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Biomedical subjects

A Rifkin

Publications and source records attributed to A Rifkin.

At least 37 records · Page 2Linked to original sources
PubMed1994

Blood levels of haloperidol and clinical outcome in schizophrenia.

Haloperidol levels in blood were measured in 55 acutely psychotic inpatients with schizophrenia, who were randomly assigned to three fixed doses of oral haloperidol. Nineteen of these subjects received 10 mg/day, 18 received 30 mg/day, and 18 of them received 80 mg/day. All of the subjects were treated under double-blind conditions for 6 weeks or until remission. Haloperidol and reduced haloperidol levels were measured in plasma and red blood cells at the end of 2, 4, and 6 weeks of treatment. There were statistically significant linear correlations between the dose of haloperidol and levels in blood. An examination of data for linear and curvilinear relationships between levels in blood and clinical response did not yield any statistically significant relations. The data did not support the concept of a "therapeutic window." The ratio of reduced haloperidol to haloperidol levels in plasma or red blood cells did not yield any statistically significant correlations to clinical outcome.

Adolescent↗
PubMed1993

Diagnosis and pharmacotherapy of conduct disorder.

1. There are few double-blind, placebo-controlled studies of the drug treatment of conduct disorders in children and adolescents. 2. The diagnosis of conduct disorders involves a persistent pattern of behavior in which the basic rights of others and standards of society are violated. 3. There is frequent comorbidity associated with conduct disorders including attention-deficit hyperactivity disorder, oppositional defiant disorder, mood disorders and substance abuse. 4. Childhood Conduct disorder is associated with a significant risk for adult psychopathology. 5. A variety of treatment approaches may be employed to combat conduct disorders. 6. The use of neuroleptics, lithium carbonate, stimulants and other agents is reviewed.

Adolescent↗
PubMed1993

Pharmacologic strategies in the treatment of schizophrenia.

One article is too short for a comprehensive discussion of drug treatment of schizophrenia. The most important features, many of which are controversial, have been emphasized. We await future research that will answer these questions, and will show us better and safer treatments. We must be sure to use our present treatments optimally, which means exerting extra effort to overcome continuing symptoms, even if it means trying many different drugs and even combinations of drugs.

Antipsychotic Agents↗
PubMed1992

Depression in physically ill patients. Don't dismiss it as 'understandable'.

Depression in the physically ill is common and may even be caused by certain physical disorders (eg, hypothyroidism, pancreatic cancer) or the use of some types of drugs. It should not be dismissed because it is "understandable" in particular situations, but rather, it should be differentiated from overlapping symptoms of the physical disorder and treated. The effect of psychosocial factors should be carefully considered.

Antidepressive Agents↗
PubMed1992

Adjunctive imipramine for dysphoric schizophrenic patients with past histories of cannabis abuse.

1. Twenty-one schizophrenic or schizoaffective patients with histories of cannabis abuse and operationally-defined syndromes of post-psychotic depression completed a double-blind trial of adjunctive imipramine added to their on-going medication regimen of fluphenazine decanoate and benztropine. 2. The imipramine-treated patients had superior global outcome. 3. Subscales suggested that specific improvement occurred in imipramine-treated patients in the domain of depression-like features. 4. Psychotic symptomatology was not found to be exacerbated by the imipramine.

Adolescent↗
PubMed1992

Discontinuation of alprazolam after long-term treatment of panic-related disorders.

Discontinuation of alprazolam after long-term treatment of 142 patients with panic-related disorders was examined in five study sites using a telephone interview. The majority (67%) of patients interviewed discontinued alprazolam for a period of at least 3 days after a gradual dosage reduction schedule over a 4-week period at the end of the long-term treatment study. A marked difference among the study sites in percentages of patients discontinuing therapy with alprazolam suggests that physician intervention played an important role in determining the ability of patients successfully to discontinue use of alprazolam: 90% and 95% of patients ceased therapy at two sites whereas only 21%, 38%, and 66% of patients discontinued therapy at the other three sites. The mean daily dosage for patients who continued using alprazolam decreased from 5.1 mg/day at the end of the long-term segment to 2.7 mg/day at the time of the poststudy interview. This decline indicates a lack of tolerance to the therapeutic effectiveness of alprazolam over an extended period of time.

