ObjectivesPost-infarct Depression appears to 15-30% of the patients treated in the Infarction Units, according to the International Standards. It appears 24-72 hours following an Acute Infarction of the Myocardium.MethodsWe studied 300 patients treated in the Infraction Treatment Unit for a period of three months, within the framework of a Liaison Consultation Psychiatry program. 180 patients were men (60%) and 120 patients were women (40%). The average age of male patients was 52 years and the average age of female patients was 58 years. These patients were submitted to the Montgomery-Arnsberg Depression Rating Scale (MADRS) to evaluate Depression. According to the results of the Scale, these 120 patients presented depressive symptomatology, 45 patients presented mild symptomatology, 70 patients presented average symptomatology, and 5 patients presented heavy symptomatology.ResultsAll the above patients were treated with SSRIs. In particular, they received Fluoxetin, Sitalopram, Esitalopram, Fluvoxamine, Sertraline. The MADRS Scale has been evaluated on 15 days, 1, 2, 3, and 6 months following the initiation of therapy. 110 patients (91%) presented a significant reduction of MADRS Scale, while 10 patients (9%) showed resistance to the treatment and had to switch their treatment scheme with SNRIS or NASSAS.ConclusionsThe SSRIs constitute the most advisable treatment for post-infraction depression, due to their low side-effect profile. The rate of positive outcome for post-infarction depression treatment was especially high (91%) during treatment with SSRIs at a level consistent with the international literature reference.

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ObjectivesTreatment-resistant schizophrenia is an old term, describing the form of schizophrenia that does not respond to a treatment dose of Chloropromazine, equal to 1,5 gr.Methods20 (n=20) patients have been studied, that were diagnosed with schizophrenia, and did not respond to any combination of typical or non-typical anti-psychotic drugs. These patients were 19-62 years of age, and were administered the BPRS and PANSS scales at start of the examination or the hospitalization, and during the 1st, 3rd, and 6th month evaluation. The said patients were treated with a combination of Amisulpiride, and Clozapine.ResultsThe patients received a dosage range of 400-1200mg for the Amisulpiride, and 300-900mg for the Clozapine. 18 patients (90%) responded to this treatment, and showed an improvement in the BPRS and PANSS scales, from the 1st month of treatment using a combination of Amisulpiride-Clozapine. Later, during the 3rd month of treatment, one of the patients discontinued the treatment, as she presented leucopenia (white cell count: 3250). The discontinuation of Clozapine treatment was decided. Clozapine was replaced by 20mg Olanzapine.ConclusionsDespite the fact that the sample of patients was very small (n=20), it seems that the combination of Amisulpiride and Clozapine is effective for the treatment of patients showing resistance in pharmaceutical treatment and the combination of typical and non-typical neuroleptics.

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