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Biomedical subjects

L Annable

Publications and source records attributed to L Annable.

At least 55 records · Page 3Linked to original sources
PubMed1983

New concepts in benzodiazepine therapy: rebound anxiety and new indications for the more potent benzodiazepines.

Abrupt withdrawal of benzodiazepine treatment in generalized anxiety patients was found to induce a rebound anxiety state in addition to minor physical symptoms. Controlled clinical trials suggest that the newer high potency benzodiazepines (alprazolam, clonazepam and bromazepam) have novel psychiatric indications and greater anxiolytic effect than the classical benzodiazepines. Alprazolam, a triazolobenzodiazepine, was superior to placebo in the treatment of panic disorder, for which medium or low potency benzodiazepines are generally inefficacious. Clonazepam, an anticonvulsant which increases 5HT synthesis, was more efficacious than lithium in reducing manic symptoms. Bromazepam, a new potent benzodiazepine, was superior to diazepam in the treatment of generalized anxiety disorder.

Alprazolam↗
PubMed1983

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

In a double-blind, placebo-controlled study, 48 anxious outpatients with a primary diagnosis of generalized anxiety disorder were randomly assigned to 4 weeks of treatment with bromazepam (18 mg/day), diazepam (15 mg/day), or placebo, after a 1-week washout period. From week 1 onward both active drugs were superior to placebo in relieving anxiety symptoms. Bromazepam was found to be significantly more effective than diazepam with respect to the somatic anxiety factor and the total score for the Hamilton Anxiety Rating Scale and the fear/anxiety factor of the Patient's Self-Rating Symptom Scale. Plasma concentrations of diazepam plus active metabolites were correlated significantly (r = 0.60, p less than 0.05) with the percentage reduction in self-rating anxiety scores. Bromazepam plasma concentration measurements showed greater variability than those of diazepam and were not found to be correlated significantly with clinical response. It is suggested that the use of strict diagnostic criteria (1978 draft of the third edition of Diagnostic and Statistical Manual of Mental Disorders), adequate sample sizes, and a 4-week study period gave increased sensitivity for the detection of significant differences between the two benzodiazepines.

Adult↗
PubMed1983

Antimanic effect of clonazepam.

Twelve acutely manic patients, newly admitted from the emergency room, were treated wih clonazepam or lithium carbonate in a double-blind cross-over design: half the patients chosen randomly received 10 days of treatment with clonazepam followed immediately by 10 days of treatment with lithium, while the others received the same treatments in reverse order. Clonazepam was found to be significantly more efficacious than lithium in reducing manic symptoms despite the fact that during clonazepam treatment less patients required PRNs of haloperidol. Furthermore, both the total dose of PRN haloperidol and the number of days it was needed were significantly lower during clonazepam treatment than during lithium treatment. Clonazepam had a rapid onset of action, was highly sedative, and was well tolerated at high doses. By reducing the need for neuroleptics in the treatment of acute mania, clonazepam may decrease the risk of tardive dyskinesia in manic patients.

Acute Disease↗
PubMed1982

Pimozide in the treatment of newly admitted schizophrenic patients.

Pimozide, a specific dopamine blocking agent, was compared with chlorpromazine in a 4-week double-blind study of the treatment of 40 schizophrenic patients newly admitted to hospital through the emergency room. Dosage was adjusted according to therapeutic effect and during the final week ranged from 10--70 mg/day (median 30 mg/day) for pimozide and 600--1,500 mg/day (median 900 mg/day) for chlorpromazine. Pimozide was found to exert somewhat less of an overall therapeutic effect than chlorpromazine, particularly in highly agitated patients. Women responded better to either treatment than men. A weighted mean of the doses given to male and female patients during the final week suggests that in the treatment of acutely ill patients the mg dose equivalency of pimozide in terms of chlorpromazine is approximately 1:25, considerably lower than estimates from maintenance studies. Pimozide induced significantly more parkinsonian symptoms but less autonomic side effects than chlorpromazine. It is suggested that the weaker presynaptic dopamine blocking effect of pimozide might be responsible for its reduced potency in the treatment of acute schizophrenic symptoms.

Acute Disease↗
PubMed1982

Alprazolam in the treatment of generalized anxiety and panic disorders: a double-blind placebo-controlled study.

In a double-blind controlled study lasting 8 weeks, 50 anxious psychoneurotic outpatients with a primary diagnosis of generalized anxiety or panic disorder were randomly assigned to alprazolam (n=30), a new benzodiazepine, or placebo (n=20), after a washout period of 1 week. Alprazolam at dosages between 0.25 and 3 mg/day was found to be significantly better than placebo in the treatment of either disorder. The finding that alprazolam was effective in the treatment of panic disorder is of interest as this diagnostic category is usually treated with tricyclic antidepressants or MAO inhibitors.

Adult↗
PubMed1982

Sexual dysfunction and plasma prolactin levels in neuroleptic-treated schizophrenic outpatients.

A random sample of 55 schizophrenic outpatients, 26 men and 29 women, treated with neuroleptics was selected from our long term follow-up clinic. The patients rated their current sexual functioning on specially designed scales. Fifty-four per cent of male and 30 per cent of female patients reported impaired sexual functioning during neuroleptic treatment. Ninety-one per cent of female patients reported changes in menstruation. Partial correlation coefficients were calculated between sexual dysfunction score and plasma prolactin level adjusting for age. Sexual dysfunction was found to be associated with high plasma prolactin levels in male patients but not in female patients. High prolactin tended also to be associated with menstrual disturbances. Antiparkinsonian medication was not found to be correlated with either sexual dysfunction or menstrual disorder score.

