NIALAMIDE AS A "STEROID SPARING" AGENT IN THE TREATMENT OF RHEUMATOID ARTHRITIS

Evolution of ideas about the risk of tyramine syndrome developing during therapy with irreversible non-selective monoamine oxidase inhibitors (to the 70th anniversary of the first use of this group of antidepressants)

We describe the history of studying of the problem of tyramine syndrome during the treatment with antidepressants, irreversible non-selective monoamine oxidase inhibitors. Data on clinical observations are presented. Early hypotheses of pathogenesis are considered. The period of discovery of the relationship between increased blood pressure and the use of foods containing tyramine is outlined. The transformation of terminology is demonstrated. The events associated with the restriction of the use of therapy are characterized. The formation of the opinion about the exaggeration of the risk of developing tyramine syndrome is analyzed. Data on the involvement in the discussion of the problem of tyramine syndrome of society as a whole are given. 

Is anxiety a more common disorder than depression in rheumatoid arthritis?

OBJECTIVE

As most of the previous studies were done to study depressive disorders and/or symptoms in patients with rheumatoid arthritis, this study was performed to investigate whether anxiety disorder is as common as depressive disorder in these patients and to look for the socio-demographic as well as the clinical characteristics of the patients developing these disorders.

METHODS

A detailed physical assessment of 80 patients with rheumatoid arthritis was performed. Also psychiatric assessment was done using Research Diagnostic Criteria for the International Classification of Diseases-10 (ICD-10). In addition, patients answered a Health Assessment Questionnaire (HAQ) to assess their functional capacity.

RESULTS

Depression was diagnosed in 66.2% of the total sample while anxiety was diagnosed in 70%. Functional disability, social stress and morning stiffness were the factors highly associated with depression. Using multiple regression analysis, anxiety was highly associated with depression as well as Ritchie articular index.

CONCLUSION

Psychiatric illness is a relatively common disorder in patients with RA, with a frequency higher than that of other general medical conditions. Anxiety is a more common disorder than depression. The first step in correct management is recognition of anxiety and depression so that appropriate treatment can be tried. Particular attention has to be paid to social stress and lack of social support.