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Biomedical subjects

C VanValkenburg

Publications and source records attributed to C VanValkenburg.

7 recordsLinked to original sources
PubMed1992

New uses of anticonvulsant drugs in psychosis.

Psychotic patients not adequately relieved by neuroleptic drugs often improve when anticonvulsants are added. In bipolar disorders and organic psychoses, anticonvulsants can sometimes be used to replace neuroleptics. No individual anticonvulsant is clearly, consistently superior. Patients who fail on one agent may improve on the next. Clonazepam is an excellent adjunct to neuroleptic therapy, but there is little evidence that it is effective as monotherapy. However, it is safe, sedates rapidly, and has an excellent patient tolerability profile. Carbamazepine is the best established drug for patients with bipolar disorders, particularly for rapid cyclers, and is often effective monotherapy. The therapeutic profile of valproic acid (sodium valproate) is similar to that of carbamazepine, but its side effects are quite different and are often preferred. Other anticonvulsants are little studied, but might be chosen to avoid certain side effects, or after better-studied drugs have failed. The pharmacological basis behind using anticonvulsants in psychoses is primarily empirical. In almost every case it has been clinicians who have first noted the beneficial effects of these drugs. Theories such as that of Post have followed.

Anticonvulsants↗
PubMed1990

Therapeutic levels of valproate for psychosis.

Valproic acid was added to the treatment regimens of 21 psychiatric inpatients whose response to antipsychotic medications had been inadequate, and steady-state serum valproate levels were obtained on 15. The 7 patients who had unequivocal positive therapeutic responses to valproate improved at a mean serum level of 68, with a 95 percent confidence interval of 50 to 86. The 8 nonresponders had a mean serum level of 37.5 with a 95 percent confidence interval of 13 to 62. There was a weak relationship between oral dose and serum level. Two patients never reached therapeutic levels in spite of oral daily dosages of 5 g and 6 g respectively. Therapeutic levels could not be reached by 7 patients (47%) who were taking more than 1,250 mg daily. Our results suggest that the therapeutic serum range for seizures is valid for psychiatric patients but that the usual suggested oral dosage is often inadequate. Drug interactions may account for this.

Humans↗
PubMed1984

Anxious depressions. Clinical, family history, and naturalistic outcome--comparisons with panic and major depressive disorders.

Patients with anxiety and depressive states were divided into 4 groups: those with panic attacks only, those with panic disorder and secondary depression, those with depression and secondary panic attacks, and those with depression only. Clinical and familial differences between the groups are described. Patients with both depression and panic attacks had the poorest outcome, and were most likely to be chronically depressed.

Adult↗
PubMed1984

Hypertension and paranoia.

No differences in blood pressure on admission were found between samples of paranoid, paranoid schizophrenic, and nonparanoid psychiatric inpatients. The findings provide evidence against the catecholamine hypotheses of these disorders.

Adult↗
PubMed1980

Familial subtypes of depression: a clinical view.

The clinical workup of 238 unipolar depressives were subdivided according to immediate family history. Pure depressives (with only depression in the family) typically have an illness involving more endogenous features and chronicity. Depression spectrum patients (with only alcoholism or sociopathy in first-degree relatives) have the mildest illness. Sporadic depression (with a negative family history) is associated with an intermediate severity. Premorbid unstable personality characteristics are more common to the spectrum patients. Sporadic patients have the least personality difficulties. While these differences are definite, they are not large enough to justify separation of unipolar depression into subsyndromes dependent on symptom differences. Rather, family history seems to exert its effect most strongly on the distinctive premorbid personality characteristics of the 3 groups.

Adult↗
PubMed1977

Depression spectrum disease versus pure depressive disease. Clinical, personality, and course differences.

In a group of 191 women admitted to the University of Iowa Psychiatric Hospital for depression over a 45-year period and selected on the basis of alcoholism or antisocial personality, vs. depression, in a parent, 105 probands fit into the depression spectrum group (parental alcoholism or antisocial personality) and 86 into the pure depression group (parental depression). Few differences were found between the presenting clinical pictures (including precipitating factors) of the two groups; but depression spectrum patients and pure depressive patients showed study differences in the areas of personal problems and personality as well as course of illness. The depression spectrum patients were significantly less likely to have loss of interest in usual activities as a symptom at index admission. They were significantly more likely to have had a history of sexual problems, to have been divorced or separated before, to have been described as irritable, and to report having previously been depressed. They are nonetheless significantly more likely to recover completely and have no relapse of depression. The pure depression group were significantly more likely to have depressed sisters, and suicide was much more frequent in their ill parents. Thus, important personality and course differences separate depressive spectrum disease from pure depressive disease;

Age Factors↗