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Biomedical subjects

Beth M Dubisar

Publications and source records attributed to Beth M Dubisar.

5 recordsLinked to original sources
PubMed2004

Extended-release divalproex sodium for mood stabilization.

STUDY OBJECTIVE: To evaluate the efficacy, safety, and tolerability of extended-release divalproex sodium. DESIGN: Prospective, open-label, 4-week study SETTING: Long-term care facility of the Missouri Department of Mental Health. PATIENTS: Ten hospitalized patients (mean age 39.4 yrs) with mood or thought disorders who were experiencing adverse effects from delayed-release divalproex sodium. INTERVENTION: All participants were switched from delayed-release to extended-release divalproex sodium. MEASUREMENTS AND MAIN RESULTS: Efficacy was monitored with the Brief Psychiatric Rating Scale (BPRS), and safety and tolerability were monitored with the Systematic Assessment for Treatment Emergent Events (SAFTEE). Frequently reported adverse effects before conversion were sedation, stomach upset, and tremor. At study conclusion, no differences were seen in total BPRS scores or individual BPRS items, although a trend pointed to decreased somatic complaints (p=0.057). The mean serum concentration of valproic acid among participants did not change significantly in the transition from the delayed-release formulation to an equivalent dose-adjusted extended-release formulation (90.5 mg/L vs 95.5 mg/L, p=0.493). At study conclusion, significant decreases in low-density lipoprotein cholesterol (p=0.010) and potassium (p=0.043) levels were identified. Three categories of adverse effects decreased significantly after patients switched to the extended-release form of divalproex sodium: sedation (p=0.022), stomach or abdominal discomfort (p=0.045), and tremor (p=0.004). CONCLUSION: This preliminary investigation suggests that patients receiving delayed-release divalproex sodium for mood lability can be converted successfully to extended-release divalproex sodium. Moreover, these findings imply that this transition is associated with a reduction in some of the adverse effects associated with divalproex sodium.

Adult↗
PubMed2004

Adverse effects of atypical antipsychotic agents and their effects on quality of life.

STUDY OBJECTIVES: To determine how axis III metabolic disturbances associated with atypical antipsychotic agents (weight gain, diabetes mellitus, and hyperlipidemia) affect patients' quality of life by comparing perceived quality of life of patients taking these agents who developed the disorders with those who did not develop them. A secondary objective was to compare patients' assessments of their quality of life with assessments made of the same patients by their treating psychiatrists. DESIGN: Analysis of questionnaire results. PATIENTS: Thirty three patients hospitalized at a Missouri Department of Mental Health long-term care psychiatric facility after January 1, 1990. MEASUREMENTS AND MAIN RESULTS: Participating patients independently completed the "long" form of the Quality of Life Enjoyment and Satisfaction Questionnaire. The psychiatrists who treated these patients completed the Physical Health-Activities section of the same questionnaire, based on their assessments of their patients' quality of life. Fifteen patients had a diagnosed axis III metabolic disturbance. For the group with these comorbid illnesses, the mean score on overall life satisfaction and contentment was 3.6 (fair to good). The corresponding value for the group without these comorbid diseases was 4.538 (good to very good). Psychiatrists' assessments of their patients' quality of life were less positive than the patients' own assessments, regardless of the existence of comorbid disease. CONCLUSION: Patients receiving atypical antipsychotic drugs had a perceived high quality of life and were satisfied with a variety of aspects of their lives. However, metabolic disturbances had a significant, detrimental effect on patients' perceived quality of life.

Adult↗
PubMed2002

Seizures and extrapyramidal symptoms in a patient with Tourette's syndrome, Asperger's syndrome, and multiple sclerosis treated with interferon beta-1a and clomipramine.

Seizure activity is a known complication associated with multiple sclerosis; however, it may also result from side effects of the treatments for the disease. A 21-year-old man with Tourette's syndrome, pedophilia, Asperger's syndrome, and multiple sclerosis experienced seizures after receiving therapy with interferon beta-1a. Adjustments in his drug regimen led to the discovery of pseudoparkinsonism and other extrapyramidal symptoms. This case report illustrates how pharmacodynamic properties of drugs can complicate the treatment of neurologic disorders. Clinicians must be aware of the delicate balance between the signs and symptoms of disease states and the effects of drugs.

Adult↗