[Obsessive-compulsive disorders: clinical forms and comorbidity].
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Biomedical subjects
Publications and source records attributed to C Pruneri.
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96 monotherapies with carbamazepine, phenytoin, phenobarbital and primidone were assessed in 42 patients with partial epilepsy. Those whose seizure frequency was reduced by 75% or more were considered to have improved. In 54 comparisons of monotherapies significant improvement in seizure frequency was achieved in only 16.7% of cases. Nonresponding patients showed practically no change across all comparisons according to the Fischer test.
A retrospective survey on 66 adults with epilepsy who received multiple drug therapy after the failure of single drugs showed: a reduction of seizure frequency of 75% or more in 16.5%, no change in 67% and an increase in seizure frequency of 100% or more in 16.5%. Multiple drug therapy is of limited value in severe epilepsies.
Phenobarbitone (PB) and primidone (PRM) plasma concentrations were measured in 88 patients of both sexes with different types of epilepsy and treated with PRM, alone or in association with carbamazepine (CBZ), phenytoin (PHT), ethosuximide (ESM) or valproic acid (VPA). A correlation was observed between the dose and the levels of both PRM and PB. Plasma PB:PRM ratio was high variable, especially interindividually. These changes seemed to be linked to age and particularly to pharmacological associations. In fact, PB:PRM ratio was increased with CBZ, ESM, VPA and PHT respectively. Moreover, a correlation was observed between the PB:PRM ratio and PHT plasma levels. The possibility of monitoring PB and PRM plasma levels during long-term treatment with PRM is discussed.
The authors investigated 37 patients with established focal epilepsy in terms of the antiepileptic drug (AED) blood levels needed to achieve control or significant abatement of seizures; then they examined the patients by computerized axial tomography (CAT) and grouped them according as they did or did not show evidence of an organic food lesion of the brain. Statistical elaboration of the data revealed that CAT-positive patients required significantly higher mean AED blood levels for clinical effectiveness than did CAT-negative patients; also, single drugs failed to produce control at any plasma level, necessitating recourse to multidrug regimes, significantly more often in the CAT-positive than in the CAT-negative patient group. In the discussion the authors examine the possible reasons for the observed difference of therapeutic responses.
On the basis of some reports, a double-blind experimental trial comparing the activity of cyclofenil, estradiol valerate and placebo in post-menopausal disturbances was carried out. 60 women among those attending the menopausal clinic and affected by climateric disorders have been treated. The objective criterium for the admission had been established on the basis of the value of plasma FSH (greater or equal to 800 ng/ml). Besides the gynecological examination (including objective and subjective examination, hormone dosage, endometrial biopsy) patients underwent psychological examination (individual interview and psychometric tests) before and after 28 days of therapy The statistical evaluation of the results obtained with the 3 drugs showed a statistically significant difference between the placebo and the active compounds: no significant difference between cyclofenil and estradiol valerate was observed.
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