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A multicentre, double-blind, randomized, prospective study comparing efficacy and safety of moclobemide and dothiepin in major depression

in a general practice setting

Hill, S.A. et al

Abstract not received.

Response to phenelzine and imipramine in placebo nonresponders with atypical depression

Quitkin, F.M., Stewart, J.W. and McGrath, P.J.

A b s t r a c t no t r ece ived .

7:q

Drug long term treatment of affective disorders - outcome of a prospective longitudinal study

Neumann, N.-U. and Schfittler, R. Department of Psychiatry, University of Uhn, Uhn, Germany

52 lust admitted patients with affective disorders {n = 22 endogenous depression [ICD.-Nr. 296.1,296.3] non-endogenous depression [ICD.Nr. 300.4] } were studied over a five years period. At the time of hospitalisation, one year after discharge and five years after discharge various aspects of the course of the disease were recorded: among them type and duration of medication, rate of readmittanee, compliance, psychopathological status (Present State Examination; PSE) and the patients general attitude to drug treatment. Information concerning the above mentioned items and the actual state were available from 48 patients after one year and from 46 patients after five years. During the course of the disease diagnosis changed in 6 cases from non-endogenous depression to endogenous depression.

The results of the study showed that the majority of the patients was compliant, had outpatient care and long term treatment (mostly antidepressants; AID). After one year, 31 patients had drug treatment (70% tricyclie A.D) and after five yeats 28 patients (60% trieyelie AID) only three patients had lithium-prophylaxis. The mean dosis of AD was 50 mg/die.

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Inspite of this a high rate of readmittance (40%) and a relatively poor psychopathological status (50% of the patients had TOT above 12, both one and five years after discharge) could not be avoided. How to improve long term medication in outpatients with affective disorders is discussed.

Rapid tolerance to the performance impairing properties of antidepressant drugs: a review of four psychometric studies

O'Hanlon, J.F. btstitute for Drugs, Safety and Behavior, University of Limburg, Maastricht, The Netherlands

Several attempts have been made to categorize antidepressants' effects on human psychomotor performance. The resulting rank-ordering of these drugs on the basis of performance-impairing properties has been offered as a guide for physicians' prescribing practices. However, data entering these analyses have been mainly drawn from acute studies employing healthy volunteer subjects. Research conducted by the author's group has generally confirmed the rank-order of antidepressants with respect to their respective effects after a single day of treatment with therapeutic doses. But is has also shown that acute effects differ markedly from those which can be measured after a week of continual medication.

Four separate double-blind, cross-over studies were conducted with 15-17 healthy volunteers each. The purpose was in every case the same; to compare the effects of a newly developed antidepressant, placebo and an older drug (i.e. amitriptyline, doxepin (2x) and mianserin) thought to possess strong sedative properties. The groups' performance was assessed during a conventional psychomotor test battery and a standard, actual driving test on the 1st and 8th day of continual medication and they kept a log of side-effects over the intervening days. The results with respect to the older drugs' effects were remarkably similar across studies: highly significant performance impairments were measured in virtually every test on the 1st treatment day but performance generally recovered to placebo levels by the 8th day. Reported side-effects also diminished systematically over days. The conclusion is that acute antidepressant drug effects on performance do not generally predict what happens after a week of medication.

Significance of cerebrospinal fluid analyses in the diagnosis of dementia disorders

Blennow, K., Wallin, A. and Gottfries, C.G. Department of Psychiatry and Neurochemistry, University of G~teborg, St. J~rgen Hospital, S-442 03 Hisings Backa,

Gothenburg, Sweden

This study focuses on potential biochemical markers in cerebrospinal fluid (CSF). First, CSF examination plays a vital role in the diagnosis of many 'secondary dementias', e.g. brain tumours and cerebral infections. Second, CSF is the optimal medium for examining potential biochemical markers of dementia disorders. Such markers should preferably reflect the underlying pathological processes. However, since no CSF-biochemical markers exist for senile plaques and neurofibrillary tangles, we have focused our research on biochemical markers in CSF for degeneration of brain components.

We present data suggesting that: (1) Gangliosides, sialic-acid-eontaining glycosphingolipids located in neuronal membranes and nerve endings (synaptosomes), have a potential as a biochemical marker for degeneration of neurons and synapses, and elevated levels of ganglioside GM1 in CSF are found in patients with Alzheimer's disease;