Of special interest is the fact that the imipramine pamoate group had significantly earlier rising times, and a trend toward better quality of sleep. The side effect profiles of the two drugs were also remarkably similar in this population though more patients complained of side effects on amitriptyline than on imipramine.
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PMID:Which tricyclic for depressed outpatients, imipramine pamoate or amitriptyline? 33 72

On the grounds of pharmacological properties and preliminary clinical trials the efficacy of the new antidepressant caroxazone was compared to amitriptyline in the management of depression. Forty patients mostly suffering from a neurotic or anxious-neurotic depression were admitted to a double-blind trial. All patients completed the study. The Hamilton Rating Scale for Depression was used for the clinical assessment at the beginning, during and at the end of treatment. The trial lasted three weeks. A significant improvement was seen for both drugs after seven days on most symptom scores and on total symptom score. No significant differences were found either at seven days of at the end of treatment between the two drugs. There were no significant differences in the incidence and severity of side-effects. In conclusion, caroxazone appears as an effective and well tolerated drug in the treatment of depression.
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PMID:A comparative double-blind trial of the new antidepressant caroxazone and amitriptyline. 35 83

A double-blind trial of flupenthixol, nortriptyline and diazepam in neurotic depression using flexible dose schedules suggested that each drug is an efficient treatment for this category of depression although the patterns of response and prevalence of side-effects varied. No differences reaching a level of significance could be shown on rating scales of depression or anxiety, but trends favoured flupenthixol. However, clinical evaluation suggested flupenthixol to be more effective than diazepam on mental state examination (P less than 0.05) and to have a greater overall therapeutic effect than nortriptyline (P less than 0.05). It also had fewer side-effects than nortriptyline (P less than 0.05).
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PMID:A double-blind comparison of flupenthixol, nortriptyline and diazepam in neurotic depression. 36 98

Lofepramine, a new tricycle antidepressant, is compared with amitriptyline in a double-blind study. A brief pharmacological description of the drug is made emphasizing its low toxicity and anticholinergic peripheral effects, high plasmatic concentration levels and good tolerance and elimination in comparison with some other known tricycle antidepressants. Sixty depressive outpatients of a Mental Health Service in Lima, 5 male and 55 female, aging 16 to 65, 29 endogenous and 31 neurotic were studied with both drugs in a equimolar dosage. Through the chi square test, no statistical significance was found in maximal therapeutic response, Hamilton Depression Rating Scale scores, type of depression, and side-effects xerostomy which is lesser with lofepramine. A discussion of these results is made and it is concluded that in the present study lofepramine compared with amitriptyline has a similar therapeutic effect. Though not statistically significant, lofepramine seems to be better for neurotic depression and patients sensitive to anticholinergic side-effects.
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PMID:[Lofepramine: a comparative clinical study with amitriptyline]. 37 79

Four examples of homicide followed by attempted suicide are presented based on the psychiatric examinations prepared for the use of the courts. Three cases were suffering from unbearable states of endogenous depression and the fourth showed a serious chronic neurotic depression following an acute grief reaction before and during homicide. The relationship between depression and homicide is discussed from the standpoint of clinical psychopathology. Criminal responsibility of these cases is also discussed.
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PMID:Depression and homicide. A psychiatric and forensic study of four cases. 42 39

In a matched retrospective study, 31 patients with hysterical neurosis were compared with 31 with depressive neurosis. There were no significant differences between the groups for siblings' position, medical work, brain disease, poor marriage, frigidity, or family history of psychiatric disorder. Significantly more of the hysterics had a preceding head injury and 29% had a past history of hysteria. By the time of the study 48% had been treated for depression.
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PMID:Hysteria: a case note study. 42 3

SAdness and normal grief are distinguished from pathological grief and depression by intensity, duration, precipitating events, and the quality of psychopathological features. Depression is evaluated as a final common pathway of potential psychodynamic, genetic, psychosocial, physiological, and personality characteristics or events. The clinical entity of depression is diagnosed by describing some of each of the affective, behavioral, and cognitive changes concomitant with depression. The clinical entity of depression is further differentiated for purposes of treatment into the categories of bipolar depression (manic-depressive illness), unipolar depression (psychotic depressive reaction or involutional melancholia), neurotic depression, and secondary depression (secondary to somatic disease, drugs, or to other psychiatric disorders). The immediate treatment depends on the type of depression diagnosed. Unipolar and bipolar depressions respond to specific pharmacologic therapy and supportive care. Neurotic and characterologic depressions respond to supportive or insight psychotherapy with possible brief adjunctive anti-anxiety or hypnotic medication. All of the treatment modalities, with the possilbe exception of insight psychotherapy, can be effected very adequately by the primary care physician who is given clear diagnostic and assessment guidelines with specific treatment approaches.
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PMID:The depressed patient. 42 80


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