Smoking cessation, depression and dysphoria.
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Depression↗
Biomedical subjects
V Reus
Publications and source records attributed to V Reus.
Neuroleptic dose: a statistical model for analyzing historical trends.
Neuroleptic dosing practices during inpatient treatment of schizophrenia were examined for 1490 admission episodes during 1973 through to 1982 in two wards of a university hospital. Chlorpromazine-equivalent dose levels (CPZE) declined 50% between 1974 and 1980. As expected, length of treatment and choice of drug were both strongly related to CPZE. The general drop in CPZE is not explained by shorter treatment and changing choice of drug, however. Oral fluphenazine, haloperidol, and depot fluphenazine are used to higher maximum levels than chlorpromazine and other neuroleptics, when maximum dose is reached after one week or longer. The results illustrate that by seeking an appropriate statistical model, aggregate trends in dosing practices can be described while avoiding several of the shortcomings of earlier surveys of hospital practice.
Antipsychotic Agents↗
Prediction of lithium dose: a mathematical alternative to the test-dose method.
A method of estimating the optimal dose of lithium is presented. The charts of 548 patients were reviewed to obtain data regarding the factors thought to affect the lithium dose, and an equation to estimate the dose was derived by stepwise multiple linear regression. The equation was also applied to 390 patients to determine the difference between the estimated and the actual dose; the mean difference was only 19 mg/day and the standard deviation was 325 mg/day. Lithium level, presence of a cyclic antidepressant, age, sex, and weight were found to be important variables for estimation of lithium dose.
Adolescent↗
Effects of carbamazepine on noradrenergic mechanisms in affectively ill patients.
Noradrenergic mechanisms have been postulated to account for the anticonvulsant and psychotropic effects of carbamazepine. In order to assess this possibility in man, cerebrospinal fluid (CSF) was obtained from affectively ill patients before and during treatment with carbamazepine (average duration 29 days) at doses averaging 860 mg/day, achieving blood levels of 8.86 micrograms/ml. Neither plasma nor CSF norepinephrine (NE) nor CSF 3-methoxy-4-hydroxy-phenylglycol (MHPG) was significantly altered by carbamazepine. Baseline medication-free values in 21 depressed patients were not predictive of the degree of subsequent clinical antidepressant response. CSF NE decreased in four manic patients treated with carbamazepine. The many effects of carbamazepine on noradrenergic mechanisms in animals are discussed in relationship to these first studies of carbamazepine in man.
Affective Disorders, Psychotic↗
Effects of two doses of methylphenidate on verbal information processing in hyperactive children.
Nine hyperactive children participated in three sessions. During each they were given one of three drugs (placebo, 10 mg, or 21 mg of methylphenidate) in a double-blind crossover study. Following drug administration they were tested on three cognitive tasks. For one task, structural, acoustic, or semantic degrees of encoding of verbal information were induced. Memory for the verbal information was then tested. The 10-mg dose resulted in overall improvement of word recognition and recall. The 21-mg dose did not result in improvement. Amount of improvement was not related to degree of encoding of words. Two other tasks, learning a list of words and visual search of letters from a briefly presented display, were not affected by either the 10- or 21-mg dose. The results indicate that verbal learning can be facilitated by a low dose of methylphenidate but that the dose range may be narrow. Also, certain individuals did not respond favorably to either dose. In discussing the results, the possibility is presented that methylphenidate-induced facilitation may be restricted to certain types of learning or certain methods of assessing retrieval of information.
Attention↗
How does methylphenidate (MP) affect information processing in man?
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Adult↗
Research training in psychiatry.
The authors examined data on 13 requests for federal support for psychiatric research investigation that were evaluated as part of the NIMH review of psychiatric education grants in fiscal year 1975. Thirteen factors were found to be associated with quality of psychiatric research training, and the interaction and importance of these factors are illustrated in summaries of 5 programs. The ideal program is described as one in which there is a clearly stated concept, content that is broad and relevant enough to interest trainees in psychiatry, a continuing evaluation process, and superior research that can be documented. Adequate depth and breadth in terms of faculty and facilities are also essential. The authors believe that all psychiatrists should be encouraged to integrate scientific observation into their professional work and to evaluate systematically the effectiveness of their clinical interventions.
Curriculum↗