ISSN:0271-0749    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Ipsapirone, an azapirone with 5-hydroxytryptamine (5-HT1Aor=to 20). The 10-mg ipsapirone treatment arm was discontinued early in the study. A total of 390 patients were eligible for evaluation in the intent-to-treat sample. The primary efficacy variable was the change in HAM-D total score from baseline to visit 8. There was no significant difference in efficacy in the two treatment groups versus the placebo group. The overall treatment response, defined as a 50% decrease in the HAM-D total score from baseline, was 43% with ipsapirone 50 mg given once daily, 34% with ipsapirone 30 mg given once daily, and 35% with placebo. In subanalyses, ipsapirone 50 mg given once daily was superior to placebo according to the HAM-D Core Depression (mood, guilt, interest, psychomotor activity) subtotal (p = 0.0453) and Melancholic item (p = 0.0225). Ipsapirone 30 mg given once daily was superior to placebo only in patients with moderate depression (baseline HAM-D total score <or=to 25; p = 0.0100). The most common adverse effect in all groups was headache. The only dose-dependent adverse effects were dizziness and nausea. (J Clin Psychopharmacol 1998;18:268-273)

ISSN:0271-0749    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Depression is a common cause of sexual dysfunction, but also antidepressant medication is often associated with sexual side effects.This article includes two related studies.The first double-blind, placebo-controlled study was conducted in men with lifelong rapid ejaculation and aimed to assess putative differences between the major selective serotonin reuptake inhibitors (SSRIs) (fluoxetine, fluvoxamine, paroxetine, and sertraline) with regard to their ejaculation-delaying effect.Sixty men with an intravaginal ejaculation latency time (IELT) of 1 minute or less were randomly assigned to receive fluoxetine 20 mg/day, fluvoxamine 100 mg/day, paroxetine 20 mg/day, sertraline 50 mg/day, or placebo for 6 weeks.During the 1-month baseline and 6-week treatment periods, the men measured their IELT at home using a stopwatch.The trial was completed by 51 men.During the 6-week treatment period, the geometric mean IELT in the placebo group was constant at approximately 20 seconds. Analysis of variance revealed a between-groups difference in the evolution of IELT delay (p = 0.0004); in the paroxetine, fluoxetine, and sertraline groups there was a gradual increase to about 110 seconds, whereas in the fluvoxamine group, IELT was increased to only approximately 40 seconds. The paroxetine, fluoxetine, and sertraline groups differed significantly (p < 0.001, p < 0.001, p = 0.017, respectively) from placebo but the fluvoxamine group did not (p = 0.38). Compared with baseline, paroxetine exerted the strongest delay in ejaculation, followed by fluoxetine and sertraline. There was no clinically relevant delay in ejaculation with fluvoxamine. In men with lifelong rapid ejaculation, paroxetine delayed ejaculation most strongly, whereas fluvoxamine delayed ejaculation the least.1 minute) to investigate whether data about SSRI-induced delayed ejaculation in men with rapid ejaculation may be extrapolated to men with less-rapid ejaculation.After measurement of IELT at home (using a stopwatch) during a 1-month baseline assessment, 32 men with an IELT of 1 minute or less (group 1) or more than 1 minute (group 2) were randomly assigned to receive paroxetine 20 mg/day or placebo for 6 weeks in a double-blind manner. Patients continued to measure their IELTs at home during the 6 weeks of the study.At baseline, 24 patients consistently had IELTs of one minute or less (group 1), and eight patients had IELTs of more than 1 minute (group 2).The geometric mean IELT was 14 seconds in group 1 and 83 seconds in group 2. Twelve patients in group 1 and five in group 2 were randomized to the paroxetine 20 mg/day. The percentage increase in the geometric mean IELT compared with baseline in patients treated with paroxetine was 420% (95% confidence interval [CI], 216-758%) in group 1 and 480% (95% CI, 177-1,118%) in group 2 (p = 0.81). After 6 weeks of treatment with paroxetine, the geometric mean IELT was 92 seconds in group 1 and 602 seconds in group 2 (p < 0.001).Therefore, the paroxetine-induced percentage increase in IELT seems to be independent of the baseline IELT. This suggests that ejaculation-delaying side effects of some SSRIs investigated in men with lifelong rapid ejaculation may be generalized to men with less-rapid ejaculation. (J Clin Psychopharmacol 1998;18:274-281)

