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Biomedical subjects

K Rickels

Publications and source records attributed to K Rickels.

At least 199 records · Page 11Linked to original sources
PubMed1981

Limbitrol (amitriptyline plus chlordiazepoxide) revisited.

A reanalysis of 4-week data from a recently published study (Feighner et al. 1979) clearly demonstrate that in a significant subgroup of highly depressed patients who also suffer from at least moderate anxiety, significant treatment differences in favor of Limbitrol over AT were present not only after 1 or 2 weeks, but also after 4 weeks of treatment. These differences were not present in the less sick patients, a population in which AT was slightly favored. These findings suggest that not only is Limbitrol more effective than AT alone for a heterogeneous group of depressed patients with some concomitant anxiety during the early phases of treatment, but remains more effective that AT for a significant subgroup of highly depressed patients after 4 weeks of treatment.

Adult↗
PubMed1981

Clobazam and diazepam in anxiety.

The anxiolytic effects of clobazam, diazepam, and placebo were compared in a 4-wk double-blind study of 159 anxious outpatients, primarily from family practice. Clobazam (30 to 80 mg/day) and diazepam (15 to 40 mg/day) were found to induce similar side effect, primarily sedation, and although both active drugs induced greater clinical improvement than placebo, clobazam induced the largest degree of improvement in most aspects. It was speculated that the relatively high daily dosage of diazepam may have been contributed to these results.

Adult↗
PubMed1981

Are benzodiazepines overused and abused?

1 Drug use has to be viewed in the context of symptoms or illnesses for which they are prescribed. It is concluded that overall psychotropic drugs are used conservatively. 2 The benzodiazepines are safe drugs and in contrast with other centrally acting agents overuse will rarely have severe consequences. 3 Abrupt discontinuation may lead to temporary withdrawal reactions in patients who have been taking benzodiazepines regularly for 4 months or longer. Such reactions may occur more frequently in patients taking high doses.

Anti-Anxiety Agents↗
PubMed1981

Coffee consumption, cigarette smoking and reporting of drowsiness in anxious patients treated with benzodiazepines or placebo.

Data obtained from anxious outpatients treated with either chlordiazepoxide or diazepam (n = 533) or placebo (n = 285) were used to explore the impact of coffee/tea and cigarette consumption upon the frequency of reporting of drowsiness after 2 weeks of treatment. Strong evidence was provided that both cigarette smoking and coffee drinking affect the frequency with which drowsiness is reported by patients receiving the two benzodiazepines. However, not only the magnitude but also the direction of the impact of coffee consumption upon drowsiness depends upon the level of cigarette smoking and vice versa. For patients smoking less than or equal to 1 pack of cigarettes/day, drowsiness is reported less frequently by heavy coffee users while for patients smoking greater than 1 pack of cigarettes/day, drowsiness is reported more frequently by heavy coffee users. Similarly, for patients drinking less than or equal to 2 cups of coffee/day, drowsiness occurs less frequently among heavier smokers while for patients drinking greater than 2 cups of coffee/day, drowsiness occurs more frequently among heavier smokers. These results are consistent with reports that particular substances contained in coffee and tea and in cigarette smoke stimulate the synthesis of hepatic enzymes which metabolize both the benzodiazepines here studied and the substances which have stimulated enzyme synthesis.

Anxiety Disorders↗
PubMed1981

Amoxapine and imipramine in the treatment of depressed outpatients: a controlled study.

In a double-blind, controlled study 158 outpatients with unipolar depression were treated for six weeks with amoxapine, imipramine, or placebo to assess the antidepressant effects of the new dibenzooxazepine compound, amoxapine. Forty-five amoxapine, 43 imipramine, and 27 placebo patients completed at least four weeks of treatment. Active drugs produced significantly more improvement at treatment endpoint, according to several physician-rated measures, but patient-rated measures failed to differentiate among treatments. Both active drugs at daily doses up to 200 mg produced an equal amount of moderate and marked global improvement, and both produced significantly more side effects than did placebo.

Amoxapine↗
PubMed1981

Withdrawal and pseudowithdrawal from diazepam therapy.

We present two cases from a double-blind placebo-controlled study of diazepam in treatment of anxiety that illustrate the importance of attitudes of patients and physicians towards use of diazepam. Patient 1 exhibited symptoms of nausea, depression and increased anxiety, which both he and the research psychiatrist interpreted as a withdrawal reaction. Examination of the treatment code, however, revealed that the patient had been kept on the same dose of diazepam throughout this period and that he had maintained therapeutic plasma diazepam levels. This case illustrated a "pseudowithdrawal reaction" in a patient being maintained on active drug treatment. Patient 2 benefited remarkably from maintenance diazepam therapy and had manifested considerable anxiety during double-blind placebo substitution but his private physician expressed great reluctance to continue this treatment regimen because he had been influenced by unfavorable publicity. Further information on maintenance diazepam therapy and problems with withdrawal must be obtained under carefully controlled conditions.

