- Email: [email protected]
P.1.161 Electroconvulsive therapy: Influence of the anaesthetic agent
PI.
S242
Affective
disorders
comprehensive psychopathological profiles of the pa-tie&. In particular “comorbidity” is ofteu the rule rather thau the exception aud becomes a misleading concept. On the other baud, specific psychopathological dimeusious could be more useful for a proper pharma-cological treatment. Multi-dimensional approach is iudepeudeut from single diagnoses, has a cross-sectional perspective, aud adopts multi-morbidity as the standard rule. Aim of the present study was to examiue the feasibility aud usefuhless of this approach to gaiu a full de-scription of the subjects’ psychopathology aud to overcome the “comorbidity” concept. 300 uuipolar aud bipolar patients who fulfilled diagnostic criteria for a Major Depressive Episode ac-cording to DSM-IV were included iuto the study. Each subject was evaluated upon referral to our “Ceutre for Diamlosis aud Treatment of Deuressive Disorders” or. if already in treatment, at the ouset of the episode; evaluatiou was cross-sectional aud iudepeudeut from the treatment received. The followiug dimeusioual axes were examined: psychic aud somatic anxiety, psychotic positive aud negative symptoms, aggressiveness aud suicidality, eating disorders aud mood disturbances. Radar graph plottings were used to describe each dimension, aud subjects were cumulated aud aualysed with descriptive statistical methods. Discrimiuaut analysis was employed to differentiate among depres-sive clinical sub-types: melancholic, psychotic, atypical etc., each represeuted by meaus of multi-axial radar graphs. Prelimiuary results seem to indicate that a multidimeusioual model is feasible, clinically useful, aud ca-pable of describe in a better way the iudividual pictures, both in typical aud atypical clinical presenta-tious. Moreover, since drug treatments are uot diaguostically specific but are effective ou symptoms or syndromes across differeut disorders, some implications of this approach ou pharmacological treatment are discussed. References [l]
[2]
[3]
Altamura AC Antidepressant therapy at the dawn of the third millennium. Amxican Journal of Psy-chiatry (Book Fomm) 2000; 157(1‘):144-5. \/ Shankman SA, Klein DN. Dimensional diagnosis of depression: Adding the dimension of course to severity, and comparison to the DSM. Comprehensive Psychiatry 2002; 43(6):42&6. Angst J, Gamma A. A new bipolar spectrum concept: a brief review. Bipolar Disorder 2002; 4 Suppll: 114.
m PI
160
Duloxetine depressive askociated w QD)
M. Wohlreich. IN, US.A.
Eli Lilly
for the treatment disorder: Safety with rapid dose
of major and efficacy escalation (60-120
and antidepressants tolerability of duloxetiue during a dose escalation from 60 mg QD to 120 mg QD. Methods: This was a single-arm, non-placebo-controlled, doseescalation study, in which patients were blinded as to timing of dose escalations. Patients (aged 218) meeting DSM-IV criteria for MDD (11~128) received placebo for 1 week followed by duloxetiue (60 mg QD) titrated after 1 week to 90 mg QD aud after a further week to 120 mg QD. The dose of 120 mg QD was theu maiutaiued for 4 weeks. Efficacy measures included the 17-item Hamilton Rating Scale for Depression (HAMD17) total score, the Clinical Global Impression of Severity (CGI-S) scale, Patient Global Impression of Improvement (PGI-I) scale, aud Visual Aualog Scales (VAS) for pain Safety was assessed using spoutaueously reported treatment-emergeut adverse eve&, chauges in vital signs, aud laboratory aualytes. Results: Siguificaut improvements were observed in all assessed efficacy measures at eudpoiut (pi.001). The rate of discoutiuuatiou due to adverse eveuts (16.3%) was comparable to rates observed in previous placebo-controlled trials. The most frequeutly reported treatment-emergeut adverse eveuts (TEAEs) were nausea, headache, dry mouth, dizziness, aud decreased appetite. The majority of TEAEs were associated with initial duloxetiue dosing ~ further escalations in dose produced few additioual adverse events. Meau chauges from baseline to eudpoiut in supiue systolic aud diastolic blood pressure were 1.2 aud 0.6 mm Hg, respectively, aud there were uo reports of sustained hypertension Meau chauge in heart rate was 1.7 bpm, while meau chauges in QTc intervals were 1.8 aud -5.4 msec for QTcB aud QTcF, respectively. Conclusions: In this study, duloxetiue was showu to be safe aud well tolerated during dose escalations from 60 mg QD to 120 mg QD. Rates of discoutiuuatiou due to adverse eveuts were similar to those seeu in previous studies of duloxetiue at 60 mg QD. Despite rapid escalation from 60 mg QD to 90 mg QD to 120 mg QD, the majority of adverse eveuts were mild aud trausieut aud occurred in the first week of duloxetiue dosiun ” (at 60 mp ” \ ouce daily). These results establish the safety aud tolerability of duloxetiue at once-daily doses above 60 mg, aud demonstrate that rapid dose escalation cau be achieved without iucurriug additioual adverse eveuts.
mPI
161
M. Garcia Compostela and Company,
Neuroscience,
Electroconvulsive anaesthetic Mahia. Hospital (La Comfia),
therapy:
Influence
of the
Psychiatry,
Santiago
agent Gil Casares, Spain
de
Indianapolis,
Background: Studies have suggested that autidepressauts iuhibitiug the reuptake of both serotouiu (5-HT) aud uorepiuephriue (NE) may exhibit efficacy superior to that of selective serotouiu reuptake iuhibitors (SSRIs) in the treatment of major depressive disorder @IDD).startsup>l Duloxetiue, a dual reuptake iuhibitor of 5-HTNE, has demo&rated efficacy for the treatment of both emotional aud painful physical symptoms of MDD in doubleblind, placebo-controlled trials at a once-daily dose of 60 mg.2 While the expected starting aud therapeutic dose for the majority of patients is 60 mg QD, higher duloxetiue doses have beeu studied using a BID dosing schedule. Therefore, to further iuvestigate the pharmacologic profile of duloxetiue withiu a ouce daily dosing regime11 at doses above 60 mg, we examined the safety aud
Introduction: The auaesthetic ageut used for Electrocouvnlsive Therapy (ECT) administration must produce quick iuductiou without shorteuiug the time of couvulsiou, because it is au eseutial factor in the efficacy of this treatment. There is uo agreement about the best auaesthetic ageut for ECT. Two of the more used are Thiopeutoue aud Propofol. Propofol is a non-barbituric auaesthetic ageut, useful for outpatient ECT. It’ s auticouvnlsivaut properties are object of controversy today. Objective of the study: To evaluate the iuflueuce of the auaesthetic ageut in convulsive activity aud possible iudicatiou of chaugiug the auaesthetic ageut in the administration of ECT Maiutemlauce (ECT-M). Methods: SAMPLE: Sesious of ECT-M (N=50) administered to a patient (male, age 65 years, weight 112 Kg, high convulsive treshold, diagnosed of Major Depressive Disorder). Treatment
PI.
Affective
disorders
with ECT-M was administered along oue year. We aualyse the period of time of EEG-couvnlsiou in relation to type aud dose of auaesthetic ageut used aud electrical stimulus administered in three phases of the treatment with ECT-M: Phase I-treatment using Thiopeutoue (11~15) Phase II-treatment using Propofol (11~20) Phase III-treatment using Thiopeutoue (11~15) Statistical analyses were made with the statistical package SPSS v.10 for windows. Summary of results: The meau of the time of couvulsiou in Phase I was 33,7 (medium dose 323 mg); in Phase II was 38,7 (medium dose 272 mg) aud in Phase III was 34.12 (medium dose 128 mg). Conclusion: 1. The time of EEG couvulsiou don’ t descend (statistical significance; p>O.OOl) wheu we use propofol. 2. In Phase III the dose of thiopeutoue required to auaesthetic iuductiou is lower thau doses required in phase I. In those patients that present tolerance to Thiopeutone, au ueed growing doses of thiopeutoue, we propose a period of chauge using propofol. References [l] [2]
Martin et al: Pmpofol aneaesthesia, seizure duration and ECT: a case report and literature review. J.ECT.14(2):99-108,1988. Geretseger C. et al: Propofol and methohexital as anaesthetic agents for electroconvulsive therapy: The Journal of the European college of ueulropsychopharlnacology, 218, 1999.
