Evaluation of efficacy and tolerability of dothiepin hydrochloride in the management of major depression in patients suffering from rheumatoid arthritis.

Abstract

Several studies have shown that 20 to 66.2% of patients with rheumatoid arthritis have associated psychiatric comorbidity especially depression. Dothiepin hydrochloride is a well-established and effective antidepressant in patients with depressive symptoms of varying severity and co-existing anxiety. To document the efficacy and tolerability of dothiepin hydrochloride in the management of major depressive disorder (MDD) in rheumatoid arthritis patients a phase IV, open, single arm, prospective study was initiated with dothiepin hydrochloride in the dose of 75 mg/day, duration of therapy was 6 weeks. Twenty-five rheumatoid arthritis patients suffering from co-morbid MDD completed the 6-week dothiepin hydrochoride treatment and were considered for final analysis. There was significant reduction (p < 0.05) in mean HAM-D scores at week 2 (13.92 +/- 5.45), week 4 (9.28 +/- 4.13) and week 6 (5.72 +/- 3.26) compared to baseline (21.64 +/- 5.93). There was significant reduction (p < 0.05) in mean HAM-A scores at week 2 (6.52 +/- 3.34), week 4 (4.0 +/- 2.25) and week 6 (2.76 +/- 1.59) compared to baseline (10.68 +/- 3.68). The global impression of efficacy at the end of 6 weeks of dothiepin hydrochloride treatment was rated by the clinician (psychiatrist) as marked and moderate improvement in 20 (80%) and 5 patients (20%) respectively. Only 2 patients reported dry mouth as an adverse event in the study. The overall assessment of tolerability at the end of 6 weeks of dothiepin hydrochloride treatment was rated by the clinician (psychiatrist) as good and fair in 19 (76%) and 6 patients (24%) respectively. Dothiepin hydrochloride was found to be an effective and well-tolerated drug in the management of MDD and anxiety in patients suffering from rheumatoid arthritis.

• Authors: H S Dhavale, Sushil Gawande, Vinaya Bhagat, Vijay Durge, Vikram Londhe, Seema Kini, M Y Nadkar, N E Borges
• Journal: Journal of the Indian Medical Association (J Indian Med Assoc) Vol. 103 Issue 5 Pg. 291-4 (May 2005) ISSN: 0019-5847 [Print] India
• PMID: 16229336 (Publication Type: Clinical Trial, Clinical Trial, Phase IV, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Dothiepin

Topics

• Adolescent
• Adult
• Aged
• Arthritis, Rheumatoid (complications, diagnosis, psychology)
• Depressive Disorder (diagnosis, drug therapy, etiology)
• Developing Countries
• Dose-Response Relationship, Drug
• Dothiepin (administration & dosage)
• Drug Administration Schedule
• Female
• Follow-Up Studies
• Humans
• India
• Male
• Maximum Tolerated Dose
• Middle Aged
• Patient Satisfaction
• Prospective Studies
• Risk Assessment
• Severity of Illness Index
• Single-Blind Method
• Treatment Outcome