Search PubMed⌕ Search

Biomedical subjects

G Chouinard

Publications and source records attributed to G Chouinard.

At least 127 records · Page 7Linked to original sources
PubMed1984

Rebound anxiety in anxious patients after abrupt withdrawal of benzodiazepine treatment.

In this double-blind, placebo-controlled study of 4 weeks of benzodiazepine treatment followed by 3 weeks of abrupt or gradual drug withdrawal, 16 patients whose benzodiazepine was withdrawn abruptly were worse (p less than .05) than 13 who had received placebo in terms of change in mean anxiety scores from the pretreatment level. The scores of seven patients (44%) whose benzodiazepine was withdrawn abruptly increased 10% or more on both the Hamilton Rating Scale for Anxiety and the Self Rating Symptom Scale. There were no cases of rebound anxiety in 14 patients whose benzodiazepine was withdrawn gradually; fewer cases of rebound anxiety were seen with a benzodiazepine that had a long half-life.

Acute Disease↗
PubMed1984

Withdrawal symptoms after long-term treatment with low-potency neuroleptics.

Twenty-six chronic schizophrenic outpatients receiving low-potency anticholinergic neuroleptics were switched over periods of up to 2 years to an equivalent dose of high-potency neuroleptics. Of these patients, 85% experienced withdrawal symptoms, mainly insomnia, anxiety, and tensional restlessness. Complete withdrawal of low-potency medication was achieved during the study period in 9 patients only. The mean duration of treatment with low-potency neuroleptics was 15 years and the mean dose was 147 mg chlorpromazine equivalents/day. It is suggested that new symptoms associated with withdrawal of low-potency neuroleptics may lead to overcompliance by patients and difficulty in achieving the minimum therapeutic dosage. Thus, low-potency neuroleptics would not appear suitable for the long-term treatment of most schizophrenic patients.

Adult↗
PubMed1983

Piracetam in elderly psychiatric patients with mild diffuse cerebral impairment.

In a 12-week double-blind study, piracetam at two dose levels (2.4 and 4.8 g/day) was compared to placebo in the treatment of 60 elderly psychiatric patients with mild diffuse cerebral impairment, but no signs of focal brain lesion. The psychiatric illness, schizophrenia or affective disorder, of patients selected was in remission at the time of the study. Monthly evaluations by the nurse revealed that piracetam improved overall functioning, particularly alertness, socialization, and cooperation, relative to the control group. Patients treated with 2.4 g/day piracetam also showed significant improvement in scores for the full IQ and the memory quotient on the Wechsler Adult Intelligence and Memory Scales; greater response was seen in those with lower initial scores. Piracetam at 4.8 g/day had a more rapid onset of action on behavioral variables than 2.4 g/day, but its therapeutic effect tended to diminish at 12 weeks, possibly as the result of overstimulation. Piracetam did not appear to interfere with concomitant psychotropic maintenance medication or affect the psychiatric illness itself.

Aged↗
PubMed1983

New concepts in benzodiazepine therapy: rebound anxiety and new indications for the more potent benzodiazepines.

Abrupt withdrawal of benzodiazepine treatment in generalized anxiety patients was found to induce a rebound anxiety state in addition to minor physical symptoms. Controlled clinical trials suggest that the newer high potency benzodiazepines (alprazolam, clonazepam and bromazepam) have novel psychiatric indications and greater anxiolytic effect than the classical benzodiazepines. Alprazolam, a triazolobenzodiazepine, was superior to placebo in the treatment of panic disorder, for which medium or low potency benzodiazepines are generally inefficacious. Clonazepam, an anticonvulsant which increases 5HT synthesis, was more efficacious than lithium in reducing manic symptoms. Bromazepam, a new potent benzodiazepine, was superior to diazepam in the treatment of generalized anxiety disorder.

Alprazolam↗
PubMed1983

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

In a double-blind, placebo-controlled study, 48 anxious outpatients with a primary diagnosis of generalized anxiety disorder were randomly assigned to 4 weeks of treatment with bromazepam (18 mg/day), diazepam (15 mg/day), or placebo, after a 1-week washout period. From week 1 onward both active drugs were superior to placebo in relieving anxiety symptoms. Bromazepam was found to be significantly more effective than diazepam with respect to the somatic anxiety factor and the total score for the Hamilton Anxiety Rating Scale and the fear/anxiety factor of the Patient's Self-Rating Symptom Scale. Plasma concentrations of diazepam plus active metabolites were correlated significantly (r = 0.60, p less than 0.05) with the percentage reduction in self-rating anxiety scores. Bromazepam plasma concentration measurements showed greater variability than those of diazepam and were not found to be correlated significantly with clinical response. It is suggested that the use of strict diagnostic criteria (1978 draft of the third edition of Diagnostic and Statistical Manual of Mental Disorders), adequate sample sizes, and a 4-week study period gave increased sensitivity for the detection of significant differences between the two benzodiazepines.

Adult↗
PubMed1983

A comparative study of bupropion and amitriptyline in depressed outpatients.

A double-blind controlled trial comparing a standard antidepressant drug, amitriptyline, with a new compound, bupropion, was conducted at six centers. There was a placebo washout, after which patients were assigned in a randomized fashion to one of the two treatments. No significant difference was found in therapeutic response to the two drugs after 4 weeks of treatment. Anticholinergic and cardiovascular side effects were less common in the bupropion-treated patients.

Adolescent↗
PubMed1983

Bupropion and amitriptyline in the treatment of depressed patients.

