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11. |
Dual Monoamine Modulation for Improved Treatment of Major Depressive Disorder |
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Journal of Clinical Psychopharmacology,
Volume 23,
Issue 1,
2003,
Page 78-86
Pierre Tran,
Frank Bymaster,
Robert McNamara,
William Potter,
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摘要:
The worldwide scope of depressive illness and lack of fully effective pharmacotherapy mandates significant improvements in treatment paradigms. Current antidepressant medications remain limited by poor efficacy, slow onset of action, and untoward side effects. While the introduction of serotoninspecific reuptake inhibitors (SSRIs) offered significant improvements in tolerability, no improvements in efficacy or speed of onset have been made relative to the traditional and poorly tolerated tricyclic antidepressants (TCA). The dominant efforts toward improving antidepressant medications are guided by cumulative evidence from neurochemical and clinical studies supporting the therapeutic potential of enhancing monoamine function in depression. A number of novel antidepressant drugs, including mirtazapine, milnacipran, venlafaxine, and duloxetine have been developed based on their interaction with both 5-HT and NE. Current clinical evidence suggests that these new agents may offer improved efficacy and/or faster onset of action compared with SSRIs and an improved side effect profile compared with TCAs. Potential neurobiological substrates mediating the enhanced antidepressant activity of dual reuptake inhibitors are discussed.
ISSN:0271-0749
出版商:OVID
年代:2003
数据来源: OVID
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12. |
Clozapine Pharmacokinetics in Children and Adolescents with Childhood-Onset Schizophrenia |
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Journal of Clinical Psychopharmacology,
Volume 23,
Issue 1,
2003,
Page 87-91
Jean Frazier,
Louise Cohen,
Leslie Jacobsen,
Dale Grothe,
James Flood,
Ross Baldessarini,
Stephen Piscitelli,
Grace Kim,
Judith Rapoport,
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摘要:
Clozapine (CLZ) dose-related adverse effects may be more common in children than adults, perhaps reflecting developmental pharmacokinetic (PK) differences. However, no pediatric CLZ PK data are available. Accordingly, we studied CLZ and its metabolites, norclozapine (NOR), and clozapine-N-oxide (NOX) in six youth, ages 9–16 years, with childhood onset schizophrenia (COS). At the time of the PK study, mean CLZ dose was 200 mg (3.4 mg/kg). Serum was collected during week 6 on CLZ before and 0.5–8 h after a morning dose. Serum concentrations were assayed by liquid chromatography/UV-detection. Mean concentration, area-under-the-curve (AUC), and clearance were calculated. CLZ clearance averaged 1.7 L/kg-h. NOR concentrations (410) exceeded CLZ (289) and NOX (63 ng/ml) and AUC0–8hof NOR (3,356) > CLZ (2,359) > NOX (559 ng/ml-h) [53, 38, and 9% of total analytes, respectively]. In adults, NOR serum concentrations on average are 10–25% < CLZ, differing significantly from our sample. Dose normalized concentrations of CLZ (mg/kg-d) did not vary with age and were similar to reported adult values. Clinical improvement seen in 5/6 patients correlated with serum CLZ concentrations. In addition, clinical response and total number of side effects correlated with NOR concentrations. NOR (a neuropharmacologically active metabolite) and free CLZ may contribute to the effectiveness and adverse effects in youth.
ISSN:0271-0749
出版商:OVID
年代:2003
数据来源: OVID
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13. |
Lithium Augmentation of Nortriptyline for Subjects Resistant to Multiple Antidepressants |
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Journal of Clinical Psychopharmacology,
Volume 23,
Issue 1,
2003,
Page 92-95
Andrew Nierenberg,
George Papakostas,
Timothy Petersen,
Heidi Montoya,
John Worthington,
Joyce Tedlow,
Jonathan Alpert,
Maurizio Fava,
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摘要:
Lithium augmentation, the most studied augmentation strategy for depression, has not been evaluated in patients with a history of non-response to multiple antidepressants. The objective of this study was to assess the efficacy of lithium augmentation for patients with a history of treatment resistant depression who also failed a prospective trial of nortriptyline. We enrolled 92 subjects with treatment resistant depression. Treatment resistance was defined by at least one, but no more than five, adequate trials of antidepressants during the current episode. Subjects were treated with nortriptyline (NT) for 6 weeks. Those subjects who tolerated NT for 6 weeks and whose depression did not respond (n=35) were randomized to receive either lithium (n=18) or placebo (N=17) augmentation of nortriptyline for an additional 6 weeks. Response was defined as an equal to or greater than 50% decrease in HAM-D-17 scores. After 6 weeks of double-blind augmentation, 12.5 % of subjects responded to lithium and 20.0% to placebo. Our results revealed no significant difference between lithium and placebo augmentation. While lithium augmentation seems to be useful in depression refractory to a single medication in some studies, our data suggest limited usefulness of this option for patients refractory to multiple treatments. More definitive data await the outcome of the NIMH Sequential Treatment Alternatives to Relieve Depression (STAR*D) study.