mP 1 162
The antiepileptic drug plasma corticosterone of HPA axis activation
levetiracetam levels in two
R. Grim&e, G. Loreut, Y. Lamberty *. UCB Pharma Chemin du Foriest, Braine-1’ Alleud, Belgium
modulates rat models
Sector
SA,
Objective: chrouic elevated glucocorticoid levels may result in allostatic load with pathophysiological cousequeuces (McEweu, 1998) like ueuroual damage with subsequent impact ou learuiug aud behavior. Moreover, disorders like anxiety, depression aud post-traumatic stress disorders are likely to result in allostatic load (McEweu, 2000). We evaluated the effect of the autiepileptic drug levetiracetam in two auimal models of HPA (hypothalamicpituitary-adrenal) dysfuuctiou, namely, bicuculliue-induced HPA activation aud stress-induced failure to turn off the HPA axis in aged rats. Method: LEV was administered orally to young (2 mouths) aud aged (21 mouths) rats. Young rats received a subcouvnlsaut dose of bicuculliue (3 mgkg, ip) aud aged rats were submitted to a 15 miu immobilization stress. The rats were subsequently sacrificed aud radioassay of corticosteroue (CORT) performed. Results: In young rats, LEV 17 mgkg significantly couuteracted the bicuculliue-induced elevatiou of plasma CORT level. In aged rats, LEV 17 mgkg siguificautly reduced the age-related iucrease in basal CORT levels. In addition, LEV siguificautly facilated recovery in the CORT levels after the stress. Conclusions: LEV is effective in two auimal models of HPA activation In particular, LEV facilitates termiuatiou of the impaired stress response in aged animals. Thus, LEV might have a poteutial in disorders related to allostatic load. The mechanism of action is uuder study.
and antidepressants
m
P 1 163
Venlafaxine as a treatment
S243
in inpatients goal
- sustained
remission
V Koriukova”2, E. Kolibas’a2, V Novot119”~. ‘Psychiatric Clinic of Medical Faculty Comenius University, Slovak Republic; 2 University Hospital in Bratislava, Slovak Republic Study purpose was to evaluate efficacy aud safety of acute treatment with veulafaxiue with the special focus ou sustained remission Patients and Methods: 33 iupatieuts (21 women) of age 25578 years (average age 51,6114,2 years) suffering from moderate to severe depression (F-32, F-33 according to ICD-10) were treated with veulafaxiue. Study was open labeled with flexible veulafaxiue dosage. Therapeutic response was evaluated according to clinical status aud social behavior just prior to discharge from hospital aud after uext 3 mouths. Exchange of veulafaxiue to auother autidepressaut because of its’ iuefficacy or side effects (SE) were also recorded. Safety of veulafaxiue therapy was evaluated according to frequency aud profile of SE. Several data are presented in relative values. ~2 test was used for evaluatiou of their statistical significaiice. Results: Meau daily dose of veulafaxiue was 226 mg (755 350 mg). In 19 patients (60% of total munber) maximal daily dose was 2200 mg. Length of autidepressive therapy during hospitalizatiou was 14-92 days (mean time 36,7 days). Accordiug to clinical evaluation, positive response was found in 85% significant improvemeutiremissiou was reached in 47% patients. During 3 mouths since starting therapy munber of patients with remission iucreased aud the ability to work was retrieved in the majority of patients where sickness absence had beeu present before. In 9% patients veulafaxiue therapy was iueffective aud therefore au exchange of therapy was made. All patients used other psychotropic drugs: hypnotics (60%) or auxiolytics (45%). In 40% patients used ueuroleptics aud in 20% autiepileptics. The most frequent SE during veulafaxiue therapy were signs of undesirable activation, iucludiug vegetative distress sensations, hyposomuia, hyporexia (in 6 patieuts, i.e. l&2%). In oue patient these SE led to premature discoutiuuatiou of therapy. Corrective comedicatiou (tiaiieptiiie) was iiecessary iii two patieiits. Conclusion: Veiilafaxiiie represeiits effective treatmeiit for iiipatients with severe depression During acute therapy positive response ou veulafaxiue was recorded in 85% patients aud half of them reached siguificaut improvement or complete aud sustained remission of symptoms. The most frequent SE of veulafaxiue were undesirable activation effects. References [l]
[2]
Thase, M., E.: Recovery from depression: Conceptual underpinnings. Presented at the meeting of the American Psychiatric Association (APA), Philadelphia, May 2002. Kolibas E, Novotny V Antidepressants of dual mechanism of action and elderly age. & Psychiatrie 2001; 97:232-239.
mP 1 164
N.P. Lekka, Department
Mood disorders and antidepressant treatment of prisoners with a history of self-mutilation S. Beratis. of Psychiatry,
University Patras,
of Patras Greece
Medical
School,
References [l] [2]
McEwen, McEwen,
B.S., 1998. New England J. Medicine, 338, 3, 171-179. B.S., 2000. Neuropsychopharlnacol., 22, 2, 108-124.
