ABSTRACT
This is a multicentre double-blind study of fluvoxamine versus mianserin in the treatment of major depressive episode in patients over 65 years of age. Fifty-seven patients received either fluvoxamine (100-200 mg daily) or mianserin (40-80 mg daily). There was no statistically significant difference in improvement between the 2 treatment groups as measured by the Montgomery-Asberg Depression Rating Scale. Eleven patients (7 in the fluvoxamine group and 4 in the mianserin group) discontinued treatment because of intolerance. No statistically significant differences were seen in biological parameters with either drug. Both drugs improved the symptoms of depression though the overall response rate was not outstanding. The side effects profile for the fluvoxamine was contrary to previous studies in that frequent nausea and vomiting were not seen.
Subject(s)
Antidepressive Agents , Depressive Disorder/drug therapy , Mianserin/therapeutic use , Oximes/therapeutic use , Aged , Aged, 80 and over , Depressive Disorder/psychology , Double-Blind Method , Female , Fluvoxamine , Follow-Up Studies , Hospitalization , Humans , Male , Mianserin/adverse effects , Oximes/adverse effects , Psychiatric Status Rating ScalesABSTRACT
A total of 18 hospitalized elderly psychotic patients in need of antipsychotic treatment took part in a double-blind exploratory study concerning the safety, tolerability and efficacy of remoxipride and thioridazine. Their median age was 78 years (range 66-90 years). Over the study period of 6 weeks, 9 patients received remoxipride and 9 thioridazine. Both drugs were given in a dosage range of 50-200 mg/day. The median total score on the Brief Psychiatric Rating Scale at the start of active treatment was 18 in the remoxipride group and 24 in the thioridazine group. The scores were reduced to 6 and 7, respectively, at the last rating. The Clinical Global Impression at last rating showed 4 of the 9 remoxipride patients to be very much improved compared to 1 of the 9 thioridazine patients. Apart from three reports of severe drowsiness in the thioridazine group, the incidence of treatment-emergent adverse effects was low in both groups. No clinically significant aberrations were seen in laboratory tests or cardiovascular data. In conclusion, remoxipride seemed to be well tolerated in this group of patients and its antipsychotic efficacy in the doses used is promising.
Subject(s)
Antipsychotic Agents/therapeutic use , Benzamides/therapeutic use , Dementia/drug therapy , Paranoid Disorders/drug therapy , Schizophrenia, Paranoid/drug therapy , Thioridazine/therapeutic use , Aged , Aged, 80 and over , Antipsychotic Agents/adverse effects , Antipsychotic Agents/pharmacokinetics , Benzamides/adverse effects , Benzamides/pharmacokinetics , Dementia/psychology , Dose-Response Relationship, Drug , Double-Blind Method , Dyskinesia, Drug-Induced/etiology , Female , Humans , Male , Neurologic Examination , Paranoid Disorders/psychology , Psychiatric Status Rating Scales , Remoxipride , Schizophrenia, Paranoid/psychology , Thioridazine/adverse effects , Thioridazine/pharmacokineticsABSTRACT
The method of calculating district psychiatric manpower described by Watson was applied to seven geriatric psychiatry services in Scotland serving a population of 1,445,000 including 209,600 individuals over the age of 65 years of age. The overall medical staffing of these services was only 63.6% of the estimated requirement and when individual consultants were considered only 62% of the necessary time was available. If it is assumed that half of the extra medical time should be provided by consultants, then 3.2 consultant WTEs will be needed for geriatric psychiatry for a population of 200,000 with 30,000 elderly people. If there was no change in the proportion of medical work provided by consultants, the figure would be 2.9 consultant WTEs per 30,000 population aged over 65 years. Extra supporting staff are also required to meet the requirements of the Watson formula.
