A comparison of fluoxetine and imipramine in the treatment of outpatients with major depressive disorder.

A double-blind clinical trial was undertaken to evaluate the clinical efficacy and safety of fluoxetine compared with imipramine in the treatment of 59 outpatients suffering from major depressive disorder. The mean scores of all depression rating scales showed that the drugs had comparable efficacy. The side effect profile of imipramine was found to be mainly anticholinergic, which was not the case for fluoxetine, where it was mainly found to be gastrointestinal, such as nausea and diarrhoea. In both groups the total number of adverse events reported were the same. Fluoxetine treatment resulted in weight loss, whereas imipramine treatment resulted in a slight but significant weight increase.

Fluvoxamine in the treatment of demented elderly patients: a double-blind, placebo-controlled study.

The efficacy of fluvoxamine on cognitive functioning and behavioral changes was evaluated in a double-blind, placebo-controlled study of 46 elderly demented patients. The patients had a DSM-III diagnosis of primary degenerative dementia or multi-infarct dementia and were aged greater than or equal to 65 years. Twenty-two patients were given 150 mg fluvoxamine per day and 24 received placebo tablets; 14 and 15 patients, respectively, completed 6 weeks of treatment. Within treatments, there were no significant changes in median scores on neuropsychological tests (picture recall and recognition, trail making and finger tapping) or the GBS scale scores (degrees of dementia) or GBS subscale score (clinical profiles, including symptoms common in dementia, motor, emotional and intellectual functioning). Between treatments, the median changes in psychometric test scores did not differ significantly. However, within and between treatments, there were trends favoring fluvoxamine on symptoms common in dementia (confusion, irritability, anxiety, fear-panic, mood level and restlessness). In conclusion, the study does not support the hypothesis that fluvoxamine improves cognitive functioning or behavioral changes in elderly dementia patients.

[Legal rights for the aged on admission to a psychiatric clinic or transfer to a psychiatric nursing home. Forms of admission, compulsory admission and incapacitation]. / De aeldres retsstilling ved indlaeggelse på psykiatrisk afdeling eller overflytning til psykiatrisk plejehjem. Indlaeggelsesformer, tvangstilbageholdelser og umyndiggørelser.

The legal position of elderly persons on transfer to a psychiatric department must be improved. The proportion of elderly persons in the population is increasing and, parallel with this, there are increasing problems concerning incapacity to manage their own affairs on account of various forms of dementia. Conditions of dementia may cause inability to make decisions about transfer to a psychiatric department. The extent of this problem is illustrated in this article. On referral to a psychiatric nursing home, it is necessary to declare these persons incapable of managing their own affairs for legal reasons. To avoid this form of intervention, the present authors suggest appointment of a personal advisor instead. It is recommended that directives for solving this problem should be incorporated in the new Danish legislation concerning mental illness.