Journal of clinical psychopharmacology
-
J Clin Psychopharmacol · Aug 1984
Randomized Controlled Trial Clinical TrialSaliva lithium levels in children: their use in monitoring serum lithium levels and lithium side effects.
The reliability of saliva lithium levels in monitoring serum lithium levels in children taking lithium has rarely been studied, despite the potential usefulness of such a study and despite a number of adult studies focusing on the technique. In a study of 61 aggressive school-age children diagnosed as undersocialized, aggressive conduct disorder, a subsample of 21 children received lithium. Saliva lithium levels aided in monitoring side effects, and in 15 of the 21 children simultaneous saliva and serum lithium levels were done. ⋯ Seventeen children from the lithium subsample experienced 41 lithium-related side effects. Most children suffered side effects on relatively high doses of lithium, and those few who experienced side effects on low dosage had saliva lithium levels that were proportionately high. However, it remains unclear whether saliva lithium can be used to monitor side effects.
-
J Clin Psychopharmacol · Jun 1984
Randomized Controlled Trial Clinical TrialAlprazolam and diazepam in the treatment of generalized anxiety.
In a 4-week double-blind study comparing alprazolam with diazepam treatments, 48 outpatients suffering from mild to moderate generalized anxiety were evaluated after a 5-day placebo washout, and then after 1, 2, and 4 weeks of treatment. The optimal therapeutic doses without excessive sedation averaged 2 mg for alprazolam and 15.8 mg for diazepam. Results from the Hamilton Anxiety Rating Scale, the Clinical Global Impression Scale, a behavior checklist questionnaire, and a symptomatic patients' self-rating scale indicated that patients improved in both treatment groups. ⋯ Few side effects were reported: mainly, drowsiness, tremor, light- headedness , and dry mouth. A toxic reaction to alprazolam, possibly allergic, was observed. Either alprazolam or diazepam appeared to be effective in the treatment of generalized anxiety disorder, and the statistically significant differences between the two drugs were not clinically striking.
-
J Clin Psychopharmacol · Apr 1983
Randomized Controlled Trial Clinical TrialBromazepam and diazepam in generalized anxiety: a placebo-controlled study with measurement of drug plasma concentrations.
In a double-blind, placebo-controlled study, 48 anxious outpatients with a primary diagnosis of generalized anxiety disorder were randomly assigned to 4 weeks of treatment with bromazepam (18 mg/day), diazepam (15 mg/day), or placebo, after a 1-week washout period. From week 1 onward both active drugs were superior to placebo in relieving anxiety symptoms. ⋯ Bromazepam plasma concentration measurements showed greater variability than those of diazepam and were not found to be correlated significantly with clinical response. It is suggested that the use of strict diagnostic criteria (1978 draft of the third edition of Diagnostic and Statistical Manual of Mental Disorders), adequate sample sizes, and a 4-week study period gave increased sensitivity for the detection of significant differences between the two benzodiazepines.
-
J Clin Psychopharmacol · Sep 1981
Review Clinical TrialCombined MAOI-tricyclic antidepressant treatment: a reevaluation.
Recent studies have shown that monoamine oxidase inhibitors (MAOIs), in appropriate patients and with proper precautions, are not as dangerous as once thought, especially in comparison to alternative antidepressants. We review the literature regarding the combined use of MAOIs and tricyclic antidepressants, which has been reported to be both highly toxic and highly effective. ⋯ We also discuss the three controlled studies of combined MAOI-tricyclic therapy that have been undertaken. We conclude that the hazards of combination therapy have been exaggerated and that MAOI-tricyclic therapy is a reasonable approach in patients found resistant to standard antidepressant treatment if certain precautions are observed.