Bupropion, a specific dopamine reuptake inhibitor, was compared to amitriptyline in two multicenter studies involving 183 depressed outpatients and inpatients. Initial results from these ongoing studies provide additional evidence of the antidepressant activity of bupropion. At the end of the treatment periods (6 weeks for inpatients and 13 weeks for outpatients), bupropion appeared to be at least as effective as amitriptyline. However, bupropion exerted a slightly but nonsignificantly smaller overall therapeutic effect than amitriptyline during the first 4 weeks of drug treatment. Slight weight loss and dopaminergic side effects, such as insomnia, nausea/vomiting, and anorexia, were somewhat more common among bupropion-treated patients. Compared to bupropion, amitriptyline induced more weight gain and had more anticholinergic, antihistaminic, and antiadrenergic side effects. In view of its numerous sites of action, amitriptyline does not appear to be the ideal antidepressant. It remains to be demonstrated whether bupropion has any advantage over secondary amine tricyclic antidepressants, such as nortriptyline and desipramine.

Adolescent↗
PubMed1983

Antimanic effect of clonazepam.

Twelve acutely manic patients, newly admitted from the emergency room, were treated wih clonazepam or lithium carbonate in a double-blind cross-over design: half the patients chosen randomly received 10 days of treatment with clonazepam followed immediately by 10 days of treatment with lithium, while the others received the same treatments in reverse order. Clonazepam was found to be significantly more efficacious than lithium in reducing manic symptoms despite the fact that during clonazepam treatment less patients required PRNs of haloperidol. Furthermore, both the total dose of PRN haloperidol and the number of days it was needed were significantly lower during clonazepam treatment than during lithium treatment. Clonazepam had a rapid onset of action, was highly sedative, and was well tolerated at high doses. By reducing the need for neuroleptics in the treatment of acute mania, clonazepam may decrease the risk of tardive dyskinesia in manic patients.

Acute Disease↗
PubMed1982

Pimozide in the treatment of newly admitted schizophrenic patients.

Pimozide, a specific dopamine blocking agent, was compared with chlorpromazine in a 4-week double-blind study of the treatment of 40 schizophrenic patients newly admitted to hospital through the emergency room. Dosage was adjusted according to therapeutic effect and during the final week ranged from 10--70 mg/day (median 30 mg/day) for pimozide and 600--1,500 mg/day (median 900 mg/day) for chlorpromazine. Pimozide was found to exert somewhat less of an overall therapeutic effect than chlorpromazine, particularly in highly agitated patients. Women responded better to either treatment than men. A weighted mean of the doses given to male and female patients during the final week suggests that in the treatment of acutely ill patients the mg dose equivalency of pimozide in terms of chlorpromazine is approximately 1:25, considerably lower than estimates from maintenance studies. Pimozide induced significantly more parkinsonian symptoms but less autonomic side effects than chlorpromazine. It is suggested that the weaker presynaptic dopamine blocking effect of pimozide might be responsible for its reduced potency in the treatment of acute schizophrenic symptoms.

Acute Disease↗
PubMed1982

Alprazolam in the treatment of generalized anxiety and panic disorders: a double-blind placebo-controlled study.

In a double-blind controlled study lasting 8 weeks, 50 anxious psychoneurotic outpatients with a primary diagnosis of generalized anxiety or panic disorder were randomly assigned to alprazolam (n=30), a new benzodiazepine, or placebo (n=20), after a washout period of 1 week. Alprazolam at dosages between 0.25 and 3 mg/day was found to be significantly better than placebo in the treatment of either disorder. The finding that alprazolam was effective in the treatment of panic disorder is of interest as this diagnostic category is usually treated with tricyclic antidepressants or MAO inhibitors.

Adult↗
PubMed1982

The effect of carbidopa and benserazide on human plasma 5-hydroxytryptophan levels.

Peripheral aromatic amino acid decarboxylase inhibitors increase human plasma 5-hydroxytryptophan (5-HTP) levels. However the 5-HTP, which is synthesized in the intestine, is not present in a sufficient quantity to influence brain 5-HT to any significant degree. Thus, peripheral decarboxylase inhibitors are unlikely to affect brain 5-HT function via 5-HTP which is synthesized peripherally.

5-Hydroxytryptophan↗
PubMed1982

Type I tardive dyskinesia induced by anticholinergic drugs, dopamine agonists and neuroleptics.

1. Type I risk factor for tardive dyskinesia is defined as a risk leading primarily to a reversible form, while Type II factors to irreversible forms. 2. Central anticholinergic drugs appear as the prototype of Type I drug factor which increased the clinical manifestations of the disorder, but not its overall incidence. 3. Clinical investigations of dopamine agonists suggest an important role for them in clinical management and understanding of neuroleptic-induced supersensitivity disorder. 4. We would like to propose a new classification of neuroleptics. Type I neuroleptics (estrogens, diphenylbutylpiperidines) are associated with milder and reversible dyskinesia, while Type II (Classical neuroleptics) with severe and irreversible forms.

Animals↗
PubMed1982

Sexual dysfunction and plasma prolactin levels in neuroleptic-treated schizophrenic outpatients.

A random sample of 55 schizophrenic outpatients, 26 men and 29 women, treated with neuroleptics was selected from our long term follow-up clinic. The patients rated their current sexual functioning on specially designed scales. Fifty-four per cent of male and 30 per cent of female patients reported impaired sexual functioning during neuroleptic treatment. Ninety-one per cent of female patients reported changes in menstruation. Partial correlation coefficients were calculated between sexual dysfunction score and plasma prolactin level adjusting for age. Sexual dysfunction was found to be associated with high plasma prolactin levels in male patients but not in female patients. High prolactin tended also to be associated with menstrual disturbances. Antiparkinsonian medication was not found to be correlated with either sexual dysfunction or menstrual disorder score.

Adult↗