PubMed Health⌕ Search

Biomedical subjects

D J Munjack

Publications and source records attributed to D J Munjack.

16 recordsLinked to original sources
PubMed1991

Alprazolam levels and response in panic disorder: preliminary results.

Fifty-five young adult patients completed a study comparing alprazolam, propranolol, and placebo in the treatment of panic disorder and agoraphobia with panic attacks. Twenty completed 5 weeks of treatment with alprazolam. No concomitant psychological treatment was administered. Plasma alprazolam levels were determined at baseline and at the end of the trial by means of automated gas chromatography. These levels were significantly correlated with dose (p = 0.001). Dividing the data into quartiles based on alprazolam concentration, no direct, linear relationship was found between alprazolam levels and response (as defined by a criterion of zero panic attacks). However, analysis of the combined middle two quartiles versus the combined upper and lower quartiles showed a positive trend toward a curvilinear relationship; i.e., there was a greater response rate within the 18-62 ng/ml concentration range than in the combined 0-17 plus 63-107 ng/ml range, (chi 2 = 2.4; p = 0.12). The findings are very preliminary in nature. It remains to be seen if the results will reach significance with a large sample size and a more tightly controlled study design.

Adolescent↗
PubMed1990

Generalized anxiety disorder: some biochemical aspects.

Fifty-one patients who met DSM-III criteria for generalized anxiety disorder, and who were recruited to participate in a drug outcome study, filled out a variety of rating scales and had blood samples drawn for plasma norepinephrine, epinephrine, and free 3-methoxy-4-hydroxyphenylglycol (MHPG) after a 20-min rest period. This group was compared to 15 normal controls who also had their blood drawn after a 20-min rest period. While the two groups were initially found to have significantly different levels of plasma free MHPG through the use of t tests, this finding was not confirmed by subsequent discriminant analysis.

Adolescent↗
PubMed1990

Clonazepam in the treatment of social phobia: a pilot study.

Twenty-three patients who met DSM-III-R criteria for social phobia were randomly assigned either to a clonazepam treatment group or to a nontreatment control group in an 8-week pilot study. Clonazepam was found to have a significant effect on the treated patients, as demonstrated by scores on a variety of instruments measuring overall anxiety and phobic avoidance, and social phobic symptoms. Initial sedation, which was experienced by 70% of the treated subjects, was the most common side effect of clonazepam treatment and usually resolved spontaneously or with dose reduction. The preliminary findings of this pilot study are sufficiently promising to warrant further study of the efficacy of clonazepam in this condition.

Adult↗
PubMed1989

Alprazolam, propranolol, and placebo in the treatment of panic disorder and agoraphobia with panic attacks.

Fifty-five patients completed a 5-week double-blind study comparing alprazolam, propranolol, and placebo in the treatment of panic disorder and agoraphobia with panic attacks. There was no concomitant behavioral treatment. Patient and therapist rating scales included Sheehan's Panic and Anxiety Attack Scales, the Marks-Sheehan Phobia Scale, the Hamilton Anxiety Scale, the Hamilton Depression Scale, and the Side Effects Checklist. The results generally support the efficacy of alprazolam, but not propranolol, in the treatment of panic disorder and agoraphobia with panic attacks. The significance of the results are discussed, as well as a number of the unique aspects of our procedures and patient population.

Adolescent↗
PubMed1988

Thyroid hormones in panic disorder, panic disorder with agoraphobia, and generalized anxiety disorder.

Fifty-two patients with generalized anxiety disorder who had symptoms persisting for at least 6 months, 41 patients suffering from either panic disorder (32 patients) or panic disorder with agoraphobia (9 patients), and 14 control subjects were screened for thyroid disease. Total serum thyroxine (TT4), serum-free thyroxine index (FT4I), and triiodothyronine resin uptake (T3RU), were examined for the entire sample, using a one-way analysis of variance (ANOVA). No significant differences were found in TT4 (p = .24), FT4I (p = .24), and T3RU (p = .19). Thyroid-stimulating hormone (TSH) was examined in a subsample of 10 patients with generalized anxiety disorder, 11 with panic disorder or panic disorder with agoraphobia, and 10 controls. One-way ANOVA again showed no significant differences, although there was a trend (p = .07). This is the first report that compares generalized anxiety disorder patients, panic disorder patients, and patients with panic disorder and agoraphobia with controls on measures of thyroid function. It is also the first to report normal values in the thyroid indices of generalized anxiety disorder patients.

