Intravenous mirtazapine is safe and effective in the treatment of depressed inpatients.

Mirtazapine is a third-generation antidepressant with a dual mode of action. The oral administration has been shown to be effective and safe in the treatment of depressed patients. In this multicenter naturalistic study, we assessed the safety, tolerability, and therapeutic efficacy of intravenously administered mirtazapine in 80 moderately to severely depressed inpatients during a treatment period of 14 days. We found a significant decrease of the Hamilton Depression Rating Scale total score compared to baseline. Side effects were mild and transient. Our data indicate that intravenous mirtazapine is an effective, safe and well-tolerated treatment for depressed inpatients.

[Patient suitability for discharge from psychiatric hospitals]. / Uber die Entlassbarkeit von Patienten in psychiatrischen Krankenhäusern.

OBJECTIVE: To assess the possibility of discharging psychiatric inpatients of two large Mental Hospitals in Lower Austria. METHODS: A point prevalence study was performed in 1992. Treating psychiatrists were asked to evaluate the possibility to discharge patients under the hypothetical assumption that a broad range of residential facilities were available. RESULTS: The inpatient proportion had decreased from 2179 in 1974 to 1032 in 1992. Of the 1992 population 75.7% might be discharged. Most patients (41.5%) were regarded as needing a permanently staffed home. CONCLUSIONS: Although the inpopulation of the two large Mental Hospitals studied had decreased over a period of 18 years already by over 50 percent, the results of this study show that there is a large potential for further reform. Since the evaluation was carried out by the treating psychiatrists in the hospital, who might have been in a conflict of interests or might have preferred the treatment they are providing themselves, this finding is particularly remarkable.

[Acute viral encephalitis with primary psychotic symptoms--diagnosis, course and prognosis]. / Akute virale Enzephalitis mit primär psychotischer Symptomatik--Diagnose, Verlauf und Prognose.

In 13 cases referred to psychiatric treatment between 1974 and 1980 acute viral encephalitis was diagnosed in the further course of the illness. The majority were female patients. Positive virological or pathological evidence was obtained in 38% of all cases. The most frequent etiology to be found was the herpes-simplex virus. These findings correspond to 36 cases from the literature. 90% of all cases showed neurological symptoms within two weeks of hospital admission. EEG and cerebrospinal fluid examinations proved to yield most in diagnosis, whereas angiography and brain scanning did not have special diagnostic importance. The present diagnostic value of CT is mainly restricted to the detection of herpes-simplex virus encephalitis and acute leukoencephalitis. Initially psychopathological findings varied largely and fluctuations in the level of consciousness were a prominent feature in most cases. In others no difference to schizophrenic psychosis could be noted on admission. Compared to other studies on acute viral encephalitis with initial neurological symptoms, patients with a psychotic onset of the illness tend to have a higher morbidity, while the mortality remains the same.