Adult↗
PubMed1980

Withdrawal reaction from long-term, low-dosage administration of diazepam. A double-blind, placebo-controlled case study.

Symptoms of diazepam withdrawal developed in a young man who had been taking diazepam in dosages of 15 to 25 mg/day during a six-year period. This was verified in a study conducted under placebo-controlled, double blind conditions, with plasma levels of diazepam and its major metabolite, desmethyldiazepam, monitored throughout the course of the study. Severe symptoms of physiological withdrawal were observed within two days of replacement of diazepam with placebo capsules. The patient recovered promptly on reinstitution of diazepam administration, and relapsed during a second withdrawal phase. During an additional two week-period of placebo administration, the patient's condition first worsened, then gradually improved. Examination of plasma levels of diazepam and desmethyldiazepam indicated no obvious pharmacokinetic abnormalities. Thus, with long-term administration of diszepam, even in therapeutically accepted doses, withdrawal reactions can be encountered on abrupt termination.

Adult↗
PubMed1980

Amitriptyline once daily vs three times daily in depressed outpatients.

Two dosage schedules of amitriptyline hydrochloride, once daily vs three times daily, were compared in a group of 124 nonpsychotic depressed outpatients. After four weeks of treatment, patients on the once daily schedule had improved significantly more than patients receiving multiple doses on both physician and patient measures. The two groups did not differ in their attrition rates nor in reporting of side effects. Since treatment response to the tricyclic antidepressants is often delayed, once-daily dosage seems to offer a distinct advantage over more conventional multiple doses in depressed outpatients.

Adjustment Disorders↗
PubMed1980

Ketazolam and diazepam in anxiety: a controlled study.

Ketazolam (both in once-daily and three-times-daily dosing), diazepam, and placebo were compared for effectiveness in relieving anxious symptomatology in a clinical trial conducted with a total of 222 anxious, non-psychotic outpatients. Results indicated that improvement occurred early in treatment, that ketazolam was equally effective in both once-daily and three-times-daily dosing, and that ketazolam was similar in effect to diazepam. Ketazolam (both once-daily and three-times-daily) and diazepam were significantly (P < 0.05) better than placebo in alleviating symptoms of anxiety, as measured by the Hamilton Anxiety Scale, the Covi Anxiety Scale, and a physician-rated measure of global improvement.

Adult↗
PubMed1980

Relapse after short-term drug therapy in neurotic outpatients.

A 6-month follow-up of 184 anxious depressed neurotic outpatients who reported improvement after controlled drug trials of several weeks duration revealed an astonishing relapse rate of 81% for anxious and 87% for depressed patients. Early as compared to late relapse was associated with more chronicity and less improvement at the end of the drug trial, while type of drug received did not affect relapse. Onset of relapse had no effect on help-seeking behavior. At time of follow-up, non-relapsed patients had lowest and untreated relapsed patients had highest symptom levels. It was concluded that short-term drug treatment alone does not represent sufficient therapy for chronic neurotic anxious or depressed outpatients.

Adult↗
PubMed1980

Adolescent contraceptive use: comparisons of male and female attitudes and information.

Information and attitudes about contraception and pregnancy were assessed with a self-administered questionnaire in a sample of urban Black teenagers. Data were obtained from 607 male and female students in high school health classes and a demographically similar group of 123 never-pregnant teenage women in a family planning clinic who had not attended these classes. Males were less likely to recognize the risk of pregnancy, had less information about contraceptives, and fewer attitudes that supported contraceptive use than females who participated in the same shool health classes. More males than females indicated that school classes had been the main source of contraceptive information. Teenage women in the family planning clinic did not differ from the high school females in attitudes about contraceptives, but the school group had somewhat more contraceptive information. The female school group was more likely to have discussed contraception with parents, obtained more contraception information from their mothers, and discussed contraception more with male friends than the teenagers who requested contraceptives at the family planning clinic.

Adolescent↗
PubMed1980

Psychiatric illness in family practice.

One hundred twenty patients from each of 6 family practices were surveyed to determine the prevalence of symptom-based psychiatric illness (emotional distress) in family practice. Assessments of presence or absence of emotional distress and the severity of this distress were made using ratings made by the treating physician and by the patient. Nineteen percent of the surveyed patients were designated by their physicians as having "high distress," and 21% by the patient-completed abbreviated Hopkins Symptom Checklist (HSCL-25). High concordance (86.7%) existed between the "case" assessment by the physician and the patient's own rating of distress. For the majority of "high distress" patients, pharmacotherapy was considered the treatment of choice by physicians.

Adult↗