A double-blind comparison of venlafaxine and fluoxetine for treatment of major depression in outpatients.

1. This was a randomized, double-blind comparison of the efficacy and safety of venlafaxine and fluoxetine in outpatients with major depression. 2. Three hundred fourteen patients were randomly assigned to either venlafaxine 37.5 mg twice daily or fluoxetine 20 mg once daily for a maximum of 8 weeks. 3. If the response was inadequate after two weeks of treatment, the dosage of venlafaxine could be increased to 75 mg twice daily. 4. A clinical response, defined as at least a 50% decrease from baseline in the total HAM-D score, was attained at week 6 in 72% of patients on venlafaxine and 60% of patients on fluoxetine (p = 0.023). 5. Among patients who increased their dose at 2 weeks, venlafaxine was significantly (p < 0.05) superior from week 3 onward on the HAM-D. 6. Venlafaxine 75 mg daily is comparable to fluoxetine, but at 150 mg daily, it may be superior to fluoxetine in outpatients with major depression who do not respond early to treatment.

A double-blind comparison of moclobemide and thioridazine versus moclobemide and placebo in the treatment of refractory, severe depression.

In a multicenter study of 78 severely depressed inpatients (44 women and 34 men; age range, 23 to 70 years), the efficacy, onset of efficacy, and tolerability of the reversible monoamine oxidase-A inhibitor moclobemide (450 mg/day) in combination with thioridazine (100 mg/day) were compared with those of moclobemide (450 mg/day) plus placebo. Patients enrolled met the DSM-III-R criteria for severe depression and had a severity score of at least 20 on the first 17 items of the Hamilton Rating Scale for Depression (HAM-D). Additionally, these patients had not responded to at least two standard antidepressants during the 2 years preceding screening and the mean duration of the current episode was 6 months. After a washout period of 3 to 5 days, patients were randomized to one of the two treatment groups, which at the outset had similar characteristics. Efficacy was assessed by the HAM-D, a depression observation rating for nurses, and a Clinical Global Impression (CGI) scale. Tolerability assessments included an overall rating, a description of adverse events, vital signs, electrocardiogram, and laboratory tests. After 4 weeks of therapy, both groups of patients showed significant improvements in HAM-D and CGI scores. The response rates (based on HAM-D > or = 50% decrease) were 74% for moclobemide/thioridazine and 77% for moclobemide/placebo, and according to CGI scores, 76 and 72% were "very much improved" or "much improved," respectively. Onset of effect was noted after 9.2 and 9.8 days, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

[Long-term development of neurotic and reactive disorders. Catamnestic study on the influence of social factors]. / L'évolution à long terme des troubles névrotiques et réactionnels. (Etude catamnestique sur l'influence des facteurs sociaux)

This study enters into the framework of long term catamnestic researches realised at Hopital de Cery in Lausanne. In this work, the evolution of neurotic and reactionnal disorders in old age has been studied through the direct catamnestic examination of 35 patients who outlived 65 years of age. The accent has been particularly put on social and psychological evolution in regard to 15 variables responding to 2 fondamental hypotheses; it is the conducting clue of the work. After discussion concerning the working method and the selection of survey material, the author is analysing the 35 patients' main caracteristics at the time of their first hospitalisation. He is also taking interest on the patients' social surroundings during their childhood until they were 15. The notion of "broken-home" is largely discussed. The various evolutive aspects are firstly treated apart and then all together in regard to 15 mentioned variables. The various results are making the subject of statistic validation.