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:

Injuries are a major public health problem among the elderly, and they have substantial medical, social, and economic consequences. There has been a longstanding concern that psychotropic drugs increase the risk of injury, particularly in the elderly, who frequently use psychotropic drugs and are more vulnerable to drug effects that may predispose to injuries. For benzodiazepines and antidepressants, the most commonly used psychotropic drugs outside of institutional settings, an extensive body of data demonstrating psychomotor function impairment establishes a firm basis for concern, which is reinforced by the more limited epidemiologic data. However, because of limitations in both types of data, this issue remains controversial. To resolve this controversy, we suggest three lines of further research: psychomotor function tests more directly relevant to the injury risk of the elderly medication user, epidemiologic studies designed to distinguish drug effects from those of underlying psychopathology, and clinical trials that include injuries as an outcome.

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Physicians often face the problem that they have to treat anxiety and insomnia in patients who are dependent on narcotics or other substances. Reports about different reinforcing properties of different benzodiazepines and increasing concern about their misuse, often in combination with other drugs, call for studies that help to establish recommendations for choosing psychopharmacologic agents in the treatment of these patients. Opiate addicts enrolled in a methadone maintenance program were interviewed about their subjective “liking” of all psychotropic substances with which they had personal experience. The results confirm previous reports that certain benzodiazepines, especially flunitrazepam and diazepam, stand out from others in terms of positive reinforcing properties. Overall, the attractiveness of benzodiazepines as drugs of abuse for poly-drug abusers is lower than that of other sedative/hypnotics. (J Clin Psychopharmacol 1992;12:397–402)

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The pharmacokinetics and pharmacodynamics of adinazolam and N-desmethyladinazolam were studied in 18 young subjects, from 21 to 36 years of age, and 18 elderly subjects, ranging in age from 65 to 76 years. Nine men and 9 women per age group were studied in a randomized three-way crossover design. Single doses of one 30-mg adinazolam mesylate sustained release tablet, one 30-mg immediate release tablet, and 15 mg of intravenous adinazolam mesylate were administered. Plasma adinazolam andN-desmethyladinazolam were determined by high-performance liquid chromatography, and psychomotor performance tests, including digit-symbol substitution and two card-sorting tasks, were performed. An effect index, defined as the maximal performance decrement divided byN-desmethyladinazolam maximum plasma concentration was calculated as a measure of sensitivity to these effects. Adinazolam oral and systemic clearances were reduced approximately 30% and 25%, respectively, in elderly volunteers. Adinazolam half-life was prolonged approximately 40% in the elderly after oral dosing.N-Desmethyladinazolam plasma concentrations and half-life were increased approximately 40% in elderly volunteers. Psychomotor performance decrements were observed following all treatments; decrements were lowest following sustained release tablets and intravenous adinazolam. Maximal performance decrements in elderly subjects were approximately twice those observed in young subjects. No significant influence of age on the effect index for digit-symbol substitution was evident.Effect indices for card-sorting tests were significantly higher in the elderly. Lower clearances of adinazolam andN-desmethyladinazolam are observed in elderly volunteers, and increasedN-desmethyladinazolam levels contribute to increased psychomotor performance decrements in elderly subjects. Results also suggest that elderly subjects may be more sensitive to certain cognitive effects ofN-desmethyladinazolam.

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Cerebral event-related potentials arise from synchronous neural activity associated with cognitive processing. The P3 is a late positive component that is related to task complexity and is directly proportional to stimulus evaluation time. P3 latency and amplitude were examined after oral administration of diazepam, a commonly prescribed medication with known cognitive side effects. Latency of the P3 was significantly increased after a single dose of both 5 and 10 mg of diazepam but not after placebo. P3 amplitude decreased slightly, but not significantly after 10 mg of diazepam. Changes in P3 occurred in the absence of significant changes in the preceding evoked waves (N1, P2). These findings should be considered when the P3 is obtained for clinical or research purposes from medicated patients.

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Serotonergic reuptake inhibitors have been the primary medications for treatment of obsessivecompulsive disorder (OCD); however, other serotonergic and α2-adrenergic medications also have been reported to reduce obsessive-compulsive symptoms. In this study, we compare three medications with reported efficacy in OCD to a control medication, diphenhydramine, a medication without theoretical or demonstrated treatment benefit. The three active medications were clomipramine, a serotonergic reuptake inhibitor; clonazepam, a benezodiazepine with putative serotonergic properties; and clonidine, an α2-adrenergic agonist. Twenty-eight subjects with DSM-III-R diagnosis of OCD rotated through 6-week trials of each of the four medications in a randomized, double-blind, multiple crossover protocol. Clomipramine and clonazepam were both effective relative to the control medication in reducing OCD symptoms. There was a significant cross-response between these two medications; however 40% of subjects failing clomipramine trials had a clinically significant response to clonazepam treatment. The control medication, diphenhydramine, itself produced a significant decrement in symptoms, whereas clonidine was ineffective in reducing OCD symptoms. Clonazepam improvement was unrelated to changes in anxiety and occurred early in treatment. Clonazepam was significantly more effective than the other medications during the first 3 weeks of treatment. The results confirm the efficacy of clomipramine in the treatment of OCD and suggest that clonazepam might be a useful alternative treatment for patients with this disorder. (J Clin Psychopharmacol 1992; 12:420–430)

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 role of dietary fiber as a cause of antidepressant malabsorption has received little attention. Three patients are described who had previously been successfully treated with tricyclic antidepressants and subsequently became refractory to treatment after commencing a high-fiber diet. Serum antidepressant levels were decreased while the patients ingested the high-fiber diets and rose when the fiber content of the diet was reduced. Clinical improvement of their depression followed the concomitant rise in serum tricyclic antidepressant levels. (J Clin Psychopharmacol 1992;12:438–440)

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID