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Biomedical subjects

P T Donlon

Publications and source records attributed to P T Donlon.

18 recordsLinked to original sources
PubMed1979

Factors influencing clinical response to psychotropic drugs. Imipramine in depression.

Numerous factors are involved in determining the efficacy of tricyclic antidepressant agents in the treatment of depression. The list includes diagnosis and patient selection; pharmacodynamics, bioavailability and tissue sensitivity; natural history; placebo response, nonspecific factors; compliance and adverse effects; the effects of concurrent life events, illness and treatment, and the bias in evaluating the outcome of treatment. Physicians should be aware of the factors that influence clinical response so they can maximize therapeutic effects and utilize the agents properly.

Biological Availability↗
PubMed1979

Overview: efficacy and safety of the rapid neuroleptization method with injectable haloperidol.

The authors review the literature on the rapid neuroleptization (titration) method with I.M. haloperidol. Most of the approximately 650 predominantly schizophrenic and manic patients represented in the studies calmed down rapidly on medication, and some demonstrated an early reduction in core psychotic symptoms. The initial doses varied widely, ranging from 1 to 30 mg, with a maximum total daily dosage of 100 mg. The medication seemed to have been well tolerated in all cases, with no reported major complications. The authors conclude that the method shows definite merit with agitated and belligerent patients. However, they make a number of specific recommendations for further research to clearly establish the effectiveness and safety of this method of neuroleptic administration.

Acute Disease↗
PubMed1979

Primary affective disorders.

This paper reviews the diagnosis and medical treatment of the major affective disorders. Patients with severe mood disturbances are frequently seen by the family physician. The diagnosis may be delayed since the patient may focus predominantly on somatic concerns which may mimic physical illness. The characteristics, course, and differential diagnosis of depression and mania are discussed. Antidepressants and lithium therapy greatly improve the prognosis of these disorders; monoamine oxidase inhibitors and neuroleptics are indicated for special subtypes of depression. Dosage schedules, interactional effects, adverse and toxic effects are reviewed for tricyclic antidepressants and lithium.

Affective Symptoms↗
PubMed1978

A twelve month comparison of penfluridol and trifluoperazine in chronic schizophrenic outpatients.

This investigation is a 52-week double-blind study comparing the efficacy and safety of penfluridol and trifluoperazine in 25 chronic schizophrenic outpatients. Penfluridol was administered once weekly and trifluoperazine daily. Measurements were made at baseline, various fixed intervals during the study period and termination. The data reveals that both agents were similarly effective in maintaining control of the symptoms of chronic schizophrenic patients at a level commensurate with or better than that provided by their previous medication. Besides being effective, medications were also well tolerated. The side effects were characteristic of marketed neuroleptics. Akathisia was more common with penfluridol but readily controlled with anti-parkinsonian medication. Other side effects were similar in severity and occurrence between study-drug groups. Both agents had low autonomic liability, and neither agent was depressogenic.

Adult↗
PubMed1978

High vs standard dosage fluphenazine HCL in acute schizophrenia.

This rater blind project compared the efficacy and safety of using an oral rapid or neuroleptization method (maximum 80 mg./day) versus fixed standard dosage (20 mg./day) fluphenazine, a commonly used neuroleptic. There were 32 hospitalized, acutely decompensated schizophrenic patients in the experiment; the study period for each patient was a maximum of 7 days. The data were collected using the Benjamin Proverb Test and rating scales for psychopathology and adverse effects. Data analysis by means of the analysis of covariance demonstrated few significant differences between the 2 treatment methods: both methods produced a similar reduction in psychopathological symptoms and incidence of adverse effects. The authors conclude that the rapid neuroleptization method is not superior to the fixed standard dosage method in treating acute schizophrenia.

Acute Disease↗
PubMed1978

The schizophrenias: medical diagnosis and treatment by the family physician.

About one percent of the population will develop schizophrenic symptoms sometime during their life. Etiologies are poorly understood and the course is highly variable. The differential diagnosis and medical treatment of the schizophrenias are discussed. Neuroleptic drugs are the most effective single treatment, for they allow most patients to be treated on an ambulatory basis, under the care of community physicians. Adverse effects of neuroleptic agents are common and often subjectively annoying. They may be prevented or minimized by agent selection, dosage schedules, or contra-active treatment.

Acute Disease↗
PubMed1977

Pimozide versus fluphenazine in ambulatory schizophrenics: A 12-month comparison study.

