Treatment response of depressed outpatients unresponsive to both a tricyclic and a monoamine oxidase inhibitor antidepressant.

BACKGROUND: Data regarding effective treatment options for the minority of patients refractory to initial antidepressant trials are essential to guide therapeutic choices and to sustain the hope of patients and perseverance of clinicians. Few such data are available concerning the treatment of patients refractory to treatment with both a tricyclic antidepressant and a monoamine oxidase inhibitor given singly. METHOD: In a study of mood reactive depressed patients, most of whom met Columbia criteria for atypical depression, 20 patients refractory to vigorous 6-week double-blind trials of both imipramine and phenelzine given singly were given clinician's choice open treatment. A chart review of course in open treatment was conducted. RESULTS: Eleven patients (55%) had a full response to subsequent treatments, principally continued phenelzine and the combination of phenelzine with amitriptyline. Another 6 (30%) had at least moderate benefit from a variety of other treatments. CONCLUSION: These data suggest that even among patients who have failed to respond to two vigorous trials of different antidepressants, at least half appear to benefit from other pharmacologic regimens.

Cuantificación fisicoquímica en gorro turco [Melocactus zehntneri (Britton & Rose) Luetzelburg - Cactaceae] / Quantificação Fitoquímica da coroa-de-frade [Melocactus zehntneri (Britton & Rose) Luetzelburg - Cactaceae] / Quantification Physicochemical in Melon Cactus [Melocactus zehntneri (Britton & Rose) Luetzelburg - Cactaceae]

RESUMO No Nordeste do Brasil é bastante comum e variado o uso da coroa-de-frade (Melocactus spp.). Assim, o objetivo deste estudo foi realizar diversas análises em cladódios de coroa-de-frade [Melocactus zehntneri (Britton & Rose) Luetzelburg], para que possamos compreender as razões estes usos. Os cladódios foram coletados na cidade de Campina Grande e levados ao Laboratório de Engenharia de Alimentos da Universidade Federal de Campina Grande, onde foram feitas as seguintes análises: peso, altura, diâmetro, cor, umidade, acidez, pH, ácido ascórbico, carotenoides, flavonoides e compostos fenólicos, tanto na epiderme quanto no parênquima aquífero. Os resultados mostraram que a epiderme tem uma acidez elevada e mais ácido ascórbico, e um pH mais baixo em comparação com o parênquima aquífero. O conteúdo de carotenoides, flavonoides e compostos fenólicos, foram diferentes nas partes estudadas. A epiderme apresentou sempre maiores quantidades de carotenoides, flavonoides e compostos fenólicos em relação ao parênquima aquífero, nas três plantas estudadas, indicando que a maior parte da defesa da planta acontece neste tecido. Mais estudos são necessários com técnicas mais precisas, para identificar os componentes bioativos desta espécie.

ABSTRACT In Northeast Brazil, the use of melon cactus (Melocactus spp.) is quite common and varied. Thus, the present study aimed to perform various analyzes in cladodes of melon cactus [Melocactus zehntneri (Britton & Rose) Luetzelburg], to understand the reasons for the use of this species. The cladodes were collected in the city of Campina Grande and taken to the Food Engineering Laboratory of the Federal University of Campina Grande, where we performed the following analyses: mass, height, diameter, color, moisture, acidity, pH, ascorbic acid, carotenoids, flavonoids and phenolic compounds, both in the epidermis and in the aquifer parenchyma. The results showed that the epidermis has a higher acidity, ascorbic acid content and lower pH compared to the aquifer parenchyma. The contents of carotenoids, flavonoids and phenolic compounds, were different from the both parts analyzed. The epidermis always had greater quantities of carotenoids, flavonoids and phenolic compounds than the aquifer parenchyma for the three plants, showing that most of the plant defense takes place in this tissue. Further studies, with more accurate techniques, are needed to identify the bioactive components of this species.

Predictive value of symptoms of atypical depression for differential drug treatment outcome.

Data for 401 depressed outpatients with mood reactivity who participated in a randomized trial comparing placebo, imipramine, and phenelzine were analyzed for predictors of differential response by stepwise multiple regression techniques. Features of the Columbia criteria for atypical depression including oversleeping, overeating, severe anergy, and pathologic rejection sensitivity were each predictive of a poorer response to imipramine than to phenelzine only when compared to those patients with none of the features. These features were not additive in their contribution to differential outcome. Lack of endogenous features was not predictive of a differential drug treatment response. Compared with patients who have no symptoms of atypical depression, patients with any of the four features had an inferior imipramine response rather than a superior phenelzine response. These analyses indicate that the clear differential responsivity to medication treatment in atypical depression is not simply related to any one defining symptom and that further correlates of this apparent biological heterogeneity need to be explored.