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Biomedical subjects

E Baca Baldomero

Publications and source records attributed to E Baca Baldomero.

15 recordsLinked to original sources
PubMed2005

Venlafaxine extended release versus conventional antidepressants in the remission of depressive disorders after previous antidepressant failure: ARGOS study.

Serotonin-norepinephrine reuptake inhibitors (SNRIs) may be used as an alternative treatment for depressed patients who do not tolerate or respond adequately to treatment with a conventional antidepressant. This randomized, open-label, multicenter study compared the effectiveness of the SNRI venlafaxine extended release (VXR) with that of conventional antidepressants (CA) in patients who were referred to an outpatient psychiatric specialty care setting for treatment after failure to tolerate or respond to at least 4 weeks of treatment with a CA in a primary care setting. Patients with a Hamilton Depression Rating Scale (HAM-D17) score > or =17 were randomly assigned to treatment with an alternative CA or VXR. Remission was defined as a score < or =7 on the HAM-D17. Efficacy analyses were carried out on 3,097 patients from the intent-to-treat (ITT) population (1,632 VXR; 1,465 CA). The antidepressants prescribed most frequently in the CA group were paroxetine (21.3%), citalopram (20.1%), sertraline (19.1%), fluoxetine (17.0%), and mirtazapine (7.9%). After 24 weeks of treatment, the VXR group demonstrated a significantly higher remission rate than did the CA group (59.3% VXR; 51.5% CA; P<.0001; odds ratio: 1.37; 95% CI: 1.19-1.58; P<.01). Despite the limitations of the open design, the results of this study suggest that venlafaxine extended release may be more effective than the conventional antidepressants used in this study when treating depressed patients who do not tolerate or respond adequately to treatment with a conventional antidepressant.

Adolescent↗
PubMed1999

[Prevalence of psychiatric disorders in primary care using the PRIME-MD questionnaire].

OBJECTIVE: To quantify the frequency of psychiatric disorders detected by primary care doctors, using the PRIME-MD questionnaire, and by psychiatrists using a structured clinical interview. DESIGN: An observational, descriptive, crossover study, using a questionnaire. One of each two patients was selected until reaching the total number of patients. SETTING: The study was conducted in five primary care centres in Madrid. PATIENTS: To be included in the study, patients had to consent verbally, be able to understand the questions asked and have been previously diagnosed as psychotic or demented. 395 patients were recruited, of which 312 completed the study. INTERVENTIONS: The primary care doctor administered the PRIME-MD questionnaire to each patient, and then a psychiatrist conducted the SCAN interview. RESULTS: The time spent by the doctor on the PRIME-MD questionnaire was usually 10 minutes. The doctor had previously detected psychiatric pathology in 18.5% of his/her patients; with the PRIME-MD questionnaire he/she detected it in 53.5%. The psychiatrist with the SCAN detected psychiatric pathology in 41.3% of patients. CONCLUSIONS: The high frequency of psychiatric disorders in primary care patients and primary care doctors' lack of ability in detecting these disorders was confirmed by this study. The PRIME-MD questionnaire, an instrument for rapid detection of the most commonly found psychiatric disorders within primary care, may considerably improve this situation.

Cross-Sectional Studies↗
PubMedDate not supplied

[Assessment of needs in schizophrenia patients].

BACKGROUND: To optimise appropriate planning of services, the care needs in patients with chronic mental illness, the organisms or individuals that cover these needs, and the relationships between specific needs and sociodemographic variables should be identified. This study was designed to assess needs in a population of persons with mental illness. METHODS: The Camberwell Assessment of Need (CAN) questionnaire was used to obtain and report quantitative information on needs. A total of 246 patients diagnosed as having schizophrenic disorder and 246 staff members of public mental health services, all living and working in the province of Granada (southern Spain, n = 187) or the city of Madrid (central Spain, n = 56), completed the questionnaire. Regression analysis was used to identify correlations between needs and sociodemographic variables. RESULTS: Mean needs score was 6.5; the most frequent needs were those related with daytime activities, company, psychotic symptoms, psychological distress, basic education and money management. The sociodemographic variables most closely associated with these needs were: not living with a life partner, low educational level, and receiving state benefits. The type of help these patients received was mainly from the family (informal help); public services (formal help) covered mainly clinical needs. CONCLUSIONS: The needs of persons with schizophrenic disorder do not differ from those of members of the more marginalised groups in Spanish society. Care provided by family members often represents a considerable burden on relatives.

Adult↗
PubMedDate not supplied

[Quality of life, in depressed patients in Primary Health Care setting. Effectiveness and safety of venlafaxine extended release].

INTRODUCTION: The aim of this observational study was to evaluate effectiveness, tolerability and impact on quality of life of treatment with venlafaxine extended release at a dose of 75 to 150 mg/day, in depressed outpatients treated in Primary Health Care. METHODS: Observational, prospective, open-labeled study, carried out by 882 Primary Health Care physicians. Outpatients, between 18 and 70 years of age with depressive symptomatology susceptible of treatment, with a Hamilton Depression Scale (HAM-D17) score 14 were included. Daily doses of 75 or 150 mg of venlafaxine extended release were administered orally for 24 weeks. Antidepressant effectiveness was assessed using the HAM-D17 scale and quality of life with the Quality of Life in Depression Scale (QLDS), Spanish version. RESULTS: 4,747 patients were recruited, of which 4,320 were included in a intention to treat effectiveness analysis and 4,557 patients in a safety analysis. HAM-D17 and QLDS mean score significantly decreased from week 4 to the end of study. 86,2% of the patients were responders and 73.8% achieved remission of the symptoms. Likewise, 95% reported absence or mild somatic and psychic anxiety on the final visit. Tolerability was considered good or excellent for 98.7% subjects. 191 patients (4.2%) reported adverse events. CONCLUSIONS: Venlafaxine extended release is a safe and effective drug that reduces depressive symptoms of Primary Health Care patients and improves their quality of life.

