ISSN:0271-0749    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Desipramine is a tricyclic antidepressant with demonstrated efficacy for some children with attention deficit hyperactivity disorder (ADHD). In this controlled study, clinical improvement was noted in a group of 12 ADHD children. There also were neuropsychological effects associated with desipramine treatment: a small but significant decline in motor performance and an improvement in long-term verbal memory. The decline in motor performance may be of only limited clinical significance, but it is an effect that desipramine seems to share with other tricyclic antidepressants. The improvement in memory performance is an effect it shares with the psychostimulants.

ISSN:0271-0749    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Adinazolam, a triazolobenzodiazepine that has an action similar to antidepressants in several pharmacological tests, was compared with amitriptyline and diazepam in endogenous depressive inpatients exhibiting dexamethasone suppression test non-suppression and/or abnormal contingent negative variation. Three parallel groups of 22 patients received in double-blind conditions either adinazolam (60–90 mg/day), amitriptyline (150–225 mg/day), or diazepam (30–45 mg/day) over a 4-week period, with weekly assessments by the Hamilton Rating Scale for Depression. Results showed significant superiority of amitriptyline over diazepam on total Hamilton depression scores. On the endogenomorphy subscale, amitriptyline induced significantly better improvement than both diazepam and adinazolam, whereas both amitriptyline and adinazolam exhibited significantly better antidepressant efficacy on the core symptoms of depression. Moreover, the dropout rate for inefficacy after 2 weeks of treatment was higher in the diazepam group. Taken together, these findings suggest that adinazolam has an antidepressant efficacy intermediate between amitriptyline and diazepam. Adinazolam was, however, much better tolerated than amitriptyline, and produced significantly fewer anticholinergic side effects.

ISSN:0271-0749    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The effects of high-dose fluoxetine (median 80 mg/ day), standard-dose imipramine (median 200 mg/day), and placebo were studied in 706 outpatients meeting DSM-III criteria for major depressive disorder. Baseline psychomotor activity of each patient was prospectively categorized as agitated, retarded, or neither. Rates of occurrence of total and significant (leading to discontinuation) activating adverse events (insomnia, agitation, anxiety, nervousness) and sedating events (somnolence, asthenia) were compared between treatments on an overall basis and within categories of baseline psychomotor activity. Additionally, these rates were compared across baseline psychomotor activity for each treatment. Efficacy was evaluated on an overall basis and with respect to baseline psychomotor activity. There was more total activation with fluoxetine than placebo (p = 0.008), but total activation with fluoxetine (28%) showed only a trend (p= 0.092) for being greater than with imipramine (21%). Discontinuations for activation with fluoxetine (5%) did not differ from imipramine (5%). Sedation and discontinuations for sedation with both fluoxetine and imipramine significantly exceeded placebo. The only drug-drug difference in discontinuations was for sedation where imipramine (11%) exceeded fluoxetine (5%;p= 0.008). Only for the occurrence of sedation with imipramine (47% among patients retarded at baseline) was there a significant association with baseline psychomotor activity (p= 0.021). Both fluoxetine and imipramine were superior to placebo and equal in efficacy in decreasing total Hamilton Rating Scale for Depression (HAM-D), the sleep disturbance HAM-D factor, and the anxiety/somatiza-tion HAM-D factor scores. These improvements were independent of baseline psychomotor activity.

ISSN:0271-0749    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Two- and 4-week double-blind placebo-controlled trials of lithium augmentation of ongoing fluvox-amine treatment trials were conducted in 20 and 10 patients, respectively, with primary obsessive-compulsive disorder (OCD) who had failed to respond to fluvoxamine alone. Although 2 weeks of double-blind lithium augmentation produced a small but statistically significant reduction in obsessive-compulsive symptoms, most patients did not have a clinically meaningful response. Furthermore, there was no statistical or clinical improvement in obsessive-compulsive symptoms during the subsequent 4-week double-blind, placebo-controlled trial of lithium augmentation. On the basis of treatment response criteria, only 18% and 0% of the patients responded to lithium augmentation of fluvoxamine during the 2− and 4-week treatment trials, respectively. In light of the previously reported 44% response rate to lithium augmentation in treatment-resistant depressed patients on fluvoxamine, the results of this study suggest that pathophysiological differences may exist between OCD and depression. The routine use of lithium augmentation in the management of patients with OCD who are refractory to serotonin reuptake inhibitors is not supported by these findings.

ISSN:0271-0749    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Four severe cases of the neuroleptic malignant syndrome (NMS) were successfully treated with intravenous infusion of the dopamine agonist lisuride in doses up to 0.25 mg per hour or 4.0 mg per day, respectively. Dramatic improvements of the clinical symptoms - in particular the extrapyramidal syndrome and state of consciousness - could be observed in two cases. The pharmacological properties of intravenous lisuride seem to make it an alternative in the treatment of NMS, which merits further study.

ISSN:0271-0749    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Clonazepam 0.5 mg was evaluated in a sleep laboratory study of 6 insomniac patients. The 16-night protocol consisted of 4 placebo-baseline nights, 7 nights of drug administration and 5 placebo-withdrawal nights. Clonazepam produced a significant decrease in total wake time initially (nights 5–7), as well as with continued administration (nights 9–11). With later but not immediate withdrawal, significant rebound insomnia occurred, on the 3rd withdrawal night, both wake time after sleep onset and total wake time increased markedly, with the latter significantly increased. These findings are discussed in light of clonazepam's increasing use for panic disorder; specifically, due to its maintained efficacy, it has the advantage of avoiding interdose rebound anxiety which is frequently reported with use of alprazolam.

ISSN:0271-0749    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Twenty chronic schizophrenic patients completed at least 2 weeks of a 6-week trial of buspirone (mean dose 23.8 mg/day) added to a stable dose of neuroleptic. At week 6, mean scores were significantly improved (p< 0.01) on the Brief Psychiatric Rating Scale, the Simpson Angus Scale for Extrapyramidal Symptoms and the Global Assessment Scale. Overall measures of akathisia and tardive dyskinesia were not significantly changed at week 6. In the 7 patients taking oral haloperidol, mean plasma concentrations of haloperidol were significantly increased (p< 0.05) by 26% 6 weeks after adding buspirone.

ISSN:0271-0749    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Macrolide antibiotics such as erythromycin have been found to impair the hepatic metabolism of carbamazepine. In addition, recent studies have shown that intestinal flora can N-demethylate tricyclic antidepressants, suggesting that the human gut may be a possible site of extrahepatic drug metabolism. Therefore, we conducted a study to determine whether the concurrent use of erythromycin might influence the metabolism and steady-state plasma concentrations of tricyclic antidepressants. Six days of erythromycin administration caused no systematic change in either the parent tricyclic or its metabolite(s). Thus, the short term concurrent use of erythromycin does not appear to alter hepatic or gut flora tricyclic metabolism to an appreciable extent. Nevertheless, prior reports of altered carbamazepine kinetics by erythromycin should increase the physician's awareness of a possible drug interaction when erythromycin is used concurrently with a tricyclic antidepressant.

ISSN:0271-0749    

出版商:OVID    

年代:1991

数据来源: OVID