The Effect of a Citrus and Pomegranate Complex on Physical Fitness and Mental Well-Being in Healthy Elderly: A Randomized Placebo-Controlled Trial.

OBJECTIVES: This study investigates whether a citrus and pomegranate complex (CPC) improves physical fitness, mental well-being, and blood biomarkers for oxidative stress and endothelial function in healthy elderly. DESIGN: A randomized placebo-controlled cross-over trial. PARTICIPANTS: The study included 36 healthy elderly aged 60-75 years old. INTERVENTION AND MEASUREMENTS: Participants received four weeks of CPC supplementation and performed the handgrip strength and senior fitness test. Quality of life (QOL) was assessed and blood samples were analyzed for oxidative stress and endothelial function markers. RESULTS: After four weeks of CPC supplementation, handgrip strength significantly improved (p=0.019), compared to placebo. Moreover, the thinking, memory, learning, and concentration facets were improved (p=0.042), compared to placebo, and plasma malondialdehyde decreased, compared to placebo (p=0.033). The intervention did not affect senior fitness and the other QOL domains and blood parameters. CONCLUSION: Four weeks of daily CPC supplementation significantly improves handgrip strength and self-evaluated measures of psychological function in healthy older adults. Further research should focus on mechanisms associated with physical performance.

Therapeutic superiority of maprotiline versus doxepin in geriatric depression.

In a double-blind study, 49 geriatric patients suffering from primary major depression were treated with maprotiline or doxepin. Efficacy and safety were assessed by the Hamilton Depression Rating Scale and the Zung Self-Rating Depression and Anxiety scales, side effects profile, routine laboratory tests, and measurements of blood levels. Although marked improvement was obtained with both antidepressants, patients on maprotiline showed statistically greater improvement than those on doxepin. No significant differences were detected between the two drugs with respect to side effects. A significant positive correlation was obtained between dosage and blood levels of maprotiline and doxepin, but there was no correlation between blood levels and clinical response. Overall, results suggest that maprotiline may be superior to doxepin in the treatment of geriatric depression.

Comparative cardiac effects of maprotiline and doxepin in elderly depressed patients.

In a double-blind study, 49 elderly patients with primary major depression, with or without cardiovascular disease, were treated with maprotiline or doxepin. Holter monitors, 12-lead ECGs, and orthostatic blood pressure measurements were used. Maprotiline was associated with decreased PVCs in patients with a "high" baseline rate, while doxepin was associated with increased PVCs in this group. There were no significant differences in orthostatic blood pressure changes between treatment and nontreatment phases or between the two drugs. Small but significant increases in heart rate and prolonged PR interval were noted with both drugs. QRS interval was prolonged by maprotiline but decreased by doxepin. Neither drug produced untoward effects in patients with stable angina or an old myocardial infarction. Maprotiline may have an antiarrhythmic effect which could be beneficial in the treatment of depression with concomitant PVCs. Conversely, doxepin may be more appropriate for depressed patients with heart block or intracardiac conduction delays. Further research is necessary to confirm these suggestions.

Reported weight loss and dexamethasone nonsuppression in depressed patients. A negative study.

In a sample of 96 patients with DSM-III major depressive disorder and in a subset of 78 melancholic patients, there was no evidence that dexamethasone nonsuppression was more common in patients with reported weight loss.