Objectives: Approximately one in two patients with multiple sclerosis (MS) suffer from comorbid depression. The primary objective of this study was to evaluate the safety and tolerability of fingolimod and antidepressant combination in relapsing-remitting MS patients with mild-to-moderate depression. Efficacy outcome variables were quality of life (QoL), fatigue, disability and depression. Methods:Patients received open-label fingolimod 0.5 mg over 2 weeks, followed by fingolimod plus citalopram (40 mg), fluoxetine (40 mg) or venlafaxine (150 mg) over 16 weeks. The antidepressant was selected at the physician's discretion. Results: In total, 54 patients were recruited at 25 centres across Germany. No new safety signals (including cardiac) emerged compared with previous clinical studies. Adverse events (mostly mild-to-moderate) were reported in 43 patients. A total of three patients had serious adverse events and 10 discontinued the study. QoL (mean [95% confidence interval]) improved by 2.2 (−3.3, −1.2; Patient Reported Indices for MS questionnaire), fatigue by 8.2 (−13.1, −3.3; modified Fatigue Impact Scale) and depression by 6.3 (−8.4, −4.2; Hamilton Depression Scale) points. However, the results must be interpreted cautiously owing to limited patient numbers. Conclusions: Combination of fingolimod with antidepressant medication showed no unexpected safety signals. Patient-reported outcomes (QoL, disability, fatigue and depression) remained stable or improved.

This paper describes the improvement of an electromagnetic elevator guiding system. Based on an existing system, which is able to control five spatial degrees of freedom of an elevator car, a system enhancement is proposed. The system of five controlled spatial degrees of freedom is augmented by a sixth degree of freedom: This is the elevator car's vertical torsion angle. Contrary to the former system, it is not longer a precondition, that the elevator car is a rigid body or the manufacturing tolerances in very high buildings are almost zero. Therefore, the system presented is more realistic than its antecessor. The present paper describes the derivation of the additional torsion controller and compares the two unequal systems. Benefits and disadvantages of the augmented system are specified and evaluated.

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