ISSN:0271-0749
出版商:OVID
年代:2003
数据来源: OVID
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14. |
Influence of DHEA Administration on 24-Hour Cortisol Concentrations |
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Journal of Clinical Psychopharmacology,
Volume 23,
Issue 1,
2003,
Page 96-99
Patricia Kroboth,
Janet Amico,
Roslyn Stone,
Maggie Folan,
Reginald Frye,
Frank Kroboth,
Kristin Bigos,
Tanya Fabian,
Ana Linares,
Bruce Pollock,
Charles Hakala,
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摘要:
DHEA is marketed and readily available as a daily nutritional supplement to counteract the effects of aging. The effect of DHEA administration on 24-hour plasma cortisol profiles has not been investigated. In this single-blind placebo-controlled crossover study, the effect of DHEA administration on cortisol concentrations was evaluated in healthy older women and men. Once each morning, subjects took either placebo (Days 1 to 7, and 23 to 29) or oral DHEA 200 mg (Days 8 to 22: doses 1 to 15). Twenty-four hour DHEA and cortisol concentrations were measured on Day 1 (placebo), Day 8 (DHEA dose 1), Day 15 (DHEA dose 8), Day 22 (DHEA dose 15), and Day 29 (placebo washout dose 7). DHEA administration resulted in a decrease in plasma cortisol concentrations (mean, peak, and/or AUC) in healthy older women and men. The cortisol-lowering effect of DHEA was more pronounced in women than in men in our study; pairwise differences in concentrations between days showed that relative to Day 1, cortisol was lower on Days 15, 22, and 29 in women (p = 0.0001) and on Day 15 in men (p = 0.002). The mechanism by which DHEA lowers plasma cortisol concentrations merits further investigation.
ISSN:0271-0749
出版商:OVID
年代:2003
数据来源: OVID
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15. |
Usefulness of Olanzapine in Refractory Panic Attacks |
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Journal of Clinical Psychopharmacology,
Volume 23,
Issue 1,
2003,
Page 100-101
Slim Khaldi,
Charles Kornreich,
Bernard Dan,
Isidore Pelc,
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ISSN:0271-0749
出版商:OVID
年代:2003
数据来源: OVID
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16. |
Olanzapine Induced “Typical” Neuroleptic Malignant Syndrome |
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Journal of Clinical Psychopharmacology,
Volume 23,
Issue 1,
2003,
Page 101-102
Joseph Goveas,
Adriana Hermida,
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ISSN:0271-0749
出版商:OVID
年代:2003
数据来源: OVID
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17. |
Pancreatitis Followed by Pericardial Effusion in an Adolescent Treated with Clozapine |
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Journal of Clinical Psychopharmacology,
Volume 23,
Issue 1,
2003,
Page 102-103
Peter Wehmeier,
Philip Heiser,
Helmut Remschmidt,
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ISSN:0271-0749
出版商:OVID
年代:2003
数据来源: OVID
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18. |
Efficacy of Clozapine in the Treatment of Atypical Antipsychotic Refractory Schizophrenia: A Pilot Study |
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Journal of Clinical Psychopharmacology,
Volume 23,
Issue 1,
2003,
Page 103-104
Rajesh Narendran,
Carolyn Young,
Cynthia Pristach,
Michele Pato,
Antoinette Valenti,
Alice Fass,
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ISSN:0271-0749
出版商:OVID
年代:2003
数据来源: OVID
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19. |
Low-dose Risperidone Augmentation of Antidepressants in Nonpsychotic Depressive Disorders with Suicidal Ideation |
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Journal of Clinical Psychopharmacology,
Volume 23,
Issue 1,
2003,
Page 104-106
Mark Viner,
Yixiang Chen,
Indu Bakshi,
Peggy Kamper,
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ISSN:0271-0749
出版商:OVID
年代:2003
数据来源: OVID
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20. |
The Effect of One-Week Treatment with Venlafaxine on 35% CO2 Hyperreactivity in Patients with Panic Disorder: An Open Study |
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Journal of Clinical Psychopharmacology,
Volume 23,
Issue 1,
2003,
Page 106-108
Angelo Bertani,
Laura Bellodi,
Riccardo Bussi,
Daniela Caldirola,
Michele Cucchi,
Giampaolo Perna,
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ISSN:0271-0749
出版商:OVID
年代:2003
数据来源: OVID
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