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Biomedical subjects

J A Mattes

Publications and source records attributed to J A Mattes.

At least 37 records · Page 2Linked to original sources
PubMed1990

Comparative effectiveness of carbamazepine and propranolol for rage outbursts.

Eighty patients (randomly assigned in 51 cases) with diverse diagnoses, were prescribed propranolol or carbamazepine for temper outbursts. Results suggested that both medications were beneficial. The diagnosis of attention deficit disorder predicted preferential response to propranolol, and a diagnosis of intermittent explosive disorder predicted preferential response to carbamazepine. Results, however, were not entirely consistent and require confirmation.

Adolescent↗
PubMed1989

Clozapine for refractory schizophrenia: an open study of 14 patients treated up to 2 years.

Clozapine is a novel antipsychotic agent that selectively blocks mesolimbic--rather than nigrostriatal--dopamine receptors, causes fewer extrapyramidal symptoms than do other neuroleptics, and has superior antipsychotic efficacy in some patients. However, clozapine also causes agranulocytosis more frequently than do other neuroleptics. The evidence documenting the superior benefits obtained with clozapine has primarily involved short-term (4-6 weeks) trials, and the systematic evaluation of long-term clozapine use has been limited. In this study, 14 patients with refractory chronic schizophrenia were treated openly with clozapine up to 2 years; 8 did substantially better when given clozapine than they had when given other neuroleptics. That finding suggests that clozapine may provide a useful addition to the therapeutic armamentarium for the long-term treatment of schizophrenia, despite the increased risks and the need for frequent blood tests.

Adult↗
PubMed1988

Methylphenidate and growth in hyperactive children. A controlled withdrawal study.

The effect of stimulants on growth has been controversial. Among hyperactive children receiving long-term methylphenidate hydrochloride treatment, we examined the effects of methylphenidate withdrawal on the growth of hyperactive children randomly assigned to be taken off, or remain on, the medication regimen over two consecutive summers. After one summer, no group difference in height was found, but weight was higher in the group that had been taken off methylphenidate therapy. In contrast, two summers of being off methylphenidate treatment had a significant positive effect on height but not on weight. The results document a linkage between exposure to methylphenidate and reduction in growth velocity. However, they do not address whether the medication has long-term effects on height.

Adolescent↗
PubMed1987

A family study of patients with temper outbursts.

To evaluate the heritability of a personality trait, "having temper outbursts," and of associated diagnoses, we obtained histories of first degree relatives on two groups: (1) patients with temper outbursts (N = 33), and (2) diverse psychiatric patients without temper outbursts (N = 12). Family interviews were conducted blind to patient (temper or not) status, using a modified version of the Family History RDC. Though Ns are relatively small, and results therefore require confirmation, the data indicate familial transmission of temper problems; an average of 18.2% of Group 1 relatives had temper problems, compared to 4.3% for Group 2. The trait of having temper outbursts was more strongly transmitted than were specific diagnoses (e.g. Intermittent Explosive Disorder, Antisocial Personality Disorder or Residual Attention Deficit Disorder) associated with temper outbursts. Patients with neurological conditions apparently related to their temper outbursts were less likely to have positive family histories.

Adult↗
PubMed1987

A controlled evaluation of a JCAH regulation.

Medical services are under increasing cost/benefit scrutiny; at the same time, regulatory agencies are increasingly involved in requiring specific formats for treatment. A 1982 report of the Joint Commission on Accreditation of Hospitals (JCAH), requiring more structure for multidisciplinary Treatment Planning Conferences (TPCs), provided an opportunity for a prospective study comparing the benefits of the "old" (N = 92) vs. the "new" (n = 91) TPCs. Ratings, obtained from patients, psychiatrists, and other staff, included ratings of helpfulness of the TPC and of coordination of treatment. Results indicated superior benefit from the new TPCs on staff ratings, but not on patient ratings. The cost/benefit ratio for the new TPCs, given the need for increased staff time, is discussed. While not definitive, this study suggests that regulatory agency requirements, when feasible, should be subjected to study and to cost/benefit analysis, prior to widespread implementation.

Accreditation↗
PubMed1986

A pilot study of combined trazodone and tryptophan in obsessive-compulsive disorder.

An open pilot trial of combined trazodone and tryptophan for 11 patients with Obsessive-Compulsive Disorder was conducted to test the hypothesis that increasing serotonin activity is therapeutic for this condition. Results were not encouraging; several patients tolerated the combination poorly, but even among patients completing 2 weeks' treatment benefit was marginal.

Adolescent↗
PubMed1986

Psychopharmacology of temper outbursts. A review.

Recent studies suggest that several drugs, specifically carbamazepine, propranolol, and lithium, may alleviate rage outbursts. This literature is reviewed and possible mechanisms of action are discussed.

Adolescent↗
PubMed1985

Ceruletide for schizophrenia: a double-blind study.

Ceruletide, an analog of cholecystokinin (CCK), has been reported to have neuroleptic-like activity in mice, and, in three open studies, to benefit schizophrenic patients. This study evaluated ceruletide in schizophrenia using a double-blind design. Subjects were 17 chronic schizophrenics with residual symptoms following stabilization with neuroleptics. Patients randomly received two injections, 1 week apart, of either ceruletide (0.6 microgram/kg im) or placebo, while continuing neuroleptics; this regimen was found helpful in earlier studies. Evaluation included ratings of 29 variables related to prognosis in schizophrenia (e.g., age, number of previous hospitalizations), regular BPRSs and SCL-90s, and psychiatrist, patient, and relative ratings of global improvement. Results showed few significant differences between ceruletide and placebo, with exceptions as likely to favor placebo as ceruletide. Among the patients on ceruletide, no predictors of benefit were found. Possible reasons for the negative results are discussed.

Antipsychotic Agents↗
PubMed1985

State-dependent learning in hyperactive children receiving methylphenidate.

State-dependent learning refers to a failure of learning mastered under one drug condition to be remembered when tested under another drug condition. Previous studies of state-dependent learning in hyperactive children receiving stimulants have yielded conflicting results. The authors systematically evaluated learning and transfer of learning in children who were or were not receiving methylphenidate and included several design features intended to optimize the likelihood of demonstrating state-dependent learning. They found no evidence of state-dependent learning. These results diminish concern regarding state-dependent effects in hyperactive children who are positive drug responders and who are clinically administered methylphenidate to control their hyperactivity.

Attention Deficit Disorder with Hyperactivity↗
PubMed1985

Metoprolol for intermittent explosive disorder.

Metoprolol, a selective beta 1-adrenoreceptor blocker, was administered to two patients with intermittent explosive disorder who had not done well with previous medications, including propranolol and carbamazepine. Both patients improved dramatically, suggesting clinical and theoretical relevance.

Adult↗