西酞普兰和阿米替林治疗老年抑郁症的双盲对照研究

目的　探讨西酞普兰治疗老年抑郁症的疗效及安全性。方法　采用西酞普兰和阿米替林对 5 1例老年抑郁症患者进行为期 6周的双盲对照研究 ,用HAMD评定疗效 ,用TESS评定副反应。结果　西酞普兰和阿米替林疗效相近 ,但西酞普兰起效较快 ,平均 (9.2± 2 .3)天。TESS评分低于阿米替林 (P <0 .0 1)。结论　西酞普兰对老年抑郁症患者可作为首选药物     

帕罗西汀与阿米替林治疗抑郁症的对照研究

６０例ＨＡＭＤ≥１８、符合ＤＳＭ－Ⅲ－Ｒ抑郁症诊断标准的患者，经６周随机、双盲、对照研究，ＨＡＭＤ、ＨＡＭＡ，ＣＧＩ、ＴＥＳＳ量表和临床疗效评定显示，帕罗西汀抗抑郁疗效肯定，显效率８３．３３％，与阿米替林７３．３４％相近，两者无显著差异。帕罗西汀治疗２周内见效，不良反应发生率和严重程度比阿米替林明显较少而轻，本研究证实，帕罗西汀是有效的抗抑郁剂，不良反应轻微。     

舍曲林与阿米替林治疗抑郁障碍对照研究

对四单位１３６例住院抑郁障碍病人进行了舍曲林与阿米替林随机双盲对照研究，用ＨＡＭＤ，ＣＧＩ和ＴＥＳＳ评定疗效和副作用，结果显示：舍曲林疗效与阿米替林相当，而有耐受性好、副作用小的特点。     

Clinical comparison between alprazolam and lorazepam. A polycentric study in double blind

The clinical efficacy and safety of alprazolam was compared to lorazepam in a double blind randomized design involving 82 out-patients suffering from primary anxiety. Seventy four patients (37 on alprazolam and 37 on lorazepam) were evaluable. They were treated with a flexible dose of 0,75 mg to 3 mg of alprazolam per day (average final dose: 1,59 mg) or 3 mg to 12 mg of lorazepam per day (average final dose: 5,97 mg). The results show that the two drugs produce similar efficacious effects at weeks 2 and 4 of the treatment as evaluated using both patient and physician scales. At week 1, as could be expected from an average daily dose of 0,99 mg of alprazolam and of 4,14 mg of lorazepam, efficacy parameters favored lorazepam. Fifty seven side effects were reported in the 37 lorazepam patients while 61 side effects were reported in the 37 alprazolam patients.     

A double-blind comparison of nomifensine and amitriptyline in the treatment of depression

A double-blind study was carried out to compare the efficacy and tolerability of nomifensine and amitriptyline in 17 Malaysian patients with moderate to severe depression. The two drugs did not differ with regard to antidepressant effect but nomifensine-treated subjects report fewer side-effects with no complaints of palpitations. Nomifensine also increases capacity for work and activity.     

A double blind trial of moclobemide versus amitriptyline in the treatment of depressive disorders

The antidepressant efficacy and side-effect profile of amitriptyline were compared to those of moclobemide, a reversible monoamine oxidase inhibitor with selectivity for the type A isozyme. Forty nine patients with DSM-III major depression were randomly assigned to receive either amitriptyline or moclobemide. Thirty seven patients (amitriptyline n = 16, moclobemide n = 21) completed the six week protocol, which was conducted under double blind conditions. The results indicated a comparable antidepressant time course and efficacy for the two treatments. Amitriptyline produced significantly more sedation and antimuscarinic side-effects. Moclobemide appears to be a well tolerated antidepressant without the liability to produce significant postural hypotension and without the need for a tyramine-poor diet.     

Nomifensine and amitriptyline in the treatment of depression. A multi-centre double-blind comparison

Nomifensine, an antidepressive agent acting like a dopamine agonist, was investigated in a randomized double-blind comparison with amitriptyline in 29 patients fulfilling the RDC criteria for major depression. The dosage was 150 mg daily in both treatment groups. Assessments were made at weekly intervals for 6 weeks with the Comprehensive Psychopathological Rating Scale. No significant difference could be demonstrated between the two drugs in overall therapeutic efficiency, and only one item, Fatiguability, differed significantly in favour of amitriptyline. Physical and laboratory variables showed no statistically significant differences. Neither drug elicited serious unwanted effects.     

