Fengabine is a new GABAmimetic compound active in animal models predictive of antidepressant activity. The present overview reports the results of 6 double-blind trials versus tricyclics (TCAs) (3 in outpatients and 3 in inpatients). Overall, 398 adult patients (149 males and 249 females) were treated; 194 with fengabine and 204 with TCAs (98 clomipramine, 63 amitriptyline and 43 imipramine). 284 suffered from major depression (MD) (including major depressive disorder and bipolar disorder, depressed; DSM III) and 114 from minor depression (MiD) including dysthymic disorder, atypical depression and adjustment disorder with depressive mood (DSM III). Dosage ranged from 600 to 2,400 mg/day for fengabine and 50 to 200 mg/day for TCAs. Efficacy was evaluated with the HAM-D scale. 311 subjects (154 fengabine and 157 TCAs) ended the 4-week treatment period. Considering the whole sample and mean 1AM-D scores, no significant differences emerged between the 2 treatment groups at any of the assessment periods. Because of a significant treatment × type of depression interaction, MD and MiD were analysed separately, and a different trend appeared in the 2 subgroups with TCAs behaving slightly better than fengabine in MD and fengabine performing slightly better than TCAs in MiD. Using the physician’s clinical improvement, 74% of patients under fengabine and 72% of those under TCAs were rated as improved or much improved. Side effects, particularly of the anticholinergic type were significantly more frequent in the TCAs group. Gamma-GT were more frequently altered in the fengabine group (30.4 vs. 10.5%); this increase was interpreted as a consequence of enzymatic induction. Lastly, more patients taking fengabine exhibited an increase in cholesterol values.
A double-blind multicenter trial was carried out in 146 patients with urinary tract infections in order to compare the combination of rifampicin and trimethoprim (450 mg plus 120 mg twice daily) with rifampicin alone (450 mg twice daily). The success rate on the day after a 10-day course of treatment was significantly higher after the combination than after rifampicin alone (72% of 60 cases vs. 45% of 55 cases). The difference was still significant, and of the same order of magnitude, 1 week after the end of the treatment (53% of 51 vs. 24% of 45 cases). The subgroups of patients with organisms sensitive to both rifampicin and trimethoprim before treatment were considered separately in each treatment group: rifampicin-resistant strains were isolated after treatment in 27% of 26 patients treated with rifampicin alone, and in 7% of 27 patients in the other group. The tolerances of the two treatments were superimposable. The combination rifampicin-trimethoprim appears to overcome the problem of selection of rifampicin-resistant strains, with the concomitant therapeutic failures, in urinary tract infections.
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