Treatment Emergent Symptom Scale Research Articles

Combination of citalopram plus paliperidone is better than citalopram alone in the treatment of somatoform disorder

The objective of this study was to evaluate the effectiveness and tolerability of citalopram versus citalopram plus paliperidone combination therapy in patients with somatoform disorders (SDs). In this 6-week, randomized, fixed-dose study, 60 patients with SD (ICD-10 F45.0), undifferentiated SD (F45.1), and somatoform autonomic dysfunction (F45.3) were randomly assigned to receive citalopram (20 mg/day) with or without paliperidone (3 mg/day). Four scales were used to evaluate effectiveness and tolerability at baseline and at the end of the second, fourth, and sixth week after treatment: Somatoform Disorders Screening Symptoms-7 (SOMS-7), Hamilton Anxiety Scale (HAMA), 17-item Hamilton Depression Scale (HAMD-17), and Treatment Emergent Symptom Scale (TESS). The rater was blinded to the kind of treatment patients received. (i) In the intention-to-treat population (N = 51), the overall response ratio (50% reduction in SMOS-7 scores) was significantly higher in the citalopram-paliperidone group compared with the citalopram group after a 6-week treatment (71.4 vs. 38.10%, χ² = 4.71, P = 0.03). (ii) The SOMS-7 and somatic subscore of the Hamilton Anxiety Scale (HAMA-SOM) total score of the citalopram plus paliperidone group decreased more significantly than that of the citalopram group, and a significant difference could be observed at the end of 4 weeks of treatment. (iii) There was no significant difference between the two groups in adverse effects, and no serious adverse event was reported in both groups. Our findings indicate that a combination with paliperidone is significantly better than monotherapy with citalopram whether synergistic or add-on for patients with SDs. Our results call for future studies with larger sample sizes and a longer duration to draw more definitive conclusions.

A Meta-analysis of the effectiveness of risperidone versus traditional agents for Tourette's syndrome

To evaluate the efficacy and safety of risperidone versus traditional agents in treating Tourette's syndrome. Randomized, controlled trials (RCTs) of risperidone versus traditional agents for Tourette's syndrome were identified, and eligible studies were included according to our established strategy. Besides methodological quality of inclusive trials, assessed by the Jadad scale, heterogeneity test, Meta-analysis, funnel plot analysis, subgroup analysis and sensitivity analysis were used to analyze the data. A total of 12 RCTs were included, with most trials of low methodological quality and high heterogeneity. Meta-analysis from 11 of the identified RCTs, involving total 741 patients, showed that there was no significant difference in efficacy between risperidone and traditional agents, based on the results of sensitivity analysis, and analyses of a haloperidol subgroup and a domesticforeign subgroup. The funnel plots was approximately symmetrical, indicating little publication bias. Risperidone presented mild side effects overall, including extrapyramidal symptoms (EPS), autonomic nervous system symptoms, toxic reactions and the Treatment Emergent Symptom Scale (TESS) score of the treatment group were significantly less than those of control. Risperidone appears to have the same efficacy and appropriate safety as traditional agents in treating Tourette's syndrome. Because of the low validity of the results, we are searching for support from the more RCTs with higher methodological quality.

The therapeutic effects of oxygen inhalation combined with relaxation training on generalized anxiety disorder

Objective To observe the therapeutic effects of oxygen inhalation combined with relaxation training on patients ,with generalized anxiety disorder （GAD）. Methods A total of 188 GAD patients were divided into the study group and the control group randomly. The two groups were treated with conventional antianxiety drugs （paroxetine） , in addition to conventional medical therapy. The study group was aided with oxygen inhalation and relaxation training, the control group was given henzodiazepine. The scores of Hamilton anxiety rating scale （HAMA） , global improvement（GI） [ a part of clinical global impression （CGI）], and treatment emergent symptom scale （TESS） were used to evaluate clinical effects and adverse reactions before and after 4-week treatment. The indexes of breathing, heart rate and blood pressure were evaluated before and after treatment. Results The scores of HAMA scale and GI in the two groups were significantly different after treatment（ P 〈 0.05 ） , and the study group changed significantly（ P 〈 0.05 or P 〈 0.01 ）. The adverse reactions of the two groups were slight, there was no significant difference of TESS before and after treatment （ P 〉 0. 05 ）. There was no significant difference in terms of breathing, heart rate and blood pressure between the two groups before treatment（ P 〉 0.05 ） , but were all lower after treatment the study group changed more apparently and significantly（ P 〈 0.01 ）. Conclusions Based on conventional drugs treatment oxygen inhalation combined with relaxation training could improve anxiety and somatization rapidly, there was no obvious adverse reaction and the patients compliance was good, so the treatment was worth to use in clinic. Key words: Oxygen inhalation; Relaxation training; Generalized anxiety disorder

Clinical studies on treatment of earthquake-caused posttraumatic stress disorder using electroacupuncture.

