Journal of clinical psychopharmacology
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J Clin Psychopharmacol · Dec 1987
ReviewModifications of the serotonin system by antidepressant treatments: implications for the therapeutic response in major depression.
Results of electrophysiological single-cell recording studies suggest that most, if not all, types of antidepressant treatments increase 5-hydroxytryptamine (5-HT) neurotransmission. Tricyclic antidepressants, electroconvulsive shock treatment, mianserin, adinazolam, and possibly sleep deprivation may exert their therapeutic effect through sensitization of postsynaptic neurons to 5-HT. ⋯ Similarly, monoamine oxidase inhibitors may act by increasing the efficacy of 5-HT neurons. Intensification of 5-HT function appears to be a common denominator to antidepressant treatments; however, evidence suggests that this modification may only be a link in a chain of events leading to an antidepressant response.
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J Clin Psychopharmacol · Jun 1987
Anticholinergic prophylaxis of acute haloperidol-induced acute dystonic reactions.
Young adults treated with a high potency neuroleptic such as haloperidol are at high risk of developing dystonic reactions. In this retrospective study, 15 of 16 young adult patients treated only with haloperidol had such reactions within 60 hours of beginning the drug, while none of the seven patients treated with haloperidol plus prophylactic benztropine mesylate developed dystonia. Although methodologic considerations limit the generalization of these results, they are consistent with other reports and suggest that initial anticholinergic prophylaxis is warranted in young patients treated with high potency antipsychotics. All dystonic reactions in these patients occurred within 2 1/2 days, justifying the consideration of discontinuing prophylaxis (which also causes side effects) after 1 week.
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J Clin Psychopharmacol · Dec 1986
Case Reports Randomized Controlled Trial Clinical Trial Controlled Clinical TrialUntoward effects of fenfluramine in autistic children.
Several recent studies have described the benefits of fenfluramine for the symptomatic treatment of infantile autism. No large surveys of side effects of this drug have been reported in autistic children. To evaluate the untoward effects of fenfluramine in children with autism, 12 subjects were systematically studied. ⋯ Irritability, agitation, and crying along with continued food refusal were noted. The subjects lost 2.1% of body weight during active drug phase, but there was a rebound weight gain during the subsequent placebo phase. A thorough understanding of fenfluramine's side effects and adverse reactions is necessary so as to differentiate them from the multiple symptoms inherent in the syndrome of autism.
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J Clin Psychopharmacol · Feb 1986
Randomized Controlled Trial Clinical Trial Controlled Clinical TrialAlprazolam treatment of postcoronary bypass anxiety and depression.
The effectiveness of alprazolam in treating symptoms of anxiety and depression in 60 patients undergoing coronary bypass surgery was assessed in a double-blind, placebo-controlled study. The results indicate that alprazolam treatment for anxiety following coronary bypass surgery, particularly symptoms occurring in the immediate postoperative period, can significantly affect patient outcome. Specifically, only modest but statistically significant improvement was observed in the alprazolam-treated groups at 1-month follow-up; however, alprazolam-treated patients were significantly more likely to experience a very rapid anxiolytic effect by postoperative day 8. The implications of this study are discussed with respect to patient management and models for future studies of anxiety in postoperative patient populations.
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J Clin Psychopharmacol · Dec 1985
Case ReportsUse of high-dose intravenous haloperidol in the treatment of agitated cardiac patients.
Although previous reports have documented the safe and effective use of intravenous haloperidol in agitated cardiac patients, the dosages advocated have in general been relatively low: 1 to 2 mg every 2 to 4 hours. In this report, the authors demonstrate that such doses may be insufficient to control severe agitation in coronary care unit patients. Four cases are presented in which more than 100 mg/day of intravenous haloperidol were required for safe and effective control of confusion and agitation.