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Biomedical subjects

H De Cuyper

Publications and source records attributed to H De Cuyper.

At least 19 recordsLinked to original sources
PubMed1994

Moclobemide versus fluoxetine for major depressive episodes.

The efficacy and tolerability of moclobemide (300 or 600 mg daily) and fluoxetine (20 or 40 mg daily) were compared in a 6-week, double-blind study of 25 inpatients and 24 outpatients who had major depressive episodes without psychotic features (DSM-III-R). Although the clinical results of this study suggest better efficacy with moclobemide and better tolerability with fluoxetine, a statistically significant difference between treatment groups was noted only with respect to Clinical Global Impressions recorded after 10 days of therapy; these were significantly better in the moclobemide group. A daily dosage of 300 mg of moclobemide and 20 mg of fluoxetine would thus appear to be comparable both in antidepressant efficacy and tolerability.

Acute Disease↗
PubMed1993

Mianserin and chronic pain: a double-blind placebo-controlled process and outcome study.

There is evidence that antidepressants may have an analgesic effect in chronic pain. To replicate this effect and to throw light on the processes involved, a 12-week cross-over double-blind trial of mianserin versus placebo was carried out in 4 diagnostic groups: A) depressive patients without pain complaints (n = 8), B) depressive patients with chronic organic pain (n = 8), C) patients with somatoform pain disorder and vital signs of depression (n = 11) and D) patients with chronic organic pain without depression (n = 8). Although a mianserin-induced antidepressant effect in group A was evident, no significant pain reduction was accomplished in any group. The reasons for this failure to replicate the antidepressant-induced analgesic effect are discussed.

Adult↗
PubMed1992

Mode of action of the triazolobenzodiazepines in the treatment of panic attacks: a hypothesis.

Alprazolam (Xanax) or 8-chloro-1-methyl-6-phenyl-4H-S-triazolobenzodiazepine is a potent drug for the treatment of anxiety disorders. The chemical structure differs from the classical benzodiazepines by incorporation of the triazoloring. Due to the triazolo ring, the drug can have additional modes of action than the normal benzodiazepines. The triazolobenzodiazepines are potent inhibitors of the platelet-activating factor. This factor is a potent stimulator of the corticotropin-releasing hormone. This hormone has an effect on the hypothalamo-pituitary-adrenal axis but the corticotropin-releasing hormone is also known to be a stimulator of the locus coeruleus. The corticotropin-releasing hormone in patients with panic attacks is elevated. This could be a result of the hyperactive metabolism which is observed by positron emission tomographic (PET) studies of the right parahippocampal area.

Alprazolam↗
PubMed1992

Risperidone versus haloperidol in the treatment of chronic schizophrenic inpatients: a multicentre double-blind comparative study.

Forty-four chronic schizophrenic inpatients participated in this multicentre 12-week parallel-group double-blind trial. After a run-in period of 2 weeks and a single-blind placebo wash-out of 1 week, they were randomly assigned to treatment with either the serotonin2 and dopamine-D2 antagonist risperidone or haloperidol. Two patients were excluded from the efficacy analysis. Five patients dropped out in the haloperidol group and 1 in the risperidone group. At the end of the trial, the mean daily dose was 12 mg for risperidone and 10 mg for haloperidol. The risperidone group showed greater improvement on the Positive and Negative Syndrome Scale for Schizophrenia, the Schedule for Affective Disorders and Schizophrenia-change version, and the Nurses' Observation Scale for Inpatient Evaluation. The improvement of negative symptoms was more pronounced in the risperidone group until week 8 of double-blind treatment. The consumption of antiparkinsonian medication was 10 times lower with risperidone. Both drugs were well tolerated and the laboratory, endocrinological and cardiovascular safety parameters were comparable. This study suggests that risperidone is comparable to haloperidol as an antipsychotic, but that it has a safer EPS profile.

Adult↗
PubMed1992

Ventricular enlargement, clinical correlates and treatment outcome in chronic schizophrenic inpatients.

The ventricle-brain ratio (VBR) of 42 chronic schizophrenic patients was compared with that of 42 age-matched medical controls. For the schizophrenics, the relationship of various clinical parameters to the VBR was assessed, and the outcome of 12 weeks of double-blind treatment with either risperidone or haloperidol. The results confirm that schizophrenic patients have slightly enlarged lateral ventricles compared with medical controls. Only for schizophrenics, an effect of age, but not of duration of illness, was noticed. This study does not support the validity of a clinical subdivision of chronic schizophrenic patients on the basis of the VBR. Neither negative, positive nor general psychopathological symptoms, as measured by the Positive and Negative Syndrome Scale for Schizophrenia (PANSS), were related to the VBR, nor were abnormal involuntary movements or extrapyramidal symptoms. No association between season of birth or a family history of major mental disorder and VBR could be demonstrated. Treatment response was predicted by the total PANSS score and the PANSS general psychopathology subscale score at baseline. There was a trend for patients with higher VBR to have a more or haloperidol). or haloperidol).

Adult↗
PubMed1992

Chronic idiopathic pain, mianserin and 'masked' depression.

