PubMed Health⌕ Search

Biomedical subjects

D J McClure

Publications and source records attributed to D J McClure.

At least 19 recordsLinked to original sources
PubMed1990

A controlled dose-ranging study of remoxipride and haloperidol in schizophrenia--a Canadian multicentre trial.

The efficacy and side-effect profile for three dose ranges of remoxipride were compared with haloperidol in 242 schizophrenic inpatients in 13 centres. All patients were in a productive phase of schizophrenia according to DSM-III criteria. Relative efficacy of low dose (30-90 mg daily) vs middle dose (120-240 mg daily) vs high dose (300-600 mg daily) was compared with the standard dose of haloperidol (15-45 mg daily), as were the side effects. It was concluded that the therapeutic efficacy of remoxipride was comparable to that of haloperidol for acute episodes of schizophrenia; that the low dose range was significantly less effective than the higher ranges; that there was a clear advantage of remoxipride over haloperidol with respect to incidence and severity of extrapyramidal symptoms. The general safety profile of remoxipride as assessed from clinical chemistry, haematology, and cardiovascular variables suggests that remoxipride in the dose ranges studied can be used safely for the treatment of schizophrenic patients.

Acute Disease↗
PubMed1990

A comparison of the efficacy, safety and withdrawal effects of zopiclone and triazolam in the treatment of insomnia.

A double-blind study comparing zopiclone and triazolam, in 48 healthy, chronic insomniacs, was undertaken in two centers to compare the hypnotic and withdrawal effects of both compounds. Comparable doses of 7.5 mg zopiclone and 0.25 mg triazolam were given at bedtime for 21 nights after a 3 day wash-out period, followed by 4 placebo nights of withdrawal monitoring. During the investigation, a 17 item post-sleep questionnaire was completed daily, the Clinical Global Impression (CGI) scale weekly, and the Hamilton Anxiety Scale (HAM-A) at baseline and at the end of the study. Withdrawal effects were evaluated with a withdrawal symptom checklist and the CGI (withdrawal). Results indicated that both compounds improved sleep and were equally effective. However, a larger number of triazolam subjects withdrew from the study because of ineffectiveness or adverse side-effects. A greater number of zopiclone subjects experienced a transient modification of taste which disappeared with discontinuation of therapy. Significant deterioration in nearly all sleep parameters were noted after the first withdrawal night of triazolam; much fewer modifications of sleep parameters were observed following the discontinuation of zopiclone.

Adolescent↗
PubMed1989

The Health Care Quality Improvement Act of 1986: what it means to medical specialty societies.

The Health Care Quality Improvement Act of 1986 offers broad immunity against damages for health care entities and individuals conducting peer review activities. Among the health care entities receiving such protection are professional societies conducting peer review. Such protection is afforded only when review and reporting requirements of the Act are met. This article focuses on the benefits of the Act and the costs of compliance for medical specialty societies.

Peer Review↗
PubMed1988

Comparison of lorazepam and flurazepam as hypnotic agents in chronic insomniacs.

Hypnotic efficacy and safety of 3 weeks of daily doses of 2 mg lorazepam or 30 mg flurazepam were compared in a double-blind cross-over study in eight chronic insomniacs between the ages of 29 and 60 years. Subjects were monitored in the sleep laboratory twice weekly for a total of 25 nights. Also, subjective estimates of sleep, vigilance tests, and adverse effects were recorded throughout the study. Findings indicated lorazepam performed better than flurazepam in most sleep parameters. With lorazepam there was improvement from baseline in percentage of sleep time (P less than .05); in total wake time after sleep onset (P less than .01) and in last third of night (P less than .05); in percentage of stage 2 (P less than .05) (weeks 1, 2, 3) and in percentage of night in stage 4 (weeks 2 and 3). Only total wake time from baseline improved (P less than .05) with flurazepam (week 2). Objective and subjective sleep parameters did not correlate well for either drug. Neither drug impaired REM sleep or vigilance test performance. Side effects (grogginess, lethargy; flurazepam only) were few and none was unexpected; neither rebound insomnia nor early morning insomnia occurred with either drug. In summary, both lorazepam 2 mg at bedtime and flurazepam 30 mg at bedtime were found to be effective and safe for treating chronic insomnia, as measured by parameters of sleep and daytime functioning. Lorazepam had more favorable effects on sleep than did flurazepam.

