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

Tianeptine is an effective antidepressant with original neurochemical properties. Tianeptine increases the serotonin (5-HT) reuptake after acute and chronic treatment. The efficacy of tianeptine (T) versus placebo (P) was evaluated in the treatment of psychasthenia, because of the role of 5-HT in obsessive-compulsive disorders, the last state of psychasthenia in term of severity. Patients were recruited using the psychasthenia scale; then, their MADRS scores limited those who turned out to the depression. Mean inclusion MADRS scores where 12 (T) and 11.8 (P). Tianeptine is an effective treatment for patients suffering from psychasthenia. Tianeptine is more effective than placebo in global score and in sub-scores (asthenia and somatic symptoms) of the psychasthenia scale. In spite of weak inclusion scores in MADRS, patients taking tianeptine also showed significant improvement, greater than with placebo. The percentage of patients with a reduction equal to or greater than 50% of their MADRS score was significantly more important in tianeptine group. These results could be the illustration of the decrease in associated depressive symptoms or the result of an improvement of symptoms common to MADRS and psychasthenia scales. The same favorable results were obtained in symptoms of anxiety scored by HARS. In term of safety, tianeptine is equivalent to a placebo if we consider somatic complaints expressed by the patients, global improvement evaluated by the patient and the investigator, weight and blood pressure. Interruption of treatment for side-effects concerns the placebo group only (3 versus 0). This excellent safety is particularly well-adapted to the treatment of these out-patients.
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PMID:[Efficacy of tianeptine in the treatment of psychasthenia. A study versus placebo]. 134 Aug 7

The question of the relationship between anxiety and depression remains to be solved. The fact that clinical pictures show substantial overlap makes it difficult, using conventional instruments, to distinguish between the co-occurrence of anxiety and depression and overlap in definitions and measurement of the two syndromes. This calls for the construction of scales which exclude symptoms common to both syndromes and incorporate symptoms specific only to anxiety or only to depression; i.e. scales with maximum discriminant validity. This article describes the construction of two such scales based on PSE symptoms; a prototypical anxiety scale and a prototypical depression scale. In a sample of 134 non-psychotic psychiatric out-patients these scales show good reliability and validity, both as a measure of severity and as a screening device. Compared to the Hamilton anxiety and depression scales (HARS and HRSD), the correlation between the prototypical anxiety and depression scales is low.
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PMID:The relationship between depression and anxiety: construction of a prototypical anxiety and depression scale. 141 85

An open multicenter study of the efficacy and acceptability of tianeptine, a new antidepressant structurally related to tricyclic antidepressants, was conducted by 36 gerontologists. There were 228 patients in the study; 140 were treated for one year. The patients' overall MADRS score started to decrease on day 14 and continued to decline to month 3. An improvement in depression was again observed near the end of the treatment period from month 9 to month 12. This pattern of improvement was also found with the HARS, the first item on the CGI scale and the Zung self-evaluation scale. These findings demonstrate the beneficial effect of long-term treatment in depressed elderly patients. Ten patients (4.4 percent) dropped out because of side effects: mainly drowsiness, anxiety or gastrointestinal disorders. The benefit/risk ratio (CGI, item 3), an expression of treatment effectiveness and acceptability, was very satisfactory even in these elderly patients. Regularly performed laboratory tests and clinical examinations (including weight and blood pressure) revealed no significant changes. Finally, somatic disorders, essentially cardiovascular and neurological diseases often occurring in depressed patients, remained remarkably quiescent throughout the entire treatment period.
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PMID:[Depression in elderly patients. Value of tianeptine in 140 patients treated for 1 year]. 183 17

We have examined the effects of a single 12.5 mg dose and of 12 weeks treatment up to 37.5 mg daily with tianeptine, a new antidepressant drug that potentiates in vivo the uptake of serotonin (5-HT). On day 0, tianeptine reduced plasma 5-HT concentration. This acute effect occurred also on subsequent examination days. However, long-term treatment tended (P < 0.06) to increase basal plasma 5-HT concentrations, in covariation with decreases of MADRS (Montgomery-Asberg Depression Rating Scale) and HARS (Hamilton Anxiety Rating Scale). Platelet 5-HT increased only in elderly patients, probably due to the higher plasma concentration of the drug in this group than in younger patients. These results show that the acute effects of therapeutic doses of tianeptine are consistent with an enhancement of the 5-HT uptake. However, long-term treatment does not result in a decreased plasma 5-HT, as might be expected from the acute effects of the drug.
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PMID:Effects of the antidepressant drug tianeptine on plasma and platelet serotonin of depressive patients and healthy controls. 751 Mar 16

