Maprotiline (Ludiomil®) in Depression: A Report of a Monitored Release Study of 10,000 Patients in General Practice

1977 ◽  
Vol 5 (1) ◽  
pp. 42-47 ◽  
Author(s):  
W A Forrest

In a three-week study of 10,000 general practice patients with depressive illness, a single dose of maprotiline 75 mg at night was effective therapy in three-quarters of the patients who completed the study. At this dose the drug was well tolerated, and troublesome side-effects presented in only a small percentage of patients. Drowsiness was the most commonly reported side-effect, and the main reason for withdrawal of treatment. The drug was acceptable to most physicians, and in this study was used in a wide range of patients and over a broad spectrum of depressive illness.

1974 ◽  
Vol 2 (4) ◽  
pp. 260-264 ◽  
Author(s):  
P F C Bayliss ◽  
A R Dewsbury ◽  
J F Donald ◽  
J W Harcup ◽  
M Mayer ◽  
...  

One hundred and twenty-three patients with mild to moderate depressive illness were entered into a double-blind between-patient study of viloxazine hydrochloride (150 mg/day, expressed as base) and imipramine hydrochloride (75 mg/day, expressed as salt) by nine general practitioners. Sixty-two took viloxazine and sixty-one took imipramine. Both drugs produced a statistically highly significant improvement in both the depressive and anxiety symptoms over the period of the study, an effect being seen as early as the seventh day of treatment. Viloxazine produced fewer side-effects than imipramine, in particular significantly less drowsiness and dry mouth. The only side-effect seen with viloxazine was an upper gastro-intestinal disturbance with nausea and occasional vomiting, but this was transient. It is concluded that viloxazine hydrochloride is an effective anti-depressant in mild to moderate cases of depression in general practice and has the advantage of fewer side-effects than imipramine. The absence of sedation with viloxazine is of particular value in the treatment of ambulant patients.


2016 ◽  
Vol 14 (1) ◽  
pp. 43-45
Author(s):  
Anjan Khadka ◽  
Dick Brashier ◽  
Amol Vijay Khanpure ◽  
Pem Chuki

Insomnia is characterized by difficulty in falling asleep, difficulty maintaining sleep, or experiencing nonrestorative sleep. Insomnia is the most common medical complaint in general practice.  Low efficacy and various side effects limit the use of existing treatment option. Suvorexant is an orexin receptor antagonist (ORA), first in a new class of drugs in development for the treatment of insomnia. It inhibits the wakefulness-promoting orexin neurons of the arousal system thereby promoting the natural transition from wakefulness. It also improves sleep onset and sleep maintenance and has a favorable tolerability and limited side-effect profile.


1974 ◽  
Vol 2 (4) ◽  
pp. 253-259 ◽  
Author(s):  
P F C Bayliss ◽  
J W Harcup ◽  
M Mayer ◽  
R Million ◽  
J E Murphy ◽  
...  

Forty-eight mild to moderate depressives were treated by six genera practitioners with a chemically novel anti-depressant, ‘Vivalan’ (viloxazine hydrochloride, ICI 58 834). Twenty-five patients took 150 mg/day in three divided doses, and twenty-three took 200 mg/day in two divided doses, each for twenty-one days. The severity of both the depressive symptoms and the anxiety symptoms showed a statistically highly significant reduction over the duration of the study. There was no difference between the efficacy of the two dose levels. Viloxazine was generally well tolerated and there was no difference between the two dose levels as far as side-effects or withdrawals were concerned. The usual sedative and anti-cholinergic side-effects of the tricyclic anti-depressants were virtually absent. The only side-effect seen was a transient upper gastro-intestinal disturbance. It was commoner at the high dose but not significantly so. It is concluded that viloxazine hydrochloride appears to be an effective anti-depressant in this type of patient and produces little or no sedative or anti-cholinergic side-effects. Either 150 mg/day or 200 mg/day would seem a reasonable dose to use in general practice.


Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4661-4661
Author(s):  
Sarah Steinemann ◽  
Tanja Falter ◽  
Mirjeta Qorraj ◽  
Thomas Vigh ◽  
Inge Scharrer

