ABSTRACT
The aim of this open label trial was to evaluate mirtazapine tolerability and effectiveness in controlling symptomatology of patients with panic disorder. Forty-five patients with panic disorder, with or without agoraphobia, 11 of them with a comorbid diagnosis of major depression, were included. Patients were assessed with a structured psychiatric interview and their symptomatology evaluated with specific psychometric scales. Three study participants dropped out due to adverse events. Mirtazapine was administered at an established dose of 30 mg daily for 3 months. Patients were assessed at weeks 2 and 4, and then at monthly intervals. All psychometric measures showed statistically significant reductions in total scores at the rated time points, with a pronounced decline in number and intensity of panic attacks and anticipatory anxiety throughout the study. Mirtazapine was well tolerated as signified by the low discontinuation rate (6.3%), and all patients showed a significant symptomatic improvement. The improvement did not appear to be linked to the concurrent presence of a depressive illness.
Subject(s)
Histamine H1 Antagonists/pharmacology , Mianserin/pharmacology , Panic Disorder/drug therapy , Adult , Comorbidity , Depressive Disorder/drug therapy , Depressive Disorder/psychology , Female , Histamine H1 Antagonists/administration & dosage , Histamine H1 Antagonists/adverse effects , Humans , Male , Mianserin/administration & dosage , Mianserin/adverse effects , Mianserin/analogs & derivatives , Middle Aged , Mirtazapine , Panic Disorder/psychology , Psychometrics , Treatment OutcomeABSTRACT
The caretaking of the patient in coma requires an anthropological and clinical approach. The ethics of well-done work suggests to reject futile medical treatment and euthanasia but, at the same time, to perform a correct palliative care and to support the family.
Subject(s)
Coma/therapy , Ethics, Medical , Family , Medical Futility , Palliative Care , Social Support , Euthanasia , Humans , Italy , Living WillsABSTRACT
Clinical and biochemical data suggest a link between anorexia nervosa (AN) and primary affective disorders (PAD). In 14 female patients, aged 15-40 years, with 7-month to 11-year histories of AN, we studied circadian cortisol periodicity, response to the dexamethasone suppression test (DST), and plasma levels of beta-endorphin and beta-lipotropin before and after desimipramine therapy. Possible correlations were sought among neuroendocrine impairments, weight loss, and depressive symptomatology. Impaired circadian cortisol periodicity, blunted DST response, and increased beta-endorphin plasma levels, observed in a subgroup of patients, could not be related to weight loss, either before or after therapy. Instead, a trend toward a relationship between neuroendocrine impairments and depressive symptoms was observed before and after treatment.
