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Open trial of the efficacy and tolerability of mirtazapine in the treatment of major depresion in HIV-1 infected outpatients
S228
PI. Affective disorders and antidepressants
= 4, 87.3; p < 0.001). We did not find any significant alterations in GH throughout both the ECTs, (F = 2.65; df = 4, 50.9; p > 0.05). There was a significant increase in ACTH levels just after ECT in both ECT procedures compared with the baseline values and the values after propofol. This increase became more marked in 30th min after ECT (F = 9.98; df = 4, 56.9; p < 0.001). PRL concentrations increased significantly immediately after ECT, and this increase became more pronounced 30 min after ECT (F = 23.98; df = 4, 80.3; p < 0.001). For all the hormones studied, we did not find any differences between the hormonal responses to the first and last ECTs, and no gender effect was detected. Conclusion: The data of the present study confirm the previous reports of rapid increases in the serum concentrations of TSH, ACTH and PRL (1). These responses were not different between the first and last ECTs, and between males and females. The results show that ECT has selective effects on the central neurotransmitter systems which control the activity of the hypothalamicpituitary system, and these effects have a tendency to remain stable throughout ongoing ECT sessions.
all the patients improved their insomnia during the first week of treatment. No side-effects on sexual functioning were observed. No significant changes on weight were observed. Conclusions: Completing patients rapid improved in all measures of depression and anxiety, especially in their sleep disturbances. Side-effects responsible for abandonment were somnolence and dizziness. However, because of the small study group and the high rate of drop-outs, these findings cannot be generalised and may need replication in a larger study group.
[l] Elliot AJ, Russo J, Bergam K, Claypoole K, Uldali KK, Roy-Byrne PP. Antidemessant efficacv in HIV seronositive outnatients with maior depressive-disorder: An open trial of nefazodone: J Clin Psych&y 1999: 60: 22&231. [2] Ferrando SJ, Goldman JD, Chamess WE. Selective serotonin reuptake inhibitor treatment of depression in symptomatic HIV infection and AIDS. Improvement in affective and somatic symptoms. Gen Hosp Psychiatry 1997; 19: 89-97. [3] Practice Guideline for the treatment of patients with HIV/AIDS. American Psychiatric Association. Washington DC, 2000.
References [l] Whalley, L.J., Eagles, J.M., Bowler, G.M.R., Bennie, LG., Dick, H.R., McGuire, R.J., Fink, G., 1987. Selective effects of ECT on hypothalamic-pituitary activity. Psychol. Med. 17, 3 19-328.
Ip.1.1121
Open trial of the efficacy and tolerability of mirtazapine in the treatment of major depresion in HIV-1 infected outpatients
J. Blanch’, J. De Pablo’, A. Rousaud’, A. Miilarro3, A. Villarroya3, G. Masana’, J.M. Gatel12, C. Gasto’. ‘Znstitut de Psiquiatria i Psicologia; ‘Institut de Malalties Infeccioses i Microbiologia, Hospital Clinic Universitari de Barcelona IDIBAPS, Vlllawoel170, Barcelona; 3Departament d’Estadisitca, Facultat de Biologia, Universitat de Barcelona, Spain Background: The prevalence of mood disorders in HIV patients is higher than general population rates. Mirtazapine could be a good treatment of choice for depressed HIV patients, particularly if they refer insomnia and loss of appetite. To our knowledge this is the first study about the efficacy and tolerability of mirtazapine in HIV infected patients with depression. Objective: Prospective, longitudinal, open-label, observational study to assess the efficacy and tolerability of mirtazapine in the treatment of major depression in HIV-l infected outpatients. Methods: Twenty-seven HIV-l infected patients whit major depression (assessed by means of the SCID-I) and a score of more than 8 in the Hospital Anxiety and Depression (I-LADS) received a mean daily dose of 30 mg of mirtazapine, and were assessed at baseline and after 1,2,4, 8 and 16 weeks of treatment using HADS, Beck Depression Inventory (BDI), State subscale of State and Trait Anxiety Inventory (STAI-s), and the Global Clinical Impression (GCI). Side effects were recorded. Outcome of completing patients was analysed using univariate repeatedmeasures analysis of variance (ANOVA) or Friedman test for ANOVA followed by Wilcoxon signed ranks tests. Results: Of the sixteen patients who dropped-out before reaching the last visit 5 referred side-effects due to mirtazapine (somnolence and dizziness). The eleven completing patients (41%) showed a signiticant (p i 0.05) improvement in all measures: 58% on GCI, 53% on BDI, 46% on HADS depression subscale, 38% on STAI-s and 38% on HADS anxiety subscale. Most of
