CITALOPRAM MAY REDUCE SYMPATHOADRENAL HYPERACTIVITY IN ELDERLY DEPRESSED PATIENTS: AN OPEN MULTICENTER STUDY IN BELGIUM AND LUXEMBOURG

Introduction: Through effects of catecholamines upon the heart, blood vessels and platelets, sympathoadrenal hyperactivity contributes to the development of cardiovascular diseases in elderly depressed patients. To assess the cardiovascular effect of Citalopram in elderly depressed patients, data from an open multicenter study in Belgium and Luxembourg, in which a total of 811 patients were evaluated, was retrospectively analysed. Although the aim of the study was to assess the efficacy and safety of Citalopram, blood pressure and heart rate were also monitored. Subject and methods: Patients included in the study were referred either by psychiatrists, geriatricians or general practitioners. Clinical assessment included ratings on the Hamilton Rating Depression Scale, the Clinical Global Impression Scale, the UKU Side effect rating scale and the assessment of side effects spontaneously reported. Results: With few side effects, Citalopram significantly improves the clinical condition of elderly patients suffering from depressive symptoms. A series of repeated multivariate analyses of covariance were performed on heart rate and blood pressure controlling for the effect of age. Interestingly, a sustained decrease of these parameters was shown during the whole study period reaching significance for systolic blood pressure (p<0.05). These effects were observed both in responding as well as non-responding patients, and were somewhat more marked in responders for heart rate (p=0.058). Conclusion: The slight but significant decrease in systolic blood pressure and heart rate suggests that citalopram may reduce sympathoadrenal hyperactivity and the related increased cardiovascular morbidity and mortality associated with depression

EEG source identification: frequency analysis during sleep

National audienc

Pratique de l'électroconvulsothérapie: apports récents. II.--Administration et évaluation du traitement.

In this second of a two-part review about electroconvulsive therapy (ECT) practice, the author highlights recent advances in ECT course management with a special emphasis on pre-ECT evaluation, treatment procedures, evaluation of outcome and post-ECT course. Pre-ECT assessment should include an evaluation of medical risk factors and concomitant use of psychotropic or medical agents have to be reconsidered. Practical and technical aspects of stimulus administration and their relationships with post-ECT cognitive disabilities are then presented. Monitoring of treatment response and cognitive changes during ECT course is also discussed as well as post-ECT pharmacotherapy maintenance or continuation ECT.SCOPUS: re.jinfo:eu-repo/semantics/publishe

Pratique de l'électroconvulsothérapie: apports récents. I.--Indications, contre-indications et effets secondaires.

In this first of a two-part review about electroconvulsive therapy (ECT) practice, the author reviews main treatment indications, contraindications and complications. Major diagnostic indications are major depression, mania and some other functional psychoses. Other indications, primary use of ECT, and use in special population (children, adolescents, elderly, pregnancy) are also discussed. There are now no absolute contraindications to treatment but high risk situations. Cardiovascular complications are the leading cause of post-ECT morbidity, as are, but at a least degree, prolonged and tardive seizures. Factors that contribute to cognitive side effects are also presented.SCOPUS: re.jinfo:eu-repo/semantics/publishe

Sleep, dexamethasone suppression test, and response to somatic therapies in an atypical affective state presenting as erotomania: A case report

The case of a woman presenting erotomania in the course of a loss-related depressive state is described. Clinical, biological and therapeutical characteristics highlight the role of mood in certain cases of erotomania and add support to previous accounts of the heterogeneity of this syndrome.SCOPUS: ar.jinfo:eu-repo/semantics/publishe