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Biomedical subjects

D O Antonuccio

Publications and source records attributed to D O Antonuccio.

12 recordsLinked to original sources
PubMed1999

Raising questions about antidepressants.

Antidepressant medication has apparently become the most popular treatment for depression in the USA. Several beliefs about the efficacy of antidepressant medications prevail among mental health professionals and the public. This paper explores relevant research data and raises questions about these beliefs. Many of the common beliefs about these medications are not adequately supported by scientific data. The following issues are raised: (1) industry-funded research studies which result in negative findings sometimes do not get published; (2) placebo washout procedures may bias results in some studies; (3) there are serious questions about the integrity of the double-blind procedure; (4) the 'true' antidepressant drug effect in adults appears to be relatively small; (5) there is minimal evidence of antidepressant efficacy in children; (6) side effects are fairly common even with the newer antidepressants; (7) combining medications raises the risk for more serious complications; (8) all antidepressants can cause withdrawal symptoms; (9) genetic influences on unipolar depression appear to be weaker than environmental influences; (10) biochemical theories of depression are as yet unproven; (11) biological markers specific for depression have been elusive; (12) dosage and plasma levels of antidepressants have been minimally related to treatment outcome; (13) preliminary evidence suggests that patients who improve with cognitive-behavioral psychotherapy show similar biological changes as those who respond to medication, and (14) the evidence suggests that psychological interventions are at least as effective as pharmacotherapy in treating depression, even if severe, especially when patient-rated measures are used and long-term follow-up is considered.

Adult↗
PubMed1996

The safety of transdermal nicotine as an aid to smoking cessation in patients with cardiac disease.

BACKGROUND: Transdermal nicotine therapy is widely used to aid smoking cessation, but there is uncertainty about its safety in patients with cardiac disease. METHODS: In a randomized, double-blind, placebo-controlled trial at 10 Veterans Affairs medical centers, we randomly assigned 584 outpatients (of whom 576 were men) with at least one diagnosis of cardiovascular disease to a 10-week course of transdermal nicotine or placebo as an aid to smoking cessation. The subjects were monitored for a total of 14 weeks for the primary end points of the study (death, myocardial infarction, cardiac arrest, and admission to the hospital due to increased severity of angina, arrhythmia, or congestive heart failure); the secondary end points (admission to the hospital for other reasons and outpatient visits necessitated by increased severity of heart disease); any side effects of therapy; and abstinence from smoking. RESULTS: There were 48 primary and 78 secondary end points noted in a total of 95 subjects. At least one of the primary end points was reached by 5.4 percent of the subjects in the nicotine group and 7.9 percent of the subjects in the placebo group (difference, 2.5 percent; 95 percent confidence interval, -1.6 to 6.5 percent; P=0.23). In the nicotine group, 11.9 percent of the subjects had at least one of the secondary end points, as compared with 9.7 percent in the placebo group (difference, 2.2 percent; 95 percent confidence interval, -2.2 to 7.4 percent; P= 0.37). After 14 weeks the rate of abstinence from smoking was 21 percent in the nicotine group, as compared with 9 percent in the placebo group (P=0.001), but after 24 weeks the abstinence rates were not significantly different (14 percent vs. 11 percent, P= 0.67). CONCLUSIONS: Transdermal nicotine does not cause a significant increase in cardiovascular events in high-risk outpatients with cardiac disease. However, the efficacy of transdermal nicotine as an aid to smoking cessation in such patients is limited and may not be sustained over time.

Administration, Cutaneous↗
PubMed1987

Physician modeling influences on patient smokers.

Physicians may be considered important models of healthful behavior for their patients. This analogue study examined the behavioral impact of advice to quit given by a smoking and nonsmoking physician model on 27 light (less than 20 cigarettes per day) and 27 heavy (greater than 20 cigarettes per day) inpatient smokers in a V.A. Medical Center setting. Results indicated that heavy smokers smoked significantly more than light smokers on all measures across conditions. Interestingly, both heavy and light smokers tended to smoke more when the model advised quitting regardless of the presence or absence of model smoking. Post hoc analyses of locus of control revealed that patients with an internal locus of control tended to react to the physician's advice to quit by smoking significantly more during exposure, irrespective of model behavior. Patients with an external locus of control seemed to respond in a manner consistent with the behavior of the model.

Analysis of Variance↗
PubMed1984

An exploratory study: the psychoeducational group treatment of drug-refractory unipolar depression.

The present study is a clinical evaluation or pilot study aimed at evaluating the practicality of implementing a psychoeducational group treatment for outpatients with unipolar depression who have not responded to antidepressant medication. The treatment was designed to teach skills related to improved mood, including: relaxation, increasing pleasant activities, cognitive strategies, and social skills. Of the 10 patients who participated, one dropped out, four were no longer depressed, two showed some improvement, and three were still depressed after treatment. Improvements were maintained at 1-month and 9-month follow-ups.

Adolescent↗