Selective serotonin reuptake inhibitors (SSRIs) are a recently developed class of drugs with significantly greater antidepressant efficacy than placebo. Generally, in double-blind comparative trials, all SSRIs demonstrated antidepressant efficacy similar to that of the 'standard' tricyclic antidepressants amitriptyline and imipramine; a meta-analysis of controlled trials found the efficacy of the SSRIs to be equivalent to that of the 2 tricyclics. Nevertheless, because of small patient numbers included in most studies that compare SSRIs with other antidepressants, no definitive statements about relative efficacy can be made. In these studies it is simply possible to state that no statistically significant differences were identified between SSRIs and the comparative antidepressants. Importantly, differences in clinical characteristics exist between the SSRIs-differences in elimination half-life (t1/2 beta) between fluoxetine and/or its metabolite (total t1/2 beta = 330 hours) and other SSRIs (t1/2 beta range = 15 to 30 hours), for example. This has implications in terms of potential drug interactions and must be considered when patients have to be switched to treatment with monoamine oxidase inhibitors. Studies with fluvoxamine have been conducted in both in- and outpatients, whereas trials with other SSRIs have been confined largely to outpatient populations. Fluvoxamine has been associated with a high incidence of nausea (37%), although this may have resulted from high initial dosages (rather than upward dose titration protocols) used in early trials. Of further interest, fluoxetine doses of 20mg may be sufficient to produce a satisfactory antidepressant response, and this SSRI may be particularly useful in patients with chronic retarded depression. More clinical data are required before the efficacy of sertraline and citalopram relative to standard antidepressants can be clearly defined. Preliminary data indicate that SSRIs are effective in the treatment of panic disorder, obsessive-compulsive disorder (OCD), eating (e.g. anorexia and bulimia) and personality disorders (e.g. anger, impulsiveness) and substance abuse (e.g. alcoholism); early results with fluvoxamine in the treatment of panic disorder and OCD, and with fluoxetine in the treatment of bulimia, personality disorders and alcohol abuse, have been encouraging. SSRIs have a more favourable tolerability profile than tricyclic antidepressants and, unlike the tricyclics, are not associated with anticholinergic adverse effects, sedation, cardiotoxicity or weight gain. SSRIs are associated with a relatively high incidence of nausea, particularly if high doses are used at the start of treatment. However, the incidence of nausea appears to decrease as treatment is continued.(ABSTRACT TRUNCATED AT 400 WORDS)

Comparative efficacy of antidepressants.

Fluvoxamine facilitates serotoninergic neurotransmission via potent and selective inhibition of serotonin (5-hydroxytryptamine; 5-HT) reuptake into presynaptic neurones The overall antidepressant efficacy of fluvoxamine 100 to 300 mg/day for 4 to 6 weeks in once daily or divided dosage regimens appears to be at least comparable to that of imipramine and similar to that of clomipramine, dothiepin, desipramine, amitriptyline, lofepramine, maprotiline, mianserin and moclobemide The efficacy of fluvoxamine has been maintained for up to 1 year, but long term data are limited, and there are no comparative studies of fluvoxamine with other selective serotonin reuptake inhibitors In some studies, fluvoxamine appeared to have an earlier beneficial effect on suicidal ideation and/or anxiety or somatic complaints compared with imipramine, dothiepin and maprotiline Gastrointestinal adverse effects, especially nausea, are commonly reported with fluvoxamine but are generally mild to moderate in severity The tolerability profile of fluvoxamine appears to be more favourable than that of tricyclic antidepressants in terms of cardiotoxic and anticholinergic adverse effects, sedation, weight gain and death from overdosage Thus, fluvoxamine is an effective and well tolerated antidepressant agent that is becoming established as an alternative to older agents in patients with mild, moderate or severe depression Fluvoxamine may be particularly beneficial in potentially suicidal patients with severe depression, in those with an underlying compulsive personality or cardiovascular disorder, in patients with coexistent anxiety or agitation, and in the elderly

Fluvoxamine. An updated review of its pharmacology, and therapeutic use in depressive illness.

In vivo assays for selecting candidate therapeutics for inhibiting amyloidoses, such as congophilic and fibrillar β/A4 amyloid deposition in brain. A candidate reagent is administered to a first rat in a first infusate comprising β/A4 peptide and perlecan by continuous infusion into the hippocampus for at least one week. The candidate reagent is selected as a candidate therapeutic for inhibiting congophilic and fibrillar β/A4 amyloid deposition in brain if the first infusate diminishes congo red and thioflavin S staining indicative of amyloid deposition adjacent to the infusion site, as compared with a second rat receiving a second infusate consisting essentially of β/A4 peptide and perlecan.

