ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

This study compares two methods for elicitation of treatment-emergent side effects. One is the open-ended general inquiry and the other is a specific inquiry that asks about a wide range of events thought to be treatment-related. The study goal was to determine the extent to which the specific inquiry method elicits clinically useful informationover and abovethat elicited by the general inquiry method. The assessment instrument we used is SAFTEE, a structured interview schedule developed by the National Institute of Mental Health. We looked for differences between general and specific inquiry formats in terms of number of events elicited, type of event, severity, functional impairment, and clinician action taken. We found that both methods contributed to elicitation of events that, in the clinician's opinion, required some change in management. However, events reported on the General Inquiry form were significantly more distressing, more often interfered with daily functioning, and elicited more extensive changes in clinical management. No medically serious events were elicited on the specific inquiry form alone. Based on these findings, and in view of the amount of time and effort required to administer and score it, we do not recommend the specific inquiry form of SAFTEE as a standard assessment tool for routine use in all clinical trials. We do consider it to be a useful method for comprehensive elicitation about treatment-emergent effects in targeted and specific research contexts. We see the schedule as a comprehensive document or library of queries to be tailored to the needs of individual protocols.

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

In this study, 14 patients with obsessive-compulsive disorder (OCD) who had received at least 3 months of treatment with clomipramine were treated with the anxiolytic agent buspirone in a 10-week, double-blind study. Before the addition of buspirone, these patients as a group had shown a partial but incomplete reduction (averaging 28%) in OCD symptoms during clomipramine treatment alone. Because buspirone has been reported to be efficacious as a sole agent and as an adjunct agent in combination with fluoxetine in patients with OCD, we were interested in assessing whether buspirone added to clomipramine treatment would be associated with further significant reductions in OCD or depressive symptoms. Although adjuvant buspirone treatment was well tolerated in most subjects, mean OCD and depressive symptoms, as evaluated by standardized rating scales, did not significantly change from baseline scores achieved on clomipramine treatment alone, either after the addition of placebo for 2 weeks or buspirone (57 ± 7 mg/day) for an additional 10 weeks. However on an individual basis, 4 (29%) of the 14 patients did have an additional 25% reduction in OCD symptoms after adjuvant buspirone treatment. This double-blind study suggests that adjunctive buspirone therapy is not generally associated with significant further clinical improvement in OCD or depressive symptoms compared with clomipramine monotherapy, but that there may be a subgroup of patients who do benefit from adjuvant buspirone therapy.

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Recent literature has addressed a common dyad: alcoholism and anxiety. Both disorders have been interdigitated with the brain amine serotonin. We investigated 51 dually diagnosed patients (generalized anxiety/alcohol abuse: dependence) in a randomized, double-blind, placebo-controlled trial of the serotonin partial agonist buspirone. Buspirone was superior to placebo as an anxiolytic, was well tolerated, and was associated with both a reduction in the number of days desiring alcohol and an overall clinical global improvement.

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Self-injury is common in mentally retarded persons and often unresponsive to pharmacotherapy. Based on the assumption that this maladaptive behavior may be related to central nervous system serotonergic imbalance or dysfunction, an open trial with a serotonin uptake inhibitor was conducted. Twenty-one severely to profoundly mentally retarded persons with aggression and self-injurious behavior were treated with 20–40 mg of fluoxetine daily. Marked improvement occurred in 13 patients, moderate in 4, mild in 2, and no improvement in 2 patients treated for a minimum of 3 months. Positive changes occurred in the areas of self-injury, agitation, emotional lability, and aggression. Only one patient required discontinuation of the medication because of anorexia and weight loss; all other patients tolerated the drug without any significant side effects. All were concurrently taking other psychotropic medications, and no adverse drug interactions were noted. Future trials will focus on more homogeneous patient samples and on the therapeutic interactions between concurrently administered psychotropic medications.

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

To investigate whether alprazolam (ALP) coprescription early in the imipramine (IMI) treatment of panic disorder would improve overall treatment response to IMI alone, 48 panic disorder patients were randomly assigned to receive either IMI plus placebo or IMI plus ALP for 4–6 weeks, followed by 2 weeks of IMI plus placebo-ALP taper and 2 more weeks of IMI alone. Although patients in the IMI plus ALP group improved more quickly, significantly more patients in the IMI plus ALP group could not follow the taper schedule. The results suggest that studies employing other benzodiazepines or other ALP dosage or taper schedules would be required to demonstrate any benefit for the IMI plus early benzodiazepine cotreatment strategy over IMI alone in the routine pharmacologic management of panic disorder.

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Calcium channel blockers, antiarrhythmic drugs, such as verapamil and diltiazem, may decrease the symptoms of tardive dyskinesia. The efficacy and safety of administering 60 mg diltiazem hydrochloride, four times daily for a period of 3 weeks, was studied in a random, double-blind, crossover trial in which the drug was compared with placebo in 17 neuroleptic-treated, chronic psychiatric inpatients of both genders with (tardive) dyskinesia. The severity of the dyskinesia was assessed using the Abnormal Involuntary Movement Scale. Neither diltiazem nor placebo produced a significant decrease in the severity of the dyskinesia. Diltiazem did not influence the psychiatric state of the patients, nor did it have a significant effect on either the blood pressure or electrocardiographic parameters. No significant adverse drug reactions were elicited.

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The Neurobehavioral Assessment Scale (NAS) was developed to measure the full range of behavioral functioning from fully alert to deep coma. This investigator-rated scale was evaluated in 60 patients undergoing conscious sedation for maxillofacial procedures. The results obtained on the NAS were reliable, as evidenced by high correlations between the ratings of the two raters. The scale is also valid as determined by high correlations between the NAS and a standard scale, the Glasgow Coma Scale (criterion validity) and between the NAS and the Digit Symbol Substitution Test (behavioral validity). The NAS clearly distinguished between two levels of sedation (heavy and light). Furthermore, the NAS appears to be better able to discriminate among the different degrees of sedation in lightly sedated patients than the Glasgow Coma Scale.

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