This study was conducted to evaluate the effectiveness and acceptability of Tianeptine (T) versus Maprotiline (M) in the management of anxiodepressive disorders in menopausal and premenopausal women. Anxio-depressive women with a Montgomery Asberg Depression score (MADRS) > 20 and a Hamilton Anxiety score (HARS) > 15 were included in the study. T or M were the only psychotropes taken by the patients during the study. Eighty-three women were enrolled and given, by double blind assignment T 37.5 mg/day or M 75 mg/day (T n = 42; M n = 41). The effectiveness of therapy was assessed on D5, D15, D30 and D60 by the MADRS, HARS, CGI and CHESS scores; acceptability was assessed by the CHESS scale. To exclude placebo responders, the patients were treated with a placebo for 7 days prior to enrollment. A significant improvement in the MADRS score, compared with the previous score, remained until D60 for the T group and M group (p < 0.01). The improvement in the MADRS score was higher (p = 0.025) in the T group than in the M group. At D60, there was a statistically significant difference between T and M in favour of T (p = 0.04). Similar results were obtain with HARS and CGI (item 1). The incidence of side effect was significantly lower in the group treated with T than in the group treated with M. At any time point, there were more patients in the M group (p < 0.001) who complained of side effects than in the T group. The patients were divided into subgroups according to whether or not they were also receiving Hormone Replacement Therapy (HRT). The group taking HRT and T had a more significant reduction in HARS (p = 0.038) and CHESS (p = 0.015) than the group taking T only. T administrated as a single psychotropic agent showed an improvement in the symptoms of anxio-depression which were significantly more important than in the control group with better control of associated complaints.
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PMID:[Anxiety-related and depressive disorders in women during the premenopausal and menopausal period. Study of the efficacy and acceptability of tianeptine versus maprotiline]. 841 73

The efficacy and safety of tianeptine were compared, in the course of a multicentre randomised, double-blind, parallel group study, to those of placebo in the treatment of Major Depressions and Bipolar Disorder, Depressed with or without melancholia, without psychotic features. After a 1-week run-in placebo period, 126 depressed out-patients presenting DSM-III-R Major Depression or Bipolar Disorder, Depressed, with a total MADRS score of at least 25, were treated for 42 days with either tianeptine (25-50 mg/day) or placebo. Efficacy assessments were MADRS, CGI, HARS, Zung Depression Self Rating Scale and a VAS. Better efficacy of tianeptine was shown, and confirmed by covariance analyses, in final MADRS scores of the intention-to-treat population, of patients treated for at least 14 days and of completers; also in CGI items 1 and 2, MADRS item 10, and VAS. The results confirmed the efficacy of tianeptine (mean dosage: 37.5 mg/day) in the treatment of Major Depression and Bipolar Disorder, Depressed, with or without melancholia, compared to placebo. Tianeptine's acceptability did not differ from that of placebo. For adverse events, a higher incidence of headaches was found with tianeptine.
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PMID:Placebo-controlled study of tianeptine in major depressive episodes. 901 20

We studied 50 patients (40 females, 10 males) diagnosed of dysthymia according to 1CD-10 criteria (F34.1), retrospectively and prospectively. All were treated with Sertraline, with an initial dose of Sertraline 50-100 mg/day, allowing increases to a maximum of 200 mg/day during the follow up. The clinical and therapeutical evolution was measured by HDRS (Hamilton Depression Rating Scale) 21 items, HARS (Hamilton Anxiety Rating Scale), Clinical Global Impression (CGI), subjective patient impression, compliance, secondary effects, complementary treatments when needed, severity, evolution evaluated on days 15, 30, 60 and 90, from the patient and psychiatrist perspective. Seventy two percent of the sample completed the three months of treatment. We obtained a good clinical efficacy with sertraline observed by a statistical significant decrease (p < 0.01) in the scales in the second week of treatment, which continued in following weeks. The mean doses varted from 78 mg/day to 98.7 mg/day during the three months of follow up The tolerance to Sertraline in our sample was good and similar to other data in the literature. Fourteen patients withdrew, but only six (12%) were due to secondary effects In spite of the study's limitations due to the lack of a control group, we could affirm that sertraline was an effective treatment for dysthymic patients and it should be recommended as a first choice in the treatment of affective disorders, facilitating other psychotherapeutical approach due to its favourable tolerance profile.
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PMID:[Treatment of dysthymia with sertraline]. 913 55

