Tianeptine in the combined treatment of combat related posttraumatic stress disorder.

BACKGROUND: The aim of this study was to evaluate the efficacy of tianeptine, an antidepressant that acts by increasing serotonin reuptake, in the treatment of posttraumatic stress disorder and to compare the effects of tianeptine and fluoxetine, an antidepressant from the selective serotonin reuptake inhibitors class. SUBJECTS AND METHODS: 43 war veterans suffering from posttraumatic stress disorder were included in the study. During the 5.5 months of treatment 21 patients were receiving tianeptine and 22 were receiving fluoxetine. In addition, all patients took part in intensive trauma specific group psychotherapy. The effects of the two antidepressants on symptoms of PTSD, depression and anxiety after 5.5 months of treatment were assessed using the Harvard Trauma Questionnaire, Beck Depression Inventory, STAI and the List of Drug Use and Side Effects. RESULTS: There was no significant difference between the two treatment groups regarding their effect on symptoms and severity of depression. The level of anxiety was the same in the first measurement but the difference became significant in other three measurements in favor of tianeptine. The anxiolytics and other co-prescribed drugs remain the same in both groups, the use of analgesics significantly increase in fluoxetine group during the course of treatment. CONCLUSION: The study demonstrated that tianeptine is as effective as fluoxetine in the treatment of PTSD, with even stronger effect on anxiety and equal tolerance.

Comorbid chronic diseases in depressed and non-depressed patients in family practice.

INTRODUCTION: Depression is one of the five most frequent disorders in primary care practice and often remains unrecognized. One of the reasons why depression often passes unnoticed is comorbidity - a number of different chronic diseases coexist with depression, especially in elderly patients. AIM: The aim of this research was to assess the difference between depressed and non-depressed patients regarding somatic and mental comorbidity. The differences in drug use were also examined. SUBJECTS AND METHODS: Five hundred successive adult patients visiting family physicians in Rijeka, Croatia, were polled using the Beck Depression Inventory and a general questionnaire which was created for the purpose of the study. The existing medical records were also used. RESULTS: Elevated depression level was determined in 48.1% of the examinees. These patients were suffering from larger number of chronic diseases (X=1.23) than non-depressed patients (X=0.70; t=5.07; p<0.001; z=4.93; p<0.001), especially cardiac, mental, renal and osteomuscular diseases. Depressed persons used significantly more drugs (X=1.28) than non-depressed patients (X=0.58; t=6.10; p<0.001; z=5.78; p<0.001), especially antirheumatics, analgesics, sedatives, antidepressants, antiallergics and diuretics. CONCLUSION: The research results point to a necessity of routine screening and early treatment of depression in patients with chronic diseases in primary care practice.

Influence of olanzapine on memory functions.

Even though memory dysfunction is not considered to be a diagnostic criterion for schizophrenia, results of a neuropsychological research indicate significant damage in mnestic functioning, especially in verbal memory (Saykin et al. 1991). This type of a disorder is recorded in patients with a first episode of schizophrenia, as well as in chronic patients (Saykin et al. 1994). These researches show that this deficit is not influenced by neuroleptics. Paulsen and associates suggest that the deficit of verbal learning in schizophrenia is related to difficulties in encoding retrieving information without significant storage (rapid forgetting) problems (Paulsen at al. 1995). We will present a case of a 36 - year old male who is suffering from a paranoid schizophrenia.

Correlation of anaemia and cognitive functions measured by the complex reactiometer Drenovac.

Cognitive impairment impinges significantly on the quality of life. Previous research revealed that anaemia can have a major influence on cognitive functioningt. The article is a correlational study examining the relationship between anaemia levels and cognitive functioning in adult patients. Sixty-one patients (both inpatients and outpatients), among them 30 anemic and 31 non-anaemic, 33 female and 28 male, aged 32-60 (median 43) treated at the Dept. of Hematology, Clinical Hospital Center Rijeka, Croatia were analysed according to hemoglobin (Hb) level and cognitive ability. Assessment of cognition (convergent inductive thinking) was performed by the Complex reactiometer Drenovac (CRD). The results showed that anaemia significantly undermines cognitive functions in adult patients (p < 0.01). Even in non-anaemic patients (Hb higher than 120 g/L), Hb level is related to better cognitive ability.