The objective of this study was to assess the efficacy and safety of electroacupuncture in 138 patients with earthquake-caused PTSD using Randomized Controlled Trials (RCTs). 138 cases enrolled were randomly assigned to an electro-acupuncture group and a paroxetine group. The electro-acupuncture group was treated by scalp electro-acupuncture on Baihui (GV 20), Sishencong (EX-HN 1), Shenting (GV 24), and Fengchi (GB 20), and the paroxetine group was treated with simple oral administration of paroxetine. The efficacy and safety of the electro-acupuncture on treatment of 69 PTSD patients were evaluated using Clinician-Administered PTSD Scale (CAPS), Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Treatment Emergent Symptom Scale (TESS) according to clinical data. The total scores of CAPS, HAMD, and HAMA in the two groups after treatment showed significant efficacy compared to those before treatment. The comparison of reduction in the scores of CAPS, HAMD, and HAMA between the two groups suggested that the efficacy in the treated group was better than that in the paroxetine group. The present study suggested that the electro-acupuncture and paroxetine groups have significant changes in test PTSD, but the electro-acupuncture 2 group was more significant.

Genetic Polymorphisms in CYP3A4 are Associated with Withdrawal Symptoms and Adverse Reactions in Methadone Maintenance Patients

Methadone maintenance therapy is one of the standard treatments for heroin addiction. The isozyme CYP3A4 of the CYP system is one of the metabolic enzymes, as well as CYP2B6, responsible for the metabolism of methadone. The aim of the present study is to evaluate the potential use of genetic polymorphisms in CYP3A4 as biomarkers for the prediction of methadone treatment responses. A total of 366 Han Chinese methadone maintenance treatment patients in Taiwan were recruited in this study. Main clinical assessments included the clinical opioid withdrawal scale (COWS), the treatment emergent symptom scale (TESS) and the plasma concentrations of methadone and its metabolites. Genetic associations of six SNPs in the CYP3A4 gene were calculated using a general linear model. Genotypes and allele types of rs4646440 and rs2242480 were found to be significantly associated with the severity of withdrawal symptoms rated by COWS (p = 0.012, 0.0096, 0.017 and 0.012, respectively) as well as the side effects rated by TESS (p = 0.0089, 0.028, 0.0027 and 0.0085, respectively). The allele types associated with more severe withdrawal symptoms are also associated with more severe side effects and less betel nut (Areca catechu) use (p = 0.009 for rs4646440, p = 0.0063 for rs2242480). Further analyses on specific withdrawal symptoms in COWS showed that the genetic variants in rs4646440 are significantly associated with heart rate (allele type p = 0.0019). These results suggested that genetic variants in the CYP3A4 gene may be useful indicators for the severity of side effects and withdrawal symptoms for methadone treatment.

A clinical controlled study on schizophrenia treated with paliperidone-ER and risperidone

Objective To compare the efficacy and side effects of paliperidone-ER and risperidone in treating schizophrenia.Methods 60 patients of schizophrenia were treated with paliperidone-ER( n = 30) or risperidone (n =30) randomly,for 8 weeks. The efficacy was assessed with the positive and negative symptoms scale( PANSS), and the safety was assessed with treatment emergent symptoms scale before treatment and at the ends of week 1,2,4and 8 treatments,respectively. Results The PANSS scores of two groups were significantly decreased after the patients received the drug treatment. Paliperidone-ER group showed lower negative symptom score at week 4 and 8 than risperidone group. The efficacy of study group was significantly higher than that of control group. Conclusion Paliperidone-ER was effective and safe antipsychotic drug with significant improvement compared with risperidone in negative symptoms. Key words: Paliperidone; Risperdal; Schizophrenia

