Background Little is known about the effect of pharmacotherapy in the prevention of post-traumatic stress disorder (PTSD) relapse. Aims To assess the efficacy and tolerability of fluoxetine in preventing PTSD relapse. Method This was a double-blind, randomised, placebo-controlled study. Following 12 weeks of acute treatment, patients who responded were re-randomised and continued in a 24-week relapse prevention phase with fluoxetine ( n =69) or placebo ( n =62). The primary efficacy assessment was the prevention of PTSD relapse, based on the time to relapse. Results Patients in the fluoxetine/fluoxetine group were less likely to relapse than patients in the fluoxetine/placebo group ( P =0.027). There were no clinically significant differences in treatment-emergent adverse events between treatment groups. Conclusions Fluoxetine is effective and well tolerated in the prevention of PTSD relapse for up to 6 months.
Article AbstractBackground: The effects of extended selectiveserotonin reuptake inhibitor (SSRI) treatment on weight are notwell characterized. Also unknown is whether different agents havedifferential effects. To examine these questions, we assessedweight changes in patients randomly assigned to long-termtreatment with fluoxetine, sertraline, or paroxetine. Method: Patients (N = 284) with major depressivedisorder (DSM-IV) were randomly assigned to double-blindtreatment with fluoxetine (N = 92), sertraline, (N = 96), orparoxetine (N = 96) for a total of 26 to 32 weeks. The meanpercent change in weight was compared for each group, as was thenumber of patients who had >= 7% weight increase frombaseline. Results: Patients (fluoxetine, N = 44;sertraline, N = 48; paroxetine, N = 47) who completed the trialwere included in these analyses. Paroxetine-treated patientsexperienced a significant weight increase, fluoxetine-treatedpatients had a modest but nonsignificant weight decrease, andpatients treated with sertraline had a modest but nonsignificantweight increase. The number of patients whose weight increased>= 7% from baseline was significantly greater forparoxetine-treated compared with either fluoxetine-treated orsertraline-treated patients. Conclusion: Risk of weight gain during extendedSSRI treatment differs depending on which SSRI is used.
Urinary incontinence in the elderly is a significant health problem fraught with isolation, depression, and an increased risk of institutionalization and medical complications. Stress urinary incontinence (SUI), the complaint of involuntary loss of urine during effort or exertion or during sneezing or coughing, is the most common type of urinary incontinence. SUI can seriously degrade the quality of life for many active seniors, and has become an economic challenge for society. With the rapid increase in the active elderly worldwide, SUI is becoming a significant global problem. However, since only a fraction of women with SUI have consulted a physician, the clinical extent and public health impact of SUI are probably underestimated. The mounting social, medical, and economic problem of SUI in active elderly women as a rapidly growing segment of the population worldwide is reviewed. We evaluate the age-related changes of the lower urinary tract, examine risk factors, and suggest different treatment options shown to be effective in reducing SUI in this population.
