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DOI: 10.1055/s-2006-941484
Duloxetine Treatment of Major Depressive Episodes in the Course of Psychotic Disorders
A Case ReportPublication History
Received: 5.10.2005
Revised: 29.12.2005
Accepted: 9.1.2006
Publication Date:
23 May 2006 (online)
During the course of psychotic disorders, patients often suffer from intercurrent major depressive episodes (MDEs), and suicides frequently occur. This constellation challenges further improvements in psychopharmacological therapy. The antidepressant duloxetine was recently introduced as a novel reuptake inhibitor of serotonin and noradrenaline. We provide the first reports on duloxetine treatment of MDEs in the course of psychotic disorders. In two cases this substance was successfully involved as an add-on to antipsychotic treatment consisting of clozapine or amisulpride. We achieved a response of the MDEs, as reflected by psychopathological rating scales. A significant rise in the clozapine serum level was detected, most likely because of pharmacokinetic interactions. Overall, the application of duloxetine was well tolerated; therefore, further investigations in prospective studies seem to be recommendable.
Abbreviations
CDSS:Calgary Depression Scale for Schizophrenia
GP:Global Psychopathology
HAMD:Hamilton Depression Scale
MDE:Major Depressive Episode
PANSS:Positive and Negative Syndrome Scale
SANS:Scale for the Assessment of Negative Symptoms
SSNRI:Selective Serotonin and Noradrenaline Reuptake Inhibitor
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Mathias Zink (MD)
Central Institute of Mental Health
P.O. Box: 12 21 20
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Germany
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Email: mathias.zink@zi-mannheim.de