human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The efficacy and safety of fluoxetine and desipramine were compared in a 6-week double-blind , parallel group study of patients with major depression . Twenty-five were studied while hospitalized for treatment , and 33 were studied as out patients . Improvement on the Hamilton Rating Scale for Depression was significant for both treatments from week 1 through the end of the study and did not differ between the two treatments at any week . Overall , 64 % of fluoxetine-treated patients and 68 % of desipramine-treated patients had at least a 50 % reduction in Hamilton Depression score . We assessed whether improvement relatively early in treatment was predictive of categorical response at 6 weeks . Among fluoxetine-treated patients , but not desipramine-treated patients , the week 3 change in the Hamilton Depression mood item was significantly predictive of the response at 6 weeks . Patients treated with fluoxetine had significantly fewer side effects than those treated with desipramine . Desipramine , but not fluoxetine , caused a persistent increase in heart rate . The results suggest that early signs of response to fluoxetine are not dependent on achieving steady-state levels of the drug & NA ; This was a 6‐week , double‐blind , r and omized trial of the efficacy and tolerability of venlafaxine and fluoxetine in 109 patients with major depression and melancholia . Hospitalized and day care patients with DSM‐IV major depression and melancholia and a baseline Montgomery‐Asberg Depression Rating Scale ( MADRS ) score of ≥ 25 were eligible . The doses were venlafaxine 75 mg/day or fluoxetine 20 mg/day from days 1‐4 , venlafaxine 150 mg/day or fluoxetine 40 mg/day from days 5‐10 , and venlafaxine 225 mg/day or fluoxetine 60 mg/day from days 11‐42 . The intention‐to‐treat analyses included 55 patients on venlafaxine and 54 on fluoxetine . At the final evaluation , 70 % of patients with venlafaxine and 66 % with fluoxetine had ≥ 50 % reduction in the MADRS score , and 70 % with venlafaxine and 62 % with fluoxetine had a Clinical Global Impression ( CGI ) score of 1 or 2.A CGI improvement score of 1 was observed in 51 % of patients with venlafaxine and 32 % with fluoxetine ( P = 0.018 ) . A final Hamilton Depression Rating Scale ( HAM‐D ) score < 7 was attained in 41 % of venlafaxine‐treated and 36 % of fluoxetine‐treated patients . Overall , 22 % of patients in each group discontinued therapy , but only 5 % on venlafaxine and 9 % on fluoxetine discontinued for adverse events . Nausea was reported in 5.5 % of venlafaxinetreated patients and 14.8 % of fluoxetine‐treated patients . Venlafaxine was effective and well tolerated for treating in patients with major depression and melancholia . Based on remission criteria ( HAM‐D < 7 or CGI of 1 ) , venlafaxine was superior to fluoxetine The clinical efficacy and safety of fluoxetine and imipramine were compared in a double-blind , 5-week , parallel study in 40 depressed out patients .  Mean scores for most depression scales improved more in patients taking fluoxetine than in those receiving imipramine ( p less than .05 ) . Nine of 16 ( 56 % ) fluoxetine patients who completed the study and 1 of 19 ( 5 % ) imipramine patients were not at all depressed at the end of the study ( p less than .001 ) . Seven fluoxetine patients and 14 imipramine patients reported one or more adverse effects during treatment ; no fluoxetine patient terminated the study early for drug-related reasons . It was concluded that fluoxetine provides effective antidepressant activity with fewer and less troublesome side effects than imipramine In a six-week double-blind r and omized trial , preceded by a one-week single-blind placebo treatment , the efficacy and the side-effects of fluoxetine ( 40 - 80 mg/d ) ( n = 30 ) and maprotiline ( 50 - 150 mg/d ) ( n = 35 ) were compared in hospitalized patients with DSM-III Major Depression without psychotic features .  