The reporting of AIDS.
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Acquired Immunodeficiency Syndrome↗
Biomedical subjects
H G Pope
Publications and source records attributed to H G Pope.
Risk factors for neuroleptic malignant syndrome. A case-control study.
A number of risk factors have been proposed for the development of neuroleptic malignant syndrome, but these have not been subjected to controlled study. To address this problem, we performed a case-control study comparing 18 patients with neuroleptic malignant syndrome and 36 matched neuroleptic-treated control patients with no known history of the syndrome to identify potential risk factors. Patients with neuroleptic malignant syndrome displayed significantly greater psychomotor agitation, received significantly higher doses of neuroleptics at greater rates of dosage increase, and received a greater number of intramuscular injections than controls.
Adolescent↗
Treatment of bulimia nervosa with trazodone: short-term response and long-term follow-up.
In a 6-week, placebo-controlled, double-blind study of trazodone in 42 women with bulimia nervosa, trazodone was well tolerated and proved significantly superior to placebo in reducing the frequency of episodes of binge eating and vomiting. Nine- to 19-month follow-up of 36 study subjects revealed that 26 (72%) continued improved, with 18 (36%) in remission. Most remained on trazodone or another antidepressant at follow-up.
Adult↗
Elevated antidepressant plasma levels after addition of fluoxetine.
Four patients treated with tricyclic antidepressants and one patient treated with trazodone all demonstrated marked increases in plasma levels of these drugs after the addition of fluoxetine. Such increases could increase adverse effects.
Adult↗
Autoinduction of hypertensive reactions by tranylcypromine?
Although rarely described in the psychiatric literature, patients treated with monoamine oxidase inhibitors may experience acute hypertensive reactions that are not readily attributable to dietary indiscretion or use of concomitant medications. Four cases of apparent autoinduction of hypertensive reactions in patients receiving tranylcypromine are presented. The mechanism of this reaction is unknown, but may involve conversion of tranylcypromine to metabolites with pressor activity.
Adult↗
Valproate in psychiatric disorders: literature review and clinical guidelines.
A growing literature suggests that the anticonvulsant medication valproate may be effective and well tolerated in the acute and prophylactic treatment of some mood and psychotic disorders, particularly the manic phase of bipolar disorder and schizoaffective disorder. Valproate may sometimes be effective even in those patients who have not responded to conventional somatic therapies. This article reviews the pharmacokinetics, neurologic uses, and side effects of valproate, discusses the drug's efficacy in the treatment of primary psychiatric disorders, and presents clinical guidelines for the use of valproate.
Bipolar Disorder↗
Long-term pharmacotherapy of bulimia nervosa.
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Antidepressive Agents↗
Fluoxetine-induced akathisia: clinical and theoretical implications.
Five patients receiving fluoxetine for the treatment of obsessive compulsive disorder or major depression developed akathisia. The typical fluoxetine-induced symptoms of restlessness, constant pacing, purposeless movements of the feet and legs, and marked anxiety were indistinguishable from those of neuroleptic-induced akathisia. Three patients who had experienced neuroleptic-induced akathisia in the past reported that the symptoms of fluoxetine-induced akathisia were identical, although somewhat milder. Akathisia appeared to be a common side effect of fluoxetine and generally responded well to treatment with the beta-adrenergic antagonist propranolol, dose reduction, or both. The authors suggest that fluoxetine-induced akathisia may be caused by serotonergically mediated inhibition of dopaminergic neurotransmission and that the pathophysiology of fluoxetine-induced akathisia and tricyclic antidepressant-induced "jitteriness" may be identical.
Adolescent↗
Frequency and presentation of neuroleptic malignant syndrome in a state psychiatric hospital.
Neuroleptic malignant syndrome, a dangerous complication of antipsychotic drugs, has recently been recognized to occur more commonly than previously thought. However, the frequency of this syndrome has been assessed primarily in academic centers, and these reports may not adequately reflect its frequency in other settings. In a 2-year retrospective assessment of 551 neuroleptic-treated patients in a state psychiatric hospital, the authors diagnosed neuroleptic malignant syndrome in 5 cases (0.9%) using previously defined operational criteria. This observation suggests that the syndrome is probably as common in state facilities as in other institutions.
Adult↗
A placebo-controlled study of trazodone in bulimia nervosa.
Forty-two women who met the new narrower criteria for bulimia nervosa of DSM-III-R completed a placebo-controlled double-blind study with trazodone. The drug proved significantly superior to placebo, both in measures of frequency of binge eating and vomiting and in the patients' subjective assessments of improvement. Trazodone produced few adverse effects.