Adult↗
PubMed1991

Dosage of haloperidol for schizophrenia.

Eighty-seven newly admitted inpatients with schizophrenia were randomized to receive 10, 30, or 80 mg/d of oral haloperidol. They were treated under double-blind conditions for 6 weeks, less if their acute symptoms remitted sooner. Survival analysis showed no differences among the three treatments. Side effects were minimal in all three treatment groups, and there were no differences in side effects among the groups. These results suggest that dosages higher than 10 mg/d of haloperidol for most patients have no additional beneficial effect in the treatment of acute or exacerbated schizophrenia.

Acute Disease↗
PubMed1991

Prophylactic antiparkinson drug use: I. Initial prophylaxis and prevention of extrapyramidal side effects.

The use of prophylactic antiparkinson medications during neuroleptic treatment is controversial. Although the efficacy of these agents in the treatment of extrapyramidal side effects is well established, the questions of when to initiate therapy and for how long remain unanswered. There are only a few double-blind, placebo-controlled studies on the value of concurrent antiparkinson drug use at the beginning of neuroleptic treatment. The authors reviewed all studies on initial prophylaxis, and found most to be methodologically deficient. There is evidence to support the use of these agents to prevent acute dystonic reactions. Further work needs to focus on other types of extrapyramidal symptoms. In light of the inability to predict who will experience these side effects, the authors conclude that initial prophylaxis is beneficial for most patients who are starting neuroleptic medications.

Antiparkinson Agents↗
PubMed1991

Prophylactic antiparkinson drug use: II. Withdrawal after long-term maintenance therapy.

Although the efficacy of long-term neuroleptic treatment of schizophrenic patients is generally accepted, the use of concurrent antiparkinson drugs is less well defined. The value of prolonged antiparkinson drug use in preventing extrapyramidal side effects is controversial. More than 30 studies of antiparkinson drug withdrawal have attempted to answer this question. The authors reviewed all double-blind, placebo-controlled studies, and found most to contain serious methodologic or statistical flaws. There is evidence to support the long-term use of these agents in preventing extrapyramidal side effects. The authors offer an analysis of the benefits and risks that are involved with prophylactic antiparkinson drug use, and conclude that most patients would benefit from maintenance therapy.

Antiparkinson Agents↗
PubMed1990

Solving panic disorder problems. When your patients' fears thwart their lives.

All in all, panic disorder with or without agoraphobia is a very satisfying illness to treat. Most patients enter treatment with considerable pain and disability and within a few weeks to months are free of panic attacks, no longer fearful of them, and no longer phobic. Panic disorder must be distinguished from generalized anxiety, and signs of agoraphobia must be sought during the initial diagnosis. Drug therapy is effective for panic disorder, while agoraphobia may respond to drug therapy or to a range of cognitive therapies.

Agoraphobia↗
PubMed1990

Sequence of improvement in agoraphobia with panic attacks.

In a multi-center comparison of alprazolam to placebo in the treatment of agoraphobia with panic attacks, the sequence of sustained remission in both treatment groups, was panic attacks before phobias. This may suggest that phobias are secondary to panic attacks in the pathogenesis of the disorder, although other explanations may account for these data and are discussed.

Adult↗
PubMed1990

Benzodiazepines for anxiety disorders. Are the concerns justified?

Treatment of anxiety disorders deserves the attention of primary care physicians because so many patients have these disorders. Effective treatment is well within the professional repertoire of any physician who chooses to become familiar with the techniques. Aside from the drugs used to treat panic disorder, benzodiazepines are the mainstay of treatment. They are effective and generally safe.

Aged↗
PubMed1990

Dose and blood levels of haloperidol in treatment of mania.

Three doses of haloperidol, 10 mg/day, 30 mg/day, and 80 mg/day, were compared in 47 newly admitted manic patients. There was no difference in outcome within 6 weeks among the three doses. Four blood levels of plasma and red blood cell (RBC) haloperidol and reduced haloperidol showed no linear or curvilinear relationships to clinical response.

Adult↗