Decreased GABA function may represent a common biological link between subtypes of depressive and premenstrual dysphoric disorders. A trait in major depressive disorder and a state-dependent decrease in premenstrual dysphoric disorder might imply a possible continuum between the two disorders.
Forty-nine patients with major depression and a reduced (less than 65.0 minute) REM latency were treated in a randomized, double-blind study with either amitriptyline or alprazolam. Predictors of response were sought for the whole group and for each drug cell individually. A longer current episode and a higher Beck Depression Inventory to Hamilton Rating Scale ratio were predictive of a poorer response for the whole group and for the alprazolam group. A longer current episode was also predictive of a poor response to amitriptyline. These data suggest that (1) a longer current episode and (2) a greater level of self-reported compared to clinician-observed symptoms correlate with a poorer response to antidepressant medications.
Minaprine dihydrochloride is a novel psychotropic drug possessing both antidepressant and psycho-stimulant properties. Prior clinical studies have shown minaprine to be as effective as standard antidepressant agents in the treatment of endogenous depression. The present study examined the safety and efficacy of minaprine at four different doses compared to placebo in 190 outpatients with major depression. Overall, minaprine demonstrated a significant antidepressant action compared to placebo, which was most evident at the maximum dose of 400 mg daily. These data, together with a favorable side effects profile, suggest that minaprine may be an effective antidepressant agent for the treatment of major depression.
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