PubMed HealthSearch

Biomedical subjects

A Bystritsky

Publications and source records attributed to A Bystritsky.

9 recordsLinked to original sources

Continuous physiological changes and subjective reports in panic patients: a preliminary methodological report.

Six panic disorder patients and six matched control subjects were studied using a new technique allowing continuous and simultaneous monitoring of physiological responses (blood pressure, heart rate, respiration) and subjective reports of anxiety and panic. This was done before, during, and after CO2 inhalation. Panic patients had significantly higher variability in their heart rate, blood pressure, and breathing rate than the control subjects. They also had irregular breathing patterns with frequent pauses. We identified three different patterns of response to CO2 inhalation in the panic patients. Some patients who panicked on CO2 showed a definite association between changes in physiological responses that preceded their subjective ratings of anxiety; however, others did not show this pattern. The possibility of different physiological mechanisms of panic in different patients is discussed.

Adolescent

Bupropion in the treatment of bipolar disorders: the same old story?

BACKGROUND: The treatment of bipolar disorders with mood stabilizing agents is complicated by breakthrough episodes of depression. Currently there are no consistently safe and effective medications for these episodes. The authors address the use of bupropion for this purpose. METHOD: Bupropion was added to the treatment regimens of 3 male and 8 female patients who had bipolar disorders as diagnosed by DSM-III-R criteria and were depressed and nonresponsive to current treatment. Ten of the 11 had previously cycled into manic episodes when treated with either a tricyclic antidepressant, fluoxetine, or phenelzine. RESULTS: Seven of the 11 patients had moderate-to-marked improvement after 6 weeks of treatment. A moderate-to-marked improvement continued in 4 of the 11 patients after a mean of 12 months of treatment (range, 0-20 months), justifying the continuation of bupropion. Baseline Global Assessment of Functioning scores, history of previous response to other antidepressants, treatment refractoriness, comorbid diagnoses, bipolar subtype, family history, cycle length, and demographics did not discriminate between bupropion responders and nonresponders. However, 6 of the 11 patients experienced manic or hypomanic episodes that necessitated discontinuation of bupropion. Five of the 6 patients who had manic episodes had been stabilized on lithium and carbamazepine or valproate prior to the addition of bupropion. CONCLUSION: These findings, based on consecutive cases, suggest that bupropion may pose the same risks as other antidepressants in precipitating manic episodes in depressed bipolar patients. The authors conclude that caution should be exercised when using bupropion in the treatment of bipolar disorders.

Adult

Low dose desipramine treatment of cocaine-related panic attacks.

Thirteen patients meeting DSM-III-R criteria for panic disorder with or without agoraphobia that started during or shortly after cocaine exposure were treated in the UCLA Anxiety Disorders Program (Los Angeles, CA). Low starting doses (ranging from 2.5 to 10 mg/day) of desipramine were used. Doses were then slowly increased to an average daily dose of 25 mg. Eleven patients who were able to tolerate an initial increase in panic anxiety responded to this treatment strategy with almost full resolution of panic attacks. The authors discuss the possible value and mechanisms of low dose treatment of cocaine-related panic attacks.

Adult

Group psychotherapy for HIV-seropositive patients with major depression.

Patients were recruited from the UCLA AIDS Research Center who had previously been referred to psychiatry for participation in an open-label pilot treating patients with major depression with fluoxetine. They chose to participate in group therapy for continuing distress in coping with their HIV-seropositive status, dissolution of their support system, "accepting patienthood," and on being placed on an experimental medical protocol. The group was a closed, twenty-session, homogeneous (for patient characteristics), psychoeducational, supportive, and cognitively oriented psychotherapy group. We found this to be a successful intervention in helping patients manage HIV illness and in providing the coping skills and social support necessary to function at home, work, and in their interaction with their health care providers.

AIDS-Related Complex

An overview of anxiety disorders.

Anxiety disorders are more prevalent than any other mental health problem in the United States. Afflicted persons are often untreated or are treated only by a primary care physician without psychiatric consultation. However, based on current knowledge of the biological and psychological factors involved in these disorders, psychiatry has defined effective treatment that integrates education, psychotherapy, and psychopharmacology. After reviewing current research on possible mechanisms of anxiety, the authors discuss therapeutic interventions and recommend ways to choose appropriate treatment modalities for anxiety-disordered patients.

Agoraphobia

A report of eight HIV-seropositive patients with major depression responding to fluoxetine.

This pilot study examined the effectiveness of fluoxetine in depressed human immunodeficiency virus (HIV)-seropositive asymptomatic patients. Eight patients, participating in an AZT trial who met criteria for major depression syndrome (DSM-III-R), were treated with fluoxetine (20 or 40 mg/day) for 4 weeks. Initially, mean Hamilton Depression scores were 23.8 (range of 17-31), and improved to 6.4 (range of 3-10). All subjects maintained their remission over a 2-month follow-up. Fluoxetine treatment may be effective in treating major depression in HIV-seropositive asymptomatic patients.

Adult