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Biomedical subjects

D R Sweeney

Publications and source records attributed to D R Sweeney.

At least 37 records · Page 2Linked to original sources

Single-dose bromocriptine reverses cocaine craving.

Thirteen hospitalized cocaine addicts complaining of cocaine craving were given a single dose of bromocriptine, a dopamine agonist, in a randomized, double-blind, placebo-controlled study design. Compared to placebo, bromocriptine caused a significant reduction in craving ratings. These data suggest that bromocriptine may be effective as a new, nonaddictive pharmacological treatment for cocaine addicts and support the notion that functional dopamine depletion occurs with chronic cocaine use. Open trials indicate that low-dose bromocriptine may be useful in cocaine detoxification.

Adult↗

Treatment of outpatients with borderline personality disorder.

Outpatient treatment of patients with borderline personality disorder is sometimes more difficult and more challenging than inpatient treatment. Because symptoms are frequently less florid and more variable in the outpatient, diagnostic evaluation must proceed at a slower pace. Diagnostic distinctions among patients with borderline personality disorder are based on whether the predominant symptoms displayed are "affective," "schizotypal," or "impulse-disordered." Outpatient evaluation requires a keen sensitivity to the presenting problems and the ability to assign priorities to treatment issues. Pharmacotherapy can be of advantage in treating outpatients with borderline personality disorder, but care must be taken in selecting appropriate drugs and dosage and in communicating to the patient what can be expected during therapy. Borderline patients with impulse-control disorders, especially substance abuse, cannot be treated effectively with individual psychotherapy alone. Although many creative and articulate psychodynamic formulations of borderline personality disorder have been proposed, an initial "cognitive" approach to psychotherapy combined with pharmacotherapy can be effective in alleviating acute symptoms, and more psychodynamic approaches can be employed when the patient is better equipped to use them.

Ambulatory Care↗

Evaluating depression in alcoholics.

The persistence of untreated depression was evaluated in 49 severely depressed alcoholics. After 2 weeks of sobriety, 80% of patients with initial major depression by Research Diagnostic Criteria were no longer depressed. These patients improved without antidepressant medications, suggesting the need for a 2-week period of sobriety before psychopharmacotherapy for depression is instituted. Many severe depressions in actively drinking or recently sober alcoholics may represent alcohol-induced organic affective syndromes which, unlike major depressive illness, remit spontaneously with sobriety.

Adult↗

Efficiently-run practices--ways to keep costs in line.

Containment of health care costs is a serious concern today for everyone, including the local, state and federal governments, industry and the private sector. Physicians are looked at as the "bad guys" in the cost containment battle as publicity focuses on the high cost of office visits, procedures, tests and hospital charges. When you add to that the additional image of the "rich doctor," it is easy to understand why so much attention is paid to the doctor as the perceived reason for the high costs of care. Medical practices are also guilty of fostering that image as patients perceive an inefficient approach about the business side of medicine. And, as an inefficient office usually adds to a practice's overhead, someone must be expected to cover that extra cost. That someone, unfortunately, is the patient--either by a direct payment of increased fees or by the added cost of the insurance premium. What follows are some basic items of good business management that should help cut your practice expenses, whether you are solo or part of a group practice. The streamlining of your practice should enable you to keep your costs--and your fees--in line. And, as medicine changes with health maintenance organizations and preferred provider organizations becoming more of a factor, it will be essential for your practice to be cost efficient to compete.

Cost Control↗