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Biomedical subjects

P L Scapicchio

Publications and source records attributed to P L Scapicchio.

7 recordsLinked to original sources

[The expressions of anxiety in the elderly. Their diagnosis and therapy].

Among the most common manifestations of anxiety in the elderly are those associated with neurological disorders. The etiology is often unclear, as anxiety and agitation may be a consequence of insight into the cognitive impairment rather than the direct expression of the neurological deficit. Benzodiazepines are the treatment of choice, particularly the 3-OH compounds that are non oxidised and without active metabolites. Concern about the use of benzodiazepines in the elderly may have been overstated. If used judiciously this class of drugs can prove extremely helpful in reducing day-time anxiety and night-time insomnia. Other medications that are commonly used to treat agitation and disruptive behaviour in demented elderly patients include antipsychotics, beta-blockers, trazodone, buspirone, anticonvulsants.

Aged↗

The rabbit syndrome.

Explore the source record for details and available documents.

Antipsychotic Agents↗

Clinical activity and tolerability of trazodone, mianserin, and amitriptyline in elderly subjects with major depression: a controlled multicenter trial.

The aim of this multicenter study was to compare trazodone (TRA) with two reference drugs, amitriptyline (AMI) and mianserin (MIA), under double-blind conditions, in an elderly population, to ascertain age-related patterns for efficacy and tolerability. One hundred six elderly depressed inpatients, ranging in age from 60 to 83 years, diagnosed as having major depression according to DSM-III, were treated with 75 mg AMI (37 patients), 60 mg MIA (33 patients) or 150 mg TRA (36 patients) p.o.t.i.d. for 5 weeks. There were no differences in the clinical outcome among the three groups of patients at the end of the trial, with a significant amelioration (p less than 0.01) for the Hamilton Rating Scale for Depression (HRS-D) and the Geriatric Depression Scale (GDS). TRA showed a lower overall prevalence of side effects than AMI or MIA, particularly for anticholinergic (p = 0.03 vs. AMI) and cardiovascular (p = 0.05 vs. MIA) effects. For these data GDS seems to be most reliable in detecting changes in elderly depressive symptomatology; moreover a comparable therapeutic response (among the three drugs) but a better tolerance for atypical antidepressants, particularly TRA, make advisable the use of the latter drug in the elderly population.

Aged↗

Trazodone in late life depressive states: a double-blind multicenter study versus amitriptyline and mianserin.

Seventy five elderly depressed in-patients, ages ranging from 60 to 83 years, diagnosed as Major Depression according to DSM III were treated, under double-blind conditions, with 75 mg Amitriptyline (AMI) (26 patients), 60 mg Mianserin (MIA) (24 patients) or 150 mg Trazodone (TRZ) (25 patients) p.o. for 5 weeks. There were no differences in the clinical outcome between the three groups of patients at the end of the trial, with a significant amelioration (P less than 0.01) at the Hamilton Rating Scale for Depression and Geriatric Depression Scale. TRZ showed a significantly lower incidence of side effects compared to MIA and AMI. Atypical antidepressants, including TRZ, seem more suitable for treating elderly depression than the first generation antidepressants on the basis of risk/benefit ratio considerations.

Aged↗

Diabetes mellitus in schizophrenic patients.

Studies conducted in the United States and Japan indicate that diabetes mellitus is more common among schizophrenic patients than among the general population. The prevalence of known diabetes was examined in 95 schizophrenic patients aged 45 to 74 years admitted to a long-term care facility in Italy. The overall prevalence of diabetes was 15.8% (95% confidence interval, 12.1% to 19.5%), and increased from 0% in those younger than 50 years, through 12.9% in the 50- to 59-year age group, and to 18.9% in the 60- to 69-year age group, and then decreased to 16.7% in those aged 70 to 74 years. These rates are considerably higher than those reported from population surveys in Italy, and indicate that a higher prevalence of diabetes in schizophrenic patients may be a universal phenomenon. The clinical picture indicated that in all cases this was the common variant of type II (non-insulin-dependent) diabetes mellitus. Diabetes was more common in patients not receiving neuroleptics than in those who were receiving such treatment. There was no association between diabetes and the use of anticholinergic drugs.

Adult↗