The Journal of clinical psychiatry
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Randomized Controlled Trial Clinical Trial
The safety and efficacy of paroxetine compared with placebo in a double-blind trial of depressed outpatients.
Considerable research shows that serotonin dysfunction is implicated in major depression. Paroxetine is an investigational antidepressant that appears to act by selectively blocking neuronal serotonin uptake. Seventy-two outpatients with moderate-to-severe major depression entered this 6-week, double-blind comparison of paroxetine and placebo. ⋯ Nausea and constipation occurred significantly more often with paroxetine, but only 9% of paroxetine patients dropped out of the study due either in whole or in part to an adverse effect. This compares to 8% of the placebo patients who were discontinued for the same reason. This study suggests that paroxetine is a safe and effective medication for the treatment of major depression.
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Comparative Study Clinical Trial Controlled Clinical Trial
P.r.n. medications in child psychiatric patients: a pilot placebo-controlled study.
The administration p.r.n. (as needed) of sedative medications is a widespread practice in the management of acute dyscontrol of child psychiatric inpatients. Its efficacy, however, has never been tested in a controlled clinical trial. ⋯ The data indicate that if p.r.n. administrations are effective, this is a placebo effect. Likewise, intramuscular administrations are more effective because of a route effect ("the needle") and not because of a specific pharmacologic activity.
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Chronic stimulant use can produce a paranoid psychosis that is similar to acute paranoid schizophrenia. While this phenomenon has been systematically explored in amphetamine abusers, it has been relatively unexplored in a systematic fashion in cocaine abusers. ⋯ Cocaine-induced paranoia is a common experience among chronic users. Amount and duration of use are related to its development. Implications for a kindling model of cocaine-induced psychosis will be discussed.
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Five benzodiazepine derivatives are currently approved for the treatment of sleep disorders. Important differences exist among the drugs in the physicochemical properties of lipid solubility and protein binding and in pharmacokinetic properties of absorption, distribution, elimination, and clearance. These differences may account for observed variations in clinical action and side effects during and after treatment. Bases for understanding and predicting differences among benzodiazepine hypnotics are discussed.
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Letter Comparative Study
Prolonged cocaine psychosis implies underlying major psychopathology.