International clinical psychopharmacology
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Int Clin Psychopharmacol · Nov 2005
Randomized Controlled Trial Comparative StudyAmisulpride versus quetiapine for the treatment of delirium: a randomized, open prospective study.
The present study aimed to: (i) provide preliminary data on the effectiveness and tolerability of atypical antipsychotics, amisulpride (AMSP) and quetiapine (QTP) for patients with delirium and (ii) investigate whether the two drugs affect sleep differently and further relation with the recovery time of delirium. Forty patients with delirium were randomly assigned to either AMSP or QTP groups, with a flexible dosing schedule. The Delirium Rating Scale-revised-98 (DRS-R-98) and clinical global impression-severity (CGI-S), total sleep time and quality of sleep were assessed daily. ⋯ Both atypical antipsychotics were generally well tolerated. The present study shows that both amisulpride and quetiapine may be useful drugs for the treatment of delirium on the basis of effectiveness and relative lack of adverse events. Further systematic controlled studies are required.
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Int Clin Psychopharmacol · Nov 2005
Clinical TrialRelationship between plasma concentration levels of risperidone and clinical effects in the treatment of delirium.
The present study aimed to examine the relationship between plasma concentration levels of risperidone and clinical effects in the treatment of delirium. We conducted a prospective, open-label, flexible-dose study of risperidone oral solution. Ten patients with delirium were assessed using Delirium Rating Scales. ⋯ A highly significant negative correlation was observed in these responders without adverse effects between the plasma levels and durations of treatment until remission (r=-0.861, P=0.0095). The plasma concentration level of risperidone at 30 min after the first 0.5 mg dose may be a favourable response predictor in the treatment of delirium. Further studies in larger samples are needed to verify this preliminary finding.
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Int Clin Psychopharmacol · May 2004
Comparative StudyEfficacy of risperidone in treating the hyperactive symptoms of delirium.
Forty-one delirious patients who received risperidone treatment and 36 who received haloperidol treatment were retrospectively analysed. Ten-point visual analog scales (scored 0 for none to 10 for extremely severe) for hyperactive and hypoactive syndromes of delirium were used for efficacy evaluation. Psychiatrists scrutinized the medical records and determined the global severity of the syndrome for each patient. ⋯ The patients on risperidone needed much less anticholinergic agent. The maximal daily dose of risperidone was in the range 0.5-4.0 mg, with a mean of 1.17+/-0.76 mg, which was much lower than that for schizophrenia. The present study showed that risperidone appears to be effective and safe for the treatment of delirium.
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Int Clin Psychopharmacol · May 2004
Randomized Controlled Trial Comparative Study Clinical TrialThe cost-effectiveness of mirtazapine versus paroxetine in treating people with depression in primary care.
Currently, there are no data available comparing cost-effectiveness of two antidepressants in the primary care setting in the UK. Alongside a randomized, double-blind, 24-week study of mirtazapine and paroxetine, data were prospectively collected on patients' use of hospital and non-hospital services and days off work. Costs were estimated in each treatment arm from National Health Service (NHS) and societal perspectives, and were compared with selected outcome measures (numbers of 17-item Hamilton Rating Scale for Depression (17-HAMD) responders and changes in Quality of Life in Depression Scale scores between baseline and 24-week endpoint) to explore and compare relative cost-effectiveness. ⋯ Mean total NHS costs per patient were also lower (120 pounds) with mirtazapine (1408 pounds) compared to paroxetine (1528 pounds). The advantage for mirtazapine remained present on all variables analysed after performing sensitivity analyses. The results suggest that mirtazapine may be a cost-effective treatment choice compared to paroxetine for depression in a primary care setting.
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Int Clin Psychopharmacol · Jan 2004
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialThe tolerability of intramuscular ziprasidone and haloperidol treatment and the transition to oral therapy.
The intramuscular (i.m.) formulation of ziprasidone offers promise as an alternative to conventional i.m. agents for the short-term management of agitated patients with psychosis. This 7-day, randomized, open-label study evaluated the tolerability of ziprasidone i.m. and haloperidol i.m. in hospitalized patients with a psychotic disorder and moderate psychopathology. Patients received three fixed doses of ziprasidone i.m. 5 mg qid (n=69), 10mg qid (currently maximum recommended daily dose in USA; n=71), 20mg qid (n=66), or flexible-dose/ flexible-schedule haloperidol i.m. up to 10 mg bid-qid (n=100) for 3 days. ⋯ All three ziprasidone i.m. doses and haloperidol i.m. maintained control of symptoms and, following the transition to oral treatment, symptoms remained controlled. Ziprasidone i.m. 5,10, and 20 mg qid, given for 3 days were well tolerated. The transition from i.m. to oral ziprasidone was well tolerated with continuing maintenance of symptom control.