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Biomedical subjects

G Chouinard

Publications and source records attributed to G Chouinard.

At least 91 records · Page 5Linked to original sources
PubMed1987

Early phase II clinical trial of remoxipride in treatment of schizophrenia with measurements of prolactin and neuroleptic activity.

Twenty hospitalized schizophrenic patients on haloperidol (doses 6 to 80 mg/day; median, 30 mg/day) underwent 4 days of placebo washout before being treated for 6 weeks with remoxipride, a new benzamide derivative with selective D2-dopamine receptor blocking properties. All patients completed the clinical trial period with week 6 doses ranging from 75 to 500 mg/day (median, 225 mg/day). Comparison of final scores with end of placebo washout showed improvement in schizophrenic symptoms in 10 patients and a reduction in the mean score for Clinical Global Impression of severity of illness (14.1%) and Brief Psychiatric Rating Scale total score (23.0%). Remoxipride caused less parkinsonism than the prior neuroleptic therapy and appeared to have little masking effect on tardive dyskinesia. Only slight evidence of serum neuroleptic activity was shown by radio-receptor assay measurements using [3H]spiperone binding and calf caudates, and the drug's effect on prolactin elevation was short-lasting (less than 10 hours). The mean elimination half-life of remoxipride was 5.9 hours. These results add to the consistent impression that D2 receptor blockade predicts clinical antipsychotic effects.

Adult↗
PubMed1987

Clonazepam in acute and maintenance treatment of bipolar affective disorder.

This is a report on the efficacy of clonazepam in the treatment of acute mania. The advantages of clonazepam over standard neuroleptics are its rapidity of action, its lack of toxicity, and, particularly important, the fact that it does not cause tardive dyskinesia, a potentially disabling neurological side effect of neuroleptic treatment. Results are reported of double-blind, controlled studies comparing clonazepam with lithium and with haloperidol in the treatment of acutely manic patients who were newly admitted through an emergency room. For the maintenance treatment of patients with bipolar illness, a combined approach is outlined that involves medications with different mechanisms of action. Treatment is initiated with lithium, and, if necessary, tryptophan is added to enhance lithium response; drug-resistant patients who fail to respond satisfactorily to lithium or lithium plus tryptophan are given adjunctive clonazepam therapy.

Acute Disease↗
PubMed1986

Bromazepam and lorazepam in generalized anxiety: a placebo-controlled study with measurement of drug plasma concentrations.

Sixty outpatients with a diagnosis of generalized anxiety were randomly assigned to 4 weeks of treatment with bromazepam, lorazepam or placebo, following a 1-week placebo washout period. There was no significant difference in the anxiolytic effects of bromazepam and lorazepam, both of which were superior to placebo. However, lorazepam-treated patients tended to have a more depressed mood than those treated with bromazepam. Drug-treated patients had consistently less cognitive impairment than those treated with placebo, the difference being statistically significant (P less than .05) in the case of bromazepam. The most frequent side-effects reported with each drug were drowsiness, which tended to subside with time, and depression, which tended to emerge toward the end of the 4-week period. There was a positive correlation (r = 0.64) between age and bromazepam plasma concentration per unit dose, adjusted for weight, and a negative correlation (r = -0.50) between weight and lorazepam plasma concentration per unit dose, adjusted for age.

Adolescent↗
PubMed1986

A controlled clinical trial of fluspirilene, a long-acting injectable neuroleptic, in schizophrenic patients with acute exacerbation.

A 4-week double-blind controlled clinical trial was carried out in which fluspirilene, an injectable diphenylbutylpiperidine neuroleptic given weekly, was compared to chlorpromazine in the treatment of 40 newly admitted schizophrenic patients with acute exacerbation. Similar therapeutic improvement was obtained with both drugs, but men needed a significantly higher mean dose of fluspirilene (23 mg/week) than women (13 mg/week). Fluspirilene induced more parkinsonism than chlorpromazine, but less drowsiness, dizziness, and dry mouth. The difference between the sexes in the potency of fluspirilene and its greater potential to induce parkinsonism may be related to its lesser presynaptic and D1-dopamine receptor blocking properties. The low incidence of autonomic side effects confirms the relative specificity of fluspirilene for dopamine receptors.

Adult↗
PubMed1986

An open clinical trial of fluoxetine in the treatment of obsessive-compulsive disorder.

In a 9-week open label study, seven outpatients with obsessive-compulsive disorder were treated with fluoxetine, a selective inhibitor of neuronal reuptake of serotonin. After a 7-day placebo washout period, patients were given a dose of 40 mg/day, which was gradually increased to a maximum of 80 mg/day. A significant improvement was found in the symptomatology of patients as measured on the obsessive-compulsive subscale of the Comprehensive Psychopathological Rating Scale (p less than 0.001) and the Clinical Global Impression of severity of illness (p less than 0.01). These findings support the hypothesis that serotonergic antidepressants may be useful in the treatment of obsessive-compulsive disorder and underline the need to carry out double-blind clinical trials to confirm these results.

Adult↗
PubMed1986

Clonazepam in the treatment of patients with recurrent panic attacks.

Imipramine, phenelzine, and alprazolam have each been shown to be efficacious in the treatment of panic disorder and in agoraphobia with panic attacks. Clonazepam is a high-potency 1,4-benzodiazepine derivative with an intermediate to long elimination half-life that is used mainly in neurology as an antiepileptic. Eight cases of recurrent panic attacks successfully treated with clonazepam are reported.

Adult↗
PubMed1985

A controlled clinical trial of L-tryptophan in acute mania.

In a 2-week study, 24 newly admitted manic patients were treated for 1 week with L-tryptophan (12 g/day); during the second week, half the patients, chosen at random, continued to receive tryptophan, while placebo was substituted in the other half under double-blind conditions. In the open phase of the study, there was a clinically and statistically (p less than 0.001) significant reduction in manic symptom scores, with little need for haloperidol prn. Patients who continued to be treated with tryptophan showed no significant change in mean scores during the second week, but those who were switched to placebo tended (p less than 0.10) to show an increase in the mean scores for manic symptoms. There was a significant (p less than 0.05) increase in the geometric mean of morning fasting total and free plasma tryptophan concentrations in men, but not in women. These results suggest that increasing the synthesis of 5-hydroxytryptamine has some therapeutic effect in mania.

Acute Disease↗
PubMed1985

An open clinical trial of clonazepam in the treatment of patients with recurrent panic attacks.

Imipramine, phenelzine and alprazolam have each been shown to be efficacious in the treatment of panic disorder and in agoraphobia with panic attacks. Clonazepam, a 1,4 benzodiazepine derivative used mainly in neurology as an anti-epileptic, has specific pharmacodynamic and pharmacokinetic properties which would make it an advantageous antipanic agent. We report 8 cases of recurrent panic attacks which were successfully treated with clonazepam.

Adult↗
PubMed1985

Remoxipride in schizophrenia: effects on plasma prolactin.

Twenty hospitalized schizophrenic patients were treated for six weeks with remoxipride. All patients completed the clinical trial. Ten patients showed marked improvement in schizophrenic symptoms, and all patients showed a statistically significant (p less than .05) reduction in the mean score for CGI severity of illness and BPRS total score. Remoxipride was found to cause less parkinsonism than the prior neuroleptic therapy and appeared to have little masking effect on tardive dyskinesia. The absence of steady state plasma prolactin elevations differentiates remoxipride from classical neuroleptics while the peak increase of plasma prolactin concentrations 1 hour after drug intake confirms that remoxipride has some effect in the pituitary system. Results from this study underline the importance of D2 receptor blockade in achieving an antischizophrenic effect.

Adult↗