Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 2 de 2
Filter
Add more filters










Database
Language
Publication year range
1.
Pharmacopsychiatry ; 48(7): 274-8, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26529118

ABSTRACT

INTRODUCTION: Electroconvulsive treatment (ECT) is an effective treatment for severe depression but carries a risk of relapse in the following months. METHODS: Major depressive disorder patients in a current episode attaining remission from ECT (17-item Hamilton Depression Rating Scale (HAM-D17) score≤9) received randomly escitalopram 10 mg, 20 mg, 30 mg or nortriptyline 100 mg as monotherapies and were followed for 6 months in a multicentre double-blind set-up. Primary endpoint was relapse (HAM-D17≥16). RESULTS: As inclusion rate was low the study was prematurely stopped with only 47 patients randomised (20% of the planned sample size). No statistically significant between-group differences could be detected. When all patients receiving escitalopram were compared with those receiving nortriptyline, a marginal superiority of nortriptyline was found (p=0.08). One third of patients relapsed during the study period, and one third completed. DISCUSSION: Due to small sample size, no valid efficacy inferences could be made. The outcome was poor, probably due to tapering off of non-study psychotropic drugs after randomisation; this has implications for future study designs. ClinicalTrials.gov Identifier: NCT00660062.


Subject(s)
Antidepressive Agents/therapeutic use , Citalopram/therapeutic use , Depressive Disorder, Major/therapy , Electroconvulsive Therapy , Nortriptyline/therapeutic use , Adult , Aged , Antidepressive Agents/administration & dosage , Citalopram/administration & dosage , Depressive Disorder, Major/drug therapy , Depressive Disorder, Major/prevention & control , Double-Blind Method , Female , Humans , Male , Middle Aged , Nortriptyline/administration & dosage , Secondary Prevention , Treatment Outcome
2.
Acta Psychiatr Scand ; 131(6): 446-57, 2015 Jun.
Article in English | MEDLINE | ID: mdl-25689725

ABSTRACT

OBJECTIVE: To investigate the long-term antidepressant effect of a chronotherapeutic intervention. METHOD: In this randomized controlled trial 75 patients with major depression were allocated to fixed duloxetine and either a chronotherapeutic intervention (wake group) with three initial wake therapies, daily bright light therapy, and sleep time stabilization or to a group using daily exercise. Patients were followed 29 weeks. We report the last 20 weeks, a follow-up phase, where medication could be altered. Patients were assessed every 4 weeks. Remission rates were primary outcome. RESULTS: Patients in the wake group had a statistically significant higher remission rate of 61.9% vs. 37.9% in the exercise group at week 29 (OR = 2.6, CL = 1.3-5.6, P = 0.01). This indicated continued improvement compared with the 9 weeks of treatment response (44.8% vs. 23.4%) with maintenance of the large difference between groups. HAM-D17 endpoint scores were statistically lower in the wake group with endpoint scores of 7.5 (SE = 0.9) vs. 10.1 (SE = 0.9) in the exercise group (difference 2.7, CL = 0.5-4.8, P = 0.02). CONCLUSION: In this clinical study patients continued to improve in the follow-up phase and obtained very high remission rates. This is the first study to show adjunct short-term wake therapy and long-term bright light therapy as an effective and feasible method to attain and maintain remission.


Subject(s)
Antidepressive Agents/administration & dosage , Depressive Disorder, Major/therapy , Duloxetine Hydrochloride/administration & dosage , Exercise Therapy/methods , Phototherapy/methods , Adult , Aged , Combined Modality Therapy , Depressive Disorder, Major/drug therapy , Depressive Disorder, Major/physiopathology , Drug Chronotherapy , Exercise , Female , Follow-Up Studies , Humans , Male , Middle Aged , Self-Assessment , Sleep/physiology , Treatment Outcome
SELECTION OF CITATIONS
SEARCH DETAIL
...