ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The current study provides estimated rates of suicide among users of antidepressant drugs. The data were derived from two population-based data resources: United Kingdom general practitioners using computers provided by Value Added Medical Products, Ltd., and Group Health Cooperative of Puget Sound. The results apply specifically to these populations. The overall rates of suicide in ever users of the study drugs usually used to treat depression were 6.5 X 10-4person-years in persons present in the U.K. resource and 5.1 X 10-4person-years in members of The Puget Sound group. Rates of suicide among users of particular antidepressant drugs varied somewhat, but the rates were consistent with biologic variability, with the possible exception of rates for mianserin (based on 4 exposed cases), which were higher than rates for other antidepressants. Consistent findings were (1) suicide rates are substantially higher in men than in women, and (2) the use of firearms as a mode of suicide is common in the northwest United States and uncommon in the United Kingdom.

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

A double-blind, placebo-controlled trial was undertaken to compare the effects of imipramine and clomipramine in the treatment of panic disorder with or without agoraphobia. The number of dropouts in the placebo-treated group was 7; in the imipramine-treated group, 4; and in the clomipramine treated group, 0. Ten subjects fulfilled the 12 weeks of treatment in the placebo group, 25 in the imipramine group, and 22 in the clomipramine group. To minimize dropouts because of side effects, a flexible dose regimen with a careful escalation of doses was applied. The maximal dose allowed was 250 mg/day. The mean (±SEM) daily doses reached were 124 ± 9 mg (range, 50–250 mg) of imipramine and 109 ± 8 mg (range, 25–200 mg) of clomipramine. At the end of the trial, the number of panic attacks as well as the anxiety between attacks (measured using the Hamilton Rating Scale for Anxiety) were markedly reduced in patients treated with either of the two antide-pressant drugs, but only slightly decreased in patients on placebo. With respect to all major outcome parameters, i.e., full panic attacks, total number of anxiety attacks (full plus mild), and anxiety between attacks, the effect of clomipramine was clearly and significantly superior to that of imipramine (p< 0.001,p< 0.002, andp< 0.002, respectively). Moderate intake of diazepam was allowed; in the clomipramine group (p< 0.006), but neither in the imipramine group nor in the placebo group, a significant decrement in diazepam intake was observed during the course of the trial. The finding that clomipramine may have a higher potency and/or efficacy than imipramine in the treatment of panic disorder supports the concept that the antipanic effect of antidepressant drugs is due to the influence of these compounds on serotonergic rather than noradrenergic neurotransmission.

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Debrisoquine hydroxylation phenotype was determined in 22 psychiatric patients who had previously developed exceptionally high serum antidepressant (AD) concentrations, and in 22 sex-, age-, and dose-matched counterparts who had low to normal serum AD levels. The patients were recruited from 641 subjects in whom serum AD levels were monitored. In each AD level group, 16 patients had been treated with tricyclic antidepressants (amitriptyline, doxepin, trimipramine, imipramine, clomipramine) and 6 with mianserin. Eight poor metabolizer (PM) phenotypes (debrisoquine/hydroxydebrisoquine ratio in 6-hour urine ≥ 41.5) were identified in the high AD level group, but only two in the group with low to normal AD level (p= 0.03, Fisher's test). Comedications in the two study groups did not differ markedly from each other and could not, therefore, explain the greater frequency of PMs among the patients with high serum AD levels. Three of 6 mianserin patients, who had developed high serum AD levels, were PMs. This high proportion of PMs raises the question of a possible involvement of the same metabolic pathway (cytochrome P-450IID6isoenzyme) also in mianserin hydroxylation. The results suggest further that during AD therapy with standard dosage, PM phenotypes are at special risk for high serum AD concentrations and, consequently, for clinical symptoms of toxicity.

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Seven patients with AIDS-related cognitive and emotional deficits had neuropsychologic testing and then were treated with methylphenidate or dextroamphetamine in individualized doses. Three patients showed marked functional improvement and 5 of the 7 became more spontaneous, reactive, and animated. Additional neuropsychologic testing showed statistically significant improvement in a subset of tests; however, scores did not return to baseline in tests done after the treatment was discontinued for 1–3 days.

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Eight schizophrenic inpatients participated in a 2-week double-blind crossover study to test the efficacy of methylphenidate treatment for patients on a stabilized neuroleptic dose. All were young men with a childhood history of hyperactivity. The instruments used, the Brief Psychiatric Rating Scale, Scale for Assessment of Positive Symptoms, Scale for Assessment of Negative Symptoms, and Nurses Observation Scale for Inpatient Evaluation, showed no significant differences between stimulant and placebo conditions. One patient suffered a repeated pressor effect and was removed from the protocol. However, staff and self-report found some improvement in 3 patients and a slight worsening in 1.

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID