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Biomedical subjects

D F Klein

Publications and source records attributed to D F Klein.

At least 271 records · Page 15Linked to original sources
PubMed1980

A slippery slope.

Explore the source record for details and available documents.

Peer Review↗
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 We believe that simply contrasting the relative efficacy of TCAs and MAO inhibitors is outdated.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

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

Comparison of the clinical effectiveness of "short" versus "long" stay psychiatric hospitalization. IV. Predictors of differential benefit.

One hundred seventy-three patients were randomly assigned to LT (long term, unlimited length of stay, mean 179 days) vs. ST (short term, 90-day limit) psychiatric hospitalization. Three-year follow-up results showed few between-group differences, although LT patients tended to be rehospitalized more and had superior relative ratings of psychopathology. Demographic and clinical data did not predict differential benefit from LT or ST hospitalization. Diagnosis did not generally predict differential benefit either, except that clinically diagnosed personality disorders, given LT as opposed to ST hospitalization, had poorer role functioning and less psychiatric treatments after discharge. Patients with a history of drug abuse did worse if given LT hospitalization in terms of role functioning and rehospitalization. Overall, this study agrees with other relevant studies in indicating that hospitalization should be kept as short as feasible.

Adjustment Disorders↗
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↗
PubMed1978

Behavior therapy, supportive psychotherapy, imipramine, and phobias.

In a controlled outcome study of phobias, 111 adult patients (69% women, 31% men) received a course of 26 weekly treatment sessions consisting of (1) behavior therapy and imipramine hydrochloride (2) behavior therapy and placebo, or (3) supportive psychotherapy and imipramine. Patients were classified as agoraphobic, mixed phobic, or simple phobic. The great majority of patients in all groups showed moderate to marked global improvement (70% to 86%, depending on rater). In agoraphobics and mixed phobics (both groups experiencing spontaneous panic attacks), imipramine was significantly superior to placebo. There was no difference between behavior therapy and supportive therapy, both resulting in high improvement rates (76% to 100%, depending on rater). In simple phobic patients, there was a high rate of improvement with all treatment regimens (72% to 93%, depending on rater), with no significant difference between imipramine and placebo or between behavior therapy and supportive therapy. Of 88 moderately to markedly improved patients followed up for one year after completing treatment, 83% maintained their gains and 17% relapsed. No patients showed symptom substitution. Eighteen percent of the patients receiving imipramine hydrochloride showed marked stimulant side effects on from 5 to 75 mg/day.

Adult↗
PubMed1978

Are prophylactic antiparkinson drugs necessary? A controlled study of procyclidine withdrawal.

Of 55 aftercare patients receiving long-term treatment with antipsychotic and antiparkinson (AP) drugs, 37 were switched to being given placebo, and 18 remained on a regimen of procyclidine hydrochloride. The dose of antipsychotic was kept constant. After three weeks extrapyramidal side effects (EPS) developed in 54% of those patients receiving placebo and in none of those receiving procyclidine (P less than .002): Twenty-seven percent of the placebo group had EPS without akinesia, and in the same percentage akinesia developed (P = .003). We believe the risk-benefit ratio favors the routine use of AP drugs for prophylaxis and maintenance so as to avoid misdiagnosing as psychopathology, unspontaneity due to akinesia, and to reduce unreliable pill-taking due to EPS.

Adult↗
PubMed1978

Long-acting oral vs injectable antipsychotic drugs in schizophrenics: a one-year double-blind comparison in multiple episode schizophrenics.

Sixty patients meeting the criteria established for schizophrenia who attained a clinical plateau following hospital discharge were randomized to receive for one year either penfluridol, 20 to 160 mg orally once each week, or fluphenazine decanoate, 0.5 to 4 ml every two weeks. The relapse rate for both treatments was low and equal. The rate of recurrence of psychosis for patients receiving penfluridol was 7% and for those receiving fluphenazine decanoate 10%. A retrospective comparison of the penfluridol group was made to a similar group of patients assigned to placebo in an earlier study. Placebo-treated patients had a relapse rate of 68%. Penfluridol patients had statistically fewer psychotic relapses. Questions about the possible carcinogenicity of penfluridol in animals will have to be resolved before it can be widely used. This study demonstrates the feasibility of using an oral, long-acting antipsychotic agent. It would be a useful psychopharmacologic addition in the treatment of outpatient schizophrenics.

Administration, Oral↗
PubMed1978

Premorbid asocial adjustment and outcome in schizophrenia.

Prognostic value of the Premorbid Asocial Adjustment Scale (PAAS) was examined for a mixed group of 135 schizophrenics. The PAAS had nonsignificant correlations with three global outcome measures 1 and 2 years after admission for the patient group as a whole. However, the previous finding that the PAAS had prognostic value for nonchronic schizophrenic patients was confirmed. Prognostic correlations were significant for the half of the subjects who were above average in prehospital functioning, and were even higher in the younger half of this subgroup. The scatterplot of the prognostic relationship suggested the expected triangular shape, with poor prognosis associated with poor outcomes and good prognosis associated with mixed outcomes.

Adult↗
PubMed1978

Comparison of the incidence and severity of extrapyramidal side effects with fluphenazine enanthate and fluphenazine decanoate.

Forty-nine schizophrenic outpatients stabilized on oral antipsychotic medication and procyclidine received 12.5 mg or 18.75 mg of fluphenazine enanthate or fluphenazine decanoate and were examined for extrapyramidal side effects one and two weeks later. Extrapyramidal side effects were present in 30 patients (61%) but were clinically significant in only 11 (22%). Fluphenazine enanthate produced more clinically significant extrapyramidal symptoms, particularly akathisia, than did fluphenazine decanoate.

Adolescent↗