fluvoxamine and Dysthymic-Disorder

The aim of the study was to evaluate therapeutic effects and tolerability of fluvoxamine (150-200 mg daily) in 21 dysthymic adolescents.. Twenty-one adolescents, attending psychiatric clinics, who met DSM-III-R criteria for dysthymia, without significant co-morbidity were the subjects.. Axis I and II diagnoses were made by using SCID-P and SCID II. Score A of >13 on HAMD-S at baseline was mandatory. The HAMD-S was completed after 4, 8, and 26 weeks. Adverse effects were recorded after 1, 2, 4, and 8, weeks. Tolerability was assessed by using CGI-T after 1, 2, and 4 weeks. Adverse effects caused three subjects to withdraw from the study.. Good clinical response (decrease of HAMD-S score >50%) was observed after 4 weeks in 48% of patients; after 8 weeks in 56% of patients, and after 26 weeks in 44% patients. Relapse occurred in 34% of subjects. Fluvoxamine was well tolerated in 76.2% of the adolescents; poor toleration resulted in its discontinuation in 14.2% adolescents.

Topics: Adolescent; Antidepressive Agents, Second-Generation; Dysthymic Disorder; Female; Fluvoxamine; Humans; Male; Psychiatric Status Rating Scales; Statistics, Nonparametric

Many patients with affective illness show partial or otherwise unsatisfactory responses to standard treatments, encouraging trials of combinations of pharmacologically dissimilar antidepressants.. Records of consecutive outpatients with affective disorders only partially responsive to treatment with a serotonin reuptake inhibitor (SRI) or bupropion, alone, were reviewed for changes in specific symptoms and risks of adverse events when an SRI and bupropion were combined.. Greater symptomatic improvement was found in 19 (70%) of 27 subjects during a mean +/- SD of 11 +/- 14 months of combined daily use of bupropion (243 +/- 99 mg) with an SRI (31 +/- 16 mg fluoxetine-equivalents) than with either agent alone. Adverse effect risks were similar to those associated with each monotherapy, with a > 10% incidence of sexual dysfunction (N = 11, 41%), insomnia (N = 6, 22%), anergy (N = 4, 15%), and tremor (N = 3, 11%) during combined therapy; there were no seizures.. With conservative dosing and close monitoring, combinations of SRIs with bupropion in this uncontrolled clinical series appeared to be safe and often more effective than monotherapy.

Topics: 1-Naphthylamine; Adult; Aged; Ambulatory Care; Anxiety Disorders; Bupropion; Depressive Disorder; Drug Administration Schedule; Drug Therapy, Combination; Dysthymic Disorder; Epilepsy; Female; Fluoxetine; Fluvoxamine; Humans; Male; Middle Aged; Panic Disorder; Selective Serotonin Reuptake Inhibitors; Sertraline; Treatment Outcome