By David S Baldwin; Jon Birtwistle
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Additional resources for An atlas of depression
37). Controlled trials have shown that mianserin is superior to placebo in the management of depression, and comparable to imipramine and clomipramine47. The longterm efficacy of mianserin is not proven. The main adverse effects of mianserin are drowsiness, dizziness, weight gain, dyspepsia and nausea. Cognitive impairment is more likely with mianserin than with SSRIs49. As with other tricyclics, mianserin increases the risk of seizures, and some patients may experience postural hypotension. The most serious adverse effect of mianserin is the lowering of the white cell count, while fatal agranulocytosis has been reported.
G. imipramine), paroxetine, trazodone and the SNRI venlafaxine. The antipsychotic drug trifluoperazine is sometimes effective in reducing anxiety but is associated with a number of long-term side-effects63. 40. Managing patients with panic disorder and agoraphobia There are numerous medical conditions that produce panic-like symptoms and these should be considered and excluded before treatment of panic disorder. g. schizophrenia, mood disorder or somatoform disorder), alcohol and drug withdrawal, caffeinism, hyperthyroidism, hyperparathyroidism, hypoglycemia, pheochromocytoma, cardiac arrhythmias, labyrinthitis and temporal lobe epilepsy.
A review of the findings of randomized controlled trials indicates that the short-term efficacy of venlafaxine is at least as good as that of the TCAs clomipramine and imipramine and the SSRIs paroxetine and fluoxetine18. In longer-term treatment, pooled analysis suggests that venlafaxine is efficacious in preventing relapse of depression18. A recent meta-analysis of the findings of comparator-controlled studies suggests that venlafaxine is significantly more efficacious than SSRIs in short-term treatment19, and treatment with dual-acting drugs such as venlafaxine may be preferable to SSRI treatment in hospitalized depressed patients1.
An atlas of depression by David S Baldwin; Jon Birtwistle