Quetiapine for the behavioral and psychological symptoms in senile dementia

Objective To explore the efficacy and safety of quetiapine and perphenazine in the treatment of Alzheimer's disease. Metbods 52 patients were randomly assigned to receive quetiapine of SO - 400mg daily ( 26 patients, study group), or perphenazine of 6-16mg daily ( 26 patients, control group )for 8 weeks. The efficacy and safety of the two therapies was compared between the two groups by using the Mini-mental State Examination ( MMSE ), Sandoz Clincal Assessment Geriatric ( SCAG ), and Treatment Emergent Symptom Scale (TESS ) 8 weeks after treatment. Results At the completion of treatment, the scores on MMSE were significantly higher ( P< 0.01 ), and those on SCAG were significantly lower in both groups ( P< 0.01 or P< 0.05 ), as compared with the baseline scores. The rate of adverse reactions was significantly lower in the study group than in the control group ( 30.8% vs. 46.2%, P< 0.05 ) Conclusions Quetiapine has a better efficacy in the treatment of Alzheimer's disease and has fewer adverse reactions. It is suitable for clinical use. Key words: Quetiapine; Senile dementia; Psychological and behavioral symptoms

Duloxetine for the treatment of mood disorder in cancer patients: a 12-week case-control clinical trial

The aim of this study was to investigate the efficacy and tolerability of duloxetine in cancer patients with mood disorder (MD) by means of a comparison with a matched control group of patients with MD without medical illness. Fifty-nine consecutive patients with MD were enrolled in this prospective case-control study and received duloxetine 60/120 mg per day for 12 weeks. Twenty-seven patients were affected by cancer, whereas 32 had an MD without cancer. All the patients were assessed by means of efficacy and effectiveness tolerability scales for depression (Montgomery-Asberg Depression Rating Scale and Hospital Anxiety and Depression Scale), anxiety (State-Trait Anxiety Inventory-Y1/Y2) and severity of symptoms (Clinical Global Impression (CGI)-Severity) at baseline (T0), after 4 weeks (T1) and 12 weeks (T2). The CGI-Improvement, CGI-Effectiveness Index and Dosage Record Treatment Emergent Symptom Scale were administered at T1 and T2. A significant global improvement in all the efficacy measures was found. The results showed no significant interaction 'Time X Group', suggesting a similar improvement in efficacy scores for cancer-depressed patients and depressed patients without cancer. No difference was found between the two groups with regard to drop-out percentage, effectiveness and tolerability. Although the results of this case-control study are preliminary, they suggest that duloxetine can be considered a good option for the treatment of MD in cancer patients.

Clinical treatment of schizophrenia due to stagnation of phlegm and qi with Shugan-qingzhang formula

Objective To explore the effects of treating schizophrenia due to stagnation of phlegm and qi with Shugan-qingzhang formula. Methods 85 patients with schizophrenia were randomly recruited into a control group and a treatment group. The treatment group was treated with Shugan-qingzhang formula, and the control group was treated with oral risperidone. Clinical effects of both groups were evaluated by positive and negative syndrome scale (PANSS) and symptom rating scale. Adverse drug reaction was evaluated by treatment emergent symptom scale (TESS). Results Score of PANSS was significantly changed after the treatment in both groups (F treatment group=4.86, t'treatment group= 17.88, v'treatment group=59, P treatment group＜0.01; F control group=4.27, t' control group=18.76, v' control group=59, P control group＜0.01); scores of PANSS in the treatment group were significantly better than the control group at the second and forth weak (F 2weeks= 1.02, t 2weeks=2.50, P 2weeks＜0.05; F 4weeks= 1.04, t 4weeks=3.55, P 4 weeks＜0.01), while no significant difference at the sixth week between the two groups (F=0.92, t=0.91, P＞0.05); There was no statistical difference of PANSS score between the two groups in terms of western medicine curative effects (x2=0.05, P＞0.05), but significant difference in terms of TCM curative effects (x2=36.26, P＜0.01); There was also statistic difference of adverse drug reaction between the two groups (x2= 8.17, P＜0.01). Conclusion Shugan-qingzhang formula can control symptoms of schizophrenia due to stagnation of phlegm and qi in a certain period. Key words: Schizophrenia; Stagnation of phlegm and qi; Treatment with Chinese medicine

A comparative study between long-acting risperidone microsphere injection for treatment of patients with schizophrenia