In this study an attempt was made to provide controlled empirical evidence for the hypothesis that chronic idiopathic pain might be a specific form of 'masked depression'. For this purpose, chronic pain patients supposed to be suffering from a 'masked depression' were compared to patients with organic pain and coexistent depression, patients with only organic pain, and patients with only depression, in a double-blind placebo-controlled therapeutic trial with mianserin. Although mianserin appeared to have effective antidepressant properties in this study, no pain improvement was found in any of the three chronic pain groups. These results challenge the validity and clinical relevance of the 'masked depression' concept for chronic idiopathic pain.

Adult↗
PubMed1986

Pharmacokinetics and therapeutic efficacy of haloperidol decanoate after loading dose administration.

For this open study, we selected 21 chronic psychotic female in-patients (16 of them schizophrenics) who were being maintained on oral neuroleptics. After a wash-out period, they were treated by intramuscular depot injections of haloperidol decanoate, once a month for four months. The dose was calculated from the previous oral dosage, and the amount of the first injection was double that of the three following injections. Relatively stable plasma levels of haloperidol were achieved with the first injection, and corresponded to those observed with oral medication. A very significant correlation was found between plasma level and the dose administered, but not between plasma level and therapeutic effect. The clinical condition of about two-thirds of the patients remained unchanged or improved, compared with the period of oral treatment. During the first two months of treatment, there was more rigidity and tremor, but from the third month, the extrapyramidal symptoms were less pronounced than during the period of oral neuroleptics.

Adult↗
PubMed1985

The effect of milenperone on the aggressive behavior of psychogeriatric patients. A double-blind placebo-controlled study.

The antiaggressive action and side effects of a new neuroleptic, milenperone, were evaluated in 20 non-psychotic psychogeriatric patients by means of a double-blind randomized pilot study in comparison with placebo. In this study, milenperone was added to the existing medication as an adjuvant. The test substance was administered in a dose of 2 X 5 mg daily for the first 3 weeks, in a dose of 2 X 10 mg daily for the following 3 weeks. The addition of milenperone to the preexisting medication decreased the aggressiveness scores, significantly on the Paranoid Belligerence Scale, not significantly on the Visual Analogue Line. The improvement of the aggressiveness scores on the Paranoid Belligerence Scale was only significantly apparent when the dose was doubled. In spite of the association with milenperone, the severity and frequency of the side effects did not increase during the investigation.

Aged↗
PubMed1985

The effect of milenperone on the aggressive behavior of oligophrenic patients. A double-blind placebo-controlled study.

The antiaggressive action and the side effects of a new neuroleptic, milenperone, were evaluated in 21 oligophrenic patients by means of a double-blind randomized pilot study in comparison with placebo. Only 3 patients appeared to be psychotic, 2 from the milenperone group and 1 from the placebo group. In this study, milenperone was added to the existing psychotropic medication as an adjuvant. The test substance was administered in a dose of 2 X 10 mg daily for 6 weeks. The results were evaluated by means of the Paranoid Belligerence Scale and the improvement of the target symptoms were visualized on the Visual Analogue Line. Although, in the last 3 weeks of the study, the aggressiveness scores had decreased more in the milenperone group than in the placebo group, the difference between both studied groups was not significant. This lack of clear result may probably be ascribed to the high standard deviations, together with the small number of patients per group. The severity and frequency of the side effects remained almost unchanged during the investigation and were independent of the substance administered: milenperone or placebo.

Adult↗
PubMed1984

The clinical significance of halopemide, a dopamine-blocker related to the butyrophenones.

The resocializing and activating properties of halopemide were investigated in an open study and a double-blind study in 20 patients who had been hospitalized on account of various psychiatric disorders. The results of the open study showed a significant improvement in contact and activity, regardless of the nosological characteristics. There was no significant difference in therapeutic effect between the single (2 X 10 mg/day) and the double (2 X 20 mg/day) dose. The patients were more approachable, sought contact with their surroundings and showed a greater interest in their work. However, these results were not confirmed by the double-blind study, which for these target symptoms showed no significant difference between the placebo phase and halopemide phase. Two factors that might explain the discrepancy between the results of the open study and the double-blind study are postulated: the difference in experimental methods and the short duration of the study phases.

Adult↗
PubMed1980

Unusual plasma level oscillations of clomipramine in man: a pharmacokinetic and pharmacodynamic dilemma.

Modern bioanalytic methodology has opened up new opportunities to study drug concentrations in the body and thereby gain an understanding of the pharmacokinetics, pharmacodynamics and hence pathways for the clinical efficacy of various drugs. Plasma clomipramine levels have therefore been studied in normal and depressed subjects after oral and intravenous administration. For eight hours after a single dose plasma clomipramine levels behaved in accordance with known pharmacokinetic principles but thereafter, whichever the route used, there were substantial oscillations, minimal in the morning, maximal early in the afternoon and falling in the late afternoon, peak levels being reached on the second or third day. One possible explanation for these oscillations is that at first much of the drug is stored at binding sites from which it is displaced from time by endogenous substances, competing with the parent drug and causing its release back into the circulation. Future studies should include the behaviour of the metabolite desmethylclomipramine, and the effect of repeated doses of clomipramine.

Administration, Oral↗