An open multicentre study to evaluate the efficacy and tolerance of fluoxetine 20 mg in depressed ambulatory patients.

In this study, 544 out-patients suffering from depressive disorders were enrolled in 6 weeks open study with fluoxetine 20 mg. A statistically significant decrease of the Hamilton Rating Scale for Depression (HRS-D) score is observed during treatment. All individual item HRS-D scores and in particular suicidal ideation, sleep disturbances and anxiety showed the same improvement. Side-effects were carefully recorded and presented a lower incidence rate than in other studies. New issues in methodology management concerning ambulatory studies are discussed.

[Lasthénie de Ferjol syndrome. Apropos of a case]. / Le syndrome de Lasthénie de Ferjol. A propos d'une observation.

After a brief review of literature, the authors report a case of the "Lasthénie de Ferjol" syndrome. From clinical observations, they establish theoretical landmarks and underline the necessity for searching the meaning.

Double-blind clinical study comparing alprazolam and doxepin in primary unipolar depression.

The therapeutic effect and safety of alprazolam and doxepin were studied in 126 outpatients suffering from primary unipolar depression. The 6-week study was double-blind with a random allocation of treatment. Patients were treated with a flexible dose of 1.0-4.5 mg of alprazolam and 50-225 mg of doxepin per day. The mean final doses were 2.7 mg for alprazolam and 137.5 mg for doxepin. The results indicate that alprazolam and doxepin were equally efficacious. The incidence of side-effects was lower in the alprazolam treatment group.

[Factor analysis of the French revision of the AMDP rating scales. Results of an international study of 388 cases]. / Analyse factorielle de la révision française de l'échelle AMDP. Résultats d'une étude internationale de 388 cas.

A total of 388 patients from 10 Belgian and French Centers were evaluated with the 1981 revision of the psychopathological and somatic scales of the AMDP System. Principal components factor analyses indicate that the somatic items contribute little to the structure. A 10-factors solution of the psychopathological items generate the following factors after orthogonal rotation: Obsessions-Phobias, Dramatization, Anxiety, Depression, Retardation, Organicity, Dissociation, Delusions, Mania, Dysphoria. This structure is similar to the analyses of the previous German edition except for Anxiety (due to additional French items) and Dramatization (which replaces the German factor on Hypochondriasis). The correlations between raw factor scores and item scores of the BPRS and of a similar AMDP-derived scale contribute to the validation of the AMDP factors and to the justification of a 13-item AMDP Syndromic Scale.

[Analysis of controlled studies comparing mianserin and clomipramine (author's transl)]. / Analyse des études contrôlées comparant la miansérine et la clomipramine.

The analysis of three controlled studies comparing mianserin and clomipramine shows that none of them has elicited statistically significant differences between drugs, although populations were different: primary depression almost equally divided in endogenous and exogenous cases (de Buck), primary depression mostly neurotic (Pinder), involutional melancholia (Blaha). The only difference found as to efficacy was a more precocious onset of action for mianserin in the group of the endogenous depressions (de Buck). Mianserin causes significantly less side effects, above all as to hypotension, dry mouth, tremor and blurred vision.

[The place of mianserin among the antidepressants (author's transl)]. / Place de la mianserine parmi les antidépresseurs.

The originality of mianserin lies mainly in its chemical formula ; it is a tetracyclic piperazino-azepine compound. Moreover its pharmacological profile differs from that of other antidepressant drugs because it is devoid of central anticholinergic effects, it inhibits 5-hydroxytryptophane (the precursor of serotonine) and contrary to the tricyclics it does not affect the re-uptake of the amine-transmitters but increases the turnover of noradrenaline. It has been shown in a clinical trial that mianserin induces a hypomania in some manic-depressed patients. Regarding the antidepressive effect, mianserin is superior to placebo and as effective as imipramine and amitriptyline. It simultaneously works on anxiety, psychomotoric retardation and suicidal tendency; sleep improves under mianserin's influence. The value of mianserin is proved by its safety in use. It has no cardiotoxic effect and does not interact with coumarin-type anticoagulants. Since there are no anticholinergic effects, mianserin can be given to patients suffering from glaucoma or prostatic hypertrophy. Finally it appears that mianserin lowers the suicidal risk through its sedative properties.

[A controlled double-blind crossover study of the efficacy of mepiprazol (EMD 16.923) and of diazepam in the treatment of neurotic disorders]. / Etude contrôlée selon la méthode du double insu cross over de l'efficacit-57e compar-57ee du mepiprazol (EMD 16.923) et du diazepam dans le traitement des troubles n-57evrotiques

After a preliminary encouraging trial of mepiprazol (EMD 16.923) on 8 patients, a double-blind cross-over study of mepiprazol and diazepam was performed in order to compare their effect in the treatment of neurotic disorders, particularly on various forms of anxiety.