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M94A0083.TXT
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1994-10-01
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Document 0083
DOCN M94A0083
TI Effects of fluoxetine on mood and immune status in depressed patients
with HIV illness.
DT 9412
AU Rabkin JG; Rabkin R; Wagner G; New York State Psychiatric Institute, NY
10032.
SO J Clin Psychiatry. 1994 Mar;55(3):92-7. Unique Identifier : AIDSLINE
MED/94350860
AB BACKGROUND: When present, depression in the context of human
immunodeficiency virus (HIV) illness not only detracts from quality of
remaining life but may interfere with motivation to obtain good medical
care as well, thus directly influencing life's duration. This study was
undertaken to assess the efficacy of fluoxetine in treating depression
occurring in the context of HIV illness and to assess effects, if any,
of fluoxetine on immune status (T-cell subsets). METHOD: Patients had
originally participated in a double-blind, placebo-controlled, 6-week
study of imipramine. Imipramine nonresponders or relapsers and side
effect dropouts were offered open treatment with fluoxetine for 12
weeks. Adjunctive dextroamphetamine was prescribed if the treating
psychiatrist considered it clinically indicated. Eligibility criteria
for the original study included a DSM-III-R diagnosis of major
depression, dysthymia, or both. Concurrent HIV medications were
permitted. RESULTS: Measures included the clinician-rated Hamilton
Rating Scale for Depression and Clinical Global Impressions Scale, and
patient-rated Brief Symptom Inventory and Beck Hopelessness Scale. Of
the 23 patients receiving only fluoxetine, 83% (N = 19) were classified
as responders. Of the 7 (30%) who also received adjunctive
dextroamphetamine, all responded. Patients with CD4 cell counts under
200/cu mm did as well as others. CD4 cell count was not influenced by
duration of treatment with fluoxetine; the average decline was that
expected due to the passage of time alone. Side effects were mild and
relatively infrequent. CONCLUSION: In this open treatment study,
fluoxetine alone and fluoxetine plus dextroamphetamine were found to be
effective treatments for patients with HIV illness and Axis I
depression, regardless of the initial level of immune deficiency or
number or type of HIV medications used concurrently. No negative effects
on immune status were observed.
DE Acquired Immunodeficiency Syndrome/COMPLICATIONS/IMMUNOLOGY/
*PSYCHOLOGY Adolescence Adult Affect/*DRUG EFFECTS Aged Depressive
Disorder/*DRUG THERAPY/ETIOLOGY/PSYCHOLOGY
Dextroamphetamine/THERAPEUTIC USE Drug Therapy, Combination Female
Fluoxetine/*THERAPEUTIC USE Human HIV
Seropositivity/COMPLICATIONS/IMMUNOLOGY/*PSYCHOLOGY Immunity/*DRUG
EFFECTS Leukocyte Count Male Middle Age Personality Inventory
Psychiatric Status Rating Scales Support, U.S. Gov't, P.H.S. Treatment
Outcome T4 Lymphocytes/IMMUNOLOGY CLINICAL TRIAL JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).