Evaluation of depression and mental health status in women with poly cystic ovary syndrome

Poly Cystic Ovary Syndrome [PCOS] is a common endocrine condition that affects up to one fifth of the women of reproductive age. The overall prevalence of the depressive disorders has been shown to be about 12% in a large multi-centric study of obstetric-gynecologic patients. This study was designed to evaluate the distribution of depression and mental health status in women with PCOS. This cross-sectional study was performed on 100 women with PCOS who were selected among patients attending the gynecologic and obstetric clinics of two referral centers. They completed Beck Depression Inventory [BDI] and General Health Questionnaire [GHQ-28]. The prevalence of depression in women with PCOS was 45% according to BDI. According to GHQ-28, 30% of our patients were considered as possible cases of mental disorder. We found that the prevalence of depression was significantly high in women with PCOS. We believe that the treatment of PCOS must include psychological treatment to improve mental health status as well

Combination of citalopram and nortriptyline in treatment of moderate to severe major depression: a double-blind, placebo- controlled trial

Depression is a major health problem, which is not only underrecognized and undertreated, but is also associated with significant morbidity and mortality. It has been suggested that combination therapy rapidly reduces depressive symptoms in patients with moderate to severe depression and is more effective than monotherapy; but this suggestion remains controversial. Serotonergic and noradrenergic enhancement may be synergistic and more effective than serotonergic enhancement alone in the management of depression. The objective of this double blind, placebo-controlled study was to investigate the efficacy and tolerability of the combination of citalopram and nortriptyline for the treatment of moderate to severe major depression. 45 patients, who met the DSM-IV criteria for major depressive disorder based on the clinical interview, were included in the study. Patients had a baseline Hamilton Depression Rating Scale score of at least 20. In this trial, patients were randomly assigned to receive nortriptyline 50 mg/day plus citalopram 40 mg/day [group 1] or placebo plus citalopram 40 mg/day [group 2], for an 8 week, double-blind, placebo-controlled trial. Both protocols significantly decreased the score of Hamilton Depression Rating Scare over the trial period, but the combination of nortriptyline and citalopram showed a significant superiority over citalopram alone in the treatment of moderate to severe major depressive disorder [t = 3.34, d. f. = 36. p = 0.001]. The difference between the two groups in the frequency of side effects was not significant. The results of this study suggest that combination of nortriptyline and citalopram is more effective than citalopram alone in the treatment of depression. This advantage is probably the result of reuptake inhibition of both serotonin and norepinephrine

Combination of citalopram and nortriptyline in the treatment of obsessive-compulsive disorder: a double - blind, placebo-controlled trial

The fact that some antidepressants with strong effects on serotonin reuptake blockade fail to relieve obsessive-compulsive symptoms has caused growing interest in investigating noradrenergic function in obsessive-compulsive disorder [COD]. In light of the above, we undertook a trial to investigate whether the combination of citalopram with nortriptyline is more effective in treating obsessive compulsive symptoms than citalopram alone. 40 patients who met the DSM-IV criteria for COD were included in the study. Patients were allocated in a random fashion: 20 patients to citalopram 40mg /day plus nortriptyline 50mg day, and 20 patients to citalopram 40mg /day plus placebo. Both protocols significantly decreased the scores of the Yale-Brown Obsessive Compulsive Scale [Y-BOCS] over the trial period, but the combination of citalopram and nortriptyline showed a significant superiority over citalopram alone in the treatment of COD. As this study indicates, nortriptyline improves the efficacy of citalopram. In addition, a rapid onset of action is one of the advantages of this combination. This study supports further investigation of the noradrenergic- serotonergic hypothesis in OCD

Increased natural killer cell activity in schizophrenic patients

Schizophrenia has been associated with altered immunity. Different studies regarding natural killer cell activity [NKA] in schizophrenic patients have shown inconsistent results. To evaluate NK cell activity in schizophrenic patients in comparison with healthy control individuals. 30 medication-free schizophrenic patients and 41 healthy sex, age and smoking status matched individuals were included in this study. NK cell activity of case and control subjects was measured by Methyl-Thiazol-Tetrazolium [MTT] test. Statistical analysis of the data was done using SPSS 11.5 software. NK activity of patients and normal subjects had a mean of 36.94 +/- 26.15 [Mean +/- SD] and 22.31 +/- 17.92, respectively. A significant increase in NK activity in schizophrenic patients compared to controls [P = 0.011]. Among patients, NK activity of smokers was significantly lower than that of non-smokers [P = 0.02]. Other demographic factors didn't show any influence on NK activity. The higher activity of NK cells in the schizophrenic patients as compared with the control population could explain the low incidence of cancer in these patients. Decreasing the effect of smoking on NK activity in the patients could be one of the responsible factors for the inconsistency in the results of different studies