The Journal of clinical psychiatry
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The effects of fluoxetine on the ECG were compared to those of placebo, imipramine, amitriptyline, and doxepin. ECG tracings at the beginning and end of several drug studies were evaluated retrospectively, without knowledge of the drug to which patients had been assigned. ⋯ Intraventricular conduction delays were noted in 5 patients who received imipramine and 1 patient who received amitriptyline: 4 of these patients developed left bundle branch block. No intraventricular conduction delays were noted in fluoxetine-treated patients.
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Twenty-six chronic schizophrenic outpatients receiving low-potency anticholinergic neuroleptics were switched over periods of up to 2 years to an equivalent dose of high-potency neuroleptics. Of these patients, 85% experienced withdrawal symptoms, mainly insomnia, anxiety, and tensional restlessness. ⋯ It is suggested that new symptoms associated with withdrawal of low-potency neuroleptics may lead to overcompliance by patients and difficulty in achieving the minimum therapeutic dosage. Thus, low-potency neuroleptics would not appear suitable for the long-term treatment of most schizophrenic patients.
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Members of the Washington State Psychiatric Association (N = 387) were sent a questionnaire asking about their experience with providing adjunctive medicinal treatment to patients in psychotherapy with someone else. Of the 202 respondents, 63% acknowledged such "therapeutic triangles." Younger psychiatrists, psychiatrists working in clinic and/or public settings, and non-psychoanalytic psychiatrists were more likely to participate in such arrangements. ⋯ S. psychiatrists participate in such arrangements, with 72,000-210,000 patients seen each month. More extensive study of all aspects of this phenomenon is urged.
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Randomized Controlled Trial Comparative Study Clinical Trial
Fluoxetine in depressed patients: a comparison with imipramine.
The clinical efficacy and safety of fluoxetine and imipramine were compared in a double-blind, 5-week, parallel study in 40 depressed outpatients. Mean scores for most depression scales improved more in patients taking fluoxetine than in those receiving imipramine (p less than .05). ⋯ Seven fluoxetine patients and 14 imipramine patients reported one or more adverse effects during treatment; no fluoxetine patient terminated the study early for drug-related reasons. It was concluded that fluoxetine provides effective antidepressant activity with fewer and less troublesome side effects than imipramine.
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Randomized Controlled Trial Comparative Study Clinical Trial
Droperidol vs. haloperidol in the initial management of acutely agitated patients.
In a double-blind clinical study, 27 acutely agitated patients were treated with an intramuscular injection of 5 mg of droperidol or 5 mg of haloperidol from identical appearing vials. At 30 minutes following treatment, 81% of the patients treated with haloperidol but only 36% treated with droperidol required a second injection (p less than .05). Thus, droperidol, a safe butyrophenone neuroleptic, appears to be a drug of choice for rapid and reliable control of acute agitation.