Animal models of human amyloidoses

To examine the validity and reliability of a Japanese version of the Symptom Checklist 90 Revised (SCL-90-R (J)). The English SCL-90-R was translated to Japanese and the Japanese version confirmed by back-translation. To determine the factor validity and internal consistency of the nine primary subscales, 460 people from the community completed SCL-90-R(J). Test-retest reliability was examined for 104 outpatients and 124 healthy undergraduate students. The convergent-discriminant validity was determined for 80 inpatients who replied to both SCL-90-R(J) and the Minnesota Multiphasic Personality Inventory (MMPI). The correlation coefficients between the nine primary subscales and items were .26 to .78. Cronbach's alpha coefficients were from .76 (Phobic Anxiety) to .86 (Interpersonal Sensitivity). Pearson's correlation coefficients between test-retest scores were from .81 (Psychoticism) to .90 (Somatization) for the outpatients and were from .64 (Phobic Anxiety) to .78 (Paranoid Ideation) for the students. Each of the nine primary subscales correlated well with their corresponding constructs in the MMPI. We confirmed the validity and reliability of SCL-90-R(J) for the measurement of individual distress. The nine primary subscales were consistent with the items of the original English version.

/pdf/the-reliability-and-validity-of-a-japanese-version-of-1fv6p7i4pe.pdf

The reliability and validity of a Japanese version of symptom checklist 90 revised

In a six-week double-blind randomized trial, preceded by a one-week period of single-blind placebo treatment, the efficacy and the side-effects of fluvoxamine (100-300 mg/d) (n = 24) and maprotiline (50-150 mg/d) (n = 24) were compared in moderately depressed outpatients with DSM-III Major Depression (n = 22) or Dysthymic Disorder (n = 26). Efficacy was measured by means of the Hamilton Depression Rating Scale, the Zung Depression Selfrating Scale, and a Clinical Global Impression of Severity Scale. Side-effects were evaluated by an Adverse Event Inventory and a Psychosomatic Symptom Scale. A statistically significant improvement was achieved in both treatment groups but success rates were modest: in both groups, 29% of the patients achieved a clinically significant improvement after six weeks of treatment. After six weeks of treatment, no difference in efficacy was found between fluvoxamine and maprotiline. Nausea was the most common complaint in the fluvoxamine group, while in the maprotiline group, it was dry mouth and constipation. One maprotiline-treated patient developed a convulsive attack.

Randomized double-blind study of fluvoxamine and maprotiline in treatment of depression.

Fluvoxamine maleate: Double-blind clinical trial vs placebo in hospitalized depressed patients

A Controlled Clinical Trial between Amitriptyline and its N-Oxide Metabolite

Global changes with glycosaminoglycan polysulfate in primary degenerative and multi-infarct dementia

Glycosaminoglycan polysulfate is a mixture of sulfomucopolysaccharides with a standardized composition and reproducible biologic activity. In a 12-week, multicenter clinical trial the therapeutic effects of two dosages—250 lipasemic-releasing units (LRU) per day and 500 LRU/day—of parenterally administered glycosaminoglycan polysulfate were compared in two diagnostically distinct populations: (1) patients with primary degenerative dementia of the Alzheimer type, and (2) patients with multi-infarct dementia. It was found that there were significant changes from pretreatment to end of therapy with regard to measures of objective performance, psychopathology, and social behavior. Improvement was consistently greater in the group with primary degenerative dementia than in the group with multi-infarct dementia. On the other hand, no consistent differences in therapeutic effects between the two doses could be seen. The drug was well tolerated; side effects were infrequent and mild. No clinically significant laboratory abnormalities were encountered during the 3-month clinical trial.

Treatment of primary degenerative dementia and multi-infarct dementia with glycosaminoglycan polysulfate: A comparison of two diagnoses and two doses

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Fluvoxamine maleate: Double-blind clinical trial vs placebo in hospitalized depressed patients

A Controlled Clinical Trial between Amitriptyline and its N-Oxide Metabolite

Global changes with glycosaminoglycan polysulfate in primary degenerative and multi-infarct dementia

Treatment of primary degenerative dementia and multi-infarct dementia with glycosaminoglycan polysulfate: A comparison of two diagnoses and two doses