Articole MedLinx Iulie 2011

MDLinx  Internal Medicine

Your Article Summary Sertraline or mirtazapine for depression in dementia (HTA-SADD): A randomised, multicentre, double-blind, placebo-controlled trial The Lancet - Early Online Publication, 07/22/11 Banerjee S et al. ?Depression is common in dementia but the evidence base for appropriate drug treatment is sparse and equivocal. The authors aimed to assess efficacy and safety of two of the most commonly prescribed drugs, sertraline and mirtazapine, compared with placebo. Because of the absence of benefit compared with placebo and increased risk of adverse events, the present practice of use of these antidepressants, with usual care, for first-line treatment of depression in Alzheimer's disease should be reconsidered. Methods We undertook the parallel-group, double-blind, placebo-controlled, Health Technology Assessment Study of the Use of Antidepressants for Depression in Dementia (HTA-SADD) trial in participants from old-age psychiatry services in nine centres in England Participants were eligible if they had probable or possible Alzheimer's disease, depression (lasting &ge4 weeks), and a Cornell scale for depression in dementia (CSDD) score of 8 or more Participants were ineligible if they were clinically critical (eg, suicide risk), contraindicated to study drugs, on antidepressants, in another trial, or had no carer Clinical trials unit at King's College London (UK) randomly allocated participants with computer-generated block randomisation sequence, stratified by centre, with varying block sizes, in a 1:1:1 ratio to receive sertraline (target dose 150 mg per day), mirtazapine (45 mg), or placebo (control group), all with standard care Primary outcome reduction in depression (CSDD score) at 13 weeks (outcomes to 39 weeks were also assessed), assessed with mixed linear-regression model adjusted for baseline CSDD, time, and treatment centre Results Decreases in depression scores at 13 weeks did not differ between 111 controls and 107 participants allocated to receive sertraline (mean difference 1?17, 95% CI -0?23 to 2?58; p=0?10) or mirtazapine (0?01, -1?37 to 1?38; p=0?99), or between participants in mirtazapine and sertraline groups (1?16, -0?25 to 2?57; p=0?11); these findings persisted to 39 weeks Fewer controls had AE (29 of 111 [26%]) than did participants in sertraline group (46 of 107, 43%; p=0?010) or mirtazapine group (44 of 108, 41%; p=0?031), and fewer serious AE rated as severe (p=0?003) 5 patients in every group died by week 39 Receive more summaries like this by joining MDLinx. We provide free daily digests of top journal articles in your field. >> Click here to choose your specialties. Other articles in Internal Medicine >> Click here to see the complete list Dementia anxiety among older adult caregivers: an exploratory study of older adult caregivers in Canada International Psychogeriatrics, 07/07/11 The Collateral Source version of the Geriatric Depression Scale: evaluation of psychometric properties and discrepancy between collateral sources and patients with dementia in reporting depression International Psychogeriatrics, 07/07/11 Sertraline Induced Hepatotoxicity: A Case Report and Review of Literature The Internet Journal of Gastroenterology, 06/30/11

©2011 MDLinx, a division of M3 USA M3 USA considers the privacy of its users to be of utmost importance and works to protect it. M3 USA uses personal user information for internal purposes only. We will not sell or share your information with outsiders. For comprehensive information about the steps that M3 USA takes to respect your privacy please read our Privacy Policy .

This email has been sent by MDLinx, a division of M3 USA, 1215 17th Street NW, Washington, DC 20036 Tel: +1.202.293.2288 Fax: +1.202.293.1690

Your Article Summary Vilazodone: In Major Depressive Disorder CNS Drugs, 06/29/11 Frampton JE – Vilazodone was generally well tolerated in the short– and long–term treatment of major depressive disorder (MDD), with diarrhoea and nausea being the most frequently occurring treatment–emergent adverse events. Vilazodone had a minimal impact on sexual functioning in the three phase III studies. Vilazodone, a novel antidepressant agent that combines selective serotonin reuptake inhibitor (SSRI) activity and serotonin 5–HT1A receptor partial agonist activity in a single molecule, is indicated for the treatment of major depressive disorder (MDD) in the US. It is administered orally, once daily, with food. At the recommended dosage of 40 mg/day, vilazodone was effective in the short–term treatment of MDD in adults, as evidenced by significant improvements versus placebo on multiple measures of depression, including the Montgomery–?sberg Depression Rating Scale (MADRS) and the 17–item Hamilton Rating Scale for Depression (HAM–D–17), in two pivotal, 8–week, randomized, double–blind, phase III studies. Significant differences between vilazodone and placebo on the MADRS and HAM–D–17 were seen after 1 week of treatment (first efficacy timepoint) in one of the two studies. Long–term treatment with vilazodone 40 mg/day was associated with an improvement from baseline in depressive symptoms in a 52–week, noncompar–ative, phase III study. Receive more summaries like this by joining MDLinx. We provide free daily digests of top journal articles in your field. >> Click here to choose your specialties. Other articles in Internal Medicine >> Click here to see the complete list Depressive Symptoms, Health Behaviors, and Subsequent Inflammation in Patients With Coronary Heart Disease: Prospective Findings From the Heart and Soul Study American Journal of Psychiatry, 07/13/11 Association between depression and inflammation?differences by race and sex: The meta-health study Psychosomatic Medicine, 07/08/11 Association between depression and inflammation?differences by race and sex: The META-Health Study Psychosomatic Medicine, 07/05/11