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Biomedical subjects

L A Labbate

Publications and source records attributed to L A Labbate.

At least 19 recordsLinked to original sources
PubMed2001

Gabapentin in PTSD: a retrospective, clinical series of adjunctive therapy.

Posttraumatic stress disorder (PTSD) symptoms may improve significantly with antidepressant medications, however some phenomena often remain refractory to the most commonly used treatments. Frequently, sleep disturbances, such as insomnia and nightmares, are symptoms of PTSD that are refractory to antidepressant treatment. Gabapentin, a novel anticonvulsant agent, has been of interest as a potential anxiolytic agent, but has not been evaluated in PTSD. We reviewed records of 30 consecutive patients who had been diagnosed with PTSD according to structured interviews and had received gabapentin as an adjunctive medication. For each patient, the target symptoms that led to the initiation of gabapentin treatment were identified. Using the most recent clinical data available, the change in target symptom severity following treatment was rated as unimproved, mildly improved, moderately improved, or markedly improved. The gabapentin was often first prescribed to facilitate sleep. The majority (77%) of patients showed moderate or greater improvement in duration of sleep, and most noted a decrease in the frequency of nightmares. The dose range was 300-3600 mg/day. Sedation and mild dizziness were the most commonly reported side effects. This retrospective study suggests that gabapentin may improve in particular sleep difficulties and also other symptoms associated with chronic PTSD. Prospective, controlled studies are needed to further investigate the effects of gabapentin on insomnia, nightmares, and other core PTSD symptoms.

Acetates↗
PubMed2001

Effects of bupropion sustained-release on sexual functioning and nocturnal erections in healthy men.

Many antidepressants are known to cause adverse sexual effects. Bupropion is an antidepressant with fewer reported adverse sexual effects. Studies of sexual side effects are often confounded by psychiatric and medical conditions affecting sexual function. In this study, the effects of bupropion on subjective and objective sexual functioning were measured in healthy men. Thirteen men without psychiatric or medical illness completed a 2-week, placebo-controlled, double-blind, crossover trial of bupropion sustained-release 300 mg/day. Subjects had a 1-week washout period between trials. Sexual function was measured using a validated, self-administered questionnaire and the RigiScan, an instrument measuring nocturnal penile tumescence and rigidity. No differences were found in self-reported sexual function, number of erections, total erection time, or penile rigidity in subjects taking bupropion compared with those taking placebo or baseline. These findings support that bupropion does not have subjective adverse sexual side effects and does not affect nocturnal erections in healthy men.

Adult↗
PubMed2000

Common psychiatric syndromes and pharmacologic treatments of traumatic brain injury.

Psychiatric syndromes are common in patients with traumatic brain injury. Patients may develop typical disorders of mood, anxiety, or psychosis, in addition to changes in personality and cognition. The frequency of these syndromes and potential pharmacologic treatments for these psychiatric syndromes are just coming to light. There are, unfortunately, a dearth of placebo-controlled trials to guide treatment, although numerous treatments are suggested in the literature. This article reviews the existing studies of clinical syndromes related to brain injury and possible pharmacologic treatments.

Brain Injuries↗
PubMed2000

A survey of police officers' experience with Tarasoff warnings in two states.

A desk sergeant at each of 48 Michigan police stations and 52 South Carolina police stations was surveyed about knowledge and experience of Tarasoff warnings. Respondents at 45 stations reported receiving warnings from mental health professionals, with a mean+/-SD of 3. 7+/-8.4 warnings a year. Only three respondents were familiar with the Tarasoff ruling. Twenty-four stations had a specific policy on such warnings. Twenty-seven stations would not warn a potential victim. Michigan stations were much more likely than South Carolina stations to have experience with or policies on Tarasoff warnings. Because police apparently have limited experience with Tarasoff warnings, calling them may not be the best way to protect potential victims from patients making threats.

Duty to Warn↗
PubMed1999

Alcohol dependence and hospitalization in schizophrenia.

Treatment of schizophrenia is often complicated by substance abuse. We report here findings of a retrospective study evaluating readmission rates of patients meeting DSM IV criteria comorbid for schizophrenia and alcohol or drug dependence treated with depot haloperidol or fluphenazine over a 2-year period. During the study period, 14 of the 26 (54%) male veteran patients were admitted to the VAMC, Charleston; 46% of patients met criteria for alcohol, marijuana or cocaine dependence. Patients with alcohol dependence appeared to be at highest risk for hospital admission (p < 0.05). Moreover, patients with alcohol dependence had longer hospital stays (p < 0.05) than patients without alcohol dependence. Marijuana or cocaine dependence was slightly, but not statistically more common among admitted patients. Marijuana or cocaine dependence did not predict length of stay or number of admissions. Alcohol dependence may be an important factor in schizophrenic exacerbation, and may be an important target for treatment.

Adult↗
PubMed1999

Use of clonazepam in an elderly bipolar patient with tardive dyskinesia: a case report.

Tardive dyskinesia (TD) is an adverse effect of long-term neuroleptic use. An effective treatment for TD is needed, especially if chronic neuroleptic therapy is indicated. The treatment of TD in the elderly is not well established. We present here the case of an 81-year-old male with TD who had a significant reduction in dyskinetic and dystonic movements when treated with clonazepam.

