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Biomedical subjects

K Rickels

Publications and source records attributed to K Rickels.

At least 145 records · Page 8Linked to original sources
PubMed1986

One-year follow-up of anxious patients treated with diazepam.

A 1-year follow-up was conducted on patients who had participated in a 6-month diazepam maintenance study. Of 180 patients contacted, 131 patients (73%) responded. Observed relapse rate was 63%, and Hopkins Symptom Checklist (HSCL) scores at follow-up were significantly higher for relapsed than for nonrelapsed patients. Two thirds of all relapsed patients sought some kind of medical, social, or psychiatric help, frequently including medication. Patients who were the most improved at the end of the diazepam maintenance trial consistently had the lowest HSCL scores at the time of follow-up. The implication of these findings for the management of chronic anxious patients is discussed.

Adult↗
PubMed1985

Alprazolam, amitriptyline, doxepin, and placebo in the treatment of depression.

Five hundred four outpatients suffering from a major depressive episode were randomly assigned to receive either amitriptyline, doxepin, alprazolam, or placebo. The study was conducted in three treatment centers during a six-week period. All three active medications produced significantly more clinical improvement than did placebo, irrespective of the patient's initial anxiety, depression, and psychomotor retardation and irrespective of the patient's assignment to various subtypes of depression, including the DSM-III melancholia subtype. Compared with placebo, sedation was reported more frequently with all three medications, whereas anticholinergic effects were reported more frequently only for the two tricyclic antidepressants, but not for alprazolam.

Adult↗
PubMed1985

Desipramine and 2-hydroxydesipramine plasma levels in endogenous depressed patients. Lack of correlation with therapeutic response.

Studies of the relationship between plasma concentrations of desipramine hydrochloride and clinical response have shown contradictory results, and only one prior study examined 2-hydroxydesipramine and its relationship to treatment. We therefore performed a study in a large, carefully diagnosed group of depressed patients taking fixed maintenance doses of desipramine to elucidate a potential relationship between clinical response and plasma concentrations of desipramine and 2-hydroxydesipramine. There was no significant correlation between clinical response and steady-state plasma levels of desipramine, 2-hydroxydesipramine, or the sum of desipramine plus 2-hydroxydesipramine. Although some commercial laboratories suggest a specific therapeutic plasma level "range" for desipramine, our data provide no support for such a range, nor for the routine measurement of plasma desipramine and 2-hydroxydesipramine concentrations in depressed patients.

Adolescent↗
PubMed1985

Psychological evaluation and support in a program of in vitro fertilization and embryo transfer.

This report describes the psychological evaluation of 200 couples consecutively seen at a pretreatment consultation in an in vitro fertilization and embryo transfer program. Attitudinal and emotional characteristics of the sample are also described. Half the women and 15% of the men reported that infertility is the most upsetting experience of their lives. On the Minnesota Multiphasic Personality Inventory (MMPI), approximately 20% of the males and females had one or more elevated scale scores, suggesting dysfunctional emotional distress or personality difficulties. Half the sample had high scores on the MMPI Ego Strength scale, which indicated effective functioning and ability to withstand stress. T scores for the Taylor Manifest Anxiety Scale were in the normal range before treatment. Further longitudinal study is needed to define the emotional impact of procedures and reactions to treatment