Efficacy was measured by means of the Hamilton Depression Rating Scale , the Raskin Depression Scale , the Covi Anxiety Scale , and a Clinical Global Impression . Side-effects were evaluated by an Adverse Events Scale . A statistically significant improvement was achieved in both treatment groups but success rates were modest . No differences in efficacy were found between the two groups . In addition , no statistically significant differences were found between the two groups either in frequency or in severity of adverse events . In fact , the only statistically significant difference found was in weight change : weight loss in the fluoxetine group and weight gain in the maprotiline group Pramipexole , a dopamine D2 receptor agonist , was tested in 174 patients with major depression , with or without melancholia and without psychotic features . Three daily dose levels ( 0.375 mg , 1.0 mg , and 5.0 mg ) were compared to fluoxetine ( Prozac ) at 20 mg and placebo in a r and omized , double-blind , parallel-group study . After a 1 week placebo run-in period , patients were treated for 8 weeks , had a post- study follow-up ( week 9 ) , and were evaluated primarily with the Hamilton Psychiatric Rating Scale for Depression ( HAM-D ) , the Montgomery-Asberg Depression Rating Scale ( MADRS ) , and the Clinician 's Global Impressions-Severity of Illness scale ( CGI-SI ) .  All patients who received one dose of study medication were included in the observed-case analysis ( no missing data were replaced ) . Results indicated that by endpoint ( week 8) , patients receiving pramipexole at the 1.0 mg per day dose had significant improvement over baseline compared to the placebo group by measure of the HAM-D , MADRS , and CGI-SI . Significant improvement in this dose group was seen at other timepoints as well . The most obvious improvement was seen in the pramipexole 5.0 mg group , although a substantial dropout rate for this group precluded statistical tests vs. placebo late in the study . Patients taking fluoxetine also showed significant improvements at endpoint on the MADRS and earlier in the study on the HAM-D. No new or unusual safety concerns were generated during this study . Pramipexole helped safely alleviate the symptoms of depression at 1.0 mg per day and especially in those patients who could tolerate the escalation to 5 mg per day Using data from a larger 12-week clinical trial , the authors evaluated the comparative efficacy and safety of sertraline  ( n=42 ) and fluoxetine  ( n=33 ) in patients over age 70 with a diagnosis of major depressive disorder . Similar improvement on measures of depression , including remission of depressive symptoms , was evident , although significantly more sertraline-treated patients achieved a criterion clinical response . Significantly greater improvement for the sertraline group was apparent on the Digit Symbol Substitution Test , but not on two other measures of cognitive functioning . Although there was no difference in the rate of adverse events experienced , fluoxetine-treated patients lost significantly more body weight over the 12-week trial than did sertraline-treated patients , whereas the latter group exhibited significantly more " shaking . Fluoxetine , a selective serotonin reuptake inhibitor , was compared with mianserin and placebo in a double‐blind study . In total , 81 depressed patients were included . Patients were rated weekly on the Hamilton Depression Rating Scale ( HDRS ) and the Montgomery & Asberg Depression Rating Scale ( MADRS ) . The duration was 6 weeks , and 52 patients completed the study . Significantly more patients on fluoxetine improved than patients on placebo . For mianserin no significant differences were found with either fluoxetine or placebo . Mean HDRS at the end of the study was also statistically significantly lower for fluoxetine , but not for mianserin , than placebo . Subscores of the MADRS showed improved sleep on mianserin at weeks 2 and 3 . Suicidal feelings were reduced to a greater degree on fluoxetine than on mianserin and placebo at weeks 6 and 7 . Fluoxetine  induced weight loss , while patients on mianserin gained weight . Side effects were present in most patients on the two active drugs ; those on fluoxetine experienced nausea and vomiting , and those on mianserin drowsiness The present study was carried out to investigate the routine use of second-generation antipsychotic drugs in the Italian psychiatric care system . Seven outpatient psychiatric services enrolled a consecutive case series of patients who were being treated , or had started treatment , with clozapine , olanzapine , risperidone , or quetiapine .  