Purpose disorders
of the study: To iuvestigate aud autidepressaut treatment
the prevalence in prisoners with
of mood a history
S242
Affective
disorders
comprehensive psychopathological profiles of the pa-tie&. In particular “comorbidity” is ofteu the rule rather thau the exception aud becomes a misleading concept. On the other baud, specific psychopathological dimeusious could be more useful for a proper pharma-cological treatment. Multi-dimensional approach is iudepeudeut from single diagnoses, has a cross-sectional perspective, aud adopts multi-morbidity as the standard rule. Aim of the present study was to examiue the feasibility aud usefuhless of this approach to gaiu a full de-scription of the subjects’ psychopathology aud to overcome the “comorbidity” concept. 300 uuipolar aud bipolar patients who fulfilled diagnostic criteria for a Major Depressive Episode ac-cording to DSM-IV were included iuto the study. Each subject was evaluated upon referral to our “Ceutre for Diamlosis aud Treatment of Deuressive Disorders” or. if already in treatment, at the ouset of the episode; evaluatiou was cross-sectional aud iudepeudeut from the treatment received. The followiug dimeusioual axes were examined: psychic aud somatic anxiety, psychotic positive aud negative symptoms, aggressiveness aud suicidality, eating disorders aud mood disturbances. Radar graph plottings were used to describe each dimension, aud subjects were cumulated aud aualysed with descriptive statistical methods. Discrimiuaut analysis was employed to differentiate among depres-sive clinical sub-types: melancholic, psychotic, atypical etc., each represeuted by meaus of multi-axial radar graphs. Prelimiuary results seem to indicate that a multidimeusioual model is feasible, clinically useful, aud ca-pable of describe in a better way the iudividual pictures, both in typical aud atypical clinical presenta-tious. Moreover, since drug treatments are uot diaguostically specific but are effective ou symptoms or syndromes across differeut disorders, some implications of this approach ou pharmacological treatment are discussed. References [l]
[2]
[3]
Altamura AC Antidepressant therapy at the dawn of the third millennium. Amxican Journal of Psy-chiatry (Book Fomm) 2000; 157(1‘):144-5. \/ Shankman SA, Klein DN. Dimensional diagnosis of depression: Adding the dimension of course to severity, and comparison to the DSM. Comprehensive Psychiatry 2002; 43(6):42&6. Angst J, Gamma A. A new bipolar spectrum concept: a brief review. Bipolar Disorder 2002; 4 Suppll: 114.
m PI
160
Duloxetine depressive askociated w QD)
M. Wohlreich. IN, US.A.
Eli Lilly
for the treatment disorder: Safety with rapid dose
of major and efficacy escalation (60-120
and antidepressants tolerability of duloxetiue during a dose escalation from 60 mg QD to 120 mg QD. Methods: This was a single-arm, non-placebo-controlled, doseescalation study, in which patients were blinded as to timing of dose escalations. Patients (aged 218) meeting DSM-IV criteria for MDD (11~128) received placebo for 1 week followed by duloxetiue (60 mg QD) titrated after 1 week to 90 mg QD aud after a further week to 120 mg QD. The dose of 120 mg QD was theu maiutaiued for 4 weeks. Efficacy measures included the 17-item Hamilton Rating Scale for Depression (HAMD17) total score, the Clinical Global Impression of Severity (CGI-S) scale, Patient Global Impression of Improvement (PGI-I) scale, aud Visual Aualog Scales (VAS) for pain Safety was assessed using spoutaueously reported treatment-emergeut adverse eve&, chauges in vital signs, aud laboratory aualytes. Results: Siguificaut improvements were observed in all assessed efficacy measures at eudpoiut (pi.001). The rate of discoutiuuatiou due to adverse eveuts (16.3%) was comparable to rates observed in previous placebo-controlled trials. The most frequeutly reported treatment-emergeut adverse eveuts (TEAEs) were nausea, headache, dry mouth, dizziness, aud decreased appetite. The majority of TEAEs were associated with initial duloxetiue dosing ~ further escalations in dose produced few additioual adverse events. Meau chauges from baseline to eudpoiut in supiue systolic aud diastolic blood pressure were 1.2 aud 0.6 mm Hg, respectively, aud there were uo reports of sustained hypertension Meau chauge in heart rate was 1.7 bpm, while meau chauges in QTc intervals were 1.8 aud -5.4 msec for QTcB aud QTcF, respectively. Conclusions: In this study, duloxetiue was showu to be safe aud well tolerated during dose escalations from 60 mg QD to 120 mg QD. Rates of discoutiuuatiou due to adverse eveuts were similar to those seeu in previous studies of duloxetiue at 60 mg QD. Despite rapid escalation from 60 mg QD to 90 mg QD to 120 mg QD, the majority of adverse eveuts were mild aud trausieut aud occurred in the first week of duloxetiue dosiun ” (at 60 mp ” \ ouce daily). These results establish the safety aud tolerability of duloxetiue at once-daily doses above 60 mg, aud demonstrate that rapid dose escalation cau be achieved without iucurriug additioual adverse eveuts.