Objective To investigate clinical efficacy and side effects of long-acting risperidone microsphere injection for treatment of patients with schizophrenia. Methods A total of 82 patients with schizophrenia were randomly divided into two groups,study group with long-acting risperidone microsphere injection and control group with atypical antipsychotics treatment for 24 weeks. The Positive and Negative Syndrome Scale (PANSS),The Personal and Social Performance (PSP) and Treatment Emergent Symptoms Scale (TESS) were used to evaluate efficacy and adverse effects of treatment at the end of 1st ,2nd,4th, 12nd and 24th week. Results The therapeutic efficacy in control group was similar to that in study group,and there was no significant difference between the two groups (P＞ 0.05 ). But the therapeutic efficacy in study group was better than that in control group at the end of the 4nd week (P＜0.05 ) , and study group was more likely to improve social function(P ＜ 0. 05 ). Incidence of adverse effects in study group was lower than that in control group , but the difference was not significant (P ＞0.05 ). The incidence of akathisia symptom in study group was higher than that in control group,but the difference was not significant (P＞0.05). The incidence of drowsiness symptom in study group was significantly lower than that in control group(P＜0.05 ). Conclusion Long-acting risperidone microsphere injection is as effective as atypical antipsychotics for treatment of patients with schizophrenia, but it has better efficacy in improving social function of the schizophrenia with lower side effects. Key words: Risperidone microsphere injection; Atypical antipsychotic drugs; Schizophrenia

Olanzapine vs. risperidone in treating aggressive behaviours in adults with intellectual disability: a single blind study

Aggressive behaviour represents a frequent symptom in people with intellectual disability (PWID). Despite uncertain evidence of effectiveness, the use of antipsychotics (APs) drugs to treat aggressive behaviour is very common. Antipsychotic medication of aggressivity in PWID has recently become one of the most debated issues in mental health and the need of further research is persistently stressed by most researchers. The present study was firstly aimed at evaluating the effectiveness (efficacy on target behaviour, safety and persistence on treatment) of new generation APs, in particular, olanzapine and risperidone in treating aggressive behaviour in PWID for who previous medication with first generation APs (FGAs) were not effective. 62 subjects with intellectual disability underwent to a 2-arm, parallel group pragmatic trial of olanzapine and risperidone with balanced randomisation and blind assessment of outcome at 4, 8, 12, 16, 20 and 24 weeks after a switch (cross-tapering) from a 24-week treatment with FGAs. Aggressive behaviours were assessed by Overt Aggression Scale (OAS) and clinical outcome by Clinical Global Impression Scale. Side effects were assessed with Dosage Record and Treatment Emergent Symptoms Scale, other symptom-specific scales, laboratory and instrumental tests. Both risperidone and olanzapine resulted to be more effective than FGAs in reducing aggressive behaviour. Repeated-measures analysis of covariance revealed that treatment groups differed for cumulative number of aggressive episodes during the FGAs treatment, which was higher for olanzapine. Our findings seem to confirm that olanzapine and risperidone can be effective in reducing aggressive behaviour in PWID. Both compounds resulted to be well tolerated, with side effects similar to those encountered in other patient populations.

Control study of Ziprasidone and Risperidone on Efficacy and Cognitive Function in First-episode Schizophrenia

Objective To compare the effect of ziprasidone and risperidone on the efficacy and cognitive function in first-episode schizophrenia.Methods 86 first-episode inpatients who met CCMD-3 diagnostic criteria for schizophrenia were randomly divided into study group(n = 42) and control group(n=44) for an 8-week observation.The study group received ziprasidone,while the control group was treated with risperidone.The Positive and Negative Syndrome Scale(PANSS) and Treatment Emergent Symptoms Scale(TESS) were used to evaluate the efficacy and side effects respectively before and after 2,4,6,8 week's treatment.WAIS-R,WMS,WCST were adopted to evaluate the cognitive function before and after treatment.Results There were significant difference in the total scores of PANSS of the two group after treatment than before(P＜0.01).The effective rate of ziprasidone group was 92.5%,in which 80% were improved remarkably.The effective rate of risperidone group was 90%,in which 80% were improved remarkably.There were significant difference in curative effect between the two groups(P＞0.05).The scores of TESS of study group were significantly lower than those of control group at 6,8 weekend(P＜0.01).The scores of WAIS-R language scale,operation scale,total scale,memory quotient(MQ),total trials,persistent errors and random errors of W CST were improved significantly in two group compared with before treatment(P ＜ 0.05 or P ＜ 0.01).After the treatment,there was remarkable difference on the scores of MQ and persistent errors in study group compared with those in control group(P＜0.05).Conclusion Ziprasidone is a safe and effective atypical antipsychotics,and it's curative effect is similar to risperidone.However,ziprasidone has few and slight side effects as well as the improvement of the cognitive function of first-episode schizophrenia obviously,it can be used as choice drug for first-episode schizophrenia. Key words: Ziprasidone; Risperidone; Schizophrenia; Cognitive function

