The American journal of psychiatry
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Ten patients with histories of postpsychotic depression responsive to adjunctive imipramine added to fluphenazine decanoate and benztropine underwent a double-blind trial of imipramine discontinuation 6 months after responding to the adjunctive imipramine. Discontinuation of imipramine was associated with depressive relapse.
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Although postcardiotomy delirium has been studied widely, there are few data about the current prevalence, compared to that reported in the late 1960s. There have been few efforts to replicate early observations. The authors review the literature using meta-analysis to combine the results of 44 studies. ⋯ Sex, previous psychiatric illness, intelligence, and time on bypass failed to correlate with postcardiotomy delirium, and age correlated with it only slightly. Correlation coefficients of more than 0.30 were found only for noncongenital heart disease and postoperative EEG abnormality. Preoperative psychiatric intervention had the highest correlation with postcardiotomy delirium (r = -0.60).
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Randomized Controlled Trial Clinical Trial
Postpsychotic depression and negative symptoms: an investigation of syndromal overlap.
The authors studied 46 patients with the operationally defined syndrome of postpsychotic depression following episodes of schizophrenia or schizoaffective disorder. Half of these patients were also found to satisfy criteria for negative symptoms. The patients with negative symptoms were rated as more severely ill on global measures, but there was only limited evidence that they were more depressed. Nevertheless, in a randomized double-blind trial of imipramine versus placebo as an adjunct to the fluphenazine decanoate and benztropine regimens of the patients with negative symptoms, the patients who received imipramine seemed to show more improvement.
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In their own practices and in consultation, requests to psychiatrists to evaluate and treat sleep disorders in the elderly are common. The five million elders in this country receive 35%-40% of the sedative-hypnotics prescribed, despite the fact that they represent only 12% of the population. ⋯ Before prescribing a sedative-hypnotic, one should consider nonpharmacologic interventions and education about normal sleep changes due to aging. As a foundation for the judicious prescribing of sedative-hypnotics, the pharmacokinetic changes associated with aging are discussed.