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Biomedical subjects

L Annable

Publications and source records attributed to L Annable.

At least 37 records · Page 2Linked to original sources
PubMed1988

A 5-year prospective longitudinal study of tardive dyskinesia: factors predicting appearance of new cases.

In a 5-year longitudinal study in a cohort of 169 schizophrenic outpatients treated with neuroleptics, we found a twofold increase (from 22% to 44%) in prevalence of tardive dyskinesia (TD) meeting the Schooler and Kane research diagnostic criteria. If we include cases of TD that were considered definite but did not meet the research criteria, the prevalence increased from 31% to 58%. In the cohort of 131 patients who did not present with the disorder in 1975, we found parkinsonism and increase in parkinsonism to be the best predictors of subsequent development of the disorder. Poor schizophrenic prognosis and long treatment duration also appeared to be risk factors. Another finding was the importance of changes in neuroleptic and antiparkinsonian dosage in both covering and uncovering TD.

Adult↗
PubMed1986

Bromazepam and lorazepam in generalized anxiety: a placebo-controlled study with measurement of drug plasma concentrations.

Sixty outpatients with a diagnosis of generalized anxiety were randomly assigned to 4 weeks of treatment with bromazepam, lorazepam or placebo, following a 1-week placebo washout period. There was no significant difference in the anxiolytic effects of bromazepam and lorazepam, both of which were superior to placebo. However, lorazepam-treated patients tended to have a more depressed mood than those treated with bromazepam. Drug-treated patients had consistently less cognitive impairment than those treated with placebo, the difference being statistically significant (P less than .05) in the case of bromazepam. The most frequent side-effects reported with each drug were drowsiness, which tended to subside with time, and depression, which tended to emerge toward the end of the 4-week period. There was a positive correlation (r = 0.64) between age and bromazepam plasma concentration per unit dose, adjusted for weight, and a negative correlation (r = -0.50) between weight and lorazepam plasma concentration per unit dose, adjusted for age.

Adolescent↗
PubMed1986

A controlled clinical trial of fluspirilene, a long-acting injectable neuroleptic, in schizophrenic patients with acute exacerbation.

A 4-week double-blind controlled clinical trial was carried out in which fluspirilene, an injectable diphenylbutylpiperidine neuroleptic given weekly, was compared to chlorpromazine in the treatment of 40 newly admitted schizophrenic patients with acute exacerbation. Similar therapeutic improvement was obtained with both drugs, but men needed a significantly higher mean dose of fluspirilene (23 mg/week) than women (13 mg/week). Fluspirilene induced more parkinsonism than chlorpromazine, but less drowsiness, dizziness, and dry mouth. The difference between the sexes in the potency of fluspirilene and its greater potential to induce parkinsonism may be related to its lesser presynaptic and D1-dopamine receptor blocking properties. The low incidence of autonomic side effects confirms the relative specificity of fluspirilene for dopamine receptors.

Adult↗
PubMed1986

Clonazepam in the treatment of patients with recurrent panic attacks.

Imipramine, phenelzine, and alprazolam have each been shown to be efficacious in the treatment of panic disorder and in agoraphobia with panic attacks. Clonazepam is a high-potency 1,4-benzodiazepine derivative with an intermediate to long elimination half-life that is used mainly in neurology as an antiepileptic. Eight cases of recurrent panic attacks successfully treated with clonazepam are reported.

Adult↗
PubMed1985

A controlled clinical trial of L-tryptophan in acute mania.

In a 2-week study, 24 newly admitted manic patients were treated for 1 week with L-tryptophan (12 g/day); during the second week, half the patients, chosen at random, continued to receive tryptophan, while placebo was substituted in the other half under double-blind conditions. In the open phase of the study, there was a clinically and statistically (p less than 0.001) significant reduction in manic symptom scores, with little need for haloperidol prn. Patients who continued to be treated with tryptophan showed no significant change in mean scores during the second week, but those who were switched to placebo tended (p less than 0.10) to show an increase in the mean scores for manic symptoms. There was a significant (p less than 0.05) increase in the geometric mean of morning fasting total and free plasma tryptophan concentrations in men, but not in women. These results suggest that increasing the synthesis of 5-hydroxytryptamine has some therapeutic effect in mania.

Acute Disease↗
PubMed1985

An open clinical trial of clonazepam in the treatment of patients with recurrent panic attacks.

