RESUMO
The authors examined patterns of improvement in quality of life (QOL) in elderly patients with recurrent major depression (MDD) after acute treatment. One hundred elderly (age 60-88 years) patients with recurrent MDD were randomized to receive either bupropion sustained-release (100 mg-300 mg/day) or paroxetine (10 mg-40 mg/day) for 6 weeks. Treatment with both paroxetine and bupropion was associated with improvements in QOL. Lower perceived Physical- and Social-Functioning QOL ratings at baseline were associated with lower treatment response. Improvement in depression symptom ratings correlated significantly with improvement in QOL on many domains, but accounted for less than one-quarter of the total variance. Remitters showed significantly (P<0.001) greater improvement than both Partial Responders and Nonresponders on various measures. Findings support the importance of treating elderly depressed patients to full remission to maximize impact on both emotional and physical QOL domains.
Assuntos
Antidepressivos de Segunda Geração/uso terapêutico , Bupropiona/uso terapêutico , Transtorno Depressivo Maior/psicologia , Transtorno Depressivo Maior/terapia , Qualidade de Vida , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Idoso , Antidepressivos de Segunda Geração/administração & dosagem , Bupropiona/administração & dosagem , Preparações de Ação Retardada , Transtorno Depressivo Maior/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Indução de Remissão , Inibidores Seletivos de Recaptação de Serotonina/administração & dosagem , Índice de Gravidade de DoençaRESUMO
The amiloride-sensitive Na+/H+ antiporter in defolliculated oocytes of Xenopus laevis was characterized by measurements of 22Na+ influx and apparent H+ efflux. Uptake of 22Na+ was linear over a 90-min incubation period and was inhibited approximately 80% with 5 x 10(-4) mol l-1 amiloride. Amiloride-sensitive sodium uptake was reduced following collagenase treatment or oocyte aging. K0.5 for amiloride inhibition was 4.13 x 10(-6) +/- 1.33 x 10(-6)mol l-1 and the Km for Na+ was 4.25 x 10(-3) mol l-1. Hill analysis of the kinetic data for Na+ revealed an nH value of 1.14, indicating an absence of interacting binding sites for Na+. Parallel measurements of amiloride-sensitive Na+ uptake and H+ efflux indicated a Na+/H+ exchange ratio of 0.88:1. Our conclusion is that the Na+/H+ antiporter of Xenopus oocytes exhibits a nominal 1:1 Na+/H+ exchange stoichiometry and is similar in its properties to the antiporter of other vertebrate cells.