Adult↗
Pharmacological treatment of kleptomania and bulimia nervosa.
We describe three patients with concurrent DSM-III-R kleptomania and bulimia nervosa who all demonstrated a partial or complete response of both bulimic and kleptomanic symptoms to fluoxetine, trazodone, or tranylcypromine. These observations raise the possibility that pharmacological treatment may benefit kleptomania, and call for further study of the relationship between kleptomania, bulimia nervosa, and major depression.
Adult↗
Fibromyalgia and psychopathology: is fibromyalgia a form of "affective spectrum disorder"?
Several lines of evidence support a relationship between fibromyalgia and various forms of psychopathology, particularly major affective (mood) disorder. We evaluate 3 hypotheses that might explain this relationship: (1) that psychopathology is an effect of fibromyalgia; (2) that fibromyalgia is an effect of psychopathology; or (3) that both fibromyalgia and its associated psychopathology are caused by a common (but as yet unknown) abnormality. The third hypothesis may be expanded to the more general proposition that fibromyalgia, major affective disorder, and several other medical and psychiatric disorders may represent a family of related conditions--provisionally named "affective spectrum disorder" (ASD)--that share common pathophysiologic features.
Fibromyalgia↗
Acute cardiovascular response to monoamine oxidase inhibitors: a prospective assessment.
Despite the widespread use of monoamine oxidase inhibitors (MAOIs) and the well-known adverse event of hypertensive crisis, few studies have addressed the acute cardiovascular response to an MAOI dose. We prospectively measured pulse and blood pressure changes just before and at 1, 2, 3, and 4 hours after MAOI administration in 18 patients. Significant but asymptomatic increases from baseline in mean systolic and diastolic blood pressure occurred within 2 hours after MAOI administration, with return to near baseline by 4 hours. The mechanism of this reaction is unknown.
Agoraphobia↗
Lycanthropy: alive and well in the twentieth century.
Lycanthropy, the belief that one has been transformed into an animal (or behaviour suggestive of such a belief), has been described by physicians and clerics since antiquity, but has received scant attention in the modern literature. Some have even thought the syndrome extinct. However, in a review of patients admitted to our centre since 1974, we identified twelve cases of lycanthropy, ranging in duration from one day to 13 years. The syndrome was generally associated with severe psychosis, but not with any specific psychiatric diagnosis or neurological findings, or with any particular outcome. As a rare but colourful presentation of psychosis, lycanthropy appears to have survived into modern times.
Adolescent↗
Bulimia in obese individuals. Relationship to normal-weight bulimia.
We compared 23 obese subjects meeting DSM-III criteria for bulimia with 47 obese nonbulimic subjects and 47 normal-weight bulimic subjects using structured diagnostic interviews. The obese bulimic subjects were similar to the normal-weight bulimic subjects but different from the nonbulimic obese subjects in exhibiting a high lifetime rate of major affective disorder. However, the obese bulimic subjects were much less likely than the normal-weight bulimic subjects to use self-induced vomiting as a method of purging. These results suggest that obese individuals with bulimic symptoms may constitute a sizable but little-recognized population. Further studies will be required, however, to assess whether the syndrome of bulimia in obesity represents a valid diagnostic entity.
Adult↗
Possible synergism between fluoxetine and lithium in refractory depression.
Five depressed patients who had shown no improvement with trials of antidepressants from several chemical families, including fluoxetine, responded when lithium was given in conjunction with fluoxetine. Lithium augmentation of fluoxetine may represent a useful strategy in refractory depression.
Adult↗
Affective and psychotic symptoms associated with anabolic steroid use.
To assess the frequency of affective and psychotic symptoms in athletes taking anabolic steroids, the authors performed structured interviews of 41 body-builders and football players who had used steroids. According to DSM-III-R, nine subjects (22%) displayed a full affective syndrome, and five (12%) displayed psychotic symptoms in association with steroid use. These findings suggest that major psychiatric symptoms may be a common adverse effect of these drugs.
Adolescent↗
Treatment of bulimia with bupropion: a multicenter controlled trial.
In a placebo-controlled, double-blind study of the unique antidepressant agent bupropion in the treatment of nondepressed subjects with bulimia (bupropion group, N = 55; placebo group, N = 26), we found the drug significantly superior to placebo in reducing episodes of binge eating and purging. In general, side effects with bupropion were minimal. However, four subjects experienced grand mal seizures during treatment with bupropion, a frequency of seizures far higher than observed in previous studies with this drug. Pending a satisfactory explanation for the occurrence of these seizures, we recommend that bupropion not be administered alone to bulimic patients.
Adolescent↗