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Biomedical subjects

G D Burrows

Publications and source records attributed to G D Burrows.

At least 19 recordsLinked to original sources
PubMed1992

Relationship of symptomatology of schizophrenia and tardive dyskinesia.

The role of drug factors and patient factors in the development of tardive dyskinesia (TD) was examined in 31 TD patients and 31 non-TD patients matched by age and sex. TD patients achieved significantly lower total scores on the anxiety-depression factor of Brief Psychiatric Rating Scale (BPRS) (5.2 +/- 1.4 vs. 6.5 +/- 2.2; less than P) and significantly higher total scores on the activation factor (6.4 +/- 2.2 vs. 5.3 +/- 2.5; less than P). The finding that TD patients were less depressed may be explained by a hypermonoaminergic state developing in TD. Based on the findings of this study it is suggested that catatonic schizophrenic patients are more vulnerable to the development of TD.

Adolescent↗
PubMed1992

New pharmacological approaches to the management of depression: from theory to clinical practice.

A review of the clinical efficacy of four structurally distinct antidepressant drugs is presented. Their antidepressant activity can be rationalised within current pharmacological hypotheses of drug action, despite markedly different effects on "in vitro" testing. Fluoxetine, a specific serotonin re-uptake inhibitor, has proven safe, effective treatment for depressive illness and may have a role to play in the treatment of obsessive-compulsive disorder and panic attacks. While it has few of the anticholinergic side effects of the tricyclic antidepressants, nausea, tremor, headache, weight loss, nervousness and sweating are side effects most frequently reported. Minaprine, a compound with weak MAO inhibiting properties and effects on serotonergic receptors, has clinical efficacy in the treatment of depression based on several comparative studies. It is claimed that minaprine lacks anticholinergic and sedative properties. Moclobemide, a specific, reversible inhibitor of MAO-A, has been extensively evaluated in depressive illness. The major advantage of this agent over other irreversible, non-specific MAO inhibitors, is the significant attenuation of the so-called "cheese effect" with doses of tyramine likely to be encountered in foodstuffs. Rolipram, a phosphodiesterase inhibitor, represents a new approach to antidepressant treatment. Limited clinical data suggest that the drug may be an effective antidepressant with few side effects. The place of these agents in therapy is yet to be established.

Antidepressive Agents↗
PubMed1992

Discontinuation of alprazolam after long-term treatment of panic-related disorders.

Discontinuation of alprazolam after long-term treatment of 142 patients with panic-related disorders was examined in five study sites using a telephone interview. The majority (67%) of patients interviewed discontinued alprazolam for a period of at least 3 days after a gradual dosage reduction schedule over a 4-week period at the end of the long-term treatment study. A marked difference among the study sites in percentages of patients discontinuing therapy with alprazolam suggests that physician intervention played an important role in determining the ability of patients successfully to discontinue use of alprazolam: 90% and 95% of patients ceased therapy at two sites whereas only 21%, 38%, and 66% of patients discontinued therapy at the other three sites. The mean daily dosage for patients who continued using alprazolam decreased from 5.1 mg/day at the end of the long-term segment to 2.7 mg/day at the time of the poststudy interview. This decline indicates a lack of tolerance to the therapeutic effectiveness of alprazolam over an extended period of time.

Adult↗
PubMed1992

Long-term clinical management of depressive disorders.

The author provides evidence that depression is an often chronic and recurrent illness. He then provides World Health Organization (WHO) and other well-established recommendations for acute treatment of depression and describes maintenance treatment, which usually lasts 3 to 6 months. He lists WHO recommendations for prophylaxis, which should probably be continued for 2 or more years in patients with chronic depression, and reviews the following problems commonly associated with continued antidepressant treatment: cardiac toxicity, drug overdose, suicide/parasuicide, drug toxicity, drug interactions, and noncompliance. Finally, the author discusses discontinuation, which should always be accomplished according to a tapered, individualized schedule with the patient as an active partner in the process. Despite this knowledge, researchers must look for additional therapies for the one third of depressed patients who are not helped by currently available measures.

Antidepressive Agents↗
PubMed1991

Depression, disease and disability: application to patients with traumatic spinal cord injury.

Depressive symptoms are common in medically ill patients. Methodological difficulties of many of the studies demonstrating this do not allow differentiation of depressive symptoms from depressive illness. This paper examines representative samples of studies in the medically ill to highlight these problems. Data from a study of patients with traumatic spinal cord injury are used to demonstrate (1) ways of overcoming some of these difficulties and (2) the means of differentiating depressive symptoms and depressive illness. Difficulties of detection and diagnosis of depression in the medically ill are discussed.