Age Factors↗
PubMed1999

Psychological conditions diagnosed among veterans seeking Department of Defense Care for Gulf War-related health concerns.

The Comprehensive Clinical Evaluation Program is a US military program that provides a voluntary, clinically oriented evaluation for Gulf War health concerns. This article presents administrative data on psychological conditions (as coded using the International Classification of Diseases, 9th Revision) from the first year of the program. The most commonly diagnosed psychological conditions were medically unexplained physical-symptom syndromes; depression and anxiety, including post-traumatic stress disorder; and alcohol abuse or dependence. Psychological conditions were significantly related to a higher number of workdays lost, and the 19% of veterans with a primary diagnosis of a psychological condition reported 28% of the lost workdays among veteran who participated. Stressful Gulf War experiences were weakly but significantly related to psychological conditions. We conclude that among Gulf War veterans seeking evaluation for Gulf War-related health concerns, psychological conditions are common and are associated with important occupational morbidity.

Adult↗
PubMed1999

Panic disorder in schizophrenia.

OBJECTIVE: To determine the frequency of panic attacks and panic disorder in patients with chronic schizophrenia or schizoaffective disorder. METHOD: Fifty-three male outpatients meeting Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for chronic schizophrenia or schizoaffective disorder were administered sections of the Structured Clinical Interview for DSM-IV (SCID). If panic attacks were reported, patients were queried about treatment and about onset relative to psychotic symptoms. RESULTS: Forty-nine patients were sufficiently organized to participate in the evaluation. Twenty-one (43%) experienced panic attacks, and 16 (33%) had current or past panic disorder. Eight (50%) of the 16 with panic disorder had been treated for panic. Substance dependence was not associated with having panic attacks or current or past panic disorder. Patients with paranoid schizophrenia were more likely than patients with schizoaffective or undifferentiated schizophrenia to have experienced panic attacks (57% versus 20%, chi 2 = 6.0, P < 0.02) or panic disorder (47% versus 10%, chi 2 = 6.9, P < 0.01). CONCLUSION: Panic attacks and panic disorder are common in men with schizophrenia or schizoaffective disorder. Panic disorder may be an overlooked comorbid diagnosis in patients with schizophrenia.

Chronic Disease↗
PubMed1998

Serotonin reuptake antidepressant effects on sexual function in patients with anxiety disorders.

BACKGROUND: Serotonin reuptake inhibitor (SRI) antidepressants have been associated with sexual dysfunction, though there have been few prospective reports specifically examining this problem. The purpose of this study was to determine if three SRIs affected sexual function in anxiety disorder patients over a 3-month period. METHODS: Thirty-one patients were enrolled in a prospective study of the effect of three SRIs, fluoxetine, sertraline, and paroxetine, on five aspects of sexual function: libido, erection/lubrication, orgasm quality, orgasm delay, and sexual frequency. Measurements were made at baseline and at each month on visual analogue scales. RESULTS: For men and women, orgasm quality was lower and orgasm delay longer at months one, two, and three compared to baseline (p < .01). Erection scores were lower over time, but this change was not statistically significant. Lubrication, libido, and sexual frequency were not appreciably changed over 3 months. A higher rate of anorgasmia was noted in women at months one and two, but this did not achieve significance. CONCLUSIONS: Orgasm appears to be a primary sexual function affected by SRIs.

1-Naphthylamine↗
PubMed1998

Sleep Deprivation in social phobia and generalized anxiety disorder.

BACKGROUND: Sleep deprivation has been shown to improve depressive symptoms in some patients with major depressive disorder, but it has not been tested in patients with generalized anxiety disorder (GAD) or social phobia (SP). METHODS: To determine if sleep deprivation altered anxiety or depressive symptoms in patients with GAD (n = 7) or SP (n = 8), we sleep deprived patients and normal controls (n = 18) for one night. RESULTS: On one measure of anxiety, GAD patients improved compared with controls, but there were otherwise no significant change differences between controls and SP or GAD patients. CONCLUSIONS: The lack of benefit is consistent with previous findings that sleep deprivation provides no benefit to patients with other anxiety disorders. Sleep deprivation may be a biological intervention that distinguishes anxiety from affective disorders.

Adolescent↗
PubMed1998

Missed and canceled appointments at a military psychiatry clinic.

Previous studies have examined missed appointments in psychiatric outpatients, but military patients have not been studied. The objective of this study was to describe the characteristics of patients who miss or cancel appointments in a military outpatient psychiatry clinic. During a 75-day period, patients presenting to the Walter Reed Army Medical Center outpatient psychiatry clinic were tracked for missed and canceled appointments. Patients included active duty and retired service members as well as military dependents. For each missed or canceled appointment, the treating psychiatrist completed a questionnaire detailing clinical information and information regarding the missed or canceled appointment. Within the study period, 20% of all scheduled appointments were either missed or canceled. Fifty-two percent of the patients who missed or canceled appointments called within 2 weeks to reschedule. Of those patients who missed or canceled appointments, 27% missed or canceled more than once during the study period. Active duty patients were significantly more likely to miss and less likely to reschedule than military dependents and retirees.

Adult↗