Ip.1.113(
First report of mirtazapine and severe depresslon
i.v. in moderate
A.A. Nimmerrichter, Ch. Stuppack, G. Eichberger, H. Hinterhuber, S. Kasper, A. Konstantinidis, A. Neumeister, H. Schubert, H.-G. Zapotocky. Organon, Austria Objective: Assessment of safety and tolerability of intravenous mirtazapine alter 2 weeks treatment. Primary parameters were adverse events (AE), vital signs and laboratory. Method: A multicenter, uncontrolled trial design was chosen. Eighty moderately to severely depressed m-patients with a HAMDi7 18 were treated intravenously for 14 days with 15 mg mirtazapine. Results: Eighty subjects were enclosed, 74 (92.5%) subjects completed the trial. Most frequently reported AE were fatigue (15%), nausea (IO%), and vertigo (8.8%). All other AE had an incidence of less than 5%. There was no premature discontinuation due to AE. Afier the infusion blood pressure decreased by 25 mmHg and pulse up to 5 bpm. There was some increase in ALAT (baseline 12.1 f SD, D15 16.2 f SD), which was clinically not significant. No changes in hematology and 12-lead ECGs occurred. Conclusions: Intravenous administration of mirtazapine was well tolerated by the patients. There was no premature termination due to adverse events. After 14 days of treatment no clinically significant changes in vital signs (heart rate, blood pressure) could be observed. With respect to antidepressant efficacy there was an improvement already within three days.
/P.l .I141Potential antidepressant-like
effects of MPEP, a potent, selective and systemlcally active mGluR5 receptor antagonist
A. Palucha, P. Branski, B. Kroczka, J.M. Wieronska, A. Pile. Institute of Pharmacology Polish Academy of Sciences, Department of Neurobiology, Kmkdw, Poland Physiological functions of glutamate, the major excitatory neurotransmitter in the brain, are mediated by the two receptors families: ionotropic glutamate receptors (iGhtRs), containing NMDA,
PI. Affective disorders and antidepressants
= 4, 87.3; p < 0.001). We did not find any significant alterations in GH throughout both the ECTs, (F = 2.65; df = 4, 50.9; p > 0.05). There was a significant increase in ACTH levels just after ECT in both ECT procedures compared with the baseline values and the values after propofol. This increase became more marked in 30th min after ECT (F = 9.98; df = 4, 56.9; p < 0.001). PRL concentrations increased significantly immediately after ECT, and this increase became more pronounced 30 min after ECT (F = 23.98; df = 4, 80.3; p < 0.001). For all the hormones studied, we did not find any differences between the hormonal responses to the first and last ECTs, and no gender effect was detected. Conclusion: The data of the present study confirm the previous reports of rapid increases in the serum concentrations of TSH, ACTH and PRL (1). These responses were not different between the first and last ECTs, and between males and females. The results show that ECT has selective effects on the central neurotransmitter systems which control the activity of the hypothalamicpituitary system, and these effects have a tendency to remain stable throughout ongoing ECT sessions.
all the patients improved their insomnia during the first week of treatment. No side-effects on sexual functioning were observed. No significant changes on weight were observed. Conclusions: Completing patients rapid improved in all measures of depression and anxiety, especially in their sleep disturbances. Side-effects responsible for abandonment were somnolence and dizziness. However, because of the small study group and the high rate of drop-outs, these findings cannot be generalised and may need replication in a larger study group.
[l] Elliot AJ, Russo J, Bergam K, Claypoole K, Uldali KK, Roy-Byrne PP. Antidemessant efficacv in HIV seronositive outnatients with maior depressive-disorder: An open trial of nefazodone: J Clin Psych&y 1999: 60: 22&231. [2] Ferrando SJ, Goldman JD, Chamess WE. Selective serotonin reuptake inhibitor treatment of depression in symptomatic HIV infection and AIDS. Improvement in affective and somatic symptoms. Gen Hosp Psychiatry 1997; 19: 89-97. [3] Practice Guideline for the treatment of patients with HIV/AIDS. American Psychiatric Association. Washington DC, 2000.
