Trazodone in late life depressive states: a double-blind multicenter study versus amitriptyline and mianserin

Altamura, Alfredo Carlo; Mauri, Massimo C.; Colacurcio, F; Scapicchio, Pierluigi; Hadjchristos, C.; Carucci, G; Minervini, Massimo; Montanini, R; Perini, Michele; Rudas, N; Carpiniello, Bernardo; D'Aloise, A.; Malinconico, A.

doi:10.1007/bf00172628

Cited by 20 publications

(9 citation statements)

References 12 publications

(15 reference statements)

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“…Georgotas et al 187 * Feighner et al 34 Altamura et al 183 Georgotas et al 207 * Gerner al. 38 Altamura et al 20 Georgotas et al 208 * Gwirtsman et al 41 Altamura et al 21 Georgotas et al 209 * Hutchinson et al 42 Ather et al 22 Gerner et al 38 Merideth et al 50 184 Jarvik et al 44 Scardigli & Jans 194 * Chesrow et al 185 * Katz et al 46 Siegfried & O'Connolly 56 Cohn et al 26 Kernohan et al 189 * Wakelin 60 Cohn et al 25 Koncevoj et al 211 21 Lakshmanan et al 49 Falk et al 33 Cohn et al 25 Feighner & Cohn 35 Lazarus et al 213 * De Vanna et al 28 Georgotas et al 36 Merideth et al 50 39 Feighner et al 34 Guillibert et al 40 Reynolds et al 215 44 Hutchinson et al 42 Katz et al 46 Schneider et al 219 54 Waite et al 59 Merideth et al 50 Phanjoo et al 181 40 Georgotas et al 36 Hutchinson et al 229 …”

Section: Klawansky 83 (M)mentioning

confidence: 99%

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Pharmacological and Psychological Treatments for Depressed Older Patients: A Meta-analysis and Overview of Recent Findings

Gerson¹,

Belin²,

Kaufman³

et al. 1999

Harvard Review of Psychiatry

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A meta-analysis was carried out to evaluate data published between January 1974 and February 1998 comparing rates of treatment response and tolerability of pharmacological and psychological treatments for depression in persons over age 55. Drugs (tricyclic antidepressants, selective serotonin-reuptake inhibitors, and a mixed group of other drugs) were significantly better than placebo, with an average reduction in symptom severity of 48.0% versus 31.3% (analysis weighted by sample size; 50.6% vs. 21.4% unweighted). No single drug or group of drugs was superior in terms of efficacy, and no statistically significant differences in tolerability emerged between tricyclic antidepressants and selective serotonin-reuptake inhibitors, whether measured by total dropouts or by dropouts due to side effects. Compared to the data on pharmacological treatments, those for outcomes of psychological treatments are very limited. Existing data indicate that cognitive-behavioral, behavioral, and psychodynamic therapies are significantly better than placebo. In the current meta-analysis, response rates to these nondrug therapies did not differ significantly from those observed with tricyclic antidepressants or selective serotonin-reuptake inhibitors, but direct comparison data are insufficient for firm conclusions to be drawn about comparative efficacy. It is possible, even likely, that not only different subtypes of depression but also different patients vary in their treatment responses. However, lack of adequate data prevented the current meta-analysis from addressing these issues. Rigorously designed prospective studies on treatment outcome, taking into account the above differences, are urgently needed to provide robust data on which to base clinical recommendations for the treatment of depression in older patients.

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Section: Klawansky 83 (M)mentioning

confidence: 99%

“…Gerner et al 38 Phanjoo et al 181 * Jarvik et al 44 Altamura et al 183 Schone & Ludwig 55 Altamura et al 20 Kane et al 45 Altamura et al 21 Katz et al 46 …”

Section: Salzman 78 (R)mentioning

confidence: 99%

Pharmacological and Psychological Treatments for Depressed Older Patients: A Meta-analysis and Overview of Recent Findings

Gerson¹,

Belin²,

Kaufman³

et al. 1999

Harvard Review of Psychiatry

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“…As observed in clinical trials, peripheral anticholinergic effects are less frequent than with tricyclics. Of note, the lack of cardiovascular side effects such as increased heart rate and hypotension is a further important advantage of Mianserin [95,96]. Mianserin is indicated for the treatment of depression associated with anxiety and agitation and, like Mirtazapine, it is particularly indicated for patients experimenting insomnia [97].…”

