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Biomedical subjects

M Versiani

Publications and source records attributed to M Versiani.

28 records · Page 2Linked to original sources

Pharmacotherapy of social phobia. A controlled study with moclobemide and phenelzine.

In a double-blind, parallel group trial, 78 subjects with social phobia received moclobemide (a new reversible inhibitor of monoamine oxidase A) phenelzine, or placebo. After eight weeks, both active drugs-phenelzine somewhat more than moclobemide--were clinically and statistically significantly more effective than placebo, as assessed by rating scales. There was some further improvement between weeks 8 and 16, particularly in the moclobemide group; at week 16, 82% of the moclobemide and 91% of the phenelzine-treated patients were almost asymptomatic. Moclobemide was, however, much better tolerated than phenelzine. Patients withdrawn from active drugs had relapsed by week 24, providing additional support for the efficacy of the active drugs.

Adult↗

Tolerability of moclobemide, a new reversible inhibitor of monoamine oxidase-A, compared with other antidepressants and placebo.

Moclobemide, a new selective and reversible inhibitor of monoamine oxidase A (RIMA), has been compared with various tricyclic antidepressants (TCAs) in numerous controlled studies. Pooled data from these studies, comprising 1656 patients, as well as the consideration of individual trials, show that moclobemide is far better tolerated than the TCAs. Its side effects mainly comprise mild degrees of nausea and dizziness at the beginning of treatment in a small proportion of patients. Age and sex do not affect the tolerability of moclobemide: it is equally well tolerated by elderly patients. In 2300 patients treated with moclobemide in doses up to 600 mg/day, without dietary restrictions, there was no tyramine-related hypertensive reaction. It is concluded that moclobemide may be the second-generation antidepressant doctors were waiting for--equally effective as the classical antidepressants but far better tolerated.

Adult↗

Moclobemide, imipramine and placebo in the treatment of major depression.

Moclobemide was compared with imipramine and placebo in the treatment of major depressive episodes in 75 outpatients. The dosage of moclobemide (25 patients) was 300 mg daily for the first 5 days, after which it could be increased to 600 mg. Imipramine (25 patients) was given in a dosage starting with 33 mg and gradually increased to 100 mg/day in the first 5 days, after which it could be further increased; 25 patients received placebo. Both drugs were equally effective as measured by the Hamilton Rating Scale for Depression, the overall assessment of efficacy and the Zung Self-rating Scale, and clearly superior to placebo; there were no significant differences between the 2 active drugs. Moclobemide was better tolerated than imipramine, and was almost comparable to placebo in this respect.

Ambulatory Care↗

A double-blind comparative trial of moclobemide v. imipramine and placebo in major depressive episodes.

Patients (n = 490) suffering from a major depressive episode according to DSM-III criteria were randomly allocated to groups receiving either moclobemide, imipramine, or placebo treatment. Subjects were treated as out-patients for 6 weeks. On overall assessment of efficacy and on results of the Hamilton Rating Scale for Depression, both moclobemide and imipramine were superior to placebo, but the differences between moclobemide and imipramine were not significant. Premature termination due to insufficient efficacy was more frequent with placebo than with moclobemide or with imipramine, these differences being significant. The overall assessment of tolerance clearly favoured placebo and moclobemide over imipramine. This was also reflected in the frequency of premature terminations due to poor tolerance, as well as in the frequency of adverse events, which were highest in the imipramine group. The only cardiovascular finding was an increase of the mean heart rate with imipramine, maximum at the end of week 1, while placebo and moclobemide displayed no relevant changes. There were no other important drug-related changes.

Adjustment Disorders↗

Moclobemide, imipramine, and placebo in the treatment of major depression (DSM III).

Seventy five patients, diagnosed according to the Structured Clinical Interview for DMS III ("unipolar", Major depression, single or recurrent, with or without melancholia) were treated, in a double-blind fashion, with either moclobemide, imipramine or placebo, during six weeks. The three treatment groups were homogeneous as far as demographic and clinical characteristics were concerned. Patients were in their forties, predominantly females and with long lasting (more than six months) episodes of moderate or severe depressions. From day seven onwards most patients took moclobemide 600 mg/d, imipramine 200 mg/d or 6 caps/d of placebo; only two cases took lower dosages due to intolerance. There were eleven drop-outs, evenly scattered among the three groups. Outcome assessed by means of the Hamilton Scale for Depression and Global Efficacy Evaluations showed a very significant superiority of the two active drugs over placebo. The efficacy of the two drugs was comparable. Side effects were significantly more frequent and more severe in the imipramine group. The tolerability of moclobemide was similar to placebo. These findings are discussed in relation to methodological issues. They point to the conclusion, that moclobemide may be the true "second generation antidepressant", comparably efficacious to the traditional compounds, producing far less side-effects, and because it is reversible, not requiring dietary or drug restrictions in clinical practice.

Adult↗

Tranylcypromine in social phobia.

Thirty-two patients meeting DSM-III criteria for social phobia entered a 1-year drug treatment with tranylcypromine in dosages between 40 and 60 mg/day. After exclusion of the early dropouts, improvement was rated as marked and moderate in 62% and 17% of the sample (N = 29), respectively. Alcohol abuse was associated with a poor outcome. Side effects were frequent and in some cases delayed the attainment of efficacious dosages until the third month of treatment. No serious adverse reactions occurred. The findings, relative to efficacy, are in accordance with a previous trial with phenelzine but need confirmation in double blind controlled studies.

Adolescent↗

Loxapine versus thioridazine in the treatment of organic psychosis.

Two double-blind trials comparing loxapine and thioridazine were conducted in hospitalized adult males diagnosed as having symptoms of chronic psychosis associated with organic brain syndrome or mental retardation. The drugs were administered orally in the ranges of loxapine 10--150 mg/day and thioridazine 150--750 mg/day for 13 weeks. In the first trial loxapine was found to be generally superior to thioridazine on the Brief Psychiatric Rating Scale, Nurses Observation Scale for In-Patient Evaluation and Clinical Global Impression. The second trial failed to confirm this superiority. The heterogeneity of diagnostic categories included may explain the discrepancy. Extra-pyramidal symptoms and sedative effects were common to both groups and consistent with the pharmacologic profiles of the study drugs.

Adolescent↗