Adolescent↗
PubMedDate not supplied

[Response and remission in depressive patients with anxiety symptoms treated with venlafaxine extended release in primary care].

INTRODUCTION: The aim of this observational study was to evaluate the long term effect of treatment with venlafaxine extended release on response and remission in patients with depressive syndrome and associated anxiety symptoms, in primary health care. METHODS: Observational, naturalistic and prospective, open-label study. Inclusion criteria were as follows: age over 18 years, diagnosis of depressive syndrome with anxiety symptoms and minimum scores of 17 and 10 on Hamilton Depression Rating (HAM-D17) and Anxiety Rating (HAM-A) scales, respectively. Daily doses of 75-150 mg of venlafaxine extended release were administered for 24 weeks. Effectiveness on the depressive-anxious symptoms was assessed using the HAM-D17 and HAM-A scales. Response and remission criteria were considered. RESULTS: 6,719 patients were evaluable for effectiveness and safety - intention to treat population. Venlafaxine extended release treatment was associated with significant decreases in the scores in the HAM-D17 and HAM-A scales, as well as with significant increases in response and remission rates. At week 24, remission rates were: 74.62% (HAM-D17<or=7), 81.55% (HAM-A<or=7) and 72.63% (HAM-D17 <or=7/HAM-A<or=7). 81.8 % of patients completed 24 weeks of treatment. 6.4% of patients reported adverse events, of mild-moderate intensity in 94.9% of cases. CONCLUSION: In this study, venlafaxine extended release shows that it is an effective and safe drug in the treatment of the depressive-anxious symptoms of patients with depressive syndrome treated in primary care, both in remission and response rates. It would be of interest to compare data of venlafaxine extended release with that of other antidepressive drugs, such as SSRI.

Adolescent↗
PubMedDate not supplied

[Cost-effectiveness of venlafaxine for the treatment of depression and anxiety. Bibliographic review].

OBJECTIVE: To compare the efficiency of the treatment of major depressive disorder (MDD) and generalized anxiety disorder (GAD) with venlafaxine in comparison with tricyclic antidepressants (TCA) and selective serotonin reuptake inhibitors (SSRI). METHODS: A bibliographic systematic review of the published pharmacoeconomic studies in which one of the treatments was venlafaxine (immediate or extended-release) was conducted for MDD or GAD indications. RESULTS: Nine studies for immediate-release venlafaxine and seven with extended-release in MDD were published, two with Spanish data. In the more extended Spanish model (1 year treatment), in depressive disorder, 106, 97 and 99 depression symptom free days (SFD) were achieved by venlafaxine, TCA and SSRI respectively, with annual costs of 6,791, 7,116 and 7,029 euros. Similar results were obtained in the second Spanish 6 month study. Regarding GAD, after the treatment of elderly patients during 8 weeks, 17 and 5 SFD were obtained with venlafaxine and placebo, with a cost per SFD of 22.94 and 65.40 euros, respectively. CONCLUSIONS: According to the available studies, venlafaxine generates lower total costs (due to the reduction of treatment failure costs) than SSRI and TCA for the treatment of MDD. Venlafaxine is cost-effective in comparison with no treatment for GAD.

Anxiety Disorders↗
PubMedDate not supplied

[Diagnostic process and management of schizophrenia in Spain: the ACEE project].

INTRODUCTION: Although schizophrenia has a great impact on the health care, social and family levels, there is little epidemiological information on patients with schizophrenia, its diagnosis and treatment in Spain. The ACEE (Abordaje Clínico de la Esquizofrenia en España; Clinical Approach to Schizophrenia in Spain) study was designed with the primary objective of defining the management of schizophrenia in Spain from the perspective of current clinical practice. METHOD: ACEE is a descriptive cross-sectional multicenter observational study with data collected in the setting of current clinical practice by means of a specifically designed questionnaire. RESULTS: A total of 1,937 patients have been studied (83% pertaining to the public sector and 17% to private one). Most subjects had paranoid schizophrenia in the stabilization phase, and did not work because of their illness. Most (96%) were receiving antipsychotic treatment and 55% also received some non-drug treatment. Negative symptoms were more frequent than positive symptoms (88% versus 63%). Significant differences were observed for type of patients and diagnostic procedures involved between the public and private health care sectors. CONCLUSIONS: The ACEE study shows that schizophrenic patients attending Spanish psychiatric centers are mainly single, non-working males who are living in their family setting. Treatment basically consists of antipsychotics combined with other drugs, and few complementary examinations are performed.

Combined Modality Therapy↗
PubMedDate not supplied

[Limitations of the diagnosis of bipolar disorder].

INTRODUCTION: It has been studied the possible confusion in the diagnosis of bipolar disorder when there are no clear mania symptoms and other psychiatric disorders, due to his clinic similarity. The diagnosis received from a group of patients admitted in a Psychiatric Unit of a General Hospital by manic episode were studied. METHODS AND MATERIAL: 84 admitted patients have been followed up along an average of 32 months. By means logistic regression, there were found the factors that explained the change in the diagnosis along the evolution. RESULTS: 87% of the patients after the follow up kept the diagnosis of bipolar disorder. However, 63.1% had received other diagnosis. Two factors predicted to receive other diagnosis: depressive clinic and not having stable couple. CONCLUSION: Bipolar disorder presents a proper stability once diagnosis have been made. It may be confused with psychotic sight, unipolar depression and B cluster personality disorders. It is checked that patients which start with manic psychosis phases are the ones that present biggest diagnosis stability.

Adult↗