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Biomedical subjects

J F Dreyfus

Publications and source records attributed to J F Dreyfus.

At least 37 records · Page 2Linked to original sources

A comparative study of zopiclone and flunitrazepam in insomniacs seen by general practitioners.

A double-blind crossover trial was conducted in 42 outpatients of either sex in order to obtain information on the properties of 7.5 mg of zopiclone in a general practice setting compared with 2 mg of flunitrazepam. Each patient went through two periods of treatment, each period lasting 10 days. A comparison of the effect of the drugs showed a significant difference with regard to effectiveness and sleep latency favoring flunitrazepam. When patient's preferences were analyzed there was a highly significant difference favoring flunitrazepam both for effectiveness and tolerance. The side effects from both drugs were generally mild.

Adolescent↗

Comparison of nitrazepam and zopiclone in psychiatric patients.

This investigation compares the effects of single and double doses of nitrazepam (5 and 10 mg) and zopiclone (7.5 and 15 mg) and placebo for 1 night in 40 psychiatric patients. The results indicate that zopiclone is an active hypnotic compound, comparable in its effects to those of nitrazepam, the higher dosage being best adapted to the type of patients included in the study.

Adolescent↗

Studies on the dependence-inducing potential of zopiclone and triazolam.

We carried out a randomized double-blind study. This was a crossover design with two periods of 2 days each with one compound (either zopiclone or triazolam). The next 2 days of active trial periods the patients were allowed to choose the preferred coloured capsule of which both neither the patients nor the investigators knew about its real contents. 40 volunteers were chosen from our patients suffering from chronic alcoholism who just finished their detoxification. There were given coloured coded capsules, each of them containing either 0.25 mg triazolam or 3.75 mg zopiclone. The capsules should be swallowed when patients felt a desire for alcohol. The maximal dosage was 8 capsules per day (2.0 mg triazolam and 30 mg zopiclone). There was a significant difference of degrees of freedom and probability at a level of 0.0005 for the items of the Addiction Research Centre Inventory and a level of 0.0005 for the items of the 'profile of mood states'. None of the volunteers developed a special desire for zopiclone after withdrawal of the medication.

Adult↗

[Early trials of substances claimed to be anxiolytic].

Phase I and phase II studies of anxiolytic compounds have been described in details in some guidelines issued by various authorities. Their methodology leads to original problems with regard to objectives, subjects, and experimental design. The performance of such studies remains difficult especially due to the use of volunteers in phase I and to the use of placebo and diagnostic criteria in phase II.

Anti-Anxiety Agents↗

[The Checklist for Evaluation of Somatic Symptoms (CHESS). Its use in anxious and depressive pathology. Factor structure].

The CH.E.S.S. is a new inventory for the assessment of somatic symptoms and complaints. Initialy it included 57 items (43 somatic complaints, 12 neurological signs and 2 "other symptoms"). The CH.E.S.S. was scored before treatment on two groups of patients (133 anxious and 133 depressed) with no schizophrenic or organic symptomatology. 71 somatic complaints or symptoms were identified. A principal component analysis with a subsequent Varimax rotation yelded 25 factors with 18 of clinical significance. 12 factors significantly discriminate between the two groups. Seven factors (21 items) have higher scores in depressed patients: sleep and general somatic disorders, 2) general impairment of intellectual functioning, 3) neurological, 4) neuro-muscular hypo-excitability, 5) lower limbs oedema-amimia, 6) and 7) digestive. Five factors (18 items) have higher scores in anxious patients: 1) and 2) autonomic hyperactivity, 3) neuro-muscular hyper-excitability, 4) digestive, 5) micturition disorders with limb paresthesias. According to these results the 67 items new version of the check-list (CH.E.S.S. 82) includes 51 somatic complaints or symptoms and 16 neurological signs.

Anxiety Disorders↗

Studies on the dependence-inducing potential of zopiclone and triazolam.

We carried out a randomized double-blind study. This was a crossover design with two periods of 2 days each with one compound (either zopiclone or triazolam). The next 2 days of active trial periods the patients were allowed to choose the preferred coloured capsule of which both neither the patients nor the investigators knew about its real contents. 40 volunteers were chosen from our patients suffering from chronic alcoholism who just finished their detoxification. There were given coloured coded capsules, each of them containing either 0.25 mg triazolam or 3.75 mg zopiclone. The capsules should be swallowed when patients felt a desire for alcohol. The maximal dosage was 8 capsules per day (2.0 mg triazolam and 30 mg zopiclone). There was a significant difference of degrees of freedom and probability at a level of 0.0005 for the items of the Addiction Research Centre Inventory and a level of 0.0005 for the items of the 'profile of mood states'. None of the volunteers developed a special desire for zopiclone after withdrawal of the medication.

