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Biomedical subjects

B L Cook

Publications and source records attributed to B L Cook.

At least 37 records · Page 2Linked to original sources
PubMed1989

A comparative trial of fluoxetine versus trazodone in outpatients with major depression.

The effectiveness of fluoxetine as an antidepressant was contrasted with trazodone in a 6-week double-blind trial in 40 patients. The total score on the Hamilton Rating Scale for Depression and the global improvement score on the Clinical Global Impressions scale favored trazodone at the end of 3 weeks of treatment. However, that difference was no longer apparent during the remainder of the study. The authors hypothesize that fluoxetine 20 mg/day may be an ineffective dosage of the drug or that fluoxetine has a slower onset of antidepressant action than does trazodone.

Adult↗
PubMed1989

Problems with tricyclic antidepressant use in patients with panic disorder or agoraphobia: results of a naturalistic follow-up study.

The authors followed up 107 patients with panic disorder or agoraphobia with panic attacks who had been placed on a regimen of tricyclic antidepressant treatment 1 to 4 years earlier. Sixty-three percent reported at least moderate improvement during treatment; however, side effects were often difficult to tolerate, and 35% discontinued tricyclic treatment on this account. Overstimulation, which occurred in 20%, was the most frequent reason for early termination, and weight gain, which occurred in 34%, was the most common reason for stopping the drug later on. Seizures occurred in 2 patients. Even though they were encouraged to discontinue drug use, most of the patients who had responded were still taking their drugs at follow-up. More than half of those who had responded before stopping drug treatment subsequently relapsed. The findings highlight problems with safety, side effects, and patient acceptance resulting from the use of tricyclic antidepressants in patients with anxiety disorders.

Adult↗
PubMed1988

Benzodiazepine withdrawal: a review of the evidence.

In a recent series of controlled studies, investigators looked at what happened when benzodiazepines were discontinued. Despite methodological problems, these studies showed that rebound anxiety occurred in a substantial minority of patients after several weeks of drug use. Also, a withdrawal syndrome developed in nearly half of patients who used benzodiazepines for more than a year. In these studies, risk factors included dose, duration of use, elimination rate of the drug, and abruptness of discontinuation. Patients who are physically dependent on benzodiazepines may need help in stopping these agents. Physicians should advise gradual discontinuation and, along with emotional support, should consider the use of alternative medications for the control of symptoms.

Anti-Anxiety Agents↗
PubMed1987

Mania with associated organic factors.

Thirty-nine patients with bipolar illness preceded by organic factors were compared to age and sex matched bipolar controls. The patients with pre-existing organic factors were older at onset of their bipolar illness, had fewer depressive episodes, less family history of affective disorder, and were symptomatically different in a number of respects. The nosology of such disorders is discussed and the literature reviewed.

Adult↗
PubMed1987

Mania following head trauma.

The authors present psychiatric and neurologic data on 20 patients who developed mania after closed head trauma. An association was seen between severity of head trauma (based on length of posttraumatic amnesia), posttraumatic seizure disorder, and type of bipolar disorder. The manic episodes were characterized by irritable mood rather than euphoria and by assaultiveness. Psychosis occurred in only 15% of the sample, and 70% had no depressive episodes. Bipolar disorders were absent among 85 first-degree relatives. The authors suggest that posttraumatic seizures may be a predisposing factor in posttraumatic mania.

Adult↗
PubMed1987

Alcoholism.

Alcoholism is a major health problem that impinges on a multitude of areas. This article will emphasize common primary care presentations, diagnosis, genetics, epidemiology, medical complications, and management.

Adult↗
PubMed1985

Lithium-carbamazepine versus lithium-neuroleptic prophylaxis in bipolar illness.

Fourteen DSM-III diagnosed patients with lithium-resistant bipolar affective disorder treated with a combination of lithium and carbamazepine were followed in a lithium clinic for one year to study the prophylactic benefit and side effects of this drug regimen. Comparison data for the previous year on lithium and neuroleptics showed that for the 9 patients who completed the study, the lithium-carbamazepine regimen was superior to lithium-neuroleptics in decreasing the number of affective episodes and side effects. Carbamazepine blood levels appeared to be a possible contributing factor in the development of side effects.

Adult↗
PubMed1985

A family study of familial positive vs. familial negative alcoholics.

Of 259 alcoholics studied, 173 were primary alcoholics. Familial positive primary alcoholics tended to have earlier onset of alcoholism and males seemed to have more complications from drinking. Family study data indicated that the familial positive group had family pedigrees more likely to contain relatives with antisocial personality disorder. This relationship to antisocial personality may help in explaining previous research findings in familial positive alcoholics.

Adult↗
PubMed1985

Separate heritability of alcoholism and psychotic symptoms.

