Befuraline, a new antidepressant drug, was studied in twenty-nine inpatients with unipolar endogenous depression. The evaluation of patients' condition was made on four different study periods by two assessors using the HDRS, the Beck depression inventory and von Zerssen depression scale. Befuraline, given in oral doses of between 100 and 300 mg/day improved the HDRS total score and the cognitive disturbances to a significant extent (p less than 0.01) after the first week of the treatment. Eleven patients withdrew from the study most of them as a result of intolerance to the stimulatory properties of the drug, however, the response was considered satisfactory in 12 of the 29 patients (41%) mostly in the "retarded depressed" class. As Befuraline proved to be well tolerated, it was continued on an outpatient basis in 11 patients, confirming the absence of clinically important untoward effects.
In an open investigation design two patient groups, under neuroleptics (n=30) and under antidepressants (n=31), were examined three times, the third time under steady-state conditions. A matched control group (n=32) provided the normative values. Various variables, thought to be psychologically relevant in traffic situations were measured on two test apparatus (tracking and complex reaction time). The result shows that the antidepressant group closely approaches the achievement of the control group on the most important variables measured. It may be concluded that psychopharmacologically well balanced depressive patients at the time of the steady-state are capable of producing results comparable to a control group with respect to traffic-relevant cognitive-psychomotor functions. The neuroleptic group, however, exhibits deviations on the same variables. In this sub-sample the primary disturbances of the underlying morbus (maintaining attention, continuous focusing ability) become conspicuous. From the medical point of view, the call for an individual clinical judgement of driving capacity by the treating physician continues to remain necessary, although the results produced offer some general decision aids.
A group of twenty depressive patients was compared during a 3-4 month course of antidepressant therapy (Maprotiline: n = 6, age = 46.1; dibenzepin: n = 4, age = 43.0; lithium: n = 6, age = 44.5; "mixed" (maprotiline, dibenzepin trimeprimine): n = 4, age = 50.2) with a healthy control group (n = 32, age = 38.2) for subjective assessment of their depressive mood and performance as well as objective measurement of variables relating to driving behaviour. The measurements were taken 2-4 weeks after a pre-treatment period (day 1) and after 2-3 months of further therapy (day 2). During therapy, all patients felt "less depressive" and "more capable" in subjective terms. All patient groups made learning progress in the objectively measured variables (psychomotor co-ordination and attentiveness tests). By day 2, the patient groups had almost reached the performance level of the control group, providing they received antidepressant therapy (regardless of the action profile) which was suitable for the basic disorder and the symptoms, and therapy was successful in the opinion of the physician. It may be concluded that depressive patients, assuming suitable antidepressant treatment and good response, are capable of driving while under maintenance therapy.
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