Document 0083
 DOCN  M94A0083
 TI    Effects of fluoxetine on mood and immune status in depressed patients
       with HIV illness.
 DT    9412
 AU    Rabkin JG; Rabkin R; Wagner G; New York State Psychiatric Institute, NY
       10032.
 SO    J Clin Psychiatry. 1994 Mar;55(3):92-7. Unique Identifier : AIDSLINE
       MED/94350860
 AB    BACKGROUND: When present, depression in the context of human
       immunodeficiency virus (HIV) illness not only detracts from quality of
       remaining life but may interfere with motivation to obtain good medical
       care as well, thus directly influencing life's duration. This study was
       undertaken to assess the efficacy of fluoxetine in treating depression
       occurring in the context of HIV illness and to assess effects, if any,
       of fluoxetine on immune status (T-cell subsets). METHOD: Patients had
       originally participated in a double-blind, placebo-controlled, 6-week
       study of imipramine. Imipramine nonresponders or relapsers and side
       effect dropouts were offered open treatment with fluoxetine for 12
       weeks. Adjunctive dextroamphetamine was prescribed if the treating
       psychiatrist considered it clinically indicated. Eligibility criteria
       for the original study included a DSM-III-R diagnosis of major
       depression, dysthymia, or both. Concurrent HIV medications were
       permitted. RESULTS: Measures included the clinician-rated Hamilton
       Rating Scale for Depression and Clinical Global Impressions Scale, and
       patient-rated Brief Symptom Inventory and Beck Hopelessness Scale. Of
       the 23 patients receiving only fluoxetine, 83% (N = 19) were classified
       as responders. Of the 7 (30%) who also received adjunctive
       dextroamphetamine, all responded. Patients with CD4 cell counts under
       200/cu mm did as well as others. CD4 cell count was not influenced by
       duration of treatment with fluoxetine; the average decline was that
       expected due to the passage of time alone. Side effects were mild and
       relatively infrequent. CONCLUSION: In this open treatment study,
       fluoxetine alone and fluoxetine plus dextroamphetamine were found to be
       effective treatments for patients with HIV illness and Axis I
       depression, regardless of the initial level of immune deficiency or
       number or type of HIV medications used concurrently. No negative effects
       on immune status were observed.
 DE    Acquired Immunodeficiency Syndrome/COMPLICATIONS/IMMUNOLOGY/
       *PSYCHOLOGY  Adolescence  Adult  Affect/*DRUG EFFECTS  Aged  Depressive
       Disorder/*DRUG THERAPY/ETIOLOGY/PSYCHOLOGY
       Dextroamphetamine/THERAPEUTIC USE  Drug Therapy, Combination  Female
       Fluoxetine/*THERAPEUTIC USE  Human  HIV
       Seropositivity/COMPLICATIONS/IMMUNOLOGY/*PSYCHOLOGY  Immunity/*DRUG
       EFFECTS  Leukocyte Count  Male  Middle Age  Personality Inventory
       Psychiatric Status Rating Scales  Support, U.S. Gov't, P.H.S.  Treatment
       Outcome  T4 Lymphocytes/IMMUNOLOGY  CLINICAL TRIAL  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).