[Assessment of the clinical activity of fluoxetin (Prozac) according of the "Stars of Liège" model]. / Evaluation de l'activité clinique de la fluoxétine (Prozac) selon "les étoiles de Liège".

Ten psychiatrists have independently rated the clinical profile of fluoxetin (Prozac) at the daily dose of 20 mg according to a "Stars of Liège" model comprising three parameters of therapeutic activity (antidepressant, psychostimulant and anxiolytic) and three parameters of side-effects (anticholinergic, sedative and hypotensive). Each parameter, graduated from 0 to 5 (no, very weak, weak, moderate, potent, very potent effect) was rated by each investigator according to his personal experience with at least 10 patients. Mean ratings given to fluoxetine show a moderate antidepressant effect, equal to amitriptyline (Rédomex, Tryptizol 75 mg/d, clomipramine (Anafranil 75 mg/d and nialamide (Niamide 100 mg/d, weak psychostimulating and anxiolytic effects, a very weak sedative effect and a lack of anticholinergic and hypotensive effects. Digestive side-effects of moderate intensity were also noted as well as a very weak anorexia. The important variability between investigators in the rating of the clinical profile of fluoxetine suggests that more experience is needed in order to define better its physiognomy.

[Novel comparative profile of the clinical activity of antidepressive agents]. / Une physionomie comparée originale de l'activité clinique des antidépresseurs.

In order to develop practical criteria to guide in the selection of antidepressant medication according to depressive symptomatology, we propose a graphical representation of the clinical activity of 24 antidepressants according to a "star" model. Six parameters have been evaluated from 0 to 5 in comparison to reference drugs (rated 5) by 11 independent "blind" psychiatrists expert in pharmacotherapy. Three parameters were used as measures of therapeutic activity: antidepressant, psychostimulant, and anxiolytic, with iproniazide 75 mg/d, metamphetamine 15 mg/d, and diazepam 20 mg/d as reference drugs respectively. Three additional parameters assessed the level of side-effects: anticholinergic, sedative, and hypotensive, with atropine 0.75 mg/d, phenobarbital 200 mg/d, and iproniazide 75 mg/d as reference drugs respectively. The defined dose represented the standard maintenance daily dose for depressive outpatients. Mean values for each parameter, rounded off to the closest number, were used for the graphical representation. Results showed an excellent agreement among evaluators for the clinical profile of classical tricyclic and MAOI antidepressants, but serious divergences for the more recent drugs (e.g., viloxazine and mianserine), possibly reflecting more atypical or more variable clinical profile of these compounds.

[Clinical comparison between alprazolam and lorazepam. A polycentric study in double blind]. / Comparaison clinique entre alprazolam et lorazepam. Une étude polycentrique en double insu.

The clinical efficacy and safety of alprazolam was compared to lorazepam in a double blind randomized design involving 82 out-patients suffering from primary anxiety. Seventy four patients (37 on alprazolam and 37 on lorazepam) were evaluable. They were treated with a flexible dose of 0,75 mg to 3 mg of alprazolam per day (average final dose: 1,59 mg) or 3 mg to 12 mg of lorazepam per day (average final dose: 5,97 mg). The results show that the two drugs produce similar efficacious effects at weeks 2 and 4 of the treatment as evaluated using both patient and physician scales. At week 1, as could be expected from an average daily dose of 0,99 mg of alprazolam and of 4,14 mg of lorazepam, efficacy parameters favored lorazepam. Fifty seven side effects were reported in the 37 lorazepam patients while 61 side effects were reported in the 37 alprazolam patients.