Biomedical subjects

L Tiffon

Publications and source records attributed to L Tiffon.

3 recordsLinked to original sources

PubMed1994

Augmentation strategies with tricyclic or fluoxetine treatment in seven partially responsive panic disorder patients.

BACKGROUND: Although panic disorder is generally responsive to single antidepressant pharmacotherapy, a substantial percentage of patients fail either to respond adequately or to maintain a therapeutic response. METHOD: The authors report on seven consecutive openly treated patients with panic disorder who showed inadequate antipanic responses to treatment regimens including either a tricyclic (TCA) or fluoxetine. Those patients taking a TCA had fluoxetine added and those patients taking fluoxetine had a TCA added. RESULTS: All seven patients showed an improvement in antipanic response to the combination treatment. CONCLUSION: The current case series is the first, to our knowledge, to suggest that the combination of a TCA and fluoxetine may provide a viable pharmacotherapeutic option for panic disorder patients who have failed to respond to an adequate trial of either a TCA or fluoxetine. Appropriate controlled studies are recommended.

Adult↗

PubMed1993

Therapeutic strategies for the patient with treatment-resistant anxiety.

Outcome of anxiety disorder treatment with psychotherapy and medication is generally as good as or better than that of other psychiatric illnesses. Nevertheless, refractory cases occur. The first step in approaching the treatment-resistant patient with an anxiety disorder is to be certain that the treatment has been adequate. Failure to provide an adequate dose of medication for adequate periods of time may be the most common cause of "treatment resistance." The second step is to reconsider the diagnosis and/or determine if new diagnoses have emerged since the original consultation. Depression and substance abuse are especially likely to complicate anxiety disorders. Several studies have shown that concomitant personality disorders (axis II) increase the occurrence of resistance to standard treatment and must be addressed through psychotherapy. Last, a variety of possible underlying medical conditions, including thyroid disorder, arrhythmia, and complex partial seizure, should be considered. Then, the clinician should consider a variety of pharmacologic approaches that are specific to each anxiety disorder. Panic disorder patients who are refractory to imipramine frequently respond to high-potency benzodiazepines, monoamine oxidase (MAO) inhibitors, serotonin reuptake inhibitors, or various combinations. Generalized anxiety disorder, if unresponsive to benzodiazepines, may respond to buspirone or a tricyclic antidepressant. Patients with obsessive compulsive disorder who have failed to respond to clomipramine or fluoxetine and other serotonin reuptake blockers may benefit from augmentation strategies using combination therapies including buspirone, fenfluramine, and neuroleptics. Social phobia refractory to beta-blockers and MAO inhibitors may benefit from buspirone, fenfluramine, and neuroleptics. Social phobia refractory to beta-blockers and MAO inhibitors may benefit from buspirone, fluoxetine, or alprazolam.

Anxiety Disorders↗

PubMedDate not supplied

[Cannabis dependence: clinical implications. Based and one case].

Cannabis has been commonly regarded as an innocuous drug, and has been used for centuries due to its multiple therapeutic effects (analgesic, anticonvulsant, sedative, antidepressant, etc.). However, growing evidence in recent years highlights the risk of adverse effects secondary to dependence and withdrawal syndrome. We report a case of severe cannabis dependence, that led to a variety of psychopathological, cognitive and somatic symptoms. This is compared with the bibliography and we analyze the influence of a possible underlying psychiatric disease. The adverse effects include affective and eating disorders, and the possibility of seizure induction. A novel therapeutic strategy in cannabis dependence is reported. Key words: Cannabis. Mania. Bulimic behaviors.

Adult↗