Information on sociodemographic and clinical variables , current psychotropic drug use , side-effects and past use of typical drugs was collected . In addition , patient symptoms and functional status were evaluated by the Health of the Nation Outcome Scale . Patients receiving off-label prescribing of second-generation antipsychotics were identified . A total of 209 patients were collected . In comparison with patients receiving other second-generation antipsychotics , living in residential facilities , unemployment , long psychiatric histories , and problems with activities of daily living and living conditions were more common in clozapine-treated patients . Nearly 80 % of patients receiving clozapine had schizophrenia compared to less than 50 % of those receiving other second-generation antipsychotics . Overall , 109 patients ( 52 % ) received off-label prescriptions of second-generation antipsychotic drugs . This survey indicates that clozapine was mostly reserved for severe cases and poor responders ; the high rate of off-label prescriptions highlights the gap existing between recommendations derived from r and omised clinical trials and the current use of drugs BACKGROUND Depression is treated by a great variety of antidepressant treatments . SSRIs ( such as fluoxetine ) are well known : it is , however , sure that further progress is needed and the search for antidepressants with other mechanisms of action ( such as tianeptine ) or different efficacy is still of interest . METHODS A multinational study compared tianeptine with fluoxetine in 387 patients with Depressive Episode , or Recurrent Depressive Disorder , or Bipolar Affective Disorder ( ICD-10 ) , in a double-blind parallel group design . They were treated for six weeks . RESULTS At inclusion , no significant difference between groups was shown . Final MADRS scores were 15.7 and 15.8 with tianeptine and fluoxetine , respectively ( ITT population ) ( p = 0.944 ) . MADRS responders were 58 % and 56 % with tianeptine and fluoxetine , respectively ( p = 0.710 ) . No statistical difference was observed for the other efficacy parameters . Thirty-six withdrawals occurred in each group , without any difference for the reasons of discontinuation . There was no major difference between groups for the other safety parameters . CONCLUSIONS In this study , both tianeptine and fluoxetine exhibited a good efficacy and safety BACKGROUND We compared the efficacy and tolerability of venlafaxine XR with that of fluoxetine in a multicenter , r and omized , double-blind , placebo-controlled study in depressed out patients . METHODS Out patients , 18 years and older , who met DSM-IV criteria for major depressive disorder were included ( n = 301 r and omized ; 232 completed ) . Patients were r and omly assigned to eight weeks of treatment with either venlafaxine XR 75 - 225 mg/day ( n = 100 ) , fluoxetine 20 - 60 mg/day ( n = 103 ) , or placebo ( n = 98 ) . The primary efficacy outcome measures were the final ratings on the Hamilton Rating Scale for Depression ( HAM-D21 ) total score , HAM-D21 depressed mood item , Montgomery-Asberg Depression Rating Scale total score , and Clinical Global Impressions Scale . RESULTS Withdrawal from the study due to adverse events occurred in 6 % of the patients in the venlafaxine XR group and 9 % of the patients in the fluoxetine group . Patients treated with venlafaxine XR , but only rarely those treated with fluoxetine , had statistically significant improvements in their depression ratings compared with placebo at the end of the study . The percentages of patients who achieved full remission of their depression ( HAM-D21 total score < or = 7 ) at the end of treatment were 37 % , 22 % and 18 % for the venlafaxine XR , fluoxetine and placebo groups , respectively . The differences in remission rates between venlafaxine XR and the other groups were statistically significant ( p < 0.05 ) . LIMITATIONS The superior remission outcome observed with venlafaxine XR treatment needs to be replicated in additional studies . CONCLUSION Venlafaxine XR is a well-tolerated and efficacious treatment for depression . The results of this study suggest that venlafaxine XR is as well-tolerated as fluoxetine but may have some efficacy advantages over fluoxetine BACKGROUND Recent studies have suggested clinical differences among selective serotonin reuptake inhibitors . 
