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Biomedical subjects

T E Hanlon

Publications and source records attributed to T E Hanlon.

13 recordsLinked to original sources
PubMed1992

Clinical predictors of relapse following neuroleptic withdrawal.

The validity of previously hypothesized predictors of elapse following neuroleptic discontinuation was examined. One hundred sixty-two outpatients, with either Research Diagnostic Criteria schizophrenia or schizoaffective disorder, were discontinued from neuroleptic medication for a 28-day period or until judged to be relapsed. Pre-discontinuation neuroleptic dosage level, the severity of psychotic symptoms, and the presence of dyskinetic movements prior to neuroleptic discontinuation were the predictor variables. Of the 162 patients, 62.7% did not relapse during the study period. There were no differences in the survival rates between the patients withdrawn from oral versus depot neuroleptics. Neuroleptic dosage, but not severity of psychotic symptoms or dyskinetic movements, predicted relapse. These results support the hypothesis that pre-withdrawal neuroleptic dosage level predicts relapse, but fail to validate either severity of psychotic symptoms or presence of dyskinetic movements as predictors of relapse.

Administration, Oral↗
PubMed1991

Carbamazepine maintenance treatment in outpatient schizophrenics.

A double-blind crossover trial was used to evaluate carbamazepine as the sole maintenance treatment of chronic, nonmanic schizophrenic outpatients whose conditions had been stabilized with the use of neuroleptics prior to study. Criteria of treatment effectiveness included the number of patients relapsing and time to relapse over a 95-day neuroleptic-free period during which either carbamazepine or placebo was administered. Relapse was determined by the concordance of psychiatric ratings and independent clinical judgements indicating significant worsening. Results for 27 patients (13 receiving carbamazepine and 14 receiving placebo) involved in the first phase of this treatment comparison were nondifferentiating. Corroborating descriptive findings in the second phase were available for 14 of these patients. There was no evidence supporting the existence of a treatment-relevant subgroup defined by episodic dyscontrol phenomena.

Adult↗
PubMed1990

Continuous versus targeted medication in schizophrenic outpatients: outcome results.

The authors report on the outcome of treatment of 116 outpatients with chronic schizophrenia who were assigned to a 2-year, single-blind course of treatment with either targeted or continuous medication. These patients were not restricted to those who were good candidates for a medication reduction strategy. Continuous medication was superior to targeted medication in preventing decompensations and hospitalizations and in extent of employment at 2 years. Other measures of psychopathology and functioning at 1 and 2 years did not differentiate the two groups of patients. The targeted approach achieved a substantial reduction in total medication through a reduction in the number of days of medication administration.

Adult↗
PubMed1977

The effectiveness and safety of electroconvulsive therapy (ECT).

Over the past several decades, psychopharmacological treatments in psychiatry have been subjected to intensive methodological scrutiny in the continual assessment of their efficacy and safety. Although one of the most dramatic and controversial therapeutic approaches in psychiatry, electroconvulsive therapy (ECT) has not received the same concentrated, systematic attention. Through a comprehensive literature search, the present authors have attempted to provide answers relating to the efficacy and the safety of conventional ECT and some of its more prominent variations. Although specific discernible trends are reported in the text, results of the survey are too disparate for a simplistic summary statement to be made regarding efficacy in all diagnostic categories. As with most somatic treatments in psychiatry, bilateral ECT does present some apparent risk, reduced but not entirely eliminated by precautionary techniques, which must be weighed against the possible benefits to be derived in a given case. Other variations of ECT offer promise of fewer side effects but must be accepted as standard clinical practice.

Acute Disease↗
PubMed1977

The treatment of perceptual disturbances in schizophrenia with naloxone hydrochloride.

The authors treated 12 schizophrenic patients who had overt hallucinatory symptoms with intravenously administered naloxone hydrochloride, a narcotic antagonist purported to have antihallucinatory properties. They found no evidence of the effectiveness of naloxone in preventing hallucinations over that of placebo when administered in a randomized, double-blind fashion.

Adult↗
PubMed1975

Contingent naloxone (N-allylnoroxymorphone) treatment of the paroled narcotic addict.