Depression↗
PubMed1991

Panic disorder: a treatment update.

Panic disorder is characterized by unexpected, unprovoked attacks of cognitive symptoms (e.g., dread, fear) and physical symptoms (e.g., palpitations, trembling, shortness of breath). It is the most common anxiety disorder seen in clinical practice. Pharmacotherapy has been shown to be effective in controlling symptoms of panic disorder, although potential disadvantages (e.g., adverse drug reactions, withdrawal syndrome, dependency) must be carefully assessed and balanced against the advantages. Current data indicate that for panic disorder, benzodiazepines prescribed for more than a 6-month period are as effective as other forms of pharmacotherapy, i.e., monoamine oxidase inhibitors and tricyclic antidepressants. Generally, doses of benzodiazepines used for the treatment of panic are higher compared to those used for generalized anxiety disorder.

Alprazolam↗
PubMed1990

Short-acting versus long-acting benzodiazepines: discontinuation effects in panic disorders.

An increasing body of evidence suggests that benzodiazepines--which have long been considered the drugs of choice in the treatment of various anxiety disorders due to their relative lack of side effects, lack of adverse drug reaction, their safety, and increased efficacy over other agents--are effective in the treatment of panic disorders. Originally, the benzodiazepines were believed to be devoid of dependence-inducing properties, even at high doses. Recent evidence, however, suggests that discontinuation of both high and normal doses of both short- and long-acting benzodiazepines generally results in similar withdrawal symptoms, including anxiety and sleep and perceptual disturbances. This article presents a brief review of benzodiazepine withdrawal, with an emphasis on the discontinuation of these drugs following treatment of panic disorders. In particular, short-acting and long-acting drugs may present different features following long-term treatment and withdrawal. Preliminary results from a study comparing alprazolam and diazepam are presented to illustrate this point in contrast to expectations: the problems associated with withdrawal of both agents were comparable.

Alprazolam↗
PubMed1979

Effect of mianserin on cardiac conduction.

A cardiovascular study of a new antidepressant, mianserin, given at 60 mg a day for a three-week period to 10 ambulant, moderately depressed patients is described. No effects on cardiac conduction were found by means of His bundle electrocardiography. Nine of 10 depressed patients improved while on the medication; mild sedation was the only side effect noted.

Adult↗
PubMed1979

Clinical measurement of pain.

The problems of clinical measurement of pain are considered. Various adjuncts to the standard clinical interview are proposed. These are: written reports, visual analogue scales, McGill's Pain Assessment Questionnaire, and a weekly pain chart. The advantages and disadvantages of each are discussed. Correlations between various pain measures are shown. The use of the weekly pain chart by doctors is recommended in cases of chronic pain.

Chronic Disease↗
PubMed1979

Affect and the menstrual cycle.

Evidence from both retrospective and prospective studies suggests that many women do show cyclical changes in affect. Negative changes such as irritability, headache, tension, anxiety, sleep disturbance and depression are more frequent in the premenstrual and menstrual phases. Positive changes, pleasantness, increased vigour and elation are reported more often in the follicular or mid-cycle phases. Various theories have been suggested to explain these changes. These include psychodynamic, sociological and biological explanations. Although there is some evidence to support each theory no definite conclusions can be reached about the aetiological basis of most affective changes. Interpretation of studies attempting to link hormonal and affective fluctuations in limited by the many methodological problems outlined. Only one study appeared able to conclusively demonstrate a hormonal basis for a cyclical symptom. Suggestions are made for further research in this area.

Adult↗
PubMed1979

Hormone therapy and affect.

This study investigated the influence of hormone therapy on affect in a double blind crossover trail. The sample consisted of 49 women who had previously undergone hysterectomy and bilateral oophorectomy. Therapy consisted of 3 mth each of ethynyl oestradiol-50 micron/day, levonorgestrel-250 micron/day, "Nordial"-a combination of these two substances, and placebo. Affect was measured by the Hamilton Depression Rating Scale, verbal reports by women and self-ratings on visual analogue scales. Ethinyl oestradiol was found to have a beneficial influence on aspects of affect such as Hamilton scores, anxiety irritability and insomnia. The influence of hormones on Hamilton scores could be partly but not fully explained by the alleviation of hot flushes. Norgestrel showed less favourable changes initially but these tended to diminish by the third therapy month. Most of the women studied were not clinically depressed. Anxiety symptoms were the major features exhibited in the group of women investigated. The results of this study suggest that visual analogue rating scales are of questionable validity in assessing affect in patients without any appreciable psychiatric morbidity.

Affect↗