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Biomedical subjects

F S Tennant

Publications and source records attributed to F S Tennant.

At least 37 records · Page 2Linked to original sources
PubMed1984

Five-year follow-up of opiate addicts with naltrexone and behavior therapy.

A group of 58 heroin addicts were treated with naltrexone and behavior therapy and followed for 5 years. At one-year post-treatment, almost half of the naltrexone-treated subjects were opiate free. Follow-up results at 5 years post-treatment indicate that over 90% of those patients treated with naltrexone became re-addicted for various periods of time. However, naltrexone-treated subjects did feel their treatment with naltrexone had provided them with the ability to remain opiate free for blocks of time. The results suggest that naltrexone is not a "cure" for opiate dependence, but is a medication which can be useful in protecting patients from re-addiction and is a modality patients should be encouraged to return to if they feel vulnerable to re-addiction.

Adult↗
PubMed1984

Double-blind comparison of desipramine and placebo in withdrawal from cocaine dependence.

Desipramine was compared with a placebo under double-blind conditions to determine if it is effective treatment for withdrawal from cocaine dependence. Eleven (11) subjects received desipramine and 11 received placebo. There was no significant statistical difference between groups in self-report on effectiveness; retention in treatment; cessation of cocaine use; or suppression of withdrawal scores. Although desipramine appears to be no more effective than placebo in withdrawal from cocaine use or suppression of withdrawal scores, it may be useful in the long-term treatment of this condition.

Adolescent↗
PubMed1984

Benzodiazepine dependence of several years duration: clinical profile and therapeutic benefits.

Twenty-two (22) patients with long-term benzodiazepine dependence ranging from 3.5 to 13 years (Mean 7.4 years) were referred to us for evaluation and treatment. Daily dosages ranged from 10 to 100 mg (Mean 43.8 mg) of diazepam or its equivalent. Psychiatric diagnosis by DSM-III criteria revealed that 13 (59.1%) had schizophrenic disorder; 7 (48%) had generalized anxiety disorder, and 2 (9.1%) had manic depression. Only one patient could be totally withdrawn and remain abstinent from benzodiazepines without substituting another psychotherapeutic drug. Benzodiazepine dependence appeared therapeutic in the majority of these patients since psychotic symptoms, anxiety, or alcohol abuse were reduced. Based on these observations and other studies, we suggest that long-term benzodiazepine dependence should not always be discontinued, since the patient may have severe underlying psychiatric and medical illnesses that are therapeutically well controlled.

Benzodiazepines↗
PubMed1984

Withdrawal from nicotine dependence using mecamylamine: comparison of three-week and six-week dosage schedules.

Mecamylamine (MCL) has been shown to extinguish nicotine dependence in animals and produce smoking cessation in some humans. This study was done to determine if MCL may be more effective and have fewer side-effects when administered at low dosages over a six-week period than at high dosages given over a three-week period. Subjects in the high-dose, three-week group demonstrated significantly more reduction of nicotine intake as evidenced by self-report and presence of nicotine in urine although side-effects were more pronounced. Although MCL's numerous side-effects should limit its clinical use to recalcitrant smokers who have failed other types of treatment, its nicotine antagonist property indicates it can be an effective agent to withdraw some persons from nicotine dependence.

Adult↗
PubMed1984

Clinical experience with naltrexone in suburban opioid addicts.

In a study of 160 patients (including 114 active heroin addicts and 42 former heroin addicts maintained on methadone, propoxyphene napsylate, or LAAM), subjects were retained on treatment with naltrexone for a mean of 50.7 days (range, 1-635). Clonidine or guanabenz acetate was used to detoxify subjects who received naltrexone within 10 days of their last dose of opioid. Because of the number of subjects dropping out of treatment after only a few days, it is recommended that there be an opioid-free period of 5 or more days for heroin-dependent subjects and 10 or more days for those on medical maintenance. A naloxone challenge should be administered at a dosage of 0.8 mg. Use of naltrexone combined with psychotherapy appears to promote long periods of opioid abstinence but does not prevent relapse after treatment. Trained clinicians utilizing an appropriate induction protocol can effectively treat volunteer opioid addicts with naltrexone.

Adult↗
PubMed1983

Efficacy of psychotherapeutic counselling during 21-day ambulatory heroin detoxification.

Structured, psychotherapeutic counselling during 21-day heroin detoxification was evaluated by randomly assigning a group of 25 heroin addicts to a detoxification treatment regimen with mandatory counselling by a therapist and 25 to a control group who received only standard detoxification without counselling. There was no significant difference between groups in the number who successfully detoxified as measured by conversion of morphine positive urine to morphine negative urine. The counselling intervention group did, however, improve the attendance of subjects while in detoxification treatment, and significantly more patients entered long-term treatment following detoxification. Maximal use of a counselor during 21-day heroin detoxification may best be realized by directing therapy toward engaging patients in long-term care.

Adolescent↗
PubMed1983

Acanthosis nigricans in adolescents. Two case reports and guidelines for management.

Acanthosis nigricans (AN) is a dermatologic condition of the flexor surfaces of the body consisting of papular hypertrophy, hyperpigmentation, and rugae. AN is commonly associated with malignancy when in adults but is primarily associated with endocrinologic disorders and obesity when found in adolescents. A special search for occult malignancy is not warranted in adolescents with AN unless no associated benign condition is found. Careful follow-up is recommended, however, since AN may be the first indication of a serious systemic disease.

