PubMed · 6569711
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J F Peutillot, A Peutillot. 1984. [Moxadil].. https://pubmed.ncbi.nlm.nih.gov/6569711/
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Analysis of National Health Service prescription data for the antidepressants from 1980 to 1989 shows a consistent secular trend towards the increased use of generic names on prescriptions for this group of drugs. This apparently reflects national trends for all drugs, and was similar for most antidepressants. However, generic prescribing had by 1989 increased significantly more rapidly with fluvoxamine, which was introduced in 1987. The two drugs introduced in 1989, fluoxetine and amoxapine, also had a high generic prescribing rate in their year of introduction. Increased generic prescribing may become a feature with further new drugs. However, the use of the generic name on the prescription has relatively little influence on what is dispensed to the patient. Pharmacists may dispense a brand name when given a generic prescription. Moreover, pressures on doctors to write generic names on prescriptions may have limited relevance for some drugs; generic alternatives were available for only four out of 22 antidepressants.
The piperazine N-alkylcarboxylic acids of 2-chlorodibenz[b,f][1,4] oxazepine (3a), 2-chlorodibenzo[b,f] [1,4] thiazepine (3b), and dipenz[b,e] azepine (3c) from the corresponding piperazines (1a-c, R1 = H) were synthesized via the piperazine N-alkylcarboxylates (2a-c). The pharmacological activities of the piperazine N-alkylcarboxylic acids (3a-c) were evaluated. Compared with the parent compounds (1a-c), 3a-c (n = 1-5) showed weak inhibitory activities on the uptake of noradrenaline and 5-hydroxytryptamine (5-HT) into hypothalamus vesicles and moderate antagonistic actions to 5-HT2 and H1 in several tissues.
The subtypes of major depression are reviewed, and a decision tree for the acute somatic treatment of major depression, including delusional and nondelusional depression, is presented. Considerations in clinicians' decisions about initiation and selection of acute somatic treatment for patients with major depression are then discussed. Current somatic therapies for nondelusional depression are described, with emphasis on the mechanisms of action of the drugs employed, the relationship between mechanism of action and side effect profile, and the selection of a drug on the basis of its side effect profile. The three current strategies for the treatment of delusional depression--electroconvulsive therapy, the combination of an antidepressant and an antipsychotic agent, and amoxapine alone--are then reviewed.