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Biomedical subjects

K Rickels

Publications and source records attributed to K Rickels.

At least 181 records · Page 10Linked to original sources
PubMed1983

Relationship between tricyclic antidepressant plasma levels and clinical response in patients treated with desipramine or doxepin.

A study examining the relationship between plasma levels of tricyclic antidepressants (TCA), clinical response, and side effects was performed in patients with major affective disorder. Patients received either desmethylimipramine (DMI) (150-200 mg/day) or doxepin (200 mg/day) for 4 weeks. No significant correlations were found between plasma levels and either clinical response or side effects when males and females were analyzed together. A significant correlation between plasma levels and response was found in females taking desmethylimipramine. Support for the finding that females may show a stronger relationship than males between clinical response and plasma TCA levels is provided from analysis of previous studies in the literature.

Adult↗
PubMed1983

A controlled clinical trial of alprazolam for the treatment of anxiety.

The authors report the results of a large-scale double-blind study comparing the anxiolytic effects of alprazolam, a triazolobenzodiazepine; diazepam, a 1,4-benzodiazepine; and placebo in 151 anxious outpatients. Alprazolam and diazepam produced similar clinical improvement, which was significantly larger than improvement produced by placebo and was clearly evident after only 1 week of treatment. The incidence of sedation was lower with alprazolam than with diazepam.

Adult↗
PubMed1983

Clinical trials of hypnotics.

This article reviews the clinical literature of flurazepam, temazepam, and triazolam. The long half-life drug flurazepam and the short half-life drug triazolam produced similar results in terms of clinical improvement and adverse effects when equivalent dosages were administered. Temazepam, in the present U.S. formulation, appeared to be less effective in sleep latency than the other two compounds.

Anti-Anxiety Agents↗
PubMed1983

Nonbenzodiazepine anxiolytics: clinical usefulness.

Although the benzodiazepines have been proven effective and safe in the treatment of anxiety, research has continued in an effort to find agents that lack sedative effects and abuse/dependence liability, and do not potentiate the effects of CNS depressants. Although several nonbenzodiazepine agents have shown anxiolytic effects, most are ineffective, or their efficacy not proven, in generalized anxiety disorder (GAD). One nonbenzodiazepine, buspirone, has shown significant efficacy in treating GAD in comparisons with placebo and reference compounds. Further investigations are necessary to assess effects of use over time.

Adrenergic beta-Antagonists↗
PubMed1982

The impact of favorable and unfavorable life events on psychotropic drug response.

A group of 410 primarily anxious psychiatric outpatients treated with chlordiazepoxide, 244 treated with diazepam, and 537 receiving placebo were asked to report any significant favorable or unfavorable life events which occurred during both the first and the second 2 weeks of a 4-week double-blind drug trial. The frequency with which favorable and unfavorable events were reported did not differ across medication groups. However, patients reporting unfavorable events showed significantly less improvement after 2 and 4 weeks of treatment than did patients reporting no events or patients reporting favorable events. The amount of improvement experienced by patients reporting positive events did not differ significantly from that of patients reporting no events. The size of the impact of reported events upon outcome did not vary with treatment agents. Essentially similar results were obtained when data based on 2- and 4-week patient improvement ratings were analyzed. It was concluded that the occurrence of significant life events during the course of drug trials of the type involved here did not affect the sensitivity with which drug-placebo differences could be detected.

Adult↗
PubMed1982

Growth hormone, prolactin and thyrotropin responses to gonadotropin-releasing hormone in depressed patients and healthy volunteers.

Growth hormone (GH), prolactin (PRL) and thyrotropin (TSH) release following gonadotropin-releasing hormone (GnRH) administration were examined in 56 patients with major affective disorder (37 unipolar, 19 bipolar) and 38 normal healthy subjects. There were no differences in GH, PRL or TSH responses after GnRH infusion between the patients and the normal subjects, in contrast to previously reported abnormalities in depressed patients. Serum GH concentration increased after GnRH in both normal and depressed men; serum TSH increased after GnRH in both normal women and bipolar women, but not in unipolar depressed women. Further studies comparing GnRH to saline infusion will be necessary to determine if the GH and TSH responses seen in this study are due to GnRH or result from the stress of the experimental procedures.

Adult↗
PubMed1982

Double-blind comparison of doxepin and desipramine in patients with primary affective disorder.