Section: Noradrenergic and Specific Serotonergic Antidepressantsmentioning

confidence: 99%

The Noradrenergic Action in Antidepressant Treatments: Pharmacological and Clinical Aspects

Dell’Osso

Palazzo

Oldani

et al. 2010

CNS Neuroscience & Therapeutics

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Even though noradrenaline has been recognized as one of the key neurotransmitters in the pathophysiology of major depression (MD), noradrenergic compounds have been less extensively utilized in clinical practice, compared to selective serotonin reuptake inhibitors (SSRIs). The development of the first selective noradrenergic reuptake inhibitor (NRI), Reboxetine, has not substantially changed the state of the art. In addition, Atomoxetine, a relatively pure NRI used for the treatment of ADHD, has shown mixed results when administered in augmentation to depressed subjects. Through a Medline search from 2000 to 2010, the present article provides an updated overview of the main pharmacological and clinical aspects of antidepressant classes that, partially or selectively, act on the noradrenergic systems. The noradrenergic action plays an important clinical effect in different antidepressant classes, as confirmed by the efficacy of dual action antidepressants such as the serotonin noradrenaline reuptake inhibitors (SNRIs), the noradrenergic and dopaminergic reuptake inhibitor (NDRI) Bupropion, and other compounds (e.g., Mianserin, Mirtazapine), which enhance the noradrenergic transmission. In addition, many tricyclics, such as Desipramine and Nortriptyline, have prevalent noradrenergic effect. Monoamine oxidase inhibitors (MAOIs), moreover, block the breakdown of serotonin, noradrenaline, dopamine and increase the availability of these monoamines. A novel class of antidepressants--the triple reuptake inhibitors--is under development to selectively act on serotonin, noradrenaline, and dopamine. Finally, the antidepressant effect of the atypical antipsychotic Quetiapine, indicated for the treatment of bipolar depression, is likely to be related to the noradrenergic action of its metabolite Norquetiapine. Even though a pure noradrenergic action might not be sufficient to obtain a full antidepressant effect, a pronoradrenergic action represents an important element for increasing the efficacy of mixed action antidepressants. In particular, the noradrenergic action seemed to be related to the motor activity, attention, and arousal.

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“…One study including alprazolam (Beutler et al, 1987), another study including alprazolam and imipramine (Weissman et al, 1992) and a third study including sulpiride and placebo (Kivela and Lehtomaki, 1987) were excluded because patients received psychotherapy in addition to antidepressant treatment. We assumed the two Italian multicentre trials (Altamura et al, 1988(Altamura et al, , 1989a were separate studies. We treated Dunner et d ' s (1992) paper as one study because only the combined data were reported, even though the title indicates it was based on two studies.…”

Section: General Findingsmentioning

confidence: 99%

Antidepressants and the elderly: Double‐blind trials 1987‐1992

Anstey

Brodaty

1995

Int J Geriat Psychiatry

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SUMMARYWe reviewed all double-blind antidepressant trials reported between 1987 and 1992 in samples of people aged 55 years or more with a primary diagnosis of major or clinical depression. There was an increase in the annual rate of trials conducted compared with the period from 1964 to 1986. About 27% of patients commencing trials withdrew prior to completion. Of those who completed, there was a general reduction of about 55% in scores on the Hamilton Rating Scale for Depression. No differences in efficacy between drugs were found. Newer antidepressants, particularly selective serotonin reuptake inhibitors, appeared to have fewer side-effects, but methodological shortcomings limited interpretation of the results. Recommendations for future research are proposed.

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Trazodone in late life depressive states: a double-blind multicenter study versus amitriptyline and mianserin

Cited by 20 publications

References 12 publications

Pharmacological and Psychological Treatments for Depressed Older Patients: A Meta-analysis and Overview of Recent Findings

Pharmacological and Psychological Treatments for Depressed Older Patients: A Meta-analysis and Overview of Recent Findings

The Noradrenergic Action in Antidepressant Treatments: Pharmacological and Clinical Aspects

Antidepressants and the elderly: Double‐blind trials 1987‐1992

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