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Abstract

BackgroundSeveral patients with unipolar depression present with prominent dysphoric mood. We aimed at examining the effectiveness of the combination of an SSRI with an anticonvulsant in such patients.MethodsThirty-five newly admitted outpatients with substantial anger, irritability, aggressiveness or hostility who were diagnosed a DSM-IV unipolar depressive disorder were rated on the Hamilton Depression Rating Scale (HDRS), the Clinical Global Improvement (CGI) scale, and a scale for the rapid dimensional assessment (SVARAD), were prescribed an SSRI and an anticonvulsant (usually valproate), and were followed up for 12 weeks. Repeated measures analysis of variance was used to test for within-subject changes in scale scores over time.ResultsThirty-two and 23 patients attended the follow-up visits 4 and 12 weeks later, respectively. Significant decreases (p < .001) were observed in HDRS total score, HDRS and SVARAD anxiety factors, HDRS and SVARAD core depression factors, and SVARAD anger/irritability factor. Adjusting for age or gender did not change the results. Most patients (82%) were rated as improved or much improved on the CGI.ConclusionAlthough our study has several limitations, we observed a remarkable improvement in most unipolar depressed outpatients with dysphoric mood treated with an SSRI and an anticonvulsant. The effectiveness of anticonvulsants might be linked to their action on symptoms of aggression and behavioural activation.

Loneliness of Older Immigrant Groups in Canada: Effects of Ethnic-Cultural Background

“…A few studies have examined the relationship between aging migrants and their social networks and have found that ethnicity and culture, such as differences in values and norms regarding social networks, can influence relationships with kin and non-kin of aging immigrants (Chappell 2003 ; Dalgard and Thapa 2007 ; Lai et al 2007 ; Mitchell 2003 ; Rao et al 2006 ; Slonim-Nevo et al 2009 ). Although kin relationships might be important for all older adults, immigrant adults originating from collectivistic countries might be especially prone to have close family ties that provide (instrumental) support and may alleviate loneliness (Johnson and Mullins 1987 ; Litwin 1997 ; Sánchez et al 2014 ).…”

Multi-dimensional relationships among dementia, depression and prescribed drugs in England and Wales hospitals

“…Diazepam use is common in patients having BPSD symptoms [ 56 ], but usage of diazepam together with citalopram can increase the risk of side effects and may contribute to fatal poisoning [ 57 ]. In comparison, valproate can be effective in treating aggression and behavioural activation related symptoms [ 58 ], and its combination with citalopram has proven to be effective, especially in depressed patients with dysphoric mood [ 58 ]…”

Anger attacks and «anger disorders»: clinical relevance, problem of classification, comorbidity and therapy (review)

“…Наиболее эффективными представ ляются психофармакологические стратегии, учи тывающие биологические механизмы, лежащие в основе патологических проявлений раздражитель ности и гнева, а также психотерапевтические ме тоды, обеспечивающие улучшение контроля над ними. [19,27,50]. Согласно данным кокрановского обзора [28] эффективность 4 антиэпилептических препара тов (вальпроат/дивалпроекс, карбамазепин, окскарбазепин и фенитоин) в отношении агрессии оценивается как противоречивая, что обусловли вает необходимость дальнейших исследований в этом направлении.…”