In this study, chronic schizophrenic outpatients who had been maintained on various neuroleptics for an average of about 4 years had their previous medications (approximately equivalent to 695 mg of chlorpromazine per day) changed abruptly to either pimozide or fluphenazine given in single daily oral doses on a double-blind basis for a period of 52 weeks. Average daily doses were pimozide 9.6 mg and fluphenazine 12.5 mg. Measurements of the therapeutic effects of the two drugs were made immediately prior to starting the study, at the end of the 2nd and 4th weeks, and thereafter every 4th week to the end of the study. Three psychometric scales were used for evaluation: Brief Psychiatric Rating Scale (BPRS); Evaluation of Social Functioning (ESFR); and Clinical Global Impressions (CGI). In addition, patients participated in a Social Adjustment Inventory (SAI) evaluation. Statistical analysis with the use of several statistical techniques for between- and within-drug group comparisons revealed that pimozide and fluphenazine were equally effective in maintaining control of symptomatology of chronic schizophrenics at a level commensurate with or better than that provided by their previous medication. Side effects were characteristic of marketed neuroleptics, similar in severity and occurrence between study-drug groups, mainly extrapyramidal symptoms, and readily controlled with antiparkinsonian medication. Pimozide, slightly more potent than fluphenazine, proved to be equally effective for the long-term management of chronic schizophrenic patients.

Adult↗
PubMed1976

Issues in developing quality aftercare clinics for the chronic mentally ill.

Two large aftercare clinics were established to provide treatment and rehabilitative care for a chronic mentally ill population requiring neuroleptic drugs. The clinics have evolved rapidly and expanded their service over the past 3 years but have required constant monitoring and modification in order to provide quality as well as quantity care in the community setting. These modifications are described and the importance of further community-based investigation in the rehabilitation and treatment of the chronic mentally ill is stressed.

Aftercare↗
PubMed1976

High dosage neuroleptic therapy. A review.

Neuroleptic agents by providing symptoms remission allow community physicians to treat the schizophrenic patient in all phases of the illness. The questions of the safety and efficacy of high dose neuroleptic therapy in subjects resistant to standard dose or requiring rapid symptom remission are frequently debated. Definitive research is, however, lacking. The author concludes, after reviewing available literature, that high dose treatment is indicated for some patients. In general, the incidence of adverse effects are dose related. The decision to administer high dose medication should weigh the added risk against the potential merit of treatment.

Basal Ganglia Diseases↗
PubMed1976

Depression and the reintegration phase of acute schizophrenia.

The authors found moderate to severe depression in 60% of a group of schizophrenic patients experiencing acute decompensations (N=30). The course of the depression was followed over an 8-week period8,during which patients were treated with depot fluphenazines. There was a statistically significant reduction in depression that closely paralleled the correction of the cognitive disorder. The authors discuss problems in identifying and quantifying depression during acute schizophrenic decompensation and suggest that the Hamilton scale anxiety/depression factor and the BRPS depression factor may be useful diagnositc tools.

Acute Disease↗
PubMed1976

Neuroleptic induced extrapyramidal symptoms.

All currently marketed neuroleptics induce extrapyramidal symptoms (EPS). These EPS are a function of biological sensitivity, neuroleptic molecular structure, dose, age, sex, and duration of neuroleptic treatment. Because of their association with EPS, at times irreversible, and their modest efficacy in the non-schizophrenic patients, neuroleptic administration should be limited predominantly to schizophrenic patients. Furthermore EPS should not be used as a guideline for the efficacy of neuroleptics as formerly assumed. For EPS may occur at subtherapeutic doses of neuroleptics and may be absent in patients experiencing clinical response. Neuroleptic dose should be the lowest efficacious dose required to provide symptom remission. In addition, antiparkinsonian (AP) agents should be administered predominently contraactively and not routinely in combination with neuroleptics. With the judicious administration of neuroleptic agents and AP medication, distressing EPS can be prevented or minimized, while providing control of schizophrenic symptoms.

Adult↗
PubMedDate not supplied

Clobazam versus placebo for anxiety and tension in psychoneurotic outpatients. A multicenter collaborative study.

Clobazam, a 1,5-benzodiazepine, was compared with placebo in 190 psychoneurotic outpatients with prominent symptoms of anxiety and tension of at least two weeks of duration. The design was one of double-blind parallel groups treated for one week. Clobazam subjects began on 40 mg daily in divided dosage, which was increased to 80 mg daily be day 3 if the drug was well tolerated. Two patients receiving clobazam had laboratory chemistry abnormalities which were possibly drug related. Adverse effects occurred more frequently in the clobazam group and were typical of those of marketed benzodiazepines. This study indicates that clobazam is an effective anxiolytic agent demonstrating its clinical effects during the first week of treatment.

Adolescent↗