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Citalopram en pacientes retrasados mentales con depresión: una investigation clínica a largo plazo

Published online by Cambridge University Press:  12 May 2020

W. M. A. Verhoeven
Affiliation:
Instituto Vincent van Gogh para la Psiquiatría, Stationsweg 46, 5803AC Venray, Países Bajos Universidad Erasmo, Facultad de Medicina y Ciencias Médicas, Rotterdam, Países Bajos
M. J. Veendrik-Meekes
Affiliation:
Instituto para la Epilepsia Kempenhaeghe, Heeze, Países Bajos
G. A. J. Jacobs
Affiliation:
Instituto para el Retraso Mental “Saamvliet”, Gennep, Países Bajos
Y. W. M. M. van den Berg
Affiliation:
Instituto Vincent van Gogh para la Psiquiatría, Stationsweg 46, 5803AC Venray, Países Bajos
S. Tuinier
Affiliation:
Instituto Vincent van Gogh para la Psiquiatría, Stationsweg 46, 5803AC Venray, Países Bajos
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Resumen

Se investigó el efecto del citalopram en 20 pacientes retrasados mentales que padecían de un trastorno depresivo caracterizado por alteraciones en los dominios de la afectividad, la motivatión, la acti-vidad motora y los signos vitales. El estudio siguió un diseño abierto controlado en la línea de base. Se inició el citalopram en una dosis diaria de 20 mg que se mantuvo igual durante 6 semanas. Después, la dosis se ajustó hasta un maximo de 60 mg por día. Los efectos del tratamiento se evaluaron según la Escala de Mejoría Clinica Global (CGIS) después de al menos 6 meses. En 12 de los 20 pacientes se observó una mejoría de moderada a acusada en todos los dominios en el tratamiento con 20-40 mg de citalopram diarios. El tratamiento durante un afio en la dosis efectiva prevenía la recaída de los sfntomas depresivos. El uso de anticonvulsivantes sedantes redujo la sensibilidad al tratamiento. No se observaron interacciones. Se concluye que el citalopram es un antidepresivo bien tolerado, seguro y efectivo en sujetos retrasados mentales con trastornos depresivos.

Type
Artículo original
Copyright
Copyright © European Psychiatric Association 2001