    Output:
    
agent
Conclusions : International differences in prescriber behaviour may influence , and in turn be influenced by , the conduct of clinical trials .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The efficacy and safety of fluoxetine and desipramine were compared in a 6-week double-blind , parallel group study of patients with major depression . Twenty-five were studied while hospitalized for treatment , and 33 were studied as out patients . Improvement on the Hamilton Rating Scale for Depression was significant for both treatments from week 1 through the end of the study and did not differ between the two treatments at any week . Overall , 64 % of fluoxetine-treated patients and 68 % of desipramine-treated patients had at least a 50 % reduction in Hamilton Depression score . We assessed whether improvement relatively early in treatment was predictive of categorical response at 6 weeks . Among fluoxetine-treated patients , but not desipramine-treated patients , the week 3 change in the Hamilton Depression mood item was significantly predictive of the response at 6 weeks . Patients treated with fluoxetine had significantly fewer side effects than those treated with desipramine . Desipramine , but not fluoxetine , caused a persistent increase in heart rate . The results suggest that early signs of response to fluoxetine are not dependent on achieving steady-state levels of the drug & NA ; This was a 6‐week , double‐blind , r and omized trial of the efficacy and tolerability of venlafaxine and fluoxetine in 109 patients with major depression and melancholia . Hospitalized and day care patients with DSM‐IV major depression and melancholia and a baseline Montgomery‐Asberg Depression Rating Scale ( MADRS ) score of ≥ 25 were eligible . The doses were venlafaxine 75 mg/day or fluoxetine 20 mg/day from days 1‐4 , venlafaxine 150 mg/day or fluoxetine 40 mg/day from days 5‐10 , and venlafaxine 225 mg/day or fluoxetine 60 mg/day from days 11‐42 . The intention‐to‐treat analyses included 55 patients on venlafaxine and 54 on fluoxetine . At the final evaluation , 70 % of patients with venlafaxine and 66 % with fluoxetine had ≥ 50 % reduction in the MADRS score , and 70 % with venlafaxine and 62 % with fluoxetine had a Clinical Global Impression ( CGI ) score of 1 or 2.A CGI improvement score of 1 was observed in 51 % of patients with venlafaxine and 32 % with fluoxetine ( P = 0.018 ) . A final Hamilton Depression Rating Scale ( HAM‐D ) score < 7 was attained in 41 % of venlafaxine‐treated and 36 % of fluoxetine‐treated patients . Overall , 22 % of patients in each group discontinued therapy , but only 5 % on venlafaxine and 9 % on fluoxetine discontinued for adverse events . Nausea was reported in 5.5 % of venlafaxinetreated patients and 14.8 % of fluoxetine‐treated patients . Venlafaxine was effective and well tolerated for treating in patients with major depression and melancholia . Based on remission criteria ( HAM‐D < 7 or CGI of 1 ) , venlafaxine was superior to fluoxetine The clinical efficacy and safety of fluoxetine and imipramine were compared in a double-blind , 5-week , parallel study in 40 depressed out patients .  Mean scores for most depression scales improved more in patients taking fluoxetine than in those receiving imipramine ( p less than .05 ) . Nine of 16 ( 56 % ) fluoxetine patients who completed the study and 1 of 19 ( 5 % ) imipramine patients were not at all depressed at the end of the study ( p less than .001 ) . Seven fluoxetine patients and 14 imipramine patients reported one or more adverse effects during treatment ; no fluoxetine patient terminated the study early for drug-related reasons . It was concluded that fluoxetine provides effective antidepressant activity with fewer and less troublesome side effects than imipramine In a six-week double-blind r and omized trial , preceded by a one-week single-blind placebo treatment , the efficacy and the side-effects of fluoxetine ( 40 - 80 mg/d ) ( n = 30 ) and maprotiline ( 50 - 150 mg/d ) ( n = 35 ) were compared in hospitalized patients with DSM-III Major Depression without psychotic features .  