ISSN:0271-0749    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Evidence that serotonergic antidepressants are effective for treating premenstrual syndrome (PMS) raises the question of whether dosing only in the symptomatic premenstrual phase is effective for this disorder.This preliminary randomized, double-blind study compared the responses to half-cycle or full-cycle dosing of sertraline in 31 patients who completed a preceding double-blind, short-term treatment trial. The subjects fulfilled criteria for severe PMS when they entered the preceding controlled trial. At the end of the short-term treatment trial, the double-blind was not broken; both improved and unimproved subjects were randomized in a double-blind fashion to receive either full-cycle or half-cycle sertraline in the 3-month extension study. Results showed that the total premenstrual scores from the Penn Daily Symptom Report (DSR) were lower in the half-cycle dosing group in each of the 3 treatment months but did not differ with statistical significance from the full-cycle dosing group. Further analysis of the 17 DSR items showed that mood swings, nervous tension, feeling out of control, and confusion were significantly lower (p < 0.05) at endpoint in the half-cycle dosing group. Overall, subjects who improved in prior treatment remained improved; approximately half the subjects who were unimproved at entry into the extension study improved, regardless of the dosing regimen. The results add support to other preliminary reports of efficacy of serotonergic antidepressants administered premenstrually and indicate the clinical importance of determining an optimal dose/benefit ratio of serotonergic antidepressants for PMS patients. (J Clin Psychopharmacol 1999;19:3-8)

ISSN:0271-0749    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

or=to3 consecutive clinic visits-a rate significantly lower than that previously reported with venlafaxine (4.8%) ([chi squared] = 13.3, p < 0.001) and similar to that previously seen with placebo (2.1%). In conclusion, these data demonstrate a low rate of sustained hypertension (1.7%) during short-term fluoxetine treatment. (J Clin Psychopharmacol 1999;19:9-14)

ISSN:0271-0749    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The purpose of this study was to examine the safety and efficacy of fluvoxamine in the treatment of psychogenic (neurotic) skin excoriation.Fourteen subjects with psychogenic excoriation were given fluvoxamine in a 12-week, open-label trial after completion of the Structured Clinical Interview for DSM-IV. All subjects met DSM-IV criteria for at least one comorbid psychiatric disorder, with mood disorder the most common. Most subjects' excoriation had features of an impulse control disorder. Both completers (N = 7) and the entire group had significant improvement on the modified Yale-Brown Obsessive Compulsive Scale but no improvement on the Hamilton Rating Scale for Depression. In the self-report data, the seven completers had significant reduction in behaviors involving the skin (e.g., scratching, picking, gouging, or squeezing) and in global assessment of symptoms. Endpoint analysis of all 14 subjects' self-report data demonstrated significant improvement in the presence of skin sensations, skin appearance and lesions, behaviors involving the skin, control over skin behavior, and global assessment. The results of this preliminary open trial suggest that fluvoxamine may be effective in reducing psychogenic excoriation, and this effect seems to be independent of mood. Controlled studies are needed to confirm these findings. (J Clin Psychopharmacol 1999;19:15-18)

ISSN:0271-0749    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

This study was designed to evaluate the safety and effectiveness of testosterone therapy for clinical symptoms of hypogonadism (low libido, low mood, low energy, loss of appetite/weight) in human immunodeficiency virus-positive men with CD4 cell counts less than 400 cells/mm3and deficient or low normal serum testosterone levels.The trial consisted of 8 weeks of open treatment with 400 mg of intramuscular testosterone cypionate biweekly.Responders were maintained at this dosage for another 4 weeks and then were randomized in a double-blind, placebo-controlled, 6-week discontinuation trial. Of the 112 men who completed at least 8 weeks of treatment, 102 (91%) were rated as responders on a global assessment of sexual desire/function. Of the 34 study completers with major depressive disorder and/or dysthymia, 79% reported significant improvement in mood at week 8. Average weight change was a gain of 3.7 pounds, with 45% gaining more than 5 pounds. Eighty-four men entered and 77 completed the double-blind phase; of these, 78% of completers randomized to testosterone and 13% randomized to placebo maintained their response. No significant medical or immunologic adverse effects were identified. Testosterone therapy was well tolerated and effective in ameliorating symptoms of clinical hypogonadism, and equally so for men with and without testosterone deficiency. For patients with major depression and/or dysthymia, improvement was equal to that achieved with standard antidepressants. (J Clin Psychopharmacol 1999;19:19-27)

ISSN:0271-0749    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Disturbed sleep is common in the elderly and is characterized by disordered sleep architecture with reduced time spent in slow wave sleep (SWS) and in rapid eye movement (REM) sleep.At present, no treatments are available to fully compensate for these disorders. In the elderly, vasopressin content is decreased at various brain sites. Investigating the effects of a 3-month intranasal vasopressin administration on sleep and cognitive functions in two elderly subjects in a foregoing pilot study, the authors found that the most pronounced influence of the peptide was a marked increase in SWS. This placebo-controlled, double-blind, randomized study examined the influences of a 3-month period of daily intranasal vasopressin treatment (20 IU before bedtime and after awakening) on nocturnal sleep in 26 healthy elderly subjects (mean age, 74.2 years). Intranasal treatment of vasopressin increased (1) the total sleep time, on average, by 45 minutes (p < 0.002); (2) time spent in SWS by 21 minutes (p < 0.025); and (3) time in REM sleep in the second half of the night by 10 minutes (p < 0.01). Vasopressin promotes sleep time and improves sleep architecture after prolonged intranasal administration in elderly subjects, although scores of subjective sleep quality did not change. Results suggest that age-related deterioration of sleep architecture can benefit from intranasal treatment with vasopressin. But a potential use in clinical settings will also depend on demonstrating improved subjective sleep quality, which remained unaffected by vasopressin in this study of elderly subjects. (J Clin Psychopharmacol 1999;19:28-36)