Abstract Abstract 4661 Introduction: Thrombotic thrombocytopenic purpura (TTP) is characterized by thrombocytopenia, hemolytic anemia and microthrombi. A deficiency of the metalloprotease ADAMTS 13, which cleaves a Tys1605-Met1606 bond in the A2 subunit of von Willebrand factor (VWF), leads to formation of ultra large von Willebrand multimers (UL-VWF) and can cause platelet aggregation and mircovascular thrombosis. Treatment of choice is the substitution of plasma with plasmaexchange. There are two different plasma types available: Fresh Frozen Plasma (FFP) and solvent/detergent (s/d) treated plasma. This treatment may carry significant risks and side effects for the patients. Therefore we investigated the side effects of the therapy and furthermore the ADAMTS13 activity of the two plasma types. Methods: A questionnaire was send to 66 TTP patients of the Department of Hematology to evaluate different side effects of the therapy. 20 batches of FFP and 4 batches of s/d plasma of all blood groups were investigated on ADAMTS13 activity. The ADAMTS13 activity was detected with BCS-Method according to Böhm and two commercial FRET assays. Results: So far 34 patients were inquired about age, weight and suspected trigger situations that might have caused their TTP manifestation. The mean age of the patients was 34 years with a mean weight of 70kg. A previous infection caused TTP manifestation in 42% of the patients; drug therapy (22%) and pregnancy (17%) were other mentioned triggers. 94% of the patients suffered from an acquired TTP and only 6% had a hereditary TTP. The patients had 2.88 relapses and were treated with 16.27 plasmaexchanges. 56% had an additional therapy with Rituximab to achieve a faster remission of the disease. These patients needed less plasmaexchanges for recovery, which proofed to be significant at 2% level in a one sided t-test. Tingling (64.7%) and shivering (51%) were the most often mentioned side effects and simultaneously described as the strongest. Shivering was significantly correlated to tachycardia (p<0.01). Headaches were significantly correlated to hot flushes, tingling and collapse (p< 0.05). Side effects and allergic reactions occurred in the therapy with FFP as well as with s/d plasma. Another side effect was the complication that came along with infection of the venous access. Most patients had a central venous catheter (72%) and described infections and pruritus (60%), 50% of them mentioned this complication more than once. We found in usual FFP slightly higher ADAMTS13 activity levels (696.97 ng/ml) than in s/d virus inactivated plasma (643.86 ng/ml). The ADAMTS13 activity varied between the different assays (normal range: 666 ± 135ng/ml). Conclusion: Our investigation demonstrated that plasmaexchange therapy is still associated with a wide range of side effects. Side effects of plasmaexchange that were most frequently described by patients were tingling and shivering. Headaches also occurred in various cases. Patients suffered generally from more than one side effect at the same time during the treatment. Allergic reactions to the plasma therapy were mentioned by 65% of the patients. Disclosures: No relevant conflicts of interest to declare.


1993 ◽  
Vol 27 (1) ◽  
pp. 49-55 ◽  
Author(s):  
Fiona K. Judd ◽  
Kate Moore ◽  
Trevor R. Norman ◽  
Graham D. Burrows ◽  
Ramesh K. Gupta ◽  
...  

The antidepressant efficacy and side effect profile of a fixed dose of 20 mg/day of fluoxetine, a specific serotonin reuptake inhibitor, were compared to those of amitriptyline. Fifty-eight patients with DSM-III-R depression were randomly assigned to receive either fluoxetine or amitriptyline. Fifty-six patients (fluoxetine N = 23, amitriptyline N = 23) completed the 6 week study. Comparable antidepressant efficacy was demonstrated for the two drugs. Patients taking fluoxetine reported less side-effects than those taking amitriptyline.


2016 ◽  
Vol 33 (S1) ◽  
pp. s261-s261
Author(s):  
S. Ramos Perdigues ◽  
A. Mane Santacana ◽  
P. Salgado Serrano ◽  
E. Jove Badia ◽  
X. Valiente Torrelles ◽  
...  

IntroductionFor resistant schizophrenia, the only approved treatment is clozapine. However, clozapine is underused, mainly due to its wide range of side-effects. Secondary effects differ amongst antipsychotics (Leucht et al., 2009). Despite that there is no good evidence that combined antipsychotics offer any advantage over the use of a single antipsychotic, combination increases the frequency of adverse events (Maudsley guidelines).ObjectivesTo compare the side-effect profile between clozapine and non-clozapinepatients.AimsTo provide evidence that clozapine patients do not show a worse side-effects profile.MethodsWe cross-sectionally analysed all patients from a Spanish long-term mental care facility (n = 139). Schizophrenic/schizoaffective patients were selected (n = 118) and their treatment was assessed, 31 patients used clozapine. We paired clozapine and non-clozapine patients by sex and age and assessed antipsychotic side effects and possible confounder variables.ResultsOur sample was 27 clozapine patients and 29 non-clozapine patients. 67,9% were male with a mean age of 51.3 (SD 9.6) years. For continuous variables: age, BMI, waist/hip, cholesterol, TG, glucose, prolactin, heart-rate, blood pressure, sleeping hours, the only statistical differences found were lower heart-rate (P = 0.001) in clozapine group and higher salivation subscale of SAS (P = 0.002) in clozapine group. For discrete variables: monotherapy, obesity, overweight, metabolic syndrome or possible confounders as propranolol, laxative, diet, antiglycemiant or insulin, fibrates or statins, antihypertensive or anticholinergic, no statistical differences were found.ConclusionsWe did not find differences in cardiometabolic parameters, which are the main barrier to prescribing clozapine, probably due to the concomitant use of other drugs in both groups.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2013 ◽  
Vol 25 (3) ◽  
pp. 184-186 ◽  
Author(s):  
Mahin Eslami Shahrbabaki ◽  
Fariborz Estilaee ◽  
Amir Eslami Shahrbabaki

ObjectivesPropranolol, the first discovered b-adrenergic receptor antagonist, has been prescribed by physicians in various fields for more than three decades. It has been applied for treating psychiatric disorders including schizophrenia, mania and anxiety disorders, as well as for controlling withdrawal symptoms or other side effects.MethodsWe describe the case of an 11-year-old boy with bipolar-I disorder comorbid with panic disorder who developed manic symptoms with a single dose of 10 mg of propranolol.Results and ConclusionAlthough depression is a better-known side effect of b-adrenergic antagonists, clinicians should take mania as a rare side effect into consideration as well.


Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 3915-3915
Author(s):  
Manuel Schmidt ◽  
Javier de Christobal ◽  
Nicole Hagner ◽  
Astrid Sander ◽  
Alberto Marco ◽  
...  

Abstract Linear, single-stranded oligonucleotides (ODN) with non-methylated cytosine-guanine (CpG) motifs are immunomodulatory since they resemble bacterial DNA and serve as “danger signals”. These CpG-ODNs promote predominately a TH1-response, with secretion of IL-12 and IFN-γ, and B-cell, natural killer (NK)-cell and dendritic cell (DC) activation and have a broad potential as therapeutic agents, i.e. for cancer gene therapy and for the treatment of allergic diseases. Distinct groups of CpG-ODNs were characterized differing in structure and function: one group promotes B-cell proliferation, monocyte stimulation and secretion of IgM and IL-6; another activates plasmacytoid DC to produce IFN-α/-β and thus γδT-cells and NK-cells to express CD69 and secrete IFN-γ. And a third group exhibits combined properties of stimulating IL-6 and IgM secretion from B cells as well as IFN-α production from pDCs. Phosphorothioate (PS) modifications, usually introduced to enhance stability, result in several side-effects, like prolongation of the blood clotting time, non-specific binding to various proteins and acute toxicities in primates. In addition, a recent publication showed severe side-effect like significant organ enlargements and morphological changes in mice [Heikenwalder et al., Nat Med. 10:187, 2004]. We generated short covalently-closed dumbbell-like structures (dSLIM) to stabilize the DNA without the otherwise necessary PS-modification. Moreover, the covalently closed constructs do not signal for apoptosis, as high intracellular concentrations of open DNA ends would do. These dSLIM molecules are stable in serum and during long-term storage regarding both DNA integrity and biological function. Their broad activity, like increasing surface expression of CD80/B7.1, CD40, HLA-DR/MHC-II and CD54/ICAM-1 and enhancing production of a wide range of cytokines (IL-6, IFN-α, IFN-γ, IL-12, IL-2), was strictly dependent on molecule structure and size. Increasing or decreasing of stem size lead to reduced potency of the dumbbell-shaped dSLIM molecule. This was observed for a decreased size of the loops as well. But the most intriguing result was the significantly reduced toxicity of dSLIM compared to PS-ODN: After repeated injection of dSLIM or PS-ODN, respectively, into mice the mice receiving PS-ODN developed enlargement of liver, spleen and lymph nodes whereas dSLIM did not induce such changes. In addition, damage of liver and spleen - such as necrotic hepatocytes or hyperplasia - was observed in PS-ODN treated but not in dSLIM treated mice. Nevertheless, both dSLIM and PS-ODN induced a comparable IL-12 production in these mice in vivo. The significant differences of side-effect were true for PS-ODN and dSLIM molecules with various nucleotide sequences. In conclusion, we present the new class of potent immunomodulators (dSLIM) with significantly reduced side-effects.


2020 ◽  
Vol 7 (3) ◽  
pp. 69-72
Author(s):  
Sonia Amin Thomas ◽  
Harnisha Patel

A 41-year-old patient with Metastatic Breast Cancer suffered from pneumonitis after administration of cyclophosphamide. A CT angiogram with IV contrast was compatible with bronchopneumonia and it was treated with broad spectrum antibiotics. Other causes of pulmonary disease were ruled out concluding patient developed cyclophosphamide induced pneumonitis. Thus, more attention is required to the serious and rare side effects of cyclophosphamide related lung toxicities. In this case report, we will focus on the rare side effects such as cyclophosphamide-induced pneumonitis (AIP) occurring in less than 1% of the population.


1972 ◽  
Vol 1 (1) ◽  
pp. 37-44
Author(s):  
W A Forrest

A total of 3,000 patients in general practice, with a diagnosis of moderate to severe anxiety with depressive overtones were treated with benzoctamine 10 mg tid for two weeks. During this period 75 % of the group obtained symptomatic relief, and 45 % were symptom free after two weeks. The profile of patients responding significantly well to this treatment was studied in detail. In this group of patients the drug was well tolerated, 11 % of the patients reporting no side effects. Drowsiness was the most commonly reported adverse reaction with an incidence of 9 %.


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