The effects of fluoxetine and dothiepin on cognitive function in depressed patients in general practice

Abstract

The objective of this study was to assess whether there are any dierences between¯uoxetine and dothiepin on cognitive function of patients with major depression (DSMIII-R). A randomized, double-blind, parallel group design, 6 week trial in patients in general practice was employed where patients were randomly allocated to one of two treatment groups, i.e.¯uoxetine 20 mg mane or dothiepin 75 mg nocte (increasing to 150 mg in the 2nd week). Eighty-four depressed patients aged 18±70 (mean 43 . 8) years were admitted to the study. Cognitive function was assessed by a valid battery of tests before and during treatment. The severity of depression was assessed using the Hamilton Depression Rating Scale (HAMD) at the start and end of the study. Both treatments were similarly ecacious in reducing the HAMD and performance tended to improve with both drugs during treatment. There were signi®cant dierences between the drugs on the critical¯icker fusion task where the¯uoxetine group performed signi®cantly better than the dothiepin group (p 5 0.05). The¯uoxetine group also had better scores on a mental arithmetic task. No signi®cant dierences were observed in the adverse event pro®les. The results of this study show that¯uoxetine and dothiepin cannot be dierentiated in terms of ecacy manifest by changes in the HAMD, but do possess dierent pro®les of action on the battery of cognitive tests.

Tolerability, pharmacokinetics and night‐time effects on postural sway and critical flicker fusion of gaboxadol and zolpidem in elderly subjects

“…However, it should be acknowledged that studies assessing next‐day residual effects of zolpidem using CFF have shown variable results, with some studies finding that zolpidem produced impairments [33, 34] and others showing no effects [35, 36]. The CFF method included in this study is not sensitive to pupil diameter, and it is therefore unlikely that variations in pupil size obscured differences between treatments [37].…”

Effects of tianeptine and mianserin on car driving skills

“…Tianeptine (7-[(chloro-6,11-dihydro-5,5-dioxo-6-methyldibenzo[c,f][1,2]thiazepin-11-yl)amino]heptanoic acid, sodium salt), is a novel compound, which in contrast to other antidepressants, facilitates the reuptake of serotonin (5-HT). The welldocumented adverse effects of the tricyclic antidepressants (TCAs) both in patients (Fairweather et al 1993;Montgomery and Kasper 1995) and asymptomatic volunteers (Sherwood and Hindmarch 1993;Dal Pozzo et al 1997) are not generally found with tianeptine (Delalleau et al 1988) and in particular, it has no anticholinergic (Wilde and Benfield 1995), or antihistaminic effects (Kato and Weitsch 1988), which may account for the observed lack of sedation with the drug (Mocaër et al 1988). Furthermore, unlike the TCAs, it has no affinity for the α-adrenergic receptors, the blockade of which is associated with postural hypertension and clumsiness (Delagrange et al 1990).…”

Next‐day cognition, psychomotor function, and driving‐related skills following nighttime administration of eszopiclone

“…Response measures were the mean ascending threshold (discriminating fusion from flicker), the mean descending threshold (discriminating flicker from fusion), the interval of uncertainty (difference between the ascending and descending thresholds), and mean threshold frequency. CFF has been shown to be sensitive to both changes in cognitive status (Curran and Wattis, 2000) and to the effects of a wide range of psychoactive compounds in both healthy volunteers (Hindmarch, 1975(Hindmarch, , 1982(Hindmarch, , 1994 and patients (Fairweather et al, , 1999. A lowering of the threshold is indicative of a reduction in the overall integrity of the central nervous system.…”