ISSN:0271-0749    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

This study compared the clinical course and response to pharmacotherapy of patients with rapid cycling affective disorder (RCAD).A retrospective study was conducted on outpatients with affective disorder from 1991 to 1992 at Okayama University Medical School to select cases of RCAD. The subjects were 35 patients who fulfilled DSM-III-R criteria for mood disorder and had experienced at least four episodes of illness during the previous year. The subjects were divided into two groups according to their age at the first phase of affective illness: an early-onset group, consisting of patients aged 25 years or younger, and a late-onset group, consisting of patients aged 26 or older. There were 14 patients in the early-onset group and 21 in the late-onset group. Both the mean duration from onset to rapid cycling and the mean duration of each phase were shorter in the early-onset group than in the late-onset group. There were no significant differences between the groups in period of remission, character of the first episode, heredity, or thyroid function. Lithium carbonate therapy was more effective for reducing manic symptoms in the late-onset group than in the early-onset group, without maintaining a prophylactic effect in either group, whereas carbamazepine was more effective in the early-onset group. Antidepressants used in the depressive phase had a tendency to be more effective in the late-onset than in the early-onset group. However, rapid cycling induced by antidepressants was more evident in the late-onset than in the early-onset group. These findings supported the differentiation of RCAD into two groups based on age at onset, the early-onset group showing a rapid cycling course at an early stage and a good response to carbamazepine, the late-onset group having a relatively long disease duration until the appearance of a rapid cycling course and a good response to lithium carbonate in the manic phase and to antidepressants in the depressive phase. (J Clin Psychopharmacol 1998;18:282-288)

ISSN:0271-0749    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

meta-Chlorophenylpiperazine (mCPP) is a compound that is frequently used in challenge tests of the serotonergic system. Its human pharmacology is largely unexplored. The objective of this study was to investigate the pharmacokinetic and pharmacodynamic profile of mCPP. Eight female and six male healthy volunteers were included in a randomized, double-blind, double-dummy, three-way crossover design of single-dose intravenous (0.1 mg/kg), oral (0.5 mg/kg), and placebo treatment, with 24-hour follow-up. mCPP showed a large variability in clearance (11-92 mL/hr) and bioavailability (14-108%). Two female subjects dropped out because of headache and dysphoria. During the 27 occasions in which mCPP was administered, autonomic physical symptoms were observed in 23 subjects and disturbances of mood in 6 subjects. Oral and intravenous mCPP caused sudden increases in cortisol levels, prolactin levels, and total scores of the Body Sensation Questionnaire. Administration of mCPP also led to concentration-dependent increases of saccadic peak velocity and adaptive tracking performance and to a decrease of electroencephalographic occipital theta activity. No clinically relevant effects on electrocardiogram, temperature, and blood pressure were found. In conclusion, it is doubtful whether mCPP is a useful compound for challenge tests in view of the large pharmacokinetic variability after intravenous and oral administration. The effects of mCPP are consistent with disinhibition of the central nervous system. (J Clin Psychopharmacol 1998;18:289-295)

ISSN:0271-0749    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

or=to30% improvement) and CGI-Improvement (score of 1 or 2) scales in the ziprasidone 160 mg/day group was similar to that in the haloperidol group and nonsignificantly greater than that in the ziprasidone 4 mg/day group. On all assessments of clinical efficacy, the improvements associated with ziprasidone 4 mg/day, 10 mg/day, and 40 mg/day were similar. Concomitant benztropine use at any time during the study was less frequent with ziprasidone 160 mg/day (15%) than with haloperidol (53%). Haloperidol was associated with a sustained hyperprolactinemia, unlike ziprasidone, where only transient elevations in prolactin that returned to normal within the dosing interval were observed. Ziprasidone was well tolerated, and the incidence of adverse events was similar in all groups. The results of this study suggest that ziprasidone 160 mg/day is as effective as haloperidol 15 mg/day in reducing overall psychopathology and positive symptoms of an acute exacerbation of schizophrenia or schizoaffective disorder but has a lower potential to induce extrapyramidal symptoms. (J Clin Psychopharmacol 1998;18:296-304)

ISSN:0271-0749    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Previous studies of the relationship between plasma prolactin and clinical effects in patients treated with antipsychotic drugs have yielded inconsistent results.A possible explanation may be that most studies have not included subtherapeutic or low doses of antipsychotics. In this exploratory, double-blind study, the relationship between plasma prolactin concentration and central D2receptor occupancy was examined in 13 schizophrenic patients treated with the experimental antipsychotic drug raclopride (2, 6, or 12 mg daily). D2receptor occupancy was determined by positron emission tomography and was related to antipsychotic effect as measured by the Brief Psychiatric Rating Scale. Plasma prolactin concentration was increased in eight of nine patients with a D2receptor occupancy greater than 50%, whereas it was normal among patients with a D2receptor occupancy less than 50% (p < 0.01). Plasma prolactin concentration measured 4 hours after the morning dose of raclopride correlated significantly with plasma raclopride concentration (r = 0.92, p < 0.01), the degree of D2receptor occupancy (r = 0.81, p < 0.01), and the antipsychotic effect (r = 0.79, p < 0.01). Further controlled studies that include low doses of antipsychotic drugs may warrant a reconciliation of plasma prolactin as a useful tool in clinical monitoring of antipsychotic drug treatment. (J Clin Psychopharmacol 1998;18:305-310)

ISSN:0271-0749    

出版商:OVID    

年代:1998

数据来源: OVID