The clinical effect of clomipramine in chronic idiopathic pain disorder revisited using the Spielberger State Anxiety Symptom Scale (SSASS) as outcome scale.

Background: We have re-analysed our previous double-blind, placebo-controlled clomipramine study, changing the focus from depression to anxiety both in the response analysis and in the classification of minor affective states.

Methods: The Spielberger State Anxiety Symptom Scale (SSASS) including only the negatively phrased items was used to measure the pure anxiolytic effect. The analgesic effect was measured by the Visual Analogue Scale (VAS) for bodily pain.

Paroxetine and imipramine in the treatment of depressive patients in psychiatric practice.

A total of 151 outpatients with endogenous or mixed endogenous and reactive depression were included in a 6-week double-blind study, with extension for up to 1 year, in psychiatric practice. The results showed trends in efficacy variables and a statistically significant difference in a benefit-risk ratio in favour of paroxetine (Seroxat, Paxil) compared with imipramine. Efficacy was largely maintained in both groups during long-term treatment.

Combined treatment with imipramine and mianserin. A controlled pilot study.

The effect of imipramine plus mianserin and imipramine plus a placebo was compared in 40 depressed patients with a median age of 60 years. The imipramine dosage was flexible to give a plasma concentration around 200 nmol/l and mianserin was given at a fixed dosage of 30 mg daily. After six weeks of treatment the results showed that the scores on the Hamilton Depression Scale as well as on the Melancholia Scale were significantly more improved in the imipramine-plus-minaserin group than in the group of patients receiving imipramine alone (P less than 0.

Imipramine binding in depressed patients with psychogenic pain.

Imipramine binding to platelet membranes from depressed patients was analyzed. The patients were divided into two groups: one with depression alone, another with depression and psychogenic pain. The depressed patients with psychogenic pain had lower imipramine binding than the depressed patients without pain.

Clomipramine and mianserin in the treatment of chronic tension headache. A double-blind, controlled study.

114 patients with chronic tension headache (more than 10 days per month for at least 6 months) were treated with placebo, clomipramine or mianserin in a double blind parallel group comparison. Eighty-two patients completed the study. Headache pain was scored weekly on visual analogue scales for the 6 weeks of treatment.

Plasma ratio tryptophan/neutral amino acids in relation to clinical response to paroxetine and clomipramine in patients with major depression.

The pretreatment plasma ratio of tryptophan (Trp) to other large neutral amino acids (LNAA), thought to reflect brain serotonin formation, was determined in 44 inpatients with major depression, who were subsequently treated double-blind on a fixed-dose schedule for 4 weeks with the selective serotonin uptake inhibitor paroxetine (n = 27) or clomipramine (n = 17). The study took place at four clinical centers. Endogenous and non-endogenous depressives were comparable with respect to the ratio Trp/LNAA and clinical improvement and were therefore analyzed together.

Clomipramine and mianserin in chronic idiopathic pain syndrome. A placebo controlled study.

The reduction of pain by two antidepressants, clomipramine and mianserin, was, in this study on 253 patients with chronic idiopathic pain syndrome, found to be not better than a placebo when all patients were compared independently of the classification of pain. The improvement rate was around 40% after 6 weeks of treatment when using a 50% or better reduction in pain level. However, in patients who fulfilled a checklist definition of minor to major depression (30% of the total patient material) clomipramine was superior to mianserin and placebo with an improvement rate of 75% after 6 weeks.

Platelet 3H-imipramine binding in psychogenic pain patients.

High-affinity binding of 3H-imipramine was analyzed in platelet membranes from patients with chronic psychogenic pain. The patients who in addition to the pain also showed affective symptoms such as depression and anxiety had lower binding than the pain patients without these symptoms.

Use of headache rating scales: a multiaxial approach.

The basic principles of the rating scale procedure have been outlined, including the Likert scale, the Guilford criteria for item definitions, and the Guttman and Rasch criteria for item combinations. With these criteria, headache rates among the core symptoms of anxiety and depression. Next, we have discussed one of the prevailing scales for headache, the Waters Headache Questionnaire (WHQ), with a multiaxial approach.