ISSN:0271-0749    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Eight normal, healthy, male volunteers each received four triazolam doses (0, 2, 4, and 8 μ/kg) and four ethanol doses (0, 0.25, 0.5 and 1.0 g/kg) in a double-blind, double-dummy experiment in which within-subject dose sequence was determined by a balanced Latin square design. Triazolam and ethanol produced dose-related and time-related effects on subject rating of mood and perceived drug effects and objective measures of memory and psychomotor performance. Dose-response curves for the two drugs were not parallel, and therefore, comparisons of the two drugs were based upon comparisons of the high dose of each drug. Although the two high-dose conditions generally were not different from one another, there were differences in their relative effect sizes, which were important. The high dose of each drug produced comparable degrees of impairment on two different psychomotor tasks. Triazolam, but not ethanol, produced significant impairment on two different memory tasks. The relative effects of each drug on subject ratings of mood and perceived drug effects varied across different subject-rated measures. Only ethanol significantly increased subject ratings of alcohol strength and feeling drunk. In comparison to ethanol, triazolam tended to produce less-pronounced subject ratings of drug effect magnitude, drug liking, and estimated performance impairment. However, less-pronounced subjective effects of triazolam were not universally observed on all subject ratings. Triazolam produced greater effects on several sedative symptoms and produced comparable effects on several mood factor scales.

ISSN:0271-0749    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Twenty-eight patients with a DSM-III diagnosis of agoraphobia with panic attacks who completed a 4-month combined drug and behavioral treatment program and who were then discharged on imipramine were interviewed 1 to 5 years after being discharged. At the time of follow-up, half of the patients were medication free, eight were receiving a lower dose of imipramine, two were receiving the same dose as at the time of discharge, and four patients were receiving other antipanic medications. Panic attack frequency remained reduced at the time of follow-up, as did all anxiety and all impairment ratings. These improvements were similar between patients receiving and not receiving imipramine at this time. Long-term outcome was independent of nonphar-macological therapy during the follow-up interval and lifetime diagnosis of major depression at the time of admission. Our data suggest that improvement observed after 4 months of treatment with imipramine and behavioral therapy is maintained after 1 to 5 years, even for many patients who reduced the dose of or discontinued imipramine. Long-term, randomized studies are needed to compare the efficacy of treatments and to determine treatment duration.

ISSN:0271-0749    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

In a double-blind study, 135 inpatients with a diagnosis of chronic schizophrenia were randomly assigned to 8 weeks of treatment with one of six parallel treatments: risperidone (a new central 5-hydroxytryptamine2and dopamine D2antagonist), 2, 6, 10, 16 mg/day; haloperidol, 20 mg/day; or placebo, after a single-blind placebo washout period. Doses were increased in fixed increments up to a fixed maintenance dose reached after 1 week. On the Clinical Global Impression–Severity of Illness and Improvement, all active medications were superior to placebo except for risperidone (2 mg) on the Clinical Global Impression–Improvement. On the total Positive and Negative Syndrome Scale (PANSS) score and positive subscale, superiority to placebo was observed for all treatment groups except for haloperidol and risperidone (2 mg), which tended to be superior to placebo on total PANSS and the positive subscale, respectively. On the PANSS negative subscale, only risperidone (6 mg/day) was significantly better than placebo. Risperidone (6 mg) was superior to haloperidol on the total PANSS, General Psychopathology, and Brief Psychiatric Rating Scale subscales. Although there was a linear increase in parkinsonism with increasing risperidone dosage, there were no statistically significant differences between risperidone (2, 6, and 16 mg/day) and placebo. At doses of 6 to 16 mg, risperidone displayed a marked anti-dyskinetic effect compared with placebo. This effect was more pronounced in patients with severe dyskinesia. By contrast, haloperidol produced significantly more parkinsonism than placebo and risperidone (2, 6 and 16 mg), with no effect on tardive dyskinesia. These data suggest that risperidone, at the optimal therapeutic dose of 6 mg/day, produced significant improvement in both positive and negative symptoms without an increase in drug-induced parkinsonian symptoms and with a significant beneficial effect on tardive dyskinesia.

ISSN:0271-0749    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Despite the trend towards lower neuroleptic dosing in the treatment of psychosis, there continue to be patients who are administered doses that are higher than recommended. Thirty-six acutely psychotic patients receiving parenteral haloperidol were evaluated by the Brief Psychiatric Rating Scale, the Schedule for Affective Disorders and Schizophrenia–Change Version, and the Nurses' Observation Scale for Inpatient Evaluation, as well as by drug levels in plasma. Patients were compared on the basis of total haloperidol dose in the first 24 hours: regular dose (RD: 10–30 mg) and high dose (HD: 40–80 mg). At baseline, patients in the HD group scored significantly higher on the Brief Psychiatric Rating Scale factor Hostile-Suspiciousness and the Nurses' Observation Scale for Inpatient Evaluation factor Irritability. Assignment to regular-dose and HD groups could not be accounted for on the basis of age, gender, weight, or duration of illness. Moreover, drug levels in plasma indicated that the HD patients did not require higher doses on the basis of differences in haloperidol levels.

ISSN:0271-0749    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Previous data suggest the possibility that haloperidol daily dosing requirements may be confounded by smoking and, at higher doses, capacity-limited metabolism. Forty hospitalized patients suffering from an acute exacerbation of schizophrenia were treated for 2 weeks with fixed oral doses of haloperidol ranging from 10 to 70 mg/day (0.13 to 0.95 mg/kg/day) that produced mean steady-state concentrations between 4.5 and 55.4 ng/ml. No significant differences between the smoking and nonsmoking groups were obvious for the factors of weight, age, sex, daily doses, steady-state clearance, and steady-state haloperidol concentrations in plasma at week 1, week 2, and their mean. The hypothesis that the relationship between haloperidol dose and steady-state haloperidol concentration in plasma was affected by patients' smoking status and metabolic capacity was tested by multiple linear regression analysis and initially rejected. The relationship of dose to haloperidol concentration was fitted as a linear function. To improve the curve fit, the haloperidol concentrations and doses were transformed to their natural logs and then the regression line was refitted. The multiple regression analysis was repeated with the data in their transformed state. It was found that, although smoking status and dose of the drug did not independently affect the average haloperidol concentration, together they interacted in such a way that individual haloperidol concentrations were dependent on the smoking status at specific doses. Thus, two haloperidol dosing equations were generated, one for smokers and one for non-smokers.

ISSN:0271-0749    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

We report six cases of rapid mood cycling induced by antidepressant treatment. The key to effective treatment involved the recognition of the pattern of apparent remission, relapse, antidepressant and/or stimulant adjustment, remission, relapse,etc. Hypomanic episodes were frequently mild and could be mistaken for remission. The destabilizing effects of antidepressant drugs were not corrected by the addition of mood stabilizers, necessitating the withdrawal of the antidepressant agent. All but one case responded to such withdrawal. Two cases required the addition of high-dose L-thyroxine for stabilization. Implications for an effective treatment protocol are discussed.

ISSN:0271-0749    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1993

数据来源: OVID