Depression and distress have in common hypercortisolism, a high turn-over of cerebral monoamines and a wide clinical variability. Results of a clinical open trial with pivagabine (4-[(2,2-dimethyl-1-oxopropyl) amino]butanoic acid, CAS 69542-93-4, Tonerg) on 22 young patients affected by dysthymic disorders and on 38 older patients affected by adjustment disorders following different stressors (mourning, retirement and recovery in institutions of assistance) are reported. Oral treatment with 1800 mg pivagabine lasting 30 days showed in both groups a significant improvement of the psychic state with variations from 50 to 80% of the criteria reported in the Hamilton Rating Scale for Depression (HDRS) and for anxiety (HARS) and in the Self-rating Anxiety Scale (SAS). Good tolerance of the drug and the complete absence of serious side effects considerably contributed to the clinical success.
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PMID:Clinical evaluation of the efficacy of pivagabine in the treatment of mood and adjustment disorders. 945 Jan 58

Panic disorder (PD) has been hypothesized to be a heterogeneous entity, with distinct clinical subgroups. The presence of depersonalization during panic attacks may distinguish a specific subgroup of PD. We sought to analyze the differential features of a subgroup of PD patients with depersonalization. A total of 274 patients with PD were assessed and divided into 2 groups according to the presence or absence of depersonalization. The Structured Clinical Interview for DSM-III-R (SCID-UP-R) was used to assess PD and comorbid disorders. The clinical scales administered included the Hamilton Anxiety and Depression Rating Scale (HARS and HDRS), the Marks and Mathews Fears and Phobia Scale, Panic-Associated Symptom Scale (PASS), and a panic attack symptoms inventory. A total of 66 patients (24.1%) exhibited depersonalization during the attacks. Patients with depersonalization appeared to be younger and had an earlier age at onset. PD was more severe in the depersonalization group (greater number of attacks, worse level of functioning, and higher scores on most self-rating scales). Also, depersonalization patients showed more comorbidity with specific phobia. Our results support the view that PD with depersonalization may be considered a distinct and more severe subcategory of PD.
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PMID:Depersonalization in panic disorder: a clinical study. 1083 25

This paper reports on the results of a pilot study comparing the efficacy of an experimental case review program between psychiatrists and primary care physicians (PCPs) with PCPs' usual care on the outcome of depressive disorders at 1-year. The secondary aim of the paper is to identify correlates of remission of depressive disorders at the 1-year follow-up. The experimental case review program consisted of 12 biweekly meetings of primary care physicians with a psychiatrist. Meetings lasted two hours and were based on review of cases identified at the interview as suffering from full-blown or subthreshold conditions. Subjects were assessed at baseline, 3 months and 1 year. The baseline assessment included the Composite International Diagnostic Interview, the Hamilton Depression (HDRS) and Anxiety (HARS) Rating Scales, the Medical Outcomes Study SF-36 and some forms to collect life events, major difficulties, social support, and ongoing treatments. At 3 months patients received by mail the General Health Questionnaire (GHQ-12) and at one year the baseline clinical assessment was replicated. Assessments were conducted on eighty cases with major, minor or subsyndromal depression (SSD). The experimental case review program was similar in efficacy to usual care, with an average reduction of 5.5 points on the HAMD. Significant reduction in the severity of depression was associated with a limited number of baseline characteristics, such as being married and having minor depression as compared to major depression and SSD. On the contrary, chronic physical illness at baseline predicted a lower reduction of HAMD scores at one year. While major difficulties and life events during the one-year interval between the two assessments significantly predicted a poorer outcome, social support at home was related to a better outcome. This pilot study indicates that a case review intervention program is not efficacious in a mixed sample of patients with subsyndromal to major depression representative of the current practice of primary case physicians. Still, it might be worthwhile for "difficult" patients selected by the PCPs. In our sample, psychosocial factors seem to be important predictors of outcome. Future trials and large naturalistic studies are needed to address this key point.
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PMID:Case review vs. usual care in primary care patients with depression: a pilot study. 1186 40


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