This is a presentation of the results of pilot and controlled research on the effectiveness of the contingent (upon narcotic drug use) administration of 500-2,000 mg daily, of the narcotic antagonist, naloxone (N-allylnoroxymorphone), to paroled narcotic addicts enrolled in a urine monitoring program conducted in a metropolitan-based outpatient clinic. Criteria of effectiveness, which include clinic attendance, the extent of narcotic drug usage, and final disposition at the end of a 6-month treatment period, are viewed in relation to already established baseline results with a sample of patients processed through the same clinic over a 5-year period prior to the introduction of naloxone treatment. Although results of the pilot study are encouraging, indicating longer patient involvement and less reinstitutionalization than baseline values, the results of the controlled evaluation reveal no benefit from contingently administered naloxone beyond placebo reactivity, which appears to be substantial in the contingent approach. The results are discussed in terms of given sample characteristics, and suggestions are offered regarding the development of new narcotic antagonist treatment approaches.

Adolescent↗
PubMed1975

Effects of control techniques on therapeutic outcome in a controlled clinical trial.

Undertaken in the context of a controlled drug trial involving newly admitted psychiatric hospital patients, this study compared the effectiveness of a "Doctor's Choice" (DC) method of administering psychotropic drugs versus an experimentally determined treatment regimen employing random assignment and double-bline procedures. The 32-day drug trial sought to determine the comparative effectiveness of thioridazine-placebo, thioridazine-chlordiazepoxide, and thioridazine-imipramine, with the daily dosage of openly administered thioridazine ranging from 100 to 900 mg and dosages for chlordiazepoxide and imipramine, administered in a double-blind fashion, fixed at daily dosages of 30 and 75 mg, respectively. DC medication, consisting of a choice (by a research physician) of any of the three experimental medications determined on the basis of judged clinical need, was added as a fourth treatment category for present purposes. Criteria of effectiveness included standarized psychiatric rating scales and global measures of imporvement completed by research team members and ward physicians. Outcome results for the DC group compared to those for a single control group made up of individuals matched with DC patients on the basis of drug assignment indicated an essentially similar clinical effectiveness under both DC and control treatment conditions. Generalization of the finding was limited by the fact that the main treatment effect, attributable to thioridazine, overshadowed the more subtle action of the ancillary drugs.

Adolescent↗
PubMed1975

A controlled comparison of cyclazocine and naloxone treatment of the paroled narcotic addict.

A controlled, double-blind study of the comparative effectiveness of the narcotic antagonists, cyclazocine and naloxone, was undertaken in a metropolitan narcotic clinic offering an abstinence program involving urine monitoring and ancillary counseling services. Seventy male addict parolees were randomly assigned to 6-month treatment with either cyclazocine, 4 mg administered on a daily basis, or naloxone, 500-2,000 mg administered on a locally developed and researched 'contingent' basis, i.e., whenever there was indication of narcotic drug use (daily and contingent placebos were utilized to preserve the double-blind). Criteria of treatment effectiveness included narcotic drug usage, clinic attendance, length of participation in the program, disposition at 6 months, and incidence of side effects. The two subsamples of 35 individuals were similar with respect to relevant demographic characteristics. Examination of comparative effects revealed little to no significant differences between the two groups in terms of measures of program adherence, treatment outcome, and personal and social adjustment. Side effects were more prevalent among cyclazocine patients. Typically, these included moderately severe somatic effects and perceptual and cognitive disturbances.

Adolescent↗
PubMedDate not supplied

Aftercare/relapse prevention and the self-help movement.

This paper presents the background and initial experiences of a treatment evaluation involving self-help techniques and principles as a means of providing aftercare services for stabilized methadone maintenance patients. It describes the Clinically Guided Self-Help (CGSH) model, which focuses on community reintegration and places emphasis on social network components following a period of primary treatment and demonstrated client stability. From our experiences, we have identified needs and issues that are of concern to stabilized clients, and we have distilled a paradigm for responding to these in a self-help group format. The model permits clients to establish their own agenda of interests and, guided by staff, to engage in a process geared toward maximum participation of their part. The model is clinically based in that staff and participants are engaged in working on present adjustment concerns. The overall goal of the investigators is to generate the prerequisite skills for successful adaptation of self-help concepts and techniques to the particular needs and interests of individual methadone maintenance programs and clients.

Aftercare↗