2003, volume 19, issue 3


The perspectives of pharmacotherapy of depression

Janusz Rybakowski
Farmakoterapia w Psychiatrii i Neurologii, 2003, 3, 5-19

In this review, the perspectives of the development of new antidepressant drugs based on previous and novel pathogenic concepts of depression have been discussed. Most antidepressant drugs introduced so far act mainly on serotonergic or/and noradrenergic neurotransmission. The directions for introducing new antidepressant drugs have been presented, related to other neurotransmitters’ concepts, and, due to the knowledge of new pathogenic mechanisms of depression, drugs acting on the disturbances of stress system, other endocrine axes, and on neurotrophic and neuroprotective processes.


The effect of antidepressants on pain

Małgorzata Rzewuska
Farmakoterapia w Psychiatrii i Neurologii, 2003, 3, 21-38

A literature review has been conducted to examine the association between depression and pain. The findings suggest that treatment of depression requires attention to the full spectrum of symptoms (both emotional and physical). Most of clinical studies indicate that the dual inhibitors of serotonine and noradrenaline reuptake show more complete resolution of painful physical symptoms than SSRI’s.


Serotonin antagonists and reuptake inhibitors (SARI) in the treatment of mental disorders

Janusz Szyndler, Anna Skórzewska, Adam Płaźnik
Farmakoterapia w Psychiatrii i Neurologii, 2003, 3, 39-51

SARIs (serotonin antagonists and reuptake inhibitors; nefazodone, trazodone) are new antidepressants with an interesting pharmacological profile. These antidepressant agents differ chemically and pharmacologically from selective serotonin-reuptake inhibitors (SSRI), monoamine oxidase inhibitors, and tricyclic antidepressants (TCA). Nefazodone and trazodone are active in a number of preclinical tests for antidepressant activity, and show high clinical efficacy in the treatment of depression with a more favorable side-effect profile than classic drugs such TCA. SARI have mechanisms of action distinct from other antidepressive agents. These compounds are potent antagonists of 5-HT2 receptors and inhibit serotonin transporter. Nefazodone blocks also norepinephrine transporter. SARI appeared effective in patients with major depression with efficacy similar to that of SSRI and TCA. SARI have been also reported to improve depression related insomnia, anxiety and many other secondary symptoms. This paper presents a review of pharmacological, pharmacokinetic and clinical profile of SARI. At the end, it is concluded that these agents present an interesting alternative for classical antidepressant drugs.


A multicentre double-blind study investigating the anxiolytic efficacy of diazepam, hydroxyzine and tofisopam in patients with generalized anxiety

Małgorzata Rzewuska
Farmakoterapia w Psychiatrii i Neurologii, 2003, 3, 53-65

The efficacy of tofisopam and hydroxyzine was investigated in a double-blind, parallel group and compared with diazepam. A total of 84 out patients with generalized anxiety disorder was allocated randomly to treatment with hydroxyzine (75 mg/d), tofisopam (150 mg/d) and diazepam (25 mg/d) for 6 weeks. Rates scales (HAMA, HDRS, CGI) were applied on days 0, 14, 42 and 2 weeks after end of the treatment. 21 (25%) of the 84 patients dropped out, but equally in the three groups.
All drugs reduced the anxiety symptom s (HAMA) in the first two and 6 week of treatment. It wasn’t differences in the efficacy and frequency of adverse event between drugs. The tofisopam may be useful and safer alternative to the benzodiazepines and hydroxyzine.