Slow vs standard up‐titration of paroxetine in the treatment of panic disorder: A prospective randomized trial

Patients with panic disorder (PD) might be sensitive to the stimulating effects of selective serotonin reuptake inhibitors (SSRI), thus requiring low dosages at treatment initiation. The aim of the present study was to assess eventual differences in terms of effectiveness and tolerability between a slow up-titration with paroxetine and a standard one. In an open randomized, multicenter, primary-care study, 60 patients (44 women and 16 men) with PD with or without agoraphobia were enrolled and randomized to receive a slow up-titration with paroxetine (increments of 2.5 mg/day every 2 days) or a standard one (increments of 10 mg/day every week) up to a maximum daily dose of 20 mg. Repeated-measures anova on sub-items scores of the Panic Attack Anticipatory Anxiety Scale (PAAS) and Dosage Record and Treatment Emergent Symptom Scale (DOTES), respectively, used as outcome measures of effectiveness and tolerability, were performed. Significance level was set at 0.05 and it was not corrected. anova showed no differences between the two treatments in terms of effectiveness and tolerability. Post hoc analysis found only one significant difference in the intensity of spontaneous panic attacks (Panic and Anticipatory Anxiety Scale) in the first 9 days of treatment between the two treatment groups, which was that this item was less intense in the slow-titration group (treatment effect: F = 4.89, P = 0.03, effect size = 0.1). Present findings suggest only a small superiority for a slow up-titration regimen of paroxetine compared to a standard one in the first 9 days of treatment but no differences at end-point.

Clinical Research into Qufeng Zhidong Recipe Used to Treat 31 Children with Tic Disorder

To assess the therapeutic effect and adverse reaction of Qufeng Zhidong Recipe (a recipe for dispelling wind to stop abnormal movement) used to treat children with tic disorder (TD). The enrolled patients were randomized into a TCM group (31 cases) treated with Qufeng Zhidong Recipe and a Western medicine group (30 cases) treated with haloperidol and trihexyphenidyl. Two courses of treatment were observed with 12 weeks as one course. The therapeutic effect and adverse reaction were assessed with Yale Global Tic Severity Scale (YGTSS), Tic Symptom Score Scale (TSSS), TCM Syndrome Score Scale (TCMSSS), Treatment Emergent Symptom Scale (TESS) and laboratory examinations. The total effective rate was 100% in the TCM group and 60% in the Western medicine group with statistical significance in difference (P < 0.05). All the scores in the TCM group were better than those in the Western medicine group (P < 0.05). Qufeng Zhidong Recipe can obviously relieve the symptoms and signs of TD children without toxic side-effects.

Efficacy of paliperidone extended-release tablets in the improvement of social functions in schizophrenics: a randomized and controlled study

To explore the efficacy of paliperidone extended-release tablets in the improvement of social functions in schizophrenics. A total of 81 schizophrenics were randomly divided into study group with paliperidone extended-release tablets and control group with risperidone for a 12-week treatment. They were assessed and analyzed by positive and negative symptoms scales (PANSS), social disability screening schedule (SDSS) and treatment emergent symptom scale (TESS) at baseline, 6(th) weekend and 12(th) weekend. In study group, the factors and total scores of PANSS in the 12(th) weekend of treatment [(12.0 ± 2.8), (12.1 ± 3.6), (26.2 ± 5.0), (50.2 ± 8.7)] were all significantly lower than those at baseline [(24.7 ± 5.3), (23.8 ± 3.6), (45.0 ± 2.9), (93.5 ± 6.8)] (t = 9.60-16.78, P < 0.05). In study group, the positive factor, negative factor and total scores of PANSS in the 12(th) weekend of treatment [(12.0 ± 2.8), (12.1 ± 3.6), (50.2 ± 8.7)] were all significantly lower than those in the 6(th) weekend of treatment [(14.2 ± 1.8), (14.6 ± 2.4), (56.5 ± 6.4)] (t = 2.58-4.26, P < 0.05). In the 12(th) weekend of treatment, the factors and total scores of PANSS in study group [(12.0 ± 2.8), (12.1 ± 3.6), (26.2 ± 5.0), (50.2 ± 8.7)] were all significantly lower than those in control group [(16.9 ± 4.9), (18.7 ± 5.3), (32.5 ± 5.1), (68.1 ± 13.0)] (t = -4.28--5.67, P < 0.05). In study group, the total scores of SDSS in the 12(th) weekend of treatment (5.93 ± 2.78) were significantly lower than those at baseline (13.9 ± 3.4) (t = 10.83, P < 0.05). In study group, the total scores of SDSS in the 12(th) weekend of treatment (5.9 ± 2.8) were significantly lower than those in the 6(th) weekend of treatment (7.6 ± 2.9) (t = 5.21, P < 0.05). But there was no significant improvement in control group (t = 1.88, P > 0.05). In the 12(th) weekend of treatment, the total scores of SDSS in study group (5.9 ± 2.8) were significantly lower than those in control group (8.8 ± 2.9) (t = -4.49, P < 0.05). No severe adverse effect was reported in either group. Paliperidone extended-release tablets are effective to improve social functions and psychiatric symptoms of schizophrenics.

