DULOXETINE IN MAJOR DEPRESSED PATIENTS RESISTANT TO SSRIS AND/OR VENLAFAXINE

Several acute depression trials suggest that only 35% of the patients achieve remission state with antidepressant monotherapy. An increasing body of evidence is emerging suggesting that multi-action antidepressants might be more effective in treatmentresistant depressed patients than single-action agents. In this context, the purpose of the study was to assess the effectiveness of duloxetine in treatment-resistant major depressed outpatients. We performed a retrospective study assessing the efficacy of duloxetine in major depressed outpatients who did not achieve full symptom remission (CGI-S (severity) ≥ 3) after treatment of adequate dose and duration (more than 8 weeks) with at least either one SSRI or the SNRI venlafaxine. We excluded patients with a severe medical illness and a personality disorder. CGI-S was used as a measure of symptom severity and administered before the prescription of duloxetine and 6 weeks later. The sample included 29 patients (9 M, 20 F). We observed a very significant decrease in CGI-S scores (4,86 ± 0.51 to 2,17 ± 1,44, p<0.0001) after treatment with duloxetine (dose between 60 and 120 mg). Remission was achieved in 48 % of the patients. The tolerance was excellent. This study suggests the potential interest of duloxetine in some treatment-resistant depressed patients

Le trouble bipolaire: Une affection bien complexe

Bipolar disorder is a multifactorial disease with a strong genetic component. However, environmental factors also play a role in the onset of the disease and in manic and depressive recurrence. The onset of the disorder is the consequence of a complex interaction between genetic and environmental factors. This gene-environment interaction is well illustrated by the influence of childhood trauma on the clinical expression of the disease in terms of age of onset, comorbidity and suicide. The complexity and heterogeneity of bipolar disorder require the identification of homogenous sub-groups with the use of biomarkers that could help reduce the etiological heterogeneity and better target the therapeutical options.SCOPUS: re.jinfo:eu-repo/semantics/publishe