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Objective: To evaluate the comparative efficacy of 3 antidepressants, each representative of a distinct psychopharmacologic class, in the treatment of depressive disorders associated to Parkinson disease with dementia (PDD). Methods: A group of 23 patients, mean age 72.1, diagnosed with PDD for at least 2 years, who were admitted in our department for a major depressive episode (DSM IV TR), received antidepressant treatment with escitalopram (mean dose 15 mg daily, n=7), duloxetine (mean dose 45 mg daily, n=8) or trazodone (mean dose 150 mg daily, n=8). All patients received treatment for PDD with rivastigmine or donepezil continuously, for at least 12 months. The distribution of patients on the antidepressant treatment was randomized, in a single-blind manner. Patients were evaluated monthly, for 6 months, using Montgomery Asberg Depression Rating Scale, Hamilton Rating Scale for Depression-17 items, Clinical Global Impression-Improvement and Mini Mental Status Examination. Results: Patients treated with duloxetine had the most significant improvement in the depressive symptoms, as the endpoint MADRS (-18.6+/-2.3, p< 0.01), HAMD (-13.2+/-1.1, p< 0.01) and CGI-I (-3.2+/-0.5, p< 0.01) scores reflected. The differences between escitalopram and trazodone didn't reach a significant level but, overall, both improved the depressive symptoms compared to baseline (p< 0.05). The difference between duloxetine and the other two antidepressants became significant after 8 weeks (p< 0.01). The severity of dementia symptoms didn't vary significantly between the three groups at endpoint. Conclusion: Duloxetine had proven itself more efficient than escitalopram and trazodone in the improvement of the depressive symptoms in PDD.

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ObjectiveTo evaluate characteristics of the antipsychotic switch from any antipsychotic to amisulpride (Solian®) through the integration of the significantly variables.MethodThis is an open, non-randomized, multicentric, retrospective, non-interventional study that included 1165 subjects who were already stabilized on amisulpride for at least 6±1 months. These patients were previously switched from other antipsychotic to Solian®. Data were collected retrospectively on the patients’ status 6±1 months ago and their present status.ResultsThe population consisted of 38.5% hospitalized patients at the moment of antipsychotic switch and 61.5% outpatients; 56.3% of the patients were in acute exacerbation at that moment. Previous treatment of the patients: 100% antipsychotic, 17.9% antidepressant, 38.8% mood stabilizer, 39.4% benzodiazepine and 22.2% other treatments. Switch type: sudden in 63.7% of the patients, gradual in 35.4% and unknown in 0.9%. The mean dosage of Solian at initiation was 581.04 mg/day. For 38.1% of the patients the initial daily dose of Solian® was of 600 mg, for 29.6% of them 400 mg and for 22.7% 800 mg. The mean dosage of Solian during the 6±1 months was 571.39 mg/day. For 39.8% of the patients the daily dose of Solian® was of 600 mg, for 30.5% of them 400 mg and for 20.7% 800 mg.ConclusionsThe switch to Solian® was made suddenly in a majority of patients, preferred start dose being 600 mg, while the mean dose was similar to baseline values (in almost 40% of cases) or smaller during the 6±1 months of the study.