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Biomedical subjects

A Rifkin

Publications and source records attributed to A Rifkin.

At least 91 records · Page 5Linked to original sources
PubMed1981

Prophylactic lithium carbonate with and without imipramine for bipolar 1 patients. A double-blind study.

The efficacy of lithium carbonate plus imipramine hydrochloride vs lithium carbonate plus placebo in preventing relapse was assessed in a prospective, random-assignment double-blind study of 75 bipolar 1 patients. Outcome measures included type of relapse, time until relapse, and subsequent illness course. Infrequent depression relapse in either treatment group precluded any demonstration of an advantage of adding imipramine to a lithium carbonate regimen. There was little evidence that the combination of lithium carbonate and imipramine caused adverse reactions. However, interactions between type of most recent episode, treatment condition, sex, and type of relapse showed that women and mania-prone patients treated with imipramine had an increased risk of mania. Life table analysis showed that the overall probability of remaining well was the same for both treatment groups and that two thirds of all relapses occurred in the first six months.

Actuarial Analysis↗
PubMed1981

The risks of long-term neuroleptic treatment of schizophrenia: especially depression and akinesia.

Most extrapyramidal side effects of neuroleptics are easily recognized and cause little problem in diagnosis and treatment. The exceptions are those which mimic psychopathology: akathesia and akinesia. Akathesia resembles anxiety. Akinesia is similar to depression, residual schizophrenia, and demoralization. Differential diagnosis may require interruption of the neuroleptic. Whether neuroleptics can cause depression not associated with akinesia has never been established. The first obligation of the clinician is to be sure that the depressive symptoms are not concomitants of akinesia, before treating with antidepressants which may not be the appropriate treatment. There is no convincing evidence that one neuroleptic drug is more likely to cause akinesia than another, although this had not been studied extensively using a broad definition of akinesia.

Antipsychotic Agents↗
PubMed1980

Efficacy of desipramine in endogenomorphically depressed patients.

This study was designed to test the hypothesis that there are 2 biochemical subgroups of 'endogenously' depressed patients--serotonin-deficient and noradrenalin-deficient groups--which respond differently to antidepressants depending on relative blockade of serotonin vs. norepinephrine (NE) reuptake. Patients with pervasive anhedonia and autonomy of depressed mood (endogenomorphic depressives) were treated first with the noradrenergic agent desipramine (DMI), then, if still depressed, such patients were randomized double-blind to continued DMI or clomipramine (CMI), a primarily serotonergic agent. Of 34 such endogenomorphically depressed patients 2 responded during a placebo period and 5 dropped out. Of 27 patients completing at least 4 weeks of DMI (mean maximum daily dose 283 mg, range 100-400 mg/d), 23 (85.2%) responded. With only 4 nonresponders, the second, or CMI, part of the study had to be abandoned. Since DMI strongly blocks neuronal reuptake of catecholamines with little effect on serotonin reuptake, these results suggest that endogenomorphic depressives may have a relatively homogeneous catecholamine deficiency. Alternatively, DMI may exert its effect by a mechanism other than blockade of EN reuptake. Eleven of the endogenomorphically depressed patients also met Research Diagnostic Criteria for situational depression (reactive). Ten of these 11 responded to DMI suggesting that presence or absence of a precipitant may be irrelevant in predicting response to tricyclic antidepressants in endogenomorphic depressions. Mean blood levels drawn at equivalent DMI dose were 238 ng/ml (range, 48-712) for responders, and 352 ng/ml (range, 160-877) for non-responders, indicating that patients appear to respond to DMI across a wide range of blood levels and suggesting the absence of a narrow therapeutic window.

Adjustment Disorders↗
PubMed1980

Can schizophrenia with premorbid asociality be genetically distinguished from the other forms of schizophrenia?

Sufficient data exist to establish a genetic basis for some forms of schizophrenia. However, genetic factors may not account for all the variance, and subtle forms of central nervous system (CNS) damage may have etiological significance for some schizophrenic subtypes. One such subtype may be chronic schizophrenia with premorbid asociality (SPA). To test this hypothesis, the risk of schizophrenia among relatives of probands who did or did not meet the criteria for SPA was examined. The incidence of schizophrenia in the relatives of SPA probands was lower than that in the relatives of non-SPA probands. This difference approached but did not reach statistical significance. Because most studies have found a higher familial genetic loading in chronic forms of schizophrenia, the apparently lower incidence of disorder in relatives of chronic schizophrenics with premorbid asociality seems to be a heuristic lead worth pursuing.

Antisocial Personality Disorder↗
PubMed1980

A comparison of trimipramine and imipramine: a controlled study.

Trimipramine, a new tricyclic antidepressant, was compared to imipramine in 38 hospitalized depressives. Both groups improved, with no major differences seen between the drugs. Analysis of the power of the statistical analysis shows that it is very unlikely that a true difference was present and not detected. There were fewer adverse reactions to trimipramine.

Adult↗
PubMed1979

Monoamine oxidase inhibitors. A review of antidepressant effectiveness.

Data from double-blind, placebo-controlled trials of the monoamine oxidase (MAO) inhibitors show that phenelzine is clearly effective in neurotic or atypical depressives, but the findings concerning its effect in endogenous depressives are inconclusive. Although few controlled studies have been done with tranylcypromine, similar conclusions are warranted. Studies have contrasted MAO inhibitors and tricyclic antidepressants (TCAs) to gain further information about the type of patients likely to respond to MAO inhibitors. We believe that simply contrasting the relative efficacy of TCAs and MAO inhibitors is outdated. Neurotic or atypical depression is probably a heterogeneous syndrome, and delineation of subtypes responsive to specific antidepressants is needed. The implications of fast acetylation, selective MAO inhibitors, types MAOA and MAOB, and measures of platelet MAO inhibition are discussed in this article.

Acetylation↗
PubMed1979

MHPG excretion.

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Depression↗
PubMed1979

Low dose fluphenazine decanoate in maintenance treatment of schizophrenia.

To test the clinical efficacy of low dose fluphenazine decanoate (1.25 mg to 5.0 mg biweekly), we carried out two separate experiments: (1) an open trial in 57 schizophrenic outpatients, lasting 6 months; (2) a double-blind, placebo-controlled discontinuation study in a subgroup of patients who maintained good remission throughout the entire 6-month open trial. The results suggest that lower doses of fluphenazine decanoate than those usually used may be effective in preventing psychotic relapse while keeping total cumulative dosage to a minimum.

Aftercare↗
PubMed1979

The effect of fluphenazine upon social and vocational functioning in remitted schizophrenics.

Thirty-six remitted schizophrenics who participated in an outpatient study of fluphenazine decanoate or oral fluphenazine vs placebo given for a year were examined for the effect of drug treatment upon social and vocational functioning. Only the period prior to any clinical relapse was evaluated. We found no difference between those on drug or placebo, and conclude that antipsychotic drugs, at least in the context of an aftercare clinic offering a rich spectrum of nonpharmacological services, and when combined with antiparkinson medication, do not interfere with social and vocational functioning.

Adult↗