Psychopharmacol Bull
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Psychopharmacol Bull · Jan 1997
Clinical TrialEconomic evaluation of paroxetine and imipramine in depressed outpatients.
In this pilot study, we compared the economic impact of paroxetine and imipramine treatment of depressed outpatients from a university teaching hospital and a community mental health center. A 12-month retrospective chart review of patients was performed. Clinical outcomes including clinic usage, death, relapse, function, adverse effects, psychiatrist visits, and drug costs were evaluated. ⋯ Our cost minimization analysis revealed no significant difference in the total cost between the two groups. However, the major cost in the paroxetine group was drug cost, whereas the major cost in the imipramine group was hospitalizations. Future large prospective trials are needed to validate these findings.
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Psychopharmacol Bull · Jan 1997
Case ReportsAnxiety and mood disorders associated with gonadotropin-releasing hormone agonist therapy.
Gonadotropin-releasing hormone (GnRH) agonists are synthetic derivatives of the native decapeptide produced by the hypothalamus. These agents cause a reversible suppression of the synthesis and release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) by the anterior pituitary gland. With GnRH agonist therapy, there is a resulting loss of endogenous ovarian gonadotropin stimulation and a severe hypo-estrogen state consistent with castrate levels of estrogen. ⋯ These women developed symptoms consistent with various psychiatric disorders, including panic disorder and major depression with and without psychotic features. Three of these patients were given sertraline while on GnRH agonist therapy, which improved their mood and anxiety symptoms. Women undergoing GnRH agonist therapy may provide a model with which to investigate mood disorders during the perimenopausal stage of life.
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Psychopharmacol Bull · Jan 1995
ReviewAn update on the use of lithium carbonate in aggressive children and adolescents with conduct disorder.
Although some knowledge has been gained concerning indications, therapeutic dose range, and safety of lithium in aggressive children and adolescents with conduct disorder, only a few double-blind and placebo-controlled studies have been conducted. A survey of the literature indicates that the four major studies are in disagreement as to lithium's ability to reduce aggression. ⋯ Methodologic issues that need to be addressed in future clinical trials involving this population are commented on and include the measurement and subtyping of aggression and assessment of psychosocial factors. Such research is needed to establish not only the role and efficacy of lithium in the treatment of aggression but also the effectiveness of this psychoactive agent in clinical practice.
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Psychopharmacol Bull · Jan 1995
Randomized Controlled Trial Clinical TrialThe lithium test dose prediction method in aggressive children.
Cooper and associates (1973) developed a method of ascertaining the lithium dosage required to attain a therapeutic serum level of 0.6 to 1.2 mEq/L. However, reports about the safety and accuracy of their method in children are limited (Geller & Fetner 1989). This study relates our experience with using this method in children. ⋯ These dosages ranged from 600 to 1,800 mg/day (mean, 1,312.5 +/- 450) and the corresponding serum lithium levels at steady-state ranged from 0.58 to 1.13 mEq/L (mean, 0.87 +/- 0.15). No severe side effects were encountered. This suggests that the method is safe and useful for predicting lithium dosages in children.