Adult↗
PubMed1988

Nortriptyline in the treatment of panic disorder and agoraphobia with panic attacks.

Thirty-four consecutive patients with panic disorder or agoraphobia with panic attacks were treated with nortriptyline at the LAC-USC Medical Center's Anxiety Disorders Clinic. Fourteen (67%) of the 21 completers totally lost their panic attacks, five (24%) showed partial improvement, and two (10%) showed no improvement. The relationship of treatment outcome to pretreatment and posttreatment measures of depression is discussed, in addition to the potential role of nortriptyline in treating panic attacks in clinical practice.

Adult↗
PubMed1979

Retarded ejaculation: a review.

Retarded ejaculation is the persistent difficulty or inability to ejaculate despite the presence of adequate sexual desire, erection, and stimulation. The causes of this dysfunction may be organic, i.e., medical illness or drug ingestion (particularly medications with antiadrenergic effects), the result of surgical interventions, or secondary to inhibiting psychological factors. With regard to psychological determinants, fear, guilt, resentment, and passively have all been implicated, although objective studies are rare. The sexual object choice of men with retarded ejaculation has ben reported by several clinicians and investigators to be other than adult members of the opposite sex, while the marital relationship of these males has been considered etiological in other instances. Outcome assessment to date consists mostly of individual case reports or reports on small groups of patients treated without controls. To some extent, routine reliance on long-term traditional therapy has yielded to shorter, symptomatic learning-based treatments. While improved outcomes have been reported, many patients do not respond well. It is not yet possible to objectively predict succes or failure. Since it is our impression that this sexual dysfunction is more common than previously assumed (or is increasing in frequency), our present lack of data should soon be remedied.

Adult↗
PubMed1979

Sex and drugs.

Explore the source record for details and available documents.

Central Nervous System Depressants↗
PubMed1978

Resistance in the behavioral treatment of sexual dysfunctions.

Although there has been a rapid burgeoning of interest in the treatment of sexual problems in recent years, particularly in treatments that include or rely heavily upon learning-based behavioral intervention strategies, little has been written about the patient "resistances" during this form of treatment. This report describes five categories of resistance: Type I resistance results from the patient not understanding what he is supposed to do, Type II resistance from a deficit in the patient's skills, Type III resistance from lack of motivation or expectation of success, Type IV resistance from anxiety or gulit elicited or mobilized by the treatment situation, and Type V resistance from positive reinforcement (secondary gain). Treatment strategies differ depending on the type of resistance.

Anxiety↗
PubMed1976

Psychological characteristics of women with sexual inhibition (frigidity) in six clinics.

Traditional psychiatric thought has equated the inability of a female to obtain an orgasm (particularly a vaginal orgasm during intercourse) with psychological maladjustment. The research literature generally does not support this position. The present paper describes the psychological characteristics of 44 frigid women who applied for treatment of their sexual problem at two university hospital sex clinics and 26 women selected for treatment by the same criterion, but treated in private practice. Presented for comparison are 53 female neurotics from a Temple University Hospital psychotherapy study, a sample of 65 consecutive female walk-ins of mixed psychiatric diagnosis from the Psychiatric Outpatient Clinic of Temple Hospital, and a group of 35 female college student sophomores from Temple University who comprised the normal sample. A battery of psychological tests including the MMPI, the Institute for Personality and Ability Testing--Self-Evaluation Form (IPAT), the Symptom Check List, and the Eysenck Personality Inventory were given to each group. The data indicate that female patients who apply to a sex dysfunction clinic, complaining primarily of sexual inhibition, appear as a group identical to a normal control group in terms of their psychological profile and less neurotic than psychiatric outpatients, with the exception that the normals were less depressed. When women with primary orgasmic dysfunction from the above three samples were combined and compared to those with secondary orgasmic dysfunction (using Masters and Johnson's criterion), the groups were identical, at least from a global psychological perspective. We suggest that little else can be gained by assessing global personality characteristics. Without discarding the primary and secondary classifications a potentially more fruitful approach would be to develop instruments that would measure specific dimensions, such as sexual misinformation, specific sexual anxiety or guilt, or resentment or hostility directed toward the immediate sexual partner. A scale to measure specific phobic-like sexual anxiety, in addition, would have treatment implications because of the recently demonstrated effectiveness of specific anxiety-reducing techniques, such as systematic desensitization. Specific scales can also be useful in the assessment and prediction of outcome in psychotherapy.

Adolescent↗