Lofepramine, an imipramine derivative, shows lower acute toxicity in animals when compared with desipramine and imipramine. Its anticholinergic effect is less pronounced than that of desipramine. In an open clinical trial lofepramine showed a marked antidepressive action. A double-blind multicenter trial of lofepramine v. imipramine, evaluated by means of the AMP system, showed a remarkable degree of concurrence with regards to the effects of those two products.
Ich bitte als ersten Vortragenden Herrn Welsch, gemeinsam mit Herrn Martens und Herrn Balser fiber die Wertigkeit von Sofortmal]nahmen bei chirurgischen Notf/~llen zu sprechen. In Anbetracht der vorgeriickten Zeit m5chte ieh an die folgenden Vortragenden die Frage richten, ob sic sich in der Lage sehen, ihre Redezeit um etwa 1 min zu kiirzen; vielleicht dadurch, daft sie etwas weniger Wichtiges weglassen.
Effects and side-effects of 150 mg and 225 mg maprotiline per day were compared by means of a double-blind trial in 20 depressed inpatients. The first 2 days patients received a high initial dosage of 300 mg per day. Patients were examined on days 0, 2, 5, 10, 15, 20, and 30. Symptoms were evaluated by the AMP system and the Hamilton scale for depressions. Laboratory examinations were carried out on days 0, 10, 20, and 30. Exanthemas developed in five patients, three of whom were on the higher dosage. Moreover, the lower dosage caused less fine hand tremor. Coinciding with the beginning of treatment a linear decrease of depressive symptoms was noted. This demonstrates the rapid onset of the antidepressant effect. Moreover, contrary to what has been stated for antidepressants generally, the onset of action was frequently noted well before 10-20 days of treatment. Some patients improved within a few days while others needed more time. The time lag until antidepressants influence depressive symptoms shows pronounced individual differences. No significant difference between the two dosages was found. The profiles show a better antidepressant effect for the higher dosage; however, because of a higher incidence of side-effects on the higher dosage of maprotiline, it cannot be recommended as routine. On the other hand, depressive inpatients should receive a daily dosage of at least 150 mg. Our findings suggest a dose-effect relationship for maprotiline.
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