Adult↗
PubMed1985

Buspirone: anxiolytic?

Sixty (60) out-patients with DSM III generalized anxiety disorder were treated after a 1-week placebo washout in a 4-week double-blind study with buspirone, diazepam and placebo; after which they were withdrawn abruptly from medication or assigned to a 2-week period of placebo. The HAM-A score was significantly lower in the diazepam group at week 2 (p less than .02) and the buspirone group at week 3 (p less than .04) as compared to the placebo group. A similar pattern was evident in the female group, but not in the male group. Dizziness was the most prominent adverse effect in the buspirone group, whereas the diazepam group had more adverse effects including sedation, fatigue, dizziness and impaired concentration. Withdrawal symptoms were more evident in the diazepam group than the buspirone group.

Adult↗
PubMed1985

Trimipramine and maprotiline: antidepressant, anxiolytic, and cardiotoxic comparison.

A 5-week placebo washout comparison of trimipramine 150 mg/day and maprotiline 150 mg/day was carried out in 15 male and 24 female patients with unipolar major affective disorder. There were no significant differences between the two groups in age, sex, weight, height, or vital signs. Both groups showed significant improvement over time, with no difference between the groups on the Severity and Improvement factors of the Clinical Global Impression scale, on the total and factor subscales of the Hamilton Depression Rating Scale, and on the Anxiety Status Inventory. The maprotiline group showed a greater increase in weight over the study period than did the trimipramine group. There was a significant lowering of systolic blood pressure in the trimipramine group only and a significant and linear increase in pulse rate by Week 3 in the maprotiline group. Analysis of ECG showed that the atrial rates were significantly increased in the maprotiline group (p less than .002) but not in the trimipramine group. Trimipramine had significantly fewer anticholinergic, neurologic, and cardiovascular adverse effects than maprotiline.

Adult↗
PubMed1982

Benzodiazepine withdrawal effects.

1. Twenty-nine patients with anxiety neurosis who had completed a one week placebo, three week active drug study on either halazepam or oxazepam were observed for eight weeks for withdrawal effects. Half of the patients received a placebo for the first two weeks of the withdrawal study and half had all medication abruptly stopped. 2. There was no significant difference in the pattern of withdrawal between halazepam, an intermediate range benzodiazepine, and oxazepam, a short acting benzodiazepine. 3. Withdrawal symptoms were apparent, maximally between week 1 and 2 together with possible rebound effects. 4. Patients who received placebo had significantly less severe withdrawal symptoms than those who had their medication abruptly discontinued.

Anti-Anxiety Agents↗
PubMed1982

Comparison of pimozide and chlorpromazine in acute schizophrenia.

A four week double-blind study comparing pimozide and chlorpromazine was designed to test the hypothesis that pimozide, a powerful dopamine receptor blocker, is more effective in the treatment of acute schizophrenia than chlorpromazine. Twenty patients, 13 males and 7 females ranging in age from 21 to 53 years (mean age 33 years) admitted to ST. Mary's Hospital with acute schizophrenia were placed on the study. They were treated on an individual titrated dosage of either chlorpromazine 300 mg to 2100 mg, or pimozide 10 to 70 mg. The results revealed that on the Brief Psychiatric Rating Scale, the chlorpromazine group significantly improved after one week, whereas the pimozide group showed no statistical improvement until the third week. By the end of the study no significant differences were apparent between the two groups. In the Clinical Global Impression Scale, a significant difference between the two groups was found at week 4 showing a greater improvement in the chlorpromazine group. In terms of adverse reactions, the chlorpromazine group had significantly fewer extrapyramidal symptoms than the pimozide group (Simpson and Angus Scale) and in addition 15 adverse reactions were noted for the pimozide group as compared with 8 for the chlorpromazine group. This study shows that chlorpromazine has an earlier onset of action than pimozide in the acute schizophrenic patient despite the fact that it has a weaker effect on the dopamine receptor than has pimozide. In view of this finding, the dopamine theory of schizophrenia should be critically re-examined.

Acute Disease↗