Efficacy was measured by means of the Hamilton Depression Rating Scale , the Raskin Depression Scale , the Covi Anxiety Scale , and a Clinical Global Impression . Side-effects were evaluated by an Adverse Events Scale . A statistically significant improvement was achieved in both treatment groups but success rates were modest . No differences in efficacy were found between the two groups . In addition , no statistically significant differences were found between the two groups either in frequency or in severity of adverse events . In fact , the only statistically significant difference found was in weight change : weight loss in the fluoxetine group and weight gain in the maprotiline group Pramipexole , a dopamine D2 receptor agonist , was tested in 174 patients with major depression , with or without melancholia and without psychotic features . Three daily dose levels ( 0.375 mg , 1.0 mg , and 5.0 mg ) were compared to fluoxetine ( Prozac ) at 20 mg and placebo in a r and omized , double-blind , parallel-group study . After a 1 week placebo run-in period , patients were treated for 8 weeks , had a post- study follow-up ( week 9 ) , and were evaluated primarily with the Hamilton Psychiatric Rating Scale for Depression ( HAM-D ) , the Montgomery-Asberg Depression Rating Scale ( MADRS ) , and the Clinician 's Global Impressions-Severity of Illness scale ( CGI-SI ) .  All patients who received one dose of study medication were included in the observed-case analysis ( no missing data were replaced ) . Results indicated that by endpoint ( week 8) , patients receiving pramipexole at the 1.0 mg per day dose had significant improvement over baseline compared to the placebo group by measure of the HAM-D , MADRS , and CGI-SI . Significant improvement in this dose group was seen at other timepoints as well . The most obvious improvement was seen in the pramipexole 5.0 mg group , although a substantial dropout rate for this group precluded statistical tests vs. placebo late in the study . Patients taking fluoxetine also showed significant improvements at endpoint on the MADRS and earlier in the study on the HAM-D. No new or unusual safety concerns were generated during this study . Pramipexole helped safely alleviate the symptoms of depression at 1.0 mg per day and especially in those patients who could tolerate the escalation to 5 mg per day Using data from a larger 12-week clinical trial , the authors evaluated the comparative efficacy and safety of sertraline  ( n=42 ) and fluoxetine  ( n=33 ) in patients over age 70 with a diagnosis of major depressive disorder . Similar improvement on measures of depression , including remission of depressive symptoms , was evident , although significantly more sertraline-treated patients achieved a criterion clinical response . Significantly greater improvement for the sertraline group was apparent on the Digit Symbol Substitution Test , but not on two other measures of cognitive functioning . Although there was no difference in the rate of adverse events experienced , fluoxetine-treated patients lost significantly more body weight over the 12-week trial than did sertraline-treated patients , whereas the latter group exhibited significantly more " shaking . Fluoxetine , a selective serotonin reuptake inhibitor , was compared with mianserin and placebo in a double‐blind study . In total , 81 depressed patients were included . Patients were rated weekly on the Hamilton Depression Rating Scale ( HDRS ) and the Montgomery & Asberg Depression Rating Scale ( MADRS ) . The duration was 6 weeks , and 52 patients completed the study . Significantly more patients on fluoxetine improved than patients on placebo . For mianserin no significant differences were found with either fluoxetine or placebo . Mean HDRS at the end of the study was also statistically significantly lower for fluoxetine , but not for mianserin , than placebo . Subscores of the MADRS showed improved sleep on mianserin at weeks 2 and 3 . Suicidal feelings were reduced to a greater degree on fluoxetine than on mianserin and placebo at weeks 6 and 7 . Fluoxetine  induced weight loss , while patients on mianserin gained weight . Side effects were present in most patients on the two active drugs ; those on fluoxetine experienced nausea and vomiting , and those on mianserin drowsiness The present study was carried out to investigate the routine use of second-generation antipsychotic drugs in the Italian psychiatric care system . Seven outpatient psychiatric services enrolled a consecutive case series of patients who were being treated , or had started treatment , with clozapine , olanzapine , risperidone , or quetiapine .  Information on sociodemographic and clinical variables , current psychotropic drug use , side-effects and past use of typical drugs was collected . In addition , patient symptoms and functional status were evaluated by the Health of the Nation Outcome Scale . Patients receiving off-label prescribing of second-generation antipsychotics were identified . A total of 209 patients were collected . In comparison with patients receiving other second-generation antipsychotics , living in residential facilities , unemployment , long psychiatric histories , and problems with activities of daily living and living conditions were more common in clozapine-treated patients . Nearly 80 % of patients receiving clozapine had schizophrenia compared to less than 50 % of those receiving other second-generation antipsychotics . Overall , 109 patients ( 52 % ) received off-label prescriptions of second-generation antipsychotic drugs . This survey indicates that clozapine was mostly reserved for severe cases and poor responders ; the high rate of off-label prescriptions highlights the gap existing between recommendations derived from r and omised clinical trials and the current use of drugs BACKGROUND Depression is treated by a great variety of antidepressant treatments . SSRIs ( such as fluoxetine ) are well known : it is , however , sure that further progress is needed and the search for antidepressants with other mechanisms of action ( such as tianeptine ) or different efficacy is still of interest . METHODS A multinational study compared tianeptine with fluoxetine in 387 patients with Depressive Episode , or Recurrent Depressive Disorder , or Bipolar Affective Disorder ( ICD-10 ) , in a double-blind parallel group design . They were treated for six weeks . RESULTS At inclusion , no significant difference between groups was shown . Final MADRS scores were 15.7 and 15.8 with tianeptine and fluoxetine , respectively ( ITT population ) ( p = 0.944 ) . MADRS responders were 58 % and 56 % with tianeptine and fluoxetine , respectively ( p = 0.710 ) . No statistical difference was observed for the other efficacy parameters . Thirty-six withdrawals occurred in each group , without any difference for the reasons of discontinuation . There was no major difference between groups for the other safety parameters . CONCLUSIONS In this study , both tianeptine and fluoxetine exhibited a good efficacy and safety BACKGROUND We compared the efficacy and tolerability of venlafaxine XR with that of fluoxetine in a multicenter , r and omized , double-blind , placebo-controlled study in depressed out patients . METHODS Out patients , 18 years and older , who met DSM-IV criteria for major depressive disorder were included ( n = 301 r and omized ; 232 completed ) . Patients were r and omly assigned to eight weeks of treatment with either venlafaxine XR 75 - 225 mg/day ( n = 100 ) , fluoxetine 20 - 60 mg/day ( n = 103 ) , or placebo ( n = 98 ) . The primary efficacy outcome measures were the final ratings on the Hamilton Rating Scale for Depression ( HAM-D21 ) total score , HAM-D21 depressed mood item , Montgomery-Asberg Depression Rating Scale total score , and Clinical Global Impressions Scale . RESULTS Withdrawal from the study due to adverse events occurred in 6 % of the patients in the venlafaxine XR group and 9 % of the patients in the fluoxetine group . Patients treated with venlafaxine XR , but only rarely those treated with fluoxetine , had statistically significant improvements in their depression ratings compared with placebo at the end of the study . The percentages of patients who achieved full remission of their depression ( HAM-D21 total score < or = 7 ) at the end of treatment were 37 % , 22 % and 18 % for the venlafaxine XR , fluoxetine and placebo groups , respectively . The differences in remission rates between venlafaxine XR and the other groups were statistically significant ( p < 0.05 ) . LIMITATIONS The superior remission outcome observed with venlafaxine XR treatment needs to be replicated in additional studies . CONCLUSION Venlafaxine XR is a well-tolerated and efficacious treatment for depression . The results of this study suggest that venlafaxine XR is as well-tolerated as fluoxetine but may have some efficacy advantages over fluoxetine BACKGROUND Recent studies have suggested clinical differences among selective serotonin reuptake inhibitors . 
    Output:
    