mPI
161
M. Garcia Compostela and Company,
Neuroscience,
Electroconvulsive anaesthetic Mahia. Hospital (La Comfia),
therapy:
Influence
of the
Psychiatry,
Santiago
agent Gil Casares, Spain
de
Indianapolis,
Background: Studies have suggested that autidepressauts iuhibitiug the reuptake of both serotouiu (5-HT) aud uorepiuephriue (NE) may exhibit efficacy superior to that of selective serotouiu reuptake iuhibitors (SSRIs) in the treatment of major depressive disorder @IDD).startsup>l Duloxetiue, a dual reuptake iuhibitor of 5-HTNE, has demo&rated efficacy for the treatment of both emotional aud painful physical symptoms of MDD in doubleblind, placebo-controlled trials at a once-daily dose of 60 mg.2 While the expected starting aud therapeutic dose for the majority of patients is 60 mg QD, higher duloxetiue doses have beeu studied using a BID dosing schedule. Therefore, to further iuvestigate the pharmacologic profile of duloxetiue withiu a ouce daily dosing regime11 at doses above 60 mg, we examined the safety aud
Introduction: The auaesthetic ageut used for Electrocouvnlsive Therapy (ECT) administration must produce quick iuductiou without shorteuiug the time of couvulsiou, because it is au eseutial factor in the efficacy of this treatment. There is uo agreement about the best auaesthetic ageut for ECT. Two of the more used are Thiopeutoue aud Propofol. Propofol is a non-barbituric auaesthetic ageut, useful for outpatient ECT. It’ s auticouvnlsivaut properties are object of controversy today. Objective of the study: To evaluate the iuflueuce of the auaesthetic ageut in convulsive activity aud possible iudicatiou of chaugiug the auaesthetic ageut in the administration of ECT Maiutemlauce (ECT-M). Methods: SAMPLE: Sesious of ECT-M (N=50) administered to a patient (male, age 65 years, weight 112 Kg, high convulsive treshold, diagnosed of Major Depressive Disorder). Treatment
PI.
Affective
disorders
with ECT-M was administered along oue year. We aualyse the period of time of EEG-couvnlsiou in relation to type aud dose of auaesthetic ageut used aud electrical stimulus administered in three phases of the treatment with ECT-M: Phase I-treatment using Thiopeutoue (11~15) Phase II-treatment using Propofol (11~20) Phase III-treatment using Thiopeutoue (11~15) Statistical analyses were made with the statistical package SPSS v.10 for windows. Summary of results: The meau of the time of couvulsiou in Phase I was 33,7 (medium dose 323 mg); in Phase II was 38,7 (medium dose 272 mg) aud in Phase III was 34.12 (medium dose 128 mg). Conclusion: 1. The time of EEG couvulsiou don’ t descend (statistical significance; p>O.OOl) wheu we use propofol. 2. In Phase III the dose of thiopeutoue required to auaesthetic iuductiou is lower thau doses required in phase I. In those patients that present tolerance to Thiopeutone, au ueed growing doses of thiopeutoue, we propose a period of chauge using propofol. References [l] [2]
Martin et al: Pmpofol aneaesthesia, seizure duration and ECT: a case report and literature review. J.ECT.14(2):99-108,1988. Geretseger C. et al: Propofol and methohexital as anaesthetic agents for electroconvulsive therapy: The Journal of the European college of ueulropsychopharlnacology, 218, 1999.