A double blind comparison of viloxazine and amitryptyline in involutional and endogenous depression

Thirty-two hospitalized patients with either endogenous (n = 15) or involutional (n = 17) depression were entered into a double blind study to compare the effectiveness and acceptability of viloxazine with amitriptyline. The severity of the depression was assessed before starting treatment and at day 7, 14 and 28 using the Hamilton Rating Scale. Spontaneously reported side effects were recorded. Patients received viloxazine 50 mg three times a day during the first week followed by 100 mg three times a day during the next three weeks or amitriptyline 25 mg three times a day during the first week followed by 50 mg three times a day during the following three weeks. Viloxazine and amitriptyline were equally effective in endogenous depression, but viloxazine was significantly more effective than amitriptyline in patients with involutional depression. Nausea and vomiting were the main side effect of viloxazine during early treatment necessitating the withdrawal of two patients. Anticholinergic side effects were reported during amitryptyline treatment, but were absent in patients on viloxazine. It is concluded that viloxazine is an effective antidepressant and particularly useful in the treatment of involutional depression.     

Psychotic vs. nonpsychotic depression: comparison of treatment response

This retrospective study compared the treatment responses of 34 primary, unipolar depressives without psychotic features and 30 with psychotic features. Patients were diagnosed by Research Diagnostic Criteria and received trials of tricyclic antidepressants, antipsychotics, the combination of the two, electroconvulsive therapy, or placebo and psychotherapy. Only three of 18 psychotic patients vs. 17 of 23 nonpsychotic patients responded to antidepressants alone. Electroconvulsive therapy and the combination of antipsychotic and antidepressant medication gave better responses. These data suggest that major depressive disorder with psychotic features is best considered as a distinct subtype rather than a severe variant of major depression.     

A double blind comparison of lofepramine,imipramine and placebo in patients with primary depression

The results of a double blind trial in which 139 patients with primary depression were randomly assigned to either lofepramine (46), imipramine (48), or placebo (45) are discussed. After treatment with either active drug, lofepramine or imipramine, the clinical outcome was significantly greater than with placebo. No significant differences were found in clinical responses between lofepramine and imipramine. With regard to reported side effects, however, a statistically significant lower number of severe and/or moderate side effects were reported for the lofepramine group than for the imipramine group. In particular, for severe and/or moderate occurrences of dry mouth, the statistically significant lower incidence in favor of lofepramine is by almost a factor of 3 (8 lofepramine vs 21 imipramine patients).     

氟西汀与阿米替林治疗老年抑郁症的疗效比较

目的：探讨氟西汀对老年抑郁症的临床疗效及副反应。方法：对80例老年抑郁症病人的随机分为氟西汀组（40例）和阿米替林组（40例）进行治疗研究，采用HAMD，TESS量表分别评定疗效及副反应。结果：氟西汀与阿米替林对老年抑郁症的疗效相似，氟西汀副反应较阿米替林少而轻微，结论：氟西汀较适合于老年抑郁症的治疗，患者有较好的依从性。     

Paroxetine in the treatment of depression - a randomized comparison with amitriptyline

ABSTRACT– Paroxetine is a new antidepressant drug with potent serotonin (5HT) uptake inhibitory properties. In this double-blind comparative study, the antidepressant effect of paroxetine and amitriptyline has been compared in 44 patients with depressive illnesses of an endogenous nature. Each drug was given for 6 weeks. The 17-item Hamilton Depression Scale was used to measure the antidepressant effect. Reported events were assessed applying a 22-item check list. Non-parametric statistical analyses were applied in the evaluation of treatment outcome for the 30 patients who completed the study. The results showed no significant differences in overall antidepressant efficacy between paroxetine and amitriptyline and that paroxetine displayed significantly fewer instances of dry mouth and orthostatic dizziness than amitriptyline. No obvious relationship was demonstrated between the plasma levels of the drugs and their clinical effects.     