Acanthosis Nigricans↗
PubMed1983

Outpatient treatment of prescription opioid dependence: comparison of two methods.

Outpatient treatment of 42 patients who presented with dependence upon prescription opioids was attempted by two different methods. The first group of 21 patients was treated by 21-day detoxification followed by psychotherapeutic counseling (D/C), and the next 21 patients were offered 21-day detoxification to be followed by opioid maintenance if detoxification was unsuccessful (D/M). Only 5 of 21 (23.8%) patients in the D/C group compared to 20 of 21 (95.2%) in the D/M group completed three weeks of treatment (P less than .001). On admission, no patient perceived that chronic pain due to a medical condition would be an impediment to withdrawal from opioids, but pain which was masked by opioid dependency and which emerged during detoxification proved to be an insurmountable barrier to total withdrawal in the majority of patients. Treatment of outpatients who presented with dependence upon prescription opioids was best provided in the study by opioid maintenance and adjunctive pain therapy.

Adult↗
PubMed1983

Efficacy of psychotherapeutic counselling during 21-day ambulatory heroin detoxification.

Structured, psychotherapeutic counselling during 21-day heroin detoxification was evaluated by randomly assigning a group of 25 heroin addicts to a detoxification treatment regimen with mandatory counselling by a therapist and 25 to a control group who received only standard detoxification without counselling. There was no significant difference between groups in the number who successfully detoxified as measured by conversion of morphine positive urine to morphine negative urine. The counselling intervention group did, however, improve the attendance of subjects while in detoxification treatment, and significantly more patients entered long-term treatment following detoxification. Maximal use of a counselor during 21-day heroin detoxification may best be realized by directing therapy toward engaging patients in long-term care.

Adolescent↗
PubMed1983

Cocaine and amphetamine dependence treated with desipramine.

Desipramine was administered to 8 amphetamine- and 14 cocaine-dependent persons to assist withdrawal. Nineteen of 22 (86.4%) reported discontinuation of drug use within two to seven days, of which 15 (68.2%) gave urine samples negative for amphetamines or cocaine. Recent primate studies show that chronic methamphetamine administration markedly depletes brain norepinephrine, which suggests that desipramine is probably effective in treating amphetamine and cocaine dependency because it selectively blocks norepinephrine uptake.

Adult↗
PubMed1983

Methadone plasma levels and persistent drug abuse in high dose maintenance patients.

Methadone maintenance patients who maintained on a high daily dose were divided into good performers and poor performers based on whether they demonstrated persistent use of heroin, non-prescription diazepam, and/or excessive alcohol consumption. Mean methadone plasma levels 24 hours after an oral dose of 80 mg were found to be 410.4 ng/ml in good performers compared to 101.8 ng/ml in poor performers (P less than .05). Seven of nine (77.8%) poor compared to two of 15 (13.3%) good performers had 24-hour methadone plasma levels under 50 ng/ml (P less than .01). High dose methadone patients who show evidence of persistent drug or alcohol abuse should have their 24-hour methadone plasma level determined to help assess whether the patient should receive more methadone or find an alternative treatment.

Alcohol Drinking↗
PubMed1982

Propoxyphene napsylate maintenance treatment of narcotic dependence: use of a non-methadone model.

One hundred seventy-eight (178) heroin addicts entered propoxyphene napsylate (PN) maintenance. Patients attended a general medical clinic two times each week and took home a three- to four-day supply of PN which was usually taken in doses of 300 to 400 mg three to four times per day. Over a 21-month period, the subjects entered and re-entered PN treatment 166 times (1.5 times per patient) and remained a mean of 10.6 weeks per treatment. A comparison with a group of methadone maintenance patients indicated similar performance in employment and heroin use. The ability to take PN, attend a clinic less often than daily, and discontinue and re-enter treatment on a discretionary basis is preferred treatment approach for some narcotic addicts.

Adult↗
PubMed1982

Peripheral blood findings associated with asymptomatic lead exposure.

This study was done to determine whether erythroid alterations can be found on a peripheral blood smear from an asymptomatic person exposure to excess atmospheric lead. Thirty healthy, asymptomatic adults who lived within five miles of a major Los Angeles, California freeway for five consecutive years were studied. Erythroid cytologic alterations-including-anisocytosis, poikilocytosis, polychromasia and basophilic stippling were statistically associated with increased free erythrocyte protoporphyrin levels. These findings indicate that erythroid alterations may be found on a peripheral blood smear prior to the development of clinical symptoms of lead intoxication.

Adult↗
PubMed1982

Outpatient treatment of prescription opioid dependence: comparison of two methods.

Twenty-one patients dependent on prescription opioids were treated by 21-day detoxification followed by psychotherapeutic counseling (D/C), and 21 patients were detoxified 21 days and provided opioid maintenance if detoxification was unsuccessful (D/M). Only five of 21 (23.8%) patients in the D/C group compared with 20 of 21 (95.2%) in the D/M group completed three weeks of treatment. No patient initially perceived that chronic pain due to a medical condition would be an impediment to withdrawal from opioids, but pain that was masked by opioid dependency and that emerged during detoxification proved to be an insurmountable barrier to total withdrawal in the majority of patients. Treatment of outpatients with dependence on prescription opioids is best provided by opioid maintenance therapy and adjunctive pain therapy.

Adult↗