ISSN:0271-0749    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Buspirone was compared with imipramine and placebo in the treatment of panic disorder in an 8-week, double-blind controlled study of 52 randomly assigned patients. The side effect profile of buspirone was less disruptive than that of imipramine. Buspirone was not significantly superior to placebo in its antipanic or anxiolytic effects in panic disorder patients.

ISSN:0271-0749    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Akathisia is a frequent and distressing side effect of neuroleptic medications. The literature regarding the pharmacologic treatment of acute neuroleptic-induced akathisia is critically reviewed, including nine reports of the use of anticholinergic agents, 15 of the use of β-blocking agents, and six of the use of benzodiazepines. Reports of trials on clonidine, amantadine, piracetam, and of a patient treated with amitriptyline are also discussed. Tentative recommendations for the management of acute akathisia are proposed.

ISSN:0271-0749    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The present paper describes a methodological review procedure for evaluating a body of research focusing on the study of a prophylactic treatment medication. An illustrative application of this procedure to research evaluating lithium prophylaxis for bipolar affective disorders revealed possible biases in respect to subject selection, and general problems with diagnostic reliability and the reliability of the dependent variable. A tendency to ignore the statistical power aspects of determining sample size was also noted, along with possible difficulties relating to infrequent assessments of patients' clinical conditions. The implications of these matters were discussed in terms of the unique vantage point offered bv this methodological review process.

ISSN:0271-0749    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Alprazolam is a widely used antianxiety agent, yet relatively little is known about the relationship between chronic oral doses and steady-state plasma levels. This study examines the relationship over a wide range of therapeutic doses. We conducted a parallel, double-blind, placebo-controlled study in 36 patients with agoraphobia with panic attacks, or panic disorder with limited phobic avoidance based on DSM- III criteria. Patients received alprazolam (N = 25) or placebo (N = 11) beginning at 1 mg/day and increased weekly until either a maximum tolerated dose or 10 mg/day was achieved. Dosages were then gradually tapered according to a predetermined schedule. The entire study period lasted 14 weeks. Laboratory and clinical assessments were conducted weekly. Doses up to 6 mg/day were tolerated by 80% of patients on alprazolam and doses of 10 mg/day were tolerated by 40% of patients. Twenty-seven percent of the placebo patients reached 10 tablets/day. In the alprazolam group, the principal cause of intolerance was sedation. Throughout the study no significant changes in vital signs or laboratory parameters were observed. Steady state alprazolam, 4-hydroxy alprazolam, and α-hydroxy alprazolam plasma levels were linearly related to dose. A 1 mg dosage increment produced, on the average, a corresponding 10 ng/ml increase in steady state level of the parent drug. Significant response was observed in subjects who achieved concentrations greater than 20 ng/ml, with a maximum of 81% of the samples classified as re- sponders within the 60 ng/ml and above group. During taper, no severe withdrawal symptoms were noted; 12 of 25 alprazolam patients, however, reported rebound anxiety (anxiety rating scale scores higher than baseline), which occurred most commonly at the reduction from 1 mg to 0 mg.

ISSN:0271-0749    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A behaviorally-oriented program for teaching medication management skills to psychiatrically disabled patients was field-tested in a broad range of inpatient and partial-hospitalization clinics representing a wide geographic distribution across the United States. Results indicated that medical practitioners and others in the allied health professions were able to implement the medication management program with a high degree of fidelity. Additionally, patients who participated in the study demonstrated significant gains in cognitive mastery of the program content, high levels of skill attainment, increased utilization of medication management skills, and a significant increase in medication compliance.

ISSN:0271-0749    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Alternatives to lithium are desirable in the prophylaxis of affective disorders, especially in patients who are intolerant of or do not respond to that drug. In the past few years the anticonvulsant carbamazepine has been in the foreground of discussion. Twenty-four patients with affective disorders (17 unipolar depressed, six bipolar, and one unipolar manic) were included in a comparative trial of lithium and carbamazepine; 12 had been pretreated with lithium without a satisfactory effect. All patients received carbamazepine (four received it in combination with lithium) over a mean time span of 20.2 months. Eighty percent of the patients improved with carbamazepine treatment. Side effects were infrequent.

ISSN:0271-0749    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

In light of the reported efficacy of clonazepam in treating acute mania, we conducted a retrospective review of clinical experience with this agent in maintenance treatment of patients with bipolar affective disorder. Twenty patients with bipolar affective disorder treated with adjunctive clonazepam were identified. A case vignette and summary data on all 20 patients are presented. Clonazepam had been prescribed, in a manner similar to neuroleptics, as part of the maintenance regimen and/or on an as needed basis for acute exacerbations. In six of 17 patients previously receiving combined lithium and neuroleptic treatment, clonazepam successfully replaced the neuroleptic. Overall, eight patients were rated much improved or very much improved, including three of the five cases initially rated most severely ill. Possible mechanisms and treatment strategies are discussed.

ISSN:0271-0749    

出版商:OVID    

年代:1990

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

During a retrospective review of 70 consecutive intensive care unit admissions for tricyclic antide-pressant (TCA) overdose, we identified 12 patients (17%) who had simultaneously ingested a neuroleptic agent. We then compared several clinical and laboratory features of patients who had ingested TCAs alone with those patients who had also taken a neuroleptic drug. The 12 patients in the TCA-neuroleptic group, when compared with patients in the TCA-only group, showed a markedly higher prevalence of first-degree atrioventricular block (p < 0.001), a significantly higher prevalence of prolongation of the QRS duration (> 0.10 sec) (p < 0.05), and a threefold increase in the prevalence of QTc prolongation (p < 0.05). Our data indicate that coingestion of neuroleptics and TCAs, when compared with the ingestion of TCA alone, may significantly increase the risk of adverse cardiac consequences. We discuss the possible mechanisms for these electrocardiographic changes as well as their potential implications.

ISSN:0271-0749    

出版商:OVID    

年代:1990

数据来源: OVID