Placebo-controlled study of tianeptine in major depressive episodes.

The efficacy and safety of tianeptine were compared, in the course of a multicentre randomised, double-blind, parallel group study, to those of placebo in the treatment of Major Depressions and Bipolar Disorder, Depressed with or without melancholia, without psychotic features. After a 1-week run-in placebo period, 126 depressed out-patients presenting DSM-III-R Major Depression or Bipolar Disorder, Depressed, with a total MADRS score of at least 25, were treated for 42 days with either tianeptine (25-50 mg/day) or placebo. Efficacy assessments were MADRS, CGI, HARS, Zung Depression Self Rating Scale and a VAS. Better efficacy of tianeptine was shown, and confirmed by covariance analyses, in final MADRS scores of the intention-to-treat population, of patients treated for at least 14 days and of completers; also in CGI items 1 and 2, MADRS item 10, and VAS. The results confirmed the efficacy of tianeptine (mean dosage: 37.5 mg/day) in the treatment of Major Depression and Bipolar Disorder, Depressed, with or without melancholia, compared to placebo. Tianeptine's acceptability did not differ from that of placebo. For adverse events, a higher incidence of headaches was found with tianeptine.

Biochemical correlate of depression in children.

The degree of depression in 88 abandoned children was analysed through a depression rating scale adapted to prepubertal children. The items were grouped into three dimensions: sociological-relational, psychological and biological. In 46 children from this sample it was dosed plasmatic cortisol and the urinary excretion of catecholamine, VMA, HVA and 5-HIAA. When analysing the principal components, the sociological and psychological dimensions were the most important ones in the sample, followed by age and catecholamine variables. The group of male depressed children presented a higher level of catecholamine urinary excretion and a lower peak of plasmatic cortisol than the non-depressed group. The variable age, in both sexes, was correlated with the biochemical variable catecholamine. Biochemical alterations are present in depressed children but it is difficult to show a correlation of dependence between them and the phenomenological aspects of depression.

Biochemical correlate of depression in children

O grau de depressäo em 88 crianças abandonadas foi analisado por escala de avaliaçäo de depressäo adaptada para crianças na pré-puberdade. Os itens da escala foram agrupados em três dimensöes: sociológico-relacional, psicológica e biológica. Em 46 crianças desta amostra foram dosados o cortisol plasmático e a excreçäo urinária de catecolomina, VMA, HVA e 5-HIAA. Pela análise dos principais componentes, mostraram-se mais importantes, na amostra, as dimensöes sociológica e psicológica, seguidas dos componentes idade e catecolomina. O grupo de crianças do sexo masculino com depressäo apresentava maior nível de excreçäo urinária de catecolomina e menor pico de cortisol plasmático que o grupo sem depressäo. A variável idade, em ambos os sexos, correlacionava-se à variável catecolomina. Alteraçöes bioquímicas estäo presentes em crianças com depressäo, mas é difícil demonstrar correlaçäo de dependência entre elas e aspectos fenomenológicos da depressäo