they continued to receive the drug or were switched to placebo. The prediction was that patients with a true drug response would sustain their benefit best if they continued to receive the drug and that patients with a placebo response would have an equivalent prognosis whether. Early or nonpersistent ("placebo") benefit is typical of a placebo response. Read moreĭelayed and persistent ("true drug") improvement characterizes the response to antidepressant medication.
The depressive symptoms of some post-stroke depression at acute phase cannot be self-relieved, and the antidepressant treatment is effective, but their abilities in the activities of daily life have no obvious improvement. Conclusion: The depressive symptoms of some post-stroke depression at acute phase can be self-relieved, and accompanied by the obvious improvement of the abilities in the activities of daily life. 1 The results of the reexamination 1 month after the first evaluation in the 74 cases showed that 28 cases self-relieved (the score of Hamilton depressive scale was less than 8), except body mass and diurnal changes, the scores of other factors in Hamilton depressive scale were decreased as compared with the first evaluation (P 0.05).
Results: All the 74 patients were involved in the analysis of results. No antidepressant treatment was given during the observation after evaluation, and the patients were evaluated again after 1 month, and those still had depression received antidepressant treatment (20 or 40 fluoxetine per day was taken at one draught) for 1 month, they also received psychological treatment at the same period, then they were evaluated for the third time 1 month after treatment. All the patients were assessed with Hamilton depressive scale (24 items, scored by 3 or 5 degrees, if the score was lower than 8, it was taken as no depression, and more than 35 as severe depression) and Barthel index (10 items, and 10 points for each item) immediately after admission. Methods: Seventy-four patients with mild to moderate post-stroke depression, whose scores of Hamilton depressive scale ranged from 8 to 35 points, were selected from the Department of Neurology, Shantou Central Hospital from June. Fieldwork with Nepali psychiatrists reveals the tenacity of local affordances over global changes in evidence and health policy.Īim: To observe the recovery of depressive symptoms and the changes of the accompanied abilities in the activities of daily life in patients with post-stroke depression. No other drug could beat amitriptyline's affordability, availability, and efficacy for the typical Nepali depression patient: a ‘somatizer’ who suffers from multiple bodily aches, insomnia, and anxiety. All the ‘new’ psychopharmaceuticals came to Nepal, but they never displaced the ‘old’ amitriptyline. The inclusion of amitriptyline in the first WHO list of Essential Drugs (1977) cemented its status. Since the 1960s, Nepali psychiatrists have been using amitriptyline as their first-line drug.
1961 is also the birth year of psychiatry in the Himalayan country of Nepal. In 2018, a large meta-analysis of clinical trials argued that antidepressants were indeed better than placebos, but that none of the new drugs was as effective as the old amitriptyline. In the 2000s, critiques that antidepressants were no better than placebos could not slow down a massive global rise of prescriptions. Over the next decades, many other antidepressants came out, including fluoxetine (Prozac). Amitriptyline (Elavil), introduced in 1961, was one of the first ‘antidepressants’. The so-called psychopharmaceutical revolution began in the 1950s, with apparently ever better drugs coming to market.
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