The effects of quetiapine and aripiprazole on platelet 5-HT concentrations in patients with schizophrenia

Objective To study the effects caused by novel antipsychotics quetiapine and aripiprazole on concentrations of platelet 5-HT in patients with schizophrenia,and to explore the relationships among the change of platelet 5-HT concentrations, psychiatric symptoms and the sensitivity of therapy. Methods Sixty-eight patients with schizophrenia meeting International Classification of Diseases-10 (ICD-10) were enrolled in the study. They were divided into quetiapine group(n=34) and aripiprazole group(n=34) according to the sequence of admis-sion. The platelet 5-HT concentrations were measured with high performance liquid chromatography method(HPLC-ECD). The positive and negative syndrome scale (PANSS) was used to evaluate the psychopathology. Treatment emergent symptom scale (TESS) was used to evaluate the side effects. PANSS,TESS were used at pre-treatment,the end of 4th and 8th week of treatment. Results The platelet 5-HT concentrations in two groups were higher af-ter 8 weeks treatment,but had no statistically significant difference (P>0.05). In quetiapine group, the platelet 5-HT concentration was (458.89±233.36) ng/10~9 at the pre-treatment, and (554.31±313.22) ng/10~9 at the end of treatment (t=1.709, P=0.099). In aripiprazole group, the platelet 5-HT concentration was (409.83±149.32)ng/10~9 at the pretreatment, and (421.27±245.96)ng/10~9 at the end of treatment (t=0.321, P=0.819). There was no difference between two groups(P>0.05). Stepwise regression analysis showed the changing rate of platelet 5-HT concentrations was positively correlated with the dosage of quetiapine (r=0.385, P=0.039).It was positively correlated with the decreasing rate of PANSS in aripiprazole group(r=0.391, P=0.040). Con-dusion The changes of psychiatric symptoms and the dosages of antipsychotics maybe have intimate relationships with platelet 5-HT concentrations in the course of medication. Key words: Schizophrenia ; Quetiapine ; Aripiprazole ;

P03-335 - Clinical controlled study of venlafaxine and fluoxetine in treatment of obsessive-compulsive disorder

ObjectiveThe aim of this study was to compare the clinical efficacy and the safety of venlafaxine and fluoxetine in the treatment of obsessive-compulsive disorder (OCD).MethodsOne hundred and Eight inpatients who met the Diagnostic and Statistical Manual of Mental Disorders, the Forth Edition(DSM-IV) for OCD were involved in this study. The subjects were randomly divided into venlafaxine group or fluoxetine group. Efficacy of venlafaxine and fluoxetine in treatment of OCD were assessed with Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and Clinical Global Impression-Severity(CGI-S), the side effects were evaluated with Treatment Emergent Symptom Scale (TESS).ResultsThe therapeutic efficacy in venlafaxine group was similar to that in fluoxetine (70.36%vs68.29%, P&gt;0.05) after eight weeks’ therapy. The improve-rates of Y-BOCS after 2 weeks’ therapy of venlafaxine were significant higher than those of baseline, while the improve-rates of Y-BOCS after 4 weeks’ therapy of fluoxetine were significant higher than those of baseline(P&lt; 0.05). The side effects of venlafaxine group were similar to fluoxetine group (P&gt;0.05).ConclusionThe results indicate that both venlafaxine and fluoxetine is effective in the treatment of OCD, but venlafaxine work faster than fluoxutine.