ISSN:0271-0749    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

This pilot study examined the efficacy and tolerability of olanzapine in the treatment of children, adolescents, and adults with pervasive developmental disorders (PDDs).Eight patients with principal diagnoses (DSM-IV) of autistic disorder (N = 5) or PDD not otherwise specified (N = 3) were given olanzapine in an open-label, prospective fashion for 12 weeks. Clinical ratings were obtained at baseline and at the end of weeks (EOWs) 4, 8, and 12. Seven of eight patients completed the 12-week trial, and six of the completers were deemed clinical responders as measured by ratings at the EOW 12 of "much improved" or "very much improved" on the global improvement item of the Clinical Global Impression Scale. Significant improvements in overall symptoms of autism, motor restlessness or hyperactivity, social relatedness, affectual reactions, sensory responses, language usage, self-injurious behavior, aggression, irritability or anger, anxiety, and depression were observed. Significant changes in repetitive behaviors were not observed for the group. The EOW 12 mean +/- SD daily dose of olanzapine was 7.8 +/- 4.7 mg/day. The drug was well tolerated with the most significant adverse effects noted to be increased appetite and weight gain in six patients and sedation in three. With respect to weight gain, the mean +/- SD weight for the group increased from 137.50 +/- 55.81 pounds (62.50 +/- 25.37 kilograms) at baseline to 155.94 +/- 55.13 pounds (70.88 +/- 25.06 kilograms) at EOW 12. No evidence of extrapyramidal side effects or liver function abnormalities was seen. These preliminary results suggest that olanzapine may be an effective and well tolerated drug in targeting core and related symptoms of PDDs in children, adolescents, and adults. Further studies, particularly those that are placebo-controlled and double-blinded, are indicated to better define the clinical use of olanzapine in these patient populations. (J Clin Psychopharmacol 1999;19:37-44)

ISSN:0271-0749    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The occurrence of acute dystonia was prospectively monitored in 39 schizophrenic patients (18 male and 21 female) treated with 9 to 27 mg/day of nemonapride, a selective dopamine antagonist, and the relationship of acute dystonia with characteristics of patients and plasma concentrations of the drug and prolactin was investigated.Twenty (51.3%) of 39 patients had dystonic reactions, the onsets of which occurred within 3 days after the initiation of treatment in 90% of dystonic patients. The incidence of acute dystonia was significantly higher in male than in female patients (77.8% vs. 28.6%, p < 0.05). Younger male patients (<or=to 30 years) especially had an extremely high incidence of this side effect (91.7%). A positive correlation between prolactin response after 1 week of treatment and dystonia rating scores was found in male (Spearman rank correlation: rs= 0.606, p < 0.01) but not in female patients (rs= -0.378, p = not significant). These results suggest that young male patients have the highest risk of neuroleptic-induced dystonia. Prolactin response after 1 week of treatment as an index of dopamine blockade may reflect vulnerability to the development of acute dystonia at least in male patients treated with nemonapride. (J Clin Psychopharmacol 1999;19:45-50)

ISSN:0271-0749    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

"Dropouts" are a major concern when monitoring treatment efficacy in clinical trials.Alcohol-dependent patients are especially prone to discontinuing treatment, perhaps because of impulsive behavior. The Tridimensional Personality Questionnaire (TPQ) measures a trait-like quality, novelty seeking, which may reflect impulsiveness. We tested the hypotheses that higher TPQ Novelty Seeking subscale scores would be associated with increased rates of treatment dropout and increased risk for dropping out earlier. A total of 170 alcohol-dependent men who participated in a double-blind, placebo-controlled pharmacotherapeutic trial for decreasing relapse drinking completed the TPQ and were monitored until treatment dropout. Logistic regression and Cox proportional hazards models were used to (1) describe the relationship between the TPQ Novelty Seeking score and the dichotomous outcome variable, treatment dropout; and (2) assess the effects of a number of potential confounding covariates on the relationship between the risk factor, novelty seeking, and the time to the outcome event. The mean Novelty Seeking score was significantly higher among study dropouts compared with nondropouts (p = 0.003). Higher Novelty Seeking scores were associated with a higher adjusted odds ratio for dropping out (adjusted odds ratio = 1.07, 95% confidence interval [CI] = 1.00-1.15) and a higher adjusted hazard rate for dropping out earlier (adjusted hazard rate = 1.05, 95% CI = 1.00-1.09). The TPQ Novelty Seeking subscale score may identify a subgroup of alcohol-dependent men who are at risk for dropping out of treatment. This information may be useful for developing treatment plans to encourage these high-risk patients to remain in treatment. (J Clin Psychopharmacol 1999;19:51-56)

ISSN:0271-0749    

出版商:OVID    

年代:1999

数据来源: OVID