The Journal of clinical psychiatry
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Comparative Study Clinical Trial Controlled Clinical Trial
Molindone hydrochloride treatment of hospitalized children with conduct disorder.
Treatment-emergent symptoms and behavioral changes were assessed during an 8-week double-blind study comparing molindone and thioridazine in 31 aggressive hospitalized children (ages 6-11). Molindone was found to be as effective as thioridazine in this sample. ⋯ Molindone is a relatively safe neuroleptic for child and adolescent inpatients because of its short half-life and minimal prolonged tissue accumulation. Additional studies on different child populations are necessary before the proper indications for molindone usage in the pediatric group can be established.
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A case is presented in which a 68-year-old man became delirious after being withdrawn from a low dosage of alprazolam. The delirium was not affected by administration of alprazolam. The authors suggest that alprazolam may have enhanced specificity for a subpopulation of benzodiazepine receptors.
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In this case study, lithium carbonate, used to control bipolar disorders, is postulated to be the cause of downbeat nystagmus; the degree of nystagmus could be correlated with the dosage and serum level of the drug. All tests for anatomic lesion were negative, including metrizamide cisternography.
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The administration of neuroleptics in the treatment of psychosis and nonspecific behavioral disorders associated with psychotic symptoms in elderly patients is not without consequences. The potential side effects (e.g., dystonia, parkinsonian syndrome, and akathisia) of medications used in treating delirium, dementia, or confusional states are discussed. General guidelines are presented regarding choice of sedatives and antipsychotics and dosage, with attention to management of the individual elderly patient with psychosis.
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Comparative Study Clinical Trial Controlled Clinical Trial
A double-blind placebo-controlled study of fluvoxamine and imipramine in depression.
Outpatients with major affective disorder, unipolar depressed type (N=101), were treated in a 4-week placebo-controlled double-blind study to compare the efficacy and safety of fluvoxamine, a new serotonin reuptake inhibitor antidepressant, with imipramine and placebo. Therapy was initiated at 50 mg/day; thereafter, dosage ranged between 100 and 300 mg/day for both drugs. ⋯ Fluvoxamine showed some evidence of earlier onset of action. Anticholinergic side effects were more common in the imipramine-treated patients, while fluvoxamine produced more gastrointestinal distress and insomnia.