Imipramine, phenelzine and alprazolam have each been shown to be efficacious in the treatment of panic disorder and in agoraphobia with panic attacks. Clonazepam, a 1,4 benzodiazepine derivative used mainly in neurology as an anti-epileptic, has specific pharmacodynamic and pharmacokinetic properties which would make it an advantageous antipanic agent. We report 8 cases of recurrent panic attacks which were successfully treated with clonazepam.

Adult↗
PubMed1984

An early phase II clinical trial of tomoxetine (LY139603) in the treatment of newly admitted depressed patients.

In a 6-week open-label study, ten newly admitted depressed patients were treated with tomoxetine , a selective inhibitor of noradrenaline reuptake. After 7 days of drug washout, patients were given an initial dose of 40 mg/day which was gradually increased to a maximum of 70 mg/day (median 50 mg/day). There was a statistically (P less than 0.001) and clinically significant improvement in the mean symptomatology of the patients measured on the Hamilton Depression Rating Scale. The drug had an early onset of action, a specific effect on mood, and no sedative properties.

Adult↗
PubMed1984

An early phase II clinical trial of BW234U in the treatment of acute schizophrenia in newly admitted patients.

Sixteen schizophrenic patients, who were newly admitted to hospital from the emergency room, underwent a 3-6-day washout before being treated for 4 weeks with BW234U, a dimethylpiperazinyl-propylcarbazole derivative. Eight patients showed moderate to marked improvement in schizophrenic symptoms and there was a statistically significant (P less than 0.001) reduction in the mean score for Clinical Global Impressions in all patients. Four patients did not complete the trial; two because of poor therapeutic effect, one because of a grand-mal seizure and one because of an episode of loss of consciousness of unknown origin. BW234U showed no evidence of neuroleptic plasma activity (as measured by radioreceptor assay), did not induce plasma prolactin elevation and did not appear to cause parkinsonism.

Acute Disease↗
PubMed1984

Rebound anxiety in anxious patients after abrupt withdrawal of benzodiazepine treatment.

In this double-blind, placebo-controlled study of 4 weeks of benzodiazepine treatment followed by 3 weeks of abrupt or gradual drug withdrawal, 16 patients whose benzodiazepine was withdrawn abruptly were worse (p less than .05) than 13 who had received placebo in terms of change in mean anxiety scores from the pretreatment level. The scores of seven patients (44%) whose benzodiazepine was withdrawn abruptly increased 10% or more on both the Hamilton Rating Scale for Anxiety and the Self Rating Symptom Scale. There were no cases of rebound anxiety in 14 patients whose benzodiazepine was withdrawn gradually; fewer cases of rebound anxiety were seen with a benzodiazepine that had a long half-life.

Acute Disease↗
PubMed1984

Withdrawal symptoms after long-term treatment with low-potency neuroleptics.

Twenty-six chronic schizophrenic outpatients receiving low-potency anticholinergic neuroleptics were switched over periods of up to 2 years to an equivalent dose of high-potency neuroleptics. Of these patients, 85% experienced withdrawal symptoms, mainly insomnia, anxiety, and tensional restlessness. Complete withdrawal of low-potency medication was achieved during the study period in 9 patients only. The mean duration of treatment with low-potency neuroleptics was 15 years and the mean dose was 147 mg chlorpromazine equivalents/day. It is suggested that new symptoms associated with withdrawal of low-potency neuroleptics may lead to overcompliance by patients and difficulty in achieving the minimum therapeutic dosage. Thus, low-potency neuroleptics would not appear suitable for the long-term treatment of most schizophrenic patients.

Adult↗
PubMed1983

Piracetam in elderly psychiatric patients with mild diffuse cerebral impairment.

In a 12-week double-blind study, piracetam at two dose levels (2.4 and 4.8 g/day) was compared to placebo in the treatment of 60 elderly psychiatric patients with mild diffuse cerebral impairment, but no signs of focal brain lesion. The psychiatric illness, schizophrenia or affective disorder, of patients selected was in remission at the time of the study. Monthly evaluations by the nurse revealed that piracetam improved overall functioning, particularly alertness, socialization, and cooperation, relative to the control group. Patients treated with 2.4 g/day piracetam also showed significant improvement in scores for the full IQ and the memory quotient on the Wechsler Adult Intelligence and Memory Scales; greater response was seen in those with lower initial scores. Piracetam at 4.8 g/day had a more rapid onset of action on behavioral variables than 2.4 g/day, but its therapeutic effect tended to diminish at 12 weeks, possibly as the result of overstimulation. Piracetam did not appear to interfere with concomitant psychotropic maintenance medication or affect the psychiatric illness itself.

Aged↗