References [l] Whalley, L.J., Eagles, J.M., Bowler, G.M.R., Bennie, LG., Dick, H.R., McGuire, R.J., Fink, G., 1987. Selective effects of ECT on hypothalamic-pituitary activity. Psychol. Med. 17, 3 19-328.
Ip.1.1121
Open trial of the efficacy and tolerability of mirtazapine in the treatment of major depresion in HIV-1 infected outpatients
J. Blanch’, J. De Pablo’, A. Rousaud’, A. Miilarro3, A. Villarroya3, G. Masana’, J.M. Gatel12, C. Gasto’. ‘Znstitut de Psiquiatria i Psicologia; ‘Institut de Malalties Infeccioses i Microbiologia, Hospital Clinic Universitari de Barcelona IDIBAPS, Vlllawoel170, Barcelona; 3Departament d’Estadisitca, Facultat de Biologia, Universitat de Barcelona, Spain Background: The prevalence of mood disorders in HIV patients is higher than general population rates. Mirtazapine could be a good treatment of choice for depressed HIV patients, particularly if they refer insomnia and loss of appetite. To our knowledge this is the first study about the efficacy and tolerability of mirtazapine in HIV infected patients with depression. Objective: Prospective, longitudinal, open-label, observational study to assess the efficacy and tolerability of mirtazapine in the treatment of major depression in HIV-l infected outpatients. Methods: Twenty-seven HIV-l infected patients whit major depression (assessed by means of the SCID-I) and a score of more than 8 in the Hospital Anxiety and Depression (I-LADS) received a mean daily dose of 30 mg of mirtazapine, and were assessed at baseline and after 1,2,4, 8 and 16 weeks of treatment using HADS, Beck Depression Inventory (BDI), State subscale of State and Trait Anxiety Inventory (STAI-s), and the Global Clinical Impression (GCI). Side effects were recorded. Outcome of completing patients was analysed using univariate repeatedmeasures analysis of variance (ANOVA) or Friedman test for ANOVA followed by Wilcoxon signed ranks tests. Results: Of the sixteen patients who dropped-out before reaching the last visit 5 referred side-effects due to mirtazapine (somnolence and dizziness). The eleven completing patients (41%) showed a signiticant (p i 0.05) improvement in all measures: 58% on GCI, 53% on BDI, 46% on HADS depression subscale, 38% on STAI-s and 38% on HADS anxiety subscale. Most of
Ip.1.113(
First report of mirtazapine and severe depresslon
i.v. in moderate
A.A. Nimmerrichter, Ch. Stuppack, G. Eichberger, H. Hinterhuber, S. Kasper, A. Konstantinidis, A. Neumeister, H. Schubert, H.-G. Zapotocky. Organon, Austria Objective: Assessment of safety and tolerability of intravenous mirtazapine alter 2 weeks treatment. Primary parameters were adverse events (AE), vital signs and laboratory. Method: A multicenter, uncontrolled trial design was chosen. Eighty moderately to severely depressed m-patients with a HAMDi7 18 were treated intravenously for 14 days with 15 mg mirtazapine. Results: Eighty subjects were enclosed, 74 (92.5%) subjects completed the trial. Most frequently reported AE were fatigue (15%), nausea (IO%), and vertigo (8.8%). All other AE had an incidence of less than 5%. There was no premature discontinuation due to AE. Afier the infusion blood pressure decreased by 25 mmHg and pulse up to 5 bpm. There was some increase in ALAT (baseline 12.1 f SD, D15 16.2 f SD), which was clinically not significant. No changes in hematology and 12-lead ECGs occurred. Conclusions: Intravenous administration of mirtazapine was well tolerated by the patients. There was no premature termination due to adverse events. After 14 days of treatment no clinically significant changes in vital signs (heart rate, blood pressure) could be observed. With respect to antidepressant efficacy there was an improvement already within three days.
/P.l .I141Potential antidepressant-like
effects of MPEP, a potent, selective and systemlcally active mGluR5 receptor antagonist
A. Palucha, P. Branski, B. Kroczka, J.M. Wieronska, A. Pile. Institute of Pharmacology Polish Academy of Sciences, Department of Neurobiology, Kmkdw, Poland Physiological functions of glutamate, the major excitatory neurotransmitter in the brain, are mediated by the two receptors families: ionotropic glutamate receptors (iGhtRs), containing NMDA,