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

[Pharmacological treatment resistant schizophrenia].

In the clinical practice, there are three different terms to designate schizophrenic patients who do not improve with antipsychotic medication: treatment-resistant, treatment-refractory and non-respondent patients. Treatment resistance is neither a synonym of chronicity nor of severity nor seriousness. Therefore, for a patient to be considered resistant, several points must be taken into account. These points are: a) whether the schizophrenia is primary or secondary; b) its nature; c) presence of previous substance abuse; d) treatment compliance and tolerance, and presence of minor neurological signs. The most widely accepted criteria to define pharmacological treatment resistance in schizophrenia were initially developed around 1988 by Kane. Nowadays, the BPRS and Independent Living Skills Survey (ILSS) are the scales used to assess the levels of lack or response or of treatment resistance. To attain a suitable therapeutic evolution in schizophrenics resistant to treatment in antipsychotic medication assays, the following guidelines must be considered: Identifying the symptoms clearly and using medication with a suitable dose and duration. Taking into account that treatment resistance can be mistaken for treatment intolerance, non-compliance to treatment, inappropriate social support or inappropriate psychosocial treatment. Using up all single therapeutic agents before applying multiple agents. Preventing extrapyramidal effects by means of an adequate choice of the primary treatment. Maintaining a positive therapeutic attitude.

Antipsychotic Agents↗

PubMedDate not supplied

[The nosological entity bulimia nerviosa].

Anorexia nervosa and bulimia nervosa are at the present moment, two well defined clinical entities among the group of the eating disorders. The psychopathological differentiation of both syndromes has a great importance for diagnosis and therapy. The authors make a phenomenological description, based on case histories of patients with diagnostics of anorexia and bulimia nervosa, and try to establish an approach to the essential symptomatology of those disorders. The presence of affective symptomatology--depressive, but not exclusively--in the eating behaviour disorders in general and particularly in bulimia nervosa, is nowadays interpreted as an unspecific emotional lability as a response to stressing situations. That is to say, it is a secondary depressive symptomatology, more than a primary mood disorder preceding or underlying bulimia. There is strong evidence in favour of a dysregulation of serotonin metabolism in patients with bulimia nervosa, in the sense of a reduced activity, which manifest itself clinically by binges with food with a high content in carbohydrates. High levels of 5-HT seem to induce increasing feelings of safety, fullness and lead to an interruption of eating. Fluoxetine and this active metabolite are selective inhibitors of the reuptake of 5-HT and their antibulimic effect could be mediated by this mechanism.

Adolescent↗

PubMedDate not supplied

[Therapeutic indications of monoamine oxidase inhibitors].

Explore the source record for details and available documents.

Depressive Disorder↗

PubMedDate not supplied

[The psychopathological aspects related to breast cancer].

During the last 30 years, many articles have been published in scientific journals dealing with psychological aspects of breast cancer and its treatment. This work, through a bibliographic revision, tries to come across the psychopathologic and psychosocial data concerning breast disease. It exposes its influence on body image, symptom appearance (essentially psychopathology, marital and social adjustment) and sets up some adjustment predictors that can improve support for breast cancer patients.

Adaptation, Psychological↗

PubMedDate not supplied

[Study of the evolution of some monocytic parameters and neuroendocrine function tests in depressed patients].

BACKGROUND: The development, evaluation and use of biological markers is extremely important in Psychiatry. However, with certain exceptions, truly sensitive and specific markers have not still emerged. Several studies have reported immune cellular and humoral dysfunction during depression. We specifically focused on the study of the monocyte because it has a key role in the activation of the immune response. We also investigated the relationship between the immune apparatus and the hypothalamic-pituitary activity in depressed patients. METHODS: We used a longitudinal design and assessed monocyte parameters (HLA-DR, CD 35, vimentin filaments and phagocytosis index) and neuroendocrine tests (DST and TRH-test) at intake (pretreatment phase: phase I) and at follow-up (post-treatment phase: phase II) in 49 depressed patients according to Research Diagnostic Criteria (RDC). The mean follow-up interval was 12.2 +/- 2 weeks. The severity of illness was measured by means of the Hamilton Depression Rating Scale (HDRS). RESULTS: Seventy per cent of patients showed a pretreatment marked monocyte dysfunction (82.5% had at least one parameter altered). After treatment, alterations in immunological variables were significantly associated (p < 0.05) with depression scores higher than 15). We did not find any significant association between the severity of depressive symptoms and the results of the neuroendocrine tests. The combined use of both immunological and neuroendocrine tests did not add sensitivity to the immunological identification of depressed patients. Before and after treatment the immunoreactive vimentin filaments significantly increased (p < 0.01) after incubation of monocyte with naloxone. There was a significant correlation (p < 0.05) between the immune parameters studied in both phases of the study. CONCLUSIONS: The findings indicate that the monocyte dysfunction is temporally associated with the state of depression and lead us to consider the role of the monocyte parameters as sensitive depressive state markers, while the combined use of both neuroendocrine and immunological tests in current clinical practice would be debatable. On the other hand, as the cytoskeletal dysfunction was reversed with naloxone, our findings underline previous reports suggesting that an increased opioid activity could mediate monocyte dysfunction.

Adult↗