Biomedical subjects
B M Maletzky
Publications and source records attributed to B M Maletzky.
Conventional and multiple-monitored electroconvulsive therapy. A comparison in major depressive episodes.
In retrospective and anecdotal reports, multiple-monitored electroconvulsive therapy (MMECT), a procedure in which a number of seizures are induced within a single treatment session, has been noted to be as effective more rapidly than conventional electroconvulsive therapy (CECT). However, several studies have reported an increased risk of very long seizures and prolonged confusional states with the multiple procedure. The present study investigated CECT and MMECT in a prospective, single-blind protocol measuring a number of variables within three general areas of concern: efficacy, safety, and efficiency of treatment. Results indicate that CECT and MMECT were equally effective in 54 patients with a major depressive episode; the treatments differed, however, in persistence of side effects and in efficiency as measured by cost-effectiveness and the utilization of staff and physician time.
Anxiolytic efficacy of alprazolam compared to diazepam and placebo.
The anxiolytic effects of alpraxolam (0.5--3.0 mg), diazepam (5--60 mg) and placebo were evaluated in eighty-six out-patients suffering from moderate to severe psychoneurotic anxiety in this 28-day, double-blind study. Efficacy was evaluated using five rating instruments, three rated by the physician (Hamilton Anxiety Rating Scale, Physician's Global Impressions and Target Symptoms) and two by the patients (Self-Rating Symptom Scale and Patient's Global Impressions). Alprazolam was more effective than placebo on all five measures of efficacy and, on several parameters, more effective than diazepam as well. The incidence of side-effects was lowest in the alprazolam group and decreased steadily over the course of the study, whereas the incidence in the diazepam and placebo groups remained relatively unchanged.
Enhancing the efficacy of lithium treatment by combined use with diuretics and low sodium diets: a preliminary report.
Because reports have indicated that sodium metabolism may bear some influence on manic-depressive illness, the present study was designed to test the efficacy of sodium depletion in enhancing lithium's therapeutic effect. Twenty-seven manic patients refractory to lithium doses producing therapeutic serum lithium levels were subjected to lithium alone, lithium in combination with a thiazide diuretic, and lithium in combination with a low sodium diet. Results indicated that such combinations could be helpful in reducing manic symptoms in the majority of patients without engendering undue toxicity. While mechanisms of action remain to be elucidated, it appears that such combinations may be safely administered to those manic patients not responding to lithium alone or to those requiring lithium but suffering either a lithium-induced nephrogenic diabetes insipidus or other severe side effects. However, caution is still advised in employing these combinations until further, better controlled research substantiates these preliminary data.
The alcohol provocation test.
An alcohol provocation test is described wherein a 20% solution of alcohol was injected intravenously in 57 subjects with three major goals: 1) To determine criminal culpability. 2) To determine alcohol activation of the electroencephalogram. 3) To aid in treatment of the chronic alcoholic through personal feedback. The test was found safe and reliable. Results are interpreted on the basis of behavioral observations and blood alcohol levels. Advantages of such a test are reviewed.
Lithium treatment for psychiatric disorders.
Although used around the world since 1949, lithium has come into extensive use in psychiatry in the United States only within the past decade. Before initiating treatment with this drug, physicians must be familiar with the diagnostic scheme of the major affective disorders, the indications and contraindications to lithium's use, and its principles of treatment, including evaluation before lithium therapy, criteria for monitoring blood levels and signs of impending toxicity. Despite earlier reports about the toxicity of lithium when it was promoted as a salt substitute, lithium is a safe drug. Its use not only has revolutionized the treatment of the major affective disorders, but has opened up new and broad avenues of research into the regulation of man's emotions.
Phenelzine as a stimulant drug antagonist: a preliminary report.
Phenelzine administration, monitored via a pharmacy-controlled program, was employed in 38 subjects over a 6-month period to prevent amphetamine-type drug abuse, in much the same manner as disulfiram programs are employed against alcohol abuse. Advantages of the program were apparent, with a majority of subjects abstaining during the enforced phenelzine trial. Subjects generally made use of this abstinent period to benefit from a variety of psychotherapeutic modes, and demonstrated enhanced job and school performance and improved marital relationships. Results based on subject and observer reports, reports from dispensing pharmacies, and random urinalyses for drugs were encouraging. However, the study was uncontrolled and observational, and thus results are merely suggestive at present. Potential dangers as well as benefits of administering phenelzine to such a population are discussed.
The diagnosis of pathological intoxication.
Subjects with a history of violent or psychotic behavior while under the influence of alcohol were infused with a 25% alcohol solution. Based on electroencephalograms, blood alcohol concentrations and behavioral observations, the results confirm the probable existence of a discrete syndrome of pathological reaction to alcohol without reference to the amount of alcohol consumed.
Addiction to diazepam.
Literature is reviewed which raises the question of diazepam's addicting potential. To explore this issue, 50 subjects referred from medical, surgical, and psychiatric clinics were evaluated by interview regarding their use of diazepam. Replies to a standardized interview were combined with physicians' ratings of addiction under two conditions: without and then with the knowledge that the drug in question was diazepam. A computer-aided analysis of these data, including a correlation matrix, revealed surprisingly strong evidence for diazepam's capacity to elicit tolerance and withdrawal in this sample. Psychiatric patients were no more "addiction-prone" in this regard than patients given diazepam for medical conditions. Of equal significance, physicians' impressions of addiction were significantly altered toward a more favorable view when they learned that the drug in question was diazepam. Implications for psychiatric and medical practice are discussed, and suggestions for further controlled research offered.
The prevalence of alcoholism in a military hospital.
Explore the source record for details and available documents.
"Assisted" covert sensitization in the treatment of exhibitionism.
Explore the source record for details and available documents.
Addiction to propoxyphene (darvon): a second look.
Explore the source record for details and available documents.
Assisted covert sensitization for drug abuse.
Explore the source record for details and available documents.
The treatment of homosexuality by 'assisted' covert sensitization.
Explore the source record for details and available documents.
The episodic dyscontrol syndrome.
Explore the source record for details and available documents.