Eighty-three patients were recruited in a multicentre study concerning the usefulness of benzodiazepines (BZ) in major depressive disorders, diagnosed according to the DSM-III-R criteria. After 1 week wash-out, patients were randomized to clomipramine (CLMP) or CLMP plus bentazepam (BTZ) treatments (47 and 36 patients respectively). It was necessary to add hypnotics, usually a BZ, in 11 patients in the CLMP group and in one patient in the CLMP+BTZ group. The clinical improvement was faster in the group treated with CLMP+BTZ and, at the end of 6 weeks of treatment, the mean score in Hamilton Anxiety Scale (HAS) was lower than the one found in the group treated with CLMP. There were no significant differences found in Hamilton Depression Scale (HDS) between the groups. The side-effects observed were those due to CLMP, and only drowsiness was more frequent in the CLMP+BTZ group. However, the CLMP+BTZ combination was equally or better tolerated by patients than by those treated with CLMP alone. Similar results were found in hospitalized as well as in outpatients. The tricyclic antidepressant (TCA)/BZ association showed better results than TCA alone, producing a symptomatic improvement extensive to the anxious components of depression.
A 23-year old woman developed headache and papilledema due to benign intracranial hypertension (BIH) while taking lithium carbonate for only seven months because of manic-depressive disease. Having discarded other causes, drug ingestion was the most likely etiology of the syndrome since it was observed that symptoms improved upon lithium withdrawal and worsened when the treatment was restarted. This report shows that BIH may appear as a side-effect of relatively short-term therapy with lithium and, therefore, funduscopic exams should be performed in every patient receiving this drug.
Pharmacotherapeutic follow-up upon admission and discharge resolves and prevents problems while improving patient information and satisfaction. Limitations on personnel prevent the population's requests from being met.
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