The authors identified 259 alcoholic probands and 507 first-degree relatives. Alcoholic relatives of probands with psychotic symptoms were significantly more likely to have psychotic symptoms than those related to probands without psychotic symptoms. This finding suggests separate genetic transmission.

Alcoholism↗
PubMed1985

Theophylline-lithium interaction.

The effect of steady state therapeutic theophylline serum levels on lithium renal clearance was investigated. Group mean lithium renal clearances and serum lithium levels varied in predicted fashion. Individual variability in these parameters was significant. Clinical implications are considered and management suggestions made.

Adult↗
PubMed1984

Theophylline precipitated alterations of lithium clearance.

The effect of steady state therapeutic theophylline serum levels on lithium clearance was investigated. A significant increase in lithium clearance occurred with the administration of theophylline. Despite considerable intersubject variability, a direct lithium clearance estimation method demonstrated a mean increase of 30% with the addition of theophylline. The concomitant use of lithium and theophylline potentially may alter lithium levels sufficiently to result in manic or depressive relapses in patients receiving lithium prophylactically.

Adult↗
PubMedDate not supplied

Antidepressant response in chronic major depression.

Treatment response to antidepressant medication was examined in 59 patients with nonchronic major depression and 35 patients with chronic major depression. Patients with chronic major depression had a poorer response to imipramine or desipramine than nonchronic patients.

Adult↗
PubMedDate not supplied

Classification of alcoholism with reference to comorbidity.

Classification of individuals with alcoholism is currently limited. The purpose of this analysis was to determine whether antisocial personality disorder and other primary psychiatric syndromes identified subgroups of alcoholics with differing characteristics. Alcoholic probands (n = 224) with alcoholism were divided into those with primary alcoholism (n = 128), antisocial alcoholism (n = 50), and secondary alcoholism (n = 46). These groups were evaluated with regard to alcohol-related symptoms and upon a variety of psychiatric signs and symptoms. The secondary alcoholism. The antisocial alcoholic and primary alcoholic groups demonstrated many similarities, but overall, the antisocial alcoholic group appeared most severe. The antisocial alcoholic group additionally exhibited a dissociation between the subjectively reported and the observed behavior. These findings support the concept of heterogeneity within the alcoholism spectrum. Longitudinal data are needed to determine whether the observed cross-sectional differences predict outcome differences.

Adult↗
PubMedDate not supplied

Personality disorder traits in generalized anxiety and panic disorder patients.

Eight-four panic disorder (PD) and 29 generalized anxiety disorder (GAD) patients were compared with respect to abnormal personality traits assessed by a structured interview (Structured Interview for DSM-III Personality [SIDP]) and a self-report inventory (Personality Diagnostic Questionnaire [PDQ]). An earlier study using many of the same patients by Noyes et al. found PD patients to have more extensive axis I psychopathology than GAD patients. However, in this study it was the GAD patients who appeared to have greater axis II pathology. In particular, when using a subset of patients who had been matched for age and gender, the GAD patients reported more antisocial traits. This finding is particularly interesting, since the matched samples consisted primarily of women in their forties and fifties.

Adult↗
PubMedDate not supplied

EEG abnormalities in bipolar affective disorder.

Forty-six patients with bipolar illness were evaluated with scalp-recorded electroencephalograms. Familial pattern of psychopathology was evaluated between groups with clinically normal and abnormal EEG tracings. Those with abnormal EEGs were noted to have a significantly negative family history of affective disorder when compared to the EEG normal group. These results may support the concept of some patients with mania having an acquired illness which occurs independent from its genetic loading.

Bipolar Disorder↗
PubMedDate not supplied

Unipolar depression in the elderly. Reoccurrence on discontinuation of tricyclic antidepressants.

Nine of 15 elderly male VA outpatients receiving long-term tricyclic antidepressant therapy underwent gradual placebo substitution under double-blind conditions. Three of the 9 (33.3%) experienced a reoccurrence of depressive symptoms on placebo (at 4, 5 and 6 months). None of the 6 remaining on active medication experienced a reoccurrence. The Hamilton Depression Scale and Montgomery Asberg Depression Rating Scale scores indicate a significantly (P less than 0.05) worse outcome for those switched to placebo. The results suggest the need for close follow-up after discontinuation of antidepressant therapy in this population.

Aged↗
PubMedDate not supplied

Failure to detect organic factors in mania.

Forty patients from an outpatient lithium clinic were studied who had a clear history of organic abnormalities which predated their affective symptomatology. In the course of reviewing the clinical histories regarding these patients, it was observed that only 37.5% of the patients had ever received a clinical diagnosis of organic affective syndrome. Variables associated with a failure to consider a diagnosis of organic affective syndrome were investigated.

Adolescent↗