mP 1 162
The antiepileptic drug plasma corticosterone of HPA axis activation
levetiracetam levels in two
R. Grim&e, G. Loreut, Y. Lamberty *. UCB Pharma Chemin du Foriest, Braine-1’ Alleud, Belgium
modulates rat models
Sector
SA,
Objective: chrouic elevated glucocorticoid levels may result in allostatic load with pathophysiological cousequeuces (McEweu, 1998) like ueuroual damage with subsequent impact ou learuiug aud behavior. Moreover, disorders like anxiety, depression aud post-traumatic stress disorders are likely to result in allostatic load (McEweu, 2000). We evaluated the effect of the autiepileptic drug levetiracetam in two auimal models of HPA (hypothalamicpituitary-adrenal) dysfuuctiou, namely, bicuculliue-induced HPA activation aud stress-induced failure to turn off the HPA axis in aged rats. Method: LEV was administered orally to young (2 mouths) aud aged (21 mouths) rats. Young rats received a subcouvnlsaut dose of bicuculliue (3 mgkg, ip) aud aged rats were submitted to a 15 miu immobilization stress. The rats were subsequently sacrificed aud radioassay of corticosteroue (CORT) performed. Results: In young rats, LEV 17 mgkg significantly couuteracted the bicuculliue-induced elevatiou of plasma CORT level. In aged rats, LEV 17 mgkg siguificautly reduced the age-related iucrease in basal CORT levels. In addition, LEV siguificautly facilated recovery in the CORT levels after the stress. Conclusions: LEV is effective in two auimal models of HPA activation In particular, LEV facilitates termiuatiou of the impaired stress response in aged animals. Thus, LEV might have a poteutial in disorders related to allostatic load. The mechanism of action is uuder study.
and antidepressants
m
P 1 163
Venlafaxine as a treatment
S243
in inpatients goal
- sustained
remission
V Koriukova”2, E. Kolibas’a2, V Novot119”~. ‘Psychiatric Clinic of Medical Faculty Comenius University, Slovak Republic; 2 University Hospital in Bratislava, Slovak Republic Study purpose was to evaluate efficacy aud safety of acute treatment with veulafaxiue with the special focus ou sustained remission Patients and Methods: 33 iupatieuts (21 women) of age 25578 years (average age 51,6114,2 years) suffering from moderate to severe depression (F-32, F-33 according to ICD-10) were treated with veulafaxiue. Study was open labeled with flexible veulafaxiue dosage. Therapeutic response was evaluated according to clinical status aud social behavior just prior to discharge from hospital aud after uext 3 mouths. Exchange of veulafaxiue to auother autidepressaut because of its’ iuefficacy or side effects (SE) were also recorded. Safety of veulafaxiue therapy was evaluated according to frequency aud profile of SE. Several data are presented in relative values. ~2 test was used for evaluatiou of their statistical significaiice. Results: Meau daily dose of veulafaxiue was 226 mg (755 350 mg). In 19 patients (60% of total munber) maximal daily dose was 2200 mg. Length of autidepressive therapy during hospitalizatiou was 14-92 days (mean time 36,7 days). Accordiug to clinical evaluation, positive response was found in 85% significant improvemeutiremissiou was reached in 47% patients. During 3 mouths since starting therapy munber of patients with remission iucreased aud the ability to work was retrieved in the majority of patients where sickness absence had beeu present before. In 9% patients veulafaxiue therapy was iueffective aud therefore au exchange of therapy was made. All patients used other psychotropic drugs: hypnotics (60%) or auxiolytics (45%). In 40% patients used ueuroleptics aud in 20% autiepileptics. The most frequent SE during veulafaxiue therapy were signs of undesirable activation, iucludiug vegetative distress sensations, hyposomuia, hyporexia (in 6 patieuts, i.e. l&2%). In oue patient these SE led to premature discoutiuuatiou of therapy. Corrective comedicatiou (tiaiieptiiie) was iiecessary iii two patieiits. Conclusion: Veiilafaxiiie represeiits effective treatmeiit for iiipatients with severe depression During acute therapy positive response ou veulafaxiue was recorded in 85% patients aud half of them reached siguificaut improvement or complete aud sustained remission of symptoms. The most frequent SE of veulafaxiue were undesirable activation effects. References [l]
[2]
Thase, M., E.: Recovery from depression: Conceptual underpinnings. Presented at the meeting of the American Psychiatric Association (APA), Philadelphia, May 2002. Kolibas E, Novotny V Antidepressants of dual mechanism of action and elderly age. & Psychiatrie 2001; 97:232-239.
mP 1 164
N.P. Lekka, Department
Mood disorders and antidepressant treatment of prisoners with a history of self-mutilation S. Beratis. of Psychiatry,
University Patras,
of Patras Greece
Medical
School,
References [l] [2]
McEwen, McEwen,
B.S., 1998. New England J. Medicine, 338, 3, 171-179. B.S., 2000. Neuropsychopharlnacol., 22, 2, 108-124.
Purpose disorders
of the study: To iuvestigate aud autidepressaut treatment
the prevalence in prisoners with
of mood a history