吗氯贝胺与阿米替林治疗抑郁症的疗效比较

目的　探讨吗氯贝胺治疗抑郁症的疗效和副作用。方法　 4 8例抑郁症病人随机分为吗氯贝胺组 (2 4例 )和阿米替林组 (2 4例 ) ,共治疗 6周 ,采用HAMD和HAMA于治疗前及治疗 1、2、4、6周后进行评定 ,于治疗 6周后进行临床疗效评定及副作用评定 (TESS)。结果　吗氯贝胺组与阿米替林组治疗前后HAMD和HAMA评分均有极显著性差异 (P <0 0 1) ,吗氯贝胺组治疗 1周后呈现显著差异 (P <0 0 5 ) ,2周后呈现极显著性差异 (P <0 0 1) ,两组间同访次相比无差异性 (P >0 0 5 )。吗氯贝胺组副作用比阿米替林组明显为轻。结论　吗氯贝胺治疗抑郁症见效快 ,疗效可靠 ,副反应轻 ,依从性好 ,是治疗抑郁症的理想药物     

Amantadine hydrochloride treatment in heredodegenerative ataxias: a double blind study.

OBJECTIVE: A group of 27 patients with Friedreich's ataxia and another group of 30 patients with olivopontocerebellar atrophies were each randomly divided into two subgroups, one receiving placebo and the other amantadine hydrochloride (AH; 200 mg daily) for three to four months. METHODS: The effect of double blind treatment was evaluated by simple visual and auditory reaction time (RT) and movement time (MT) for both right and left hands. RESULTS: The subgroup with olivopontocerebellar atrophies receiving AH showed significant improvement on seven out of eight variables studied by analysis of covariance. In patients with Friedreich's ataxia, improvement was definitely less. Treatment remained contraindicated for those with cardiomyopathies or drug intolerance. CONCLUSION: The rationale of AH use in heredodegenerative ataxias can be explained by its replacement effect (dopamine release) and by direct involvement of N-methyl-D-aspartate (NMDA) in glutamate mediated neurotoxicity in cerebellar granular cells; memantine, an AH analogue, is a potent blocker of NMDA receptors.     

Sertraline as monotherapy in the treatment of psychotic and nonpsychotic depression

BACKGROUND: Previous studies suggest that selective serotonin reuptake inhibitors (SSRIs) are effective when used alone in the treatment of unipolar depression with psychotic features. The purpose of the present study was to examine the response to sertraline for patients with and without psychotic features using standard criteria such as recovery and remission. METHOD: An 8-week open-label trial of sertraline in depressed inpatients was conducted. Twenty-five subjects had DSM-IV major depressive disorder with psychotic features, and 25 had DSM-IV major depressive disorder without psychotic features. After a 1-week open washout, all subjects were rated using the Hamilton Rating Scale for Depression (HAM-D) and Brief Psychiatric Rating Scale (BPRS) at baseline. The HAM-D was administered weekly, and the BPRS was administered again only at the end of the 8-week trial. Medication dosage was started at 50 mg/day, increased to 100 mg/day after 1 week, and then increased up to 200 mg/day if subjects had not remitted. RESULTS: Depressed patients without psychosis responded significantly better than did depressed patients with psychosis using the criteria of remission (HAM-D score - 7; p =.001), response (HAM-D score - 50% of baseline score; p =.011), referral for electroconvulsive therapy (HAM-D score >/= 15; p =.011), or change in HAM-D scores (p =.016). Baseline HAM-D score and psychosis independently predicted response, whereas baseline BPRS scores did not, regardless of whether psychotic status was entered into the analyses. CONCLUSION: Psychotic depression responds more poorly than depression without psychosis to sertraline alone. Psychosis was a predictor of response independent of degree of depression and general psychopathology. Limitations due to an open-label design are discussed, as are differences between this study and others using SSRIs for psychotic depression.     

Psychotic and nonpsychotic depression: comparison of response to ECT

The charts of 46 patients who underwent ECT in a teaching hospital between 1980 and 1986 were reviewed. All patients were suffering from major depression, with or without psychotic features, and were resistant to pharmacotherapy. Response to ECT was compared between those with psychotic features (N = 27) and those without psychotic features (N = 19). Both groups had equal and effective response to ECT. Therefore, the presence of psychotic features was not significant in predicting response to ECT.