We report on the results of controlled clinical antidepressant trials with elderly depressed patients which meet certain methodological requirements and have been published since 1980. The safety, tolerability, and efficacy of the investigated compounds are reviewed. In the light of the diagnostic problems and the altered pharmacokinetic behavior in this special age group we conclude that the progress in scientific knowledge in the last 13 years has only been moderate.

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Gabapentin, a novel antiepileptic drug, is effective in the treatment of partial seizures with and without secondary generalization. Evidence suggests that it may have mood-stabilizing and possibly antidepressant properties in bipolar depression. We report on a 48-year-old woman who had recurrent major depressive disorder. Following inguinal herniorrhaphy, she developed severe stabbing pain in the lower abdomen and inguinal area that progressed to constant pain in her whole body. She was depressive, hopeless, and had given up her social activities. A diagnosis of major depressive disorder and somatoform pain disorder was made. Antidepressants and carbamazepine were ineffective, and she had attempted suicide. Gabapentin resulted in remission of both the pain and the depressive mood at a dose of 1.800 mg/day.

Well-established findings in schizophrenics suggest that they have difficulties in interpreting contextual information. We used electrophysiological means to investigate this hypothesis. The N 400 paradigm was used in 29 acute schizophrenic patients and 28 controls. The main findings were a changed topographical distribution of amplitude in the schizophrenic group; that is, a reduced amplitude at the frontal sites and a pronunciation at the occipital sites. We did not find latency differences. When remitted patients (n = 17) were reinvestigated, a negative correlation of the amplitude to the total amount of neuroleptics used was found. These results are discussed in relation to structural and functional findings supporting the hypofrontality hypothesis in schizophrenia.