Adult↗

A comparative study of zopiclone and flunitrazepam in insomniacs seen by general practitioners.

A double-blind crossover trial was conducted in 42 outpatients of either sex in order to obtain information on the properties of 7.5 mg of zopiclone in a general practice setting compared with 2 mg of flunitrazepam. Each patient went through two periods of treatment, each period lasting 10 days. A comparison of the effect of the drugs showed a significant difference with regard to effectiveness and sleep latency favoring flunitrazepam. When patient's preferences were analyzed there was a highly significant difference favoring flunitrazepam both for effectiveness and tolerance. The side effects from both drugs were generally mild.

Adolescent↗

Comparison of nitrazepam and zopiclone in psychiatric patients.

This investigation compares the effects of single and double doses of nitrazepam (5 and 10 mg) and zopiclone (7.5 and 15 mg) and placebo for 1 night in 40 psychiatric patients. The results indicate that zopiclone is an active hypnotic compound, comparable in its effects to those of nitrazepam, the higher dosage being best adapted to the type of patients included in the study.

Adolescent↗

Effects of hypnotics on memory.

The influence on memory of 7.5 mg zopiclone, given in single and repeated doses was compared with that of 2 mg flunitrazepam, 5 mg nitrazepam and placebo. Compared with placebo, all three drugs induced some impairment of memory especially after the first day of administration. Effects were more pronounced for the two benzodiazepines and more marked for flunitrazepam. There was one report of an anterograde amnestic episode after flunitrazepam.

Adult↗

Drug-alcohol interactions on psychomotor skills: zopiclone and flunitrazepam.

Interaction between alcohol and zopiclone or flunitrazepam as well as the residual effects of both these hypnotics were studied in 20 normal male volunteers who received each 3 of 6 different drug and drink combinations according to a balanced incomplete block design as follows: placebo, zopiclone (7.5 mg), or flunitrazepam (2 mg) was administered double-blind in identical capsules at 23.00 h, and 0.5 g/kg body weight of alcohol or placebo alcohol was given at 08.30 h the following morning. Psychomotor skills of the volunteers were measured before drinking and 30 min, 1.5 h and 2.5 h after it. As compared with placebo, zopiclone had no residual effects, while flunitrazepam had some effects on standing steadiness, tracking, and flicker recognition. Alcohol alone had a non-significant effect on skills, and the combination zopiclone plus alcohol behaved as alcohol alone. Flunitrazepam plus alcohol impaired significantly standing steadiness, tracking, and reactive skills when compared with all other treatments. Time anticipation and hand and foot proprioception were not affected by any treatment. The results suggest that flunitrazepam, unlike zopiclone, has residual effects and interacts with alcohol in the morning following overnight ingestion of the drug.

Adult↗

Polygraphical sleep recordings in insomniac patients under zopiclone or nitrazepam.

Zopiclone, a new hypnotic with an original chemical structure, was compared in a sleep laboratory study with nitrazepam according to a double-blind, parallel group randomized design. Zopiclone (7.5 mg) and nitrazepam (5 mg) were each given for 14 nights to 5 insomniacs; a placebo washout period of 4 nights and a placebo withdrawal period of 10 nights were included in the design. Both drugs were found to be immediately and lastingly effective. Some slight insomnia rebound was found with nitrazepam, but not with zopiclone. Stage 2 was decreased, slow wave sleep (SWS) increased, and rapid eye movement unchanged by both drugs: however, only nitrazepam increased rapid eye movement latency. The differences between the effects of the drugs were quite limited. However, 3 out of 50 comparisons favoured zopiclone and none nitrazepam.

Adult↗

Pharmacokinetics and metabolism of zopiclone.

Pharmacokinetics and metabolism of a new hypnotic, zopiclone (ZD), were studied under the following conditions: (1) rats and dogs were given oral doses of the molecule, 14C-labeled either on the side chain or on the pyrrolopyrazine nucleus; (2) rats, rabbits and dogs were given increasing oral doses of the cold compound; (3) human subjects in various physiopathological situations - young and elderly healthy volunteers, patients with liver or renal impairments, nursing mothers - were given single or repeated doses, p.o. or i.v. (range 3.5-15 mg). ZD is rapidly and efficiently absorbed: its oral bioavailability was greater than 75% in all species except rats, where a first-pass effect of about 65% was recorded. Plasma protein binding is about 45%. The radioactive material rapidly diffuses from the vascular compartment, with a marked affinity for the brain. Plasma kinetics of ZD are generally well described by a two-compartment open model; in man, terminal half-life is 4-5 h; total body clearance is large (300 ml/mn), renal clearance very low (10 ml/min). The relationship between doses and concentrations, doses and urinary excretion of unchanged compound and major metabolites was linear in all species, except rabbits. The major metabolic routes involve decarboxylation affecting more than 50% of dose (rats and dogs), N-demethylation and N-oxidation - more than 30% as N-desmethyl and N-oxide derivatives in urine (humans). Due to intensive metabolism, only 7-10% of the dose is recovered in urine and feces as unchanged compounds (all species). In nursing mothers, milk and plasma kinetics of ZD are similar with a milk/plasma ratio around 0.80. In human volunteers, plasma half-life of ZD increases with age, while patients with liver or renal impairments show little or no modification of pharmacokinetic parameters.

Administration, Oral↗

[Clinical evaluation of pipothiazine and its palmitic ester in the therapy of schizophrenia].

20 schizophrenic patients presenting with an acute episode were treated first, whilst hospitalized, by a single oral dose of pipotiazine, then, when their symptomatology had been controlled, thus allowing their discharge, by a monthly injection of pipotiazine palmitate for 6 months. The patients were assessed with a CGI and the BPRS. The tablets provided control of the symptoms of most patients as early as the second week of treatment, the improvement bearing particularly on thought disorder, concept disorganization, excitation, anxiety, depression, tension and somatic symptoms. This led to an improvement in activities and sociability. Injections not only provided the prevention of relapses but even an improvement over the already obtained results which allowed these patients to insert themselves in the community. Adverse effects were infrequent and easily controlled. There were no abnormal modifications of the vital signs and laboratory tests. Pipotiazine appears as an extremely useful drug for countries in which the psychiatric treatment network is still being constructed.

Acute Disease↗

[Factorial structure of the Hamilton depression scale. I].

A development version (N I M H 67) of the Hamilton depression rating scale with 26 items was scored on 125 depressed inpatients recently hospitalized for a major non schizophrenic depressive illness. The data were obtained before any antidepressant treatment or after an adequate wash out period. A principal component factorial analysis with Varimax rotation was used. Computer simulations showed that only 2 factors were really outside the non significant range. A criterion is defined to allow the choice of an optimal saturation threshold for inclusion of an item in a factor. It assigns 25 of the 26 items of the scale to one of 2 independent factors: depression and anxiety-somatization.

Adolescent↗

[Factorial analysis of the Hamilton depression scale, II].

A factorial analysis (principal components with Varimax rotation) was performed on 85 ratings of the Hamilton Depression Rating Scale obtained in 1979-1980 on inpatients with a major depressive illness. Using a replicable statistical technique, 4 factors were obtained. These factors do not overlap with those obtain on a similar sample with a similar technique nor with those obtained by other authors. It thus appears that there is no such thing as a factorial structure of this scale.

Depressive Disorder↗

[Prediction test of nomifensine prescription from symptomatic pre-therapeutic status (author's transl)].

Heighty two outpatients, suffering from reactive or neurotic depression have been treated with a daily 100 mg dose of nomifensine. The symptomatic status before treatment was appreciated by a self-rating scale, the Hopkins Symptoms Check List (HSCL). At the end of the study, the patient again filled out this same rating scale, and also a seven-score amelioration questionnaire. The investigator filled out this same questionnaire and a fourscore global impression scale. We tried to find out if by appreciating initial symptoms with the HSCL, it was possible to predict which patients would be responders to the treatment. The only highly significant result was obtained with a discriminant analysis, which combines 22 items of the pre-therapeutic HSCL and with which it is possible to predict the amelioration measured by the difference between the total pre- and post-therapeutic HSCL notations. The authors point out to the interest of this method in psychopharmacology.

Adjustment Disorders↗

A double-blind multicentre trial comparing mianserin with imipramine.

1. Fifty-four depressive in-patients aged 18-45 yr, were treated at random, in double-blind conditions, with mianserin 60 mg daily or imipramine 150 mg daily in three divided doses for 4 weeks. Nitrazepam and diazepam were also allowed if necessary. 2. There was no significant difference in antidepressant efficacy between the two groups, as assessed by the rating scales of Hamilton, Beck and Overall, the Brief Psychiatric Rating Scale, and a global clinical rating. 3. The overall frequency of side-effects was significantly lower with mianserin than with imipramine. Autonomic symptoms increased in severity during treatment with imipramine, but not with mianserin. 4. the patients treated with imipramine had a fall in blood pressure which was not observed during mianserin treatment.

Adjustment Disorders↗