ISSN:0271-0749    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Recent studies have shown that monoamine oxidase inhibitors (MAOIs), in appropriate patients and with proper precautions, are not as dangerous as once thought, especially in comparison to alternative antidepressants. We review the literature regarding the combined use of MAOIs and tricyclic antidepressants, which has been reported to be both highly toxic and highly effective. A large number of reports of adverse effects and their management, uncontrolled clinical trials, and animal studies are summarized. We also discuss the three controlled studies of combined MAOI‐tricyclic therapy that have been undertaken. We conclude that the hazards of combination therapy have been exaggerated and that MAOI‐tricyclic therapy is a reasonable approach in patients found resistant to standard antidepressant treatment if certain precautions are observed.

ISSN:0271-0749    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;In evaluations of new drugs, even when a random assignment, double‐blind, controlled clinical trial design is used, an array of methodological problems associated with treatment of those who do not respond (treatment nonresponders) can lead to unclear or misleading conclusions. Four such problems are reviewed and illustrated: unwitting diagnostic heterogeneity of depressive subtypes in study samples, inadequate dose and duration of medication, selection of inappropriate criteria for determination of efficacy, and nonreporting of global outcome measures for individual patients. The solutions offered to these problems are not novel. However, the frequent occurrence of these errors in recent reports of antidepressant trials suggests that a review of these problems and possible solutions would be timely. In addition, the authors describe an alternate, comparatively underutilized strategy, the discontinuation design, that is particularly suitable for new drug trials and that circumvents the problem of treatment nonre‐sponders.

ISSN:0271-0749    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;A study was conducted to assess the feasibility of substituting diazepam for pentobarbital and phenobarbital in sedative‐hypnotic tolerance testing and withdrawal of tolerant patients. Nineteen patients potentially dependent on sedative‐hypnotics were tolerance tested with either diazepam or pentobarbital and, if tolerant, were withdrawn with diazepam or phenobarbital, respectively. Seventy‐eight subjects previously described in the literature with drug dependencies similar to the diazepam and barbiturate groups provided a basis for comparing the diazepam group to untreated patients to determine whether diazepam was able to prevent abstinence symptoms. Withdrawal was successfully completed in all patients. The expected and observed incidence of seizures, delirium, and minor withdrawal for the barbiturate group and seizures and delirium for the diazepam group did not differ significantly, although a large type II error compromised these conclusions. A significant difference was seen between the observed and expected incidence of minor withdrawal symptoms in the diazepam‐withdrawn patients.

ISSN:0271-0749    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;In psychiatric literature, the term extrapyramidal syndrome has traditionally encompassed a wide variety of drug‐induced movement disorders. Recently, it has become increasingly clear that the natural history, pathophysiology, and pharmacology of individual movement disorders are distinct, making this unifying term obsolete and, in fact, a source of confusion. The topic of drug‐induced movement disorders is reviewed, and a classification system based on anatomy, pharmacology, and therapeutic considerations is discussed.

ISSN:0271-0749    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;This article reviews the literature concerning obsessive‐compulsive disorder (OCD) and its treatment with drugs. We survey the differential diagnosis of OCD and the problems involved in evaluating its severity in a research setting. Pharmacological treatment of OCD has usually involved antidepressants, especially clomipramine, with equivocal but nevertheless encouraging success. Anxiolytics and neuroleptics have also been tried, but the results are inconsistent. We discuss the implications of these findings for treatment of patients with OCD and for future research.

ISSN:0271-0749    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1981

数据来源: OVID