A clinical comparative study of citalopram augmented with aripiprzole on depression

Objective To explore the efficacy of low-dose aripiprazole combining with citalopram on the depression. Methods A total 57 patients with depression were randomly assigned to the study group and the control group. Either group was treated with a fixed dose 20 mg citalopram per day, and the study group was simultaneously titrated to low dose (5～10mg/d) of aripiprazole at initiating dose 2.5 mg per day within two weeks. They were evaluated with Hamilton Depression Scale (HAMD).Clinical Global Impression (CGI-SI) and Treatment Emergent Symptom Scale(TESS) before treatment and at the end of 1st, 2nd, 4th and 6th week after treatment. The study lasted for 6 weeks. Results HAMD total score of either group were 11.54 ± 5.58 and 16.59 ± 6.67 respectively, which had statistically significant difference between two groups(t = 2.961, P 0.05). TESS scores were not statistically significant difference between two groups at each point of measure. Conclusion The results suggest low dose of aripiprazole augmentation of citalopram may be effective and safe in the treatment of depression. Key words: Depression; Citalopram; Aripiprazole

Association of Brain-Derived Neurotrophic Factor Genetic Val66Met Polymorphism with Severity of Depression, Efficacy of Fluoxetine and Its Side Effects in Chinese Major Depressive Patients

Background: Preclinical studies have shown that brain-derived neurotrophic factor (BDNF) may be involved in antidepressant action, and the BDNF gene has been suggested to be involved in the pharmacological treatment of major depressive disorder (MDD). In this study, the relationship between BDNF Val66Met polymorphism (Single Nucleotide Polymorphism Database ID: rs6265) and severity of depression, efficacy of fluoxetine and its side effects was tested in Chinese patients with MDD. Methods: Patients with MDD took the oral selective serotonin reuptake inhibitor (SSRI) fluoxetine (20 mg/day) for 6 weeks. Its clinical efficacy and side effects were measured by the 17-item Hamilton Rating Scale for Depression and the Treatment-Emergent Symptoms Scale (TESS), respectively. The patients were genotyped for Val66Met polymorphism of the BDNF gene. Results: In the multivariate regression analysis, there was no significant association between severity of depression and BDNF Val66Met polymorphism. There was no association between efficacy of fluoxetine and BDNF Val66Met polymorphism, but there was a marginal positive suggestion that heterozygous patients tended to have a better remission with fluoxetine in comparison with homozygous analogs. Insomnia and decreased sexual desire, side effects of fluoxetine, may have an association with the BDNF Val66Met polymorphism, and Met allele carriers showed a lower incidence of these side effects. Conclusions: These results indicate that there was a lack of association between severity of depression and BDNF Val66Met polymorphism in Chinese patients with MDD. The BDNF Val66Met polymorphism may play a major role in the efficacy and side effects of SSRI (fluoxetine) in Chinese patients with MDD.

A randomized double-blind clinical trial on analgesic efficacy of fluoxetine for persistent somatoform pain disorder

Objectives To verify the efficacy and safety of fluoxetine in treating patients with persistent somatoform pain disorder (PSPD). Methods In this 8-week, randomized double-blind placebo-controlled study, 80 patients with an ICD-10 diagnosis of PSPD were randomly assigned to receive 20 mg fluoxetine or a placebo. Several psychological scales including Medical Outcomes Study Pain Measures (MOSPM), Hamilton Depression Scale-17 items (HAMD 17) and Treatment Emergent Symptom Scale (TESS) were used to assess analgesic efficacy and safety of fluoxetine, and the possible analgesic mechanism of fluoxetine was preliminarily analyzed. All data were analyzed by SPSS11.5 with t-test, one-way ANOVA and a mixed-effects model repeated measures analysis. Intent-to-treat (ITT) analysis was performed and the last observation carry forward (LOCF) was used for missing values. Results There was a significant difference of MOSPM total score between the fluoxetine and placebo group after 2 weeks of treatment. The analgesic effect of fluoxetine was related with treatment time, and depressive patients showed a better analgesic effect than non-depressive patients. An adverse effect of fluoxetine was scarcely found. Conclusions Fluoxetine has a better analgesic effect than a placebo in treating persistent somatoform pain disorder, and is considered a safe treatment; its analgesic effect may be related to an antidepressant effect.