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References

Bibliografía

Charlot, LR, Doucette, AC, Mezzacappa, E. Affective symptoms of institutionalized adults with mental retardation. Am J Mental Retard 1993; 8: 408–16.Google Scholar
Flint, J. Behavioural phenotypes: conceptual and methodological issues. Am J Med Genet 1998, 81: 235–40.3.0.CO;2-V>CrossRefGoogle ScholarPubMed
Franchini, L, Zanardi, R, Gasperini, M, Smeraldi, E. Two-year maintenance treatment with citalopram, 20 mg, in unipolar subjects with high recurrence rate. J Clin Psychiatry 1999; 60: 861–5.CrossRefGoogle ScholarPubMed
Gottfries, CG. Recognition and management of depression in the elderly. Int Clin Psychopharmacol 1997; 12: S31S6.CrossRefGoogle ScholarPubMed
Gottfries, CG. Scandinavian experience with citalopram in the elderly. Int Clin Psychopharmacol 1996; 11: S41S4.CrossRefGoogle ScholarPubMed
Guy, W. Early clinical drug evaluation (ECDEU) assessment manual. Rockville (MD): National Institute on Mental Health; 1976.Google Scholar
Joffe, P, Larsen, FS, Perdersen, V, Ring-Larsen, H, Aaes-Torgensen, T, Sidhu, J. Single dose pharmacokinetics of citalopram in patients with moderate renal insufficiency or hepatic cirrhosis comparad with healthy subjects. Eur J Clin Pharmacol 1998, 54: 237–42.CrossRefGoogle ScholarPubMed
Ketter, TA, Post, RM, Theodore, WH. Positive and negative psychiatric effects of antiepileptic drugs in patients with seizure disorders. Neurology 1999; 53: S53S67.Google ScholarPubMed
Lewis, MH, Gluck, JP, BodfishJW, Brauchamp AJ, Mailman, RB. Neurobiological basis of stereotyped movement disorder. In: Sprague, RL, Newell, KM, Eds. Stereotyped movements; brain and behaviour relationships. Washington DC: Ameritan Psychological Association; 1996. p. 37-68.Google Scholar
Marston, GM, Perry, DW, Roy, A. Manifestations of depression in people with intellectual disability. J Intellect Disabil Res 1997; 41: 476–80.CrossRefGoogle ScholarPubMed
Meins, W. A new depression scale designad for use with adults with mental retardation. J Intellect Disabil Res 1996; 40: 222–6.CrossRefGoogle ScholarPubMed
Meins, W. Symptoms of major depression in mentally retardad adults. J Intellect Disabil Res 1995; 39: 41–5.CrossRefGoogle ScholarPubMed
Meins, W. Wie werden geistig bebinderte Erwachsene mi depressiven Storungen psychopharmacologisch behan-delt? Nervenartzt 1996; 67: 216–8.Google Scholar
Menolascino, FJ, Gilson, SF, Levitas, AS. Issues in the treatment of mentally retardad patients in the community mental health system. Community Ment Health J 1986; 22: 314–27.CrossRefGoogle ScholarPubMed
Myers, BA, Pueschel, SM. Major depression in a small group of adults with Down syndrome. Res Dev Disabil 1995; 16: 289–99.CrossRefGoogle Scholar
Myers, BA. Psychopathology in hospitalizad developmen-tally disabled individuals. Compr Psychiatry 1986; 27: 115–26.CrossRefGoogle Scholar
Noble, S, Benfield, P. Citalopram. A review of its pharmacology, clinical efficacy and tolerability in the treatment of depression. CNS Daigs 1997;8:410–31.Google Scholar
Praag, HM. Barking up the wrong tree. Towards a more effective system of psychiatric diagnosing. Neuropsycho-pharmacology 1993; 9: S52S3.Google Scholar
Praag, HM. Inflationary tendencies in judging the field of depression research. Neuropsychobiology 1998; 37: 130–41.CrossRefGoogle ScholarPubMed
Rasmussen, SL, Overo, KF, Tanghoj, P. Cardiac safety of citalopram: prospective trials and retrospective analyses. J Clin Psychopharmacol 1999; 19: 407–15.CrossRefGoogle ScholarPubMed
Sproule, BA, Naranjo, CA, Brenmer, KE, Hassan, PC. Selective serotonin reuptake inhibitors and CNS drug interactions. A critical review of the evidence. Clin Pharmacokinet 1997; 33: 454–71.CrossRefGoogle ScholarPubMed
Syvalahti, EK, Taiminen, T, Saarijarvi, S, Lento, H, Niemi, H, Ahola, V, et al. Citalopram causes no significant alterations in plasma neuroleptic levels in schizophrenic patients. J Int Med Res 1997; 25: 2432.CrossRefGoogle ScholarPubMed
Turk, J, Hill, P. Behavioural phenotypes in dysmorphic syndromes. Clin Dysmorphology 1995; 4: 105–15.CrossRefGoogle ScholarPubMed
Verhoeven, WMA, Tuinier, S. The serotonin syndrome: four case reports and a concise review of the literatura. Eur J Psychiatry 1998; 12: 12–8.Google Scholar
Verhoeven, WMA, Tuinier, S. The psychopharmacology of challenging behaviours in developmental disabilities. In: Bouras, N, Ed. Psychiatric and behavioural disorders in mental retardation. Cambridge: Cambridge University Press; 1999. p. 295-316.Google ScholarPubMed
Verhoeven, WMA, Tuinier, S, Van, den Berg YWMM, Coppus, AMW, Fekkes, D, Pepplinkhuizen, L, et al. Stress and self-injurious behaviour: hormonal and serotonergic parameters in mentally retardad subjects. Pharmacopsychiatry 1999; 32:1320.CrossRefGoogle ScholarPubMed
Wiegartz, P, Seidenherg, M, Woodard, A, Gidal, B, Hermann, B. Comorbid psychiatric disorder in chronic epilepsy: recognition and etiology of depression. Neurology 1999; 53; S3S8.Google Scholar