Adult↗
PubMed1982

Characteristics of chronically anxious patients who respond to EMG feedback training.

Anxiety levels of 40 chronically anxious patients given 8 weekly sessions of EMG feedback training were evaluated over a 6-month period. All subjects succeeded in reducing their EMG scores during treatment. Improvement was partly maintained during follow-up, but only 25% of the subjects who completed the evaluation believed their anxiety levels had improved substantially. Responders did not differ from nonresponders on pre- or posttreatment EMG scores, but there was a consistently closer association between EMG score and anxiety level for responders. No difference was seen between the two groups on demographic variables or IQ, but responders had higher mean scores for extraversion on two scales and a lower mean score for depression on one scale. Although EMG feedback alone does not appear to be an effective treatment for all subjects with chronic anxiety, the technique can be of value in some patients.

Adult↗
PubMed1981

Lack of tolerance to long-term neuroleptic treatment in dopamine tuberoinfundibular system.

The plasma prolactin (PRL) levels of 35 chronic schizophrenic patients undergoing long-term maintenance treatment with neuroleptic drugs were measured before and after either neuroleptic withdrawal or a switch to a fixed dose of chlorpromazine 900 mg/day. In both men and women there tended to be a significant correlation between the initial log plasma PRL level while on neuroleptic maintenance treatment and the dosage received converted to chlorpromazine equivalents. Neuroleptic withdrawal in ech of 19 cases was followed by a decline in PRL plasma levels. Switching to chlorpromazine 900 mg/day (16 cases) produced either increases or decreases in PRL plasma levels that were significantly correlated with the change in neuroleptic dosage converted to chlorpromazine equivalents. Thus there was no evidence of tolerance to the PRL-elevating effect of neuroleptics in these patients who had been treated for many years with neuroleptics.

Adult↗
PubMed1980

Acupuncture for smokers: lack of long-term therapeutic effect in a controlled study.

Two types of acupuncture therapy, one aimed specifically at smoking withdrawal and the other aimed at enhancing relaxation, were compared with self-monitoring in 75 healthy men that wished to stop smoking. During the 2 weeks following treatment there was no significant difference in the adjusted mean daily smoking rates of the subjects receiving acupuncture therapy of the two types, but their combined rate was significantly lower than the rate of the subjects in the self-monitoring group. However, at 1, 3, and 6 months following treatment there were no longer statistically significant differences between the three treatment groups in the adjusted mean smoking rates. At no time were there significant differences between the three treatment groups in the proportion of subjects that stopped smoking during the study. Although acupuncture appears to have become a popular treatment for cigarette smokers, its effectiveness remains to be proven in the treatment of tobacco addiction.

Acupuncture Therapy↗
PubMed1979

Ineffectiveness of deanol in tardive dyskinesia: a placebo controlled study.

In a double-blind placebo-controlled study, deanol acetamidobenzoate, administered in doses up to 1.5 g q.d. for three weeks to chronic schizophrenic patients presenting moderate to severe tardive dyskinesia, failed to alleviate the dyskinetic movements. However, there was a tendency for a significant increase in the schizophrenic symptoms of the deanol-treated group relative to the control group. The ineffectiveness of deanol in alleviating tardive dyskinesia is consistent with its inability to enhance brain acetylcholine synthesis. The worsening of the schizophrenic symptoms may possibly result from an interference by deanol with central cholinergic function.

Adult↗
PubMed1979

Tryptophan-nicotinamide, imipramine and their combination in depression. A controlled study.

In a double-blind controlled study lasting 4 weeks 25 newly admitted severely depressed patients were randomly assigned to tryptophan-nicotinamide or imipramine or tryptophan-nicotinamide-imipramine combination. Nicotinamide was given to reduce peripheral breakdown of tryptophan. Although there were no substantial differences between the three treatments, the efficacy of tryptophan-nicotinamide tended to diminish after 2 weeks when the dose of tryptophan was increased from 4 g/day to 6 g/day and that of nicotinamide from 1.0 g/day to 1.5 g/day. The therapeutic response of patients treated with tryptophan-nicotinamide was significantly correlated with the rise in plasma tryptophan. For the tryptophan-nicotinamide-imipramine group, however, therapeutic response and rise in plasma tryptophan were negatively correlated, implying that tryptophan levels were too high in some patients. The data suggest that tryptophan-nicotamide may be as effective as imipramine in unipolar patients providing the dose is kept within the therapeutic window, and that at low doses it could also potentiate the action of tricyclic antidepressants. Bipolar patients seem to require higher doses of tryptophan than unipolar patients.

Adult↗
PubMed1979

Factors related to tardive dyskinesia.

The authors found a 31% incidence of tardive dyskinesia among 261 schizophrenic outpatients treated with neuroleptics. Multiple linear logistic regression analysis revealed a higher incidence of tardive dyskinesia among elderly patients, those with longer records of hospitalization, those for whom neuroleptic medication had little therapeutic effect, and those treated with fluphenazine. Patients manifesting tardive dyskinesia tended to have fewer parkinsonian symptoms than those without the disorder, especially when tremors and akathisia were excluded from consideration. Multiple linear regression analysis indicated that brain-damaged patients and male patients were more susceptible to severe forms of the disorder, even though these factors were not implicated in its initial appearance.

Adult↗