Blood dyscrasia

Hypertensive crisis with sympatheto-

Low Low Low


NRI, noradrenaline reuptake inhibitor; SRI, serotonin reuptake inhibitor, 5HT2, 5HT2 antagonist; 5HT3, 5HT3, antagonist; a^/a^ a! antagonist/a2 antagonist; RIMA, reversible inhibitor of monoamine oxidase-A; + +, relatively common or strong; +, may occur or moderately strong; - absent or rare/weak; ?, unknown/insufficient information. Reprinted by permission of Sage Publications Ltd from Anderson, I. M. ; Nutt, D. J.; Deakin, J. F. W. J. Psychopharmacol. 2000, 14, 3-20. Copyright (© British Association for Psychopharmacology, 2000).

aThese refer to symptoms commonly caused by muscarinic receptor blockade including dry mouth, sweating, blurred vision, constipation, and urinary retention; however, the occurrence of one or more of these symptoms may be caused by other mechanisms and does not necessarily imply that the drug binds to muscarinic receptors.The side-effect profiles given are not comprehensive and are for an approximate comparison only. Details of drugs used and potential cautions and interactions should be looked up in a reference book such as the latest US or British National Formulary.

Table 8 The three treatment phases for antidepressants

Phase Length Treatment goal

Acute 6-12 weeks Achieve remission/stabilization

Countinuation 4—12 months Prevent relapse

Maintenance Varies Protect against recurrence

Remission = a virtual elimination of symptoms; score of 7 or less on 17-item HAM-D scale. Relapse = re-emergence of significant depressive symptoms.

approaches, which have a number of theoretical and practical advantages for analysis of longitudinal data and dropouts. One method that is gaining acceptance is mixed model repeated measures (MMRM) and this has been extensively studied in the context of neuropsychiatry clinical trials.33 Data from studies suggest that MMRM yields 75% empirical power compared with 50% for LOCK MMRM is simple to use, easy to implement, and to specify a priori. It is also more likely than LOCF to give adequate control of type I (false-positive) and type II (false-negative) errors. In other words, the use of either MMRM or LOCF will lead to the same conclusions but MMRM is likely to yield fewer mis-steps along the way.33

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