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A randomized clinical trial for elderly
inpatients with major depression attempted to demonstrate the
benefit of a systematic intervention vs usual care over six
months (Cole et al ). There were no clinically or statistically
significant differences in the primary (HAMD or SF-36) or secondary
measures. Of note were the high prevalence of major depression
(15%) in the inpatient population screened, the high mortality
(23%) and high withdrawal rates (36%) in both treatment groups,
limiting the statistical power of the study. Other important
methodological issues are discussed by the authors, who should
be congratulated for publishing negative results that will improve
the design of future studies in this important population.
Systematic detection and multidisciplinary
care of depression in older medical inpatients: a randomized
trial
(CMAJ 2006;174(I):38-44)
MARTIN G. COLE,
JANE MCCUSKER,
MICHEL ELIE,
NANDINI DENDUKURI,
ET AL,
MONTREAL, QC
MEMANTINE IS SAFE AND EFECTIVE
OVER ONE YEAR
This report from an open-label extension
study adding six months of treatment with memantine to a six
months of placebo-controlled study showed that patients in moderate
to severe stages of AD (mean MMSE 7) living in the community
demonstrate a slower amount of decline on cognitive, functional
and global measures (Reisberg et al ). The accompanying
editorial by J. Cummings (Arch Neurol 2006;63: 18-19)
notes that this report adds useful information to the clinical
use of memantine up to one year; furthermore, the data does
not provide evidence for disease modification but does not exclude
it either.
A 24-week open-label extension study
of memantine in moderate to severe Alzheimer disease
(ARCH NEUROL 2006;63:49-54)
BARRY REISBERG, MD,
RACHELLE DOODY, MD, PHD,
ALBRECHT STÖFFLER, MD,
FREDERICK SCHMITT, PHD,
ET AL,
NEW YORK, NY,
DALLAS, TX,
FRANKFURT, GERMANY,
LEXINGTON, KY
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