A double-blind comparison of doxepin versus desipramine was performed in carefully defined patients with research diagnosis of Primary Affective Disorder. While both drugs showed equal efficacy after 4 weeks, doxepin demonstrated a more rapid onset of action and surprisingly few side effects. Desipramine did not prove to be "activating" and did not worsen agitated depression. Although doxepin showed few autonomic side effects, it was nevertheless sedating, indicating that tricyclics with more anticholinergic effects are not necessarily more sedating drugs.

Adult↗
PubMed1982

Trazodone in depressed outpatients.

The authors compared the nontricyclic antidepressant trazodone with amitriptyline and placebo in a double-blind study of 202 unipolar depressed outpatients. Trazodone's clinical efficacy was similar to that of amitriptyline, with both active drugs producing significantly more clinical improvement than placebo. The incidence of anticholinergic side effects was lower for the patients taking trazodone than for those taking amitriptyline.

Adult↗
PubMed1982

Benzodiazepines in the treatment of anxiety.

The efficacy of the benzodiazepines in the symptomatic treatment of nonpsychotic anxiety has been well established. Eight benzodiazepines are presently available in the U.S. as anxiolytics. Research conducted over many years has shown that such nonpsychotic anxious patients respond best to anxiolytics if they suffer from high levels of emotional and somatic symptoms of anxiety and from low levels of depression and interpersonal problems. Despite the widespread use of benzodiazepines, it has been difficult to demonstrate tolerance or physical dependence to these drugs when used in therapeutic doses. In addition, data clearly indicate a pattern of conservative benzodiazepine use and possible an under- rather than overuse. Thus, the argument is made that cost-benefit ratios should be considered when discussing the use of benzodiazepines for the treatment of anxiety.

Anti-Anxiety Agents↗
PubMed1982

Never-pregnant adolescents and family planning programs: contraception, continuation, and pregnancy risk.

Four hundred urban Black teenagers enrolling in a family planning program before pregnancies occurred were followed for one year to assess factors influencing continuation of contraceptive use. Over half the follow-up respondents claimed to always use contraception. Program discontinuers were less likely to use contraception, but nearly half had no sex activity when contacted at follow-up. Sex frequency reported in the sample was low. Background factors of age, grade, and household were associated with contraceptive use and with pregnancy. Girls who had pregnancies were significantly more likely to live in a single-parent household, to have sex more frequently, and to have stated at enrollment that they wanted their first child before age 20. A majority of the sample, nearly all of whom obtained oral contraception, did not know at the one year follow-up how to use any alternative methods for preventing conception, hence many would again be at risk of pregnancy when sex activity resumed.

Adolescent↗
PubMed1982

Buspirone and diazepam in anxiety: a controlled study.

The anxiolytic properties of buspirone were assessed in a 4-week double-blind study in 240 anxious patients, 81 of whom received buspirone, 81 diazepam, and 78 placebo. Patients were required to have scores greater than or equal to 9 on the Covi and greater than or equal to 18 on the Hamilton Rating Scale for Anxiety, and to endorse at least 5 items on a 17-item Anxiety Entry Checklist. Among 212 evaluable patients, those who improved most were married, well-educated females who had both a positive family adjustment and a low level of depression. Diazepam produced relatively equal improvement in females and males. Diazepam seems more effective in reducing somatic symptoms, while buspirone appears more effective in reducing symptoms associated with cognitive and interpersonal problems. Main differences between the drugs were seen in side effect profiles.

Adult↗
PubMed1982

Amitriptyline-perphenazine and doxepin in depressed outpatients: a controlled double-blind study.

Amitriptyline-perphenazine (100/8-150/12 mg/day) and doxepin (100-150 mg/day) were compared for clinical efficacy and safety in a sample of 130 nonpsychotic depressed outpatients. Maximum study duration was 4 weeks; 19 amitriptyline-perphenazine and 29 doxepin patients completed less than or equal to 3 weeks of treatment and 45 amitriptyline-perphenazine and 37 doxepin patients completed 4 weeks of treatment. Patients in both groups showed significant improvement in depression, but amitriptyline-perphenazine produced greater improvement than doxepin on several measures of depressive symptomatology. The incidence of anticholinergic and sedative side effects was higher in the amitriptyline-perphenazine treated group.

Adult↗