ISSN:0254-4962    

DOI:10.1159/000284085

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Pharmacological and biochemical data on trazodone are reviewed in order to compare this drug to imipramine and other tricyclics both from the point of view of the mechanism of action and preferential clinical indications. Trazodone tends to inhibit biochemical and pharmacological functions depending on the catecholaminergic system, whereas imipramine has a potentiating activity. However, both these drugs decrease the density of β-receptors following repeated administrations. Trazodone and imipramine have similar effects on the serotoninergic system. The two drugs also share an antinociceptive activity. It is stressed that this activity has been of critical importance in the discovery of trazodone. In fact, the development of this drug was based on the working hypothesis that a disturbance in the perception of unpleasant experience has a role in the pathogenesis of depression. Some medical implications of the α-blocking activity of trazodone are discussed. Trazodone is preferable to other antidepressant treatment when depression is associated with angle-closure glaucoma, cardiovascular disturbances depending on noradrenaline release, tremor, some psychotic conditions and alcoholis

ISSN:0254-4962    

DOI:10.1159/000284086

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

In summary, on the basis of our inpatient and outpatient double-blind control trials and open-label experience with trazodone, we find it to be an effective broad-spectrum antidepressant generally well tolerated by most patients. When atropine side effects of the standard tricyclic antidepressants and bridged tricyclic antidepressants are undesirable and medically contraindicated, trazodone should be one of the drugs of choice in major depressive disorders.

ISSN:0254-4962    

DOI:10.1159/000284088

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

In a double-blind, noncrossover study, general practice patients suffering from depression were treated with either trazodone (100–200 mg, nocte) or mianserin (60–120 mg, nocte) for 6 weeks. For entry into the study, a minimum score of 14 on the 17-point Hamilton Depression Rating Scale (HDRS) was necessary. By random allocation, 125 patients (61 on trazodone and 64 on mianserin) entered the study. Altogether there were 43 withdrawals, of whom 31 (72%) had received mianserin. At least one of the reasons for 22 withdrawals from the mianserin group was an unacceptable side effect, frequently being daytime drowsiness. In contrast, only 5 of the trazodone group withdrew because of side effects. These differences in the withdrawal rates for those patients entering the study were statistically significant (p < 0.001). A total of 82 patients completed treatment and entered the analysis for efficacy; 49 on trazodone and 33 on mianserin. Results show that both treatments were equally effective in reducing symptoms of depression and anxiety. Thus, the mean HDRS score was 21.3 and 21.5 for trazodone and mianserin, respectively, at the start of treatment which decreased to 6.2 and 5.9, respectively, at the end of 6 weeks. The mean Zung self-rating anxiety scores for trazodone and mianserin were 45.6 and 44.4 at the start of treatment and 33.6 and 31.1 at the end of the study. The results suggest that, on the basis of fewer significant side effects, trazodone is more acceptable to mianserin in treating depression, with or without anxiety, in general practice patie

ISSN:0254-4962    

DOI:10.1159/000284089

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

In a double-blind study on 40 outpatients (20 per group) suffering from endogenous and psychogenic depression of the anxious-agitated or inhibited form, trazodone was compared with doxepin to determine their efficacy and safety, and whether a single daily administration was adequate. Increasing doses of trazodone 50–200 mg and doxepin 25–100 mg were given once a day in the evening for a period of 5 weeks. Both drugs were found to be approximately equivalent as far as their antidepressive and anxiolytic effects and safety are concerned. Treatment with trazodone promises less risks according to the clinical experience described in the international literature. Administration once a day provides sufficient efficacy and saf

ISSN:0254-4962    

DOI:10.1159/000284090

出版商:S. Karger AG    

年代:1984

数据来源: Karger

ISSN:0254-4962    

DOI:10.1159/000284091

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Side effects are a concomitant of almost all therapeutic agents and are also present as part of the pharmacological profile of psychotropic agents. However, the laboratory pharmacological characteristics of agents are a more reliable predictor of side effect profiles than they are of their therapeutic activities. Therefore, it would seem possible to be able to predict with much greater accuracy the clinically significant side effects that may be encountered from the preclinical data. This has been established in the case of trazodone and imipramine. The anticholinergic profile of imipramine was clearly determined in the laboratory and in man it produces a range of activity varying from mild peripheral anticholinergic activity to impairment of various functions involving vision, cardiovascular function and gastrointestinal activity. However, in the geriatric population, because of the vast amount of research implicating cholinergic mechanisms in memory functions and particularly in some aspects of cognitive deficit, it may be predicted that the anticholinergic activity of the tricyclics may present an especially troublesome pattern in a geriatric population that requires antidepressant therapy. These comparative effects between the two agents will be discussed and documented from control study data.

ISSN:0254-4962    

DOI:10.1159/000284092

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Based on a sample of 300 psychiatric patients the items of the Standard Progressive Matrices test are analyzed in terms of classical and probabilistic methods, and a version shortened to 30 items is developed. This new version of the test is then standardized from a new sample of 1,200 patients. A table of selected percentiles is computed. Validation with respect to rough classification of intelligence is proved by comparison with results of the WIP.

ISSN:0254-4962    

DOI:10.1159/000284003

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

The novel antidepressant trazodone is hypothesized to be less cardiotoxic than the tri-tetracyclic antidepressants. Recently, however, 2 patients with preexisting ventricular irritability showed an increased number of ventricular premature beats and of repetitive forms after starting on trazodone. Data are presented here from four studies on the cardiovascular safety of trazodone. Conclusions are: (1) Trazodone has little effect on cardiac conduction. (2) Trazodone does not worsen supraventricular arrhythmias. (3) Trazodone produces less postural hypotension than most other antidepressants and it tends to lower heart rate. (4) Lower doses of trazodone (100–300 mg) are better tolerated and more effective in major depressives simultaneously debilitated by significant cardiovascular disease. (5) It is possible that the so-called ‘trazodone aggravation’ of ventricular irritability is a statistical artifact – although further research is needed to verify this conclusion, and in the meantime the drug should be used with caution in such p

ISSN:0254-4962    

DOI:10.1159/000284093

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Using a psychodynamic framework and an underlying structural configuration, the borderline patient is described. Statistical methods are then used to differentiate this group from both a schizophrenic and a character disorder group of patients. The borderline group emerges as a clear-cut entity characterized by (1) the lack of an integrated self concept, and (2) a particular ego structure consisting of a specific pattern of superficial ego strengths and underlying ego weaknesses.

ISSN:0254-4962    

DOI:10.1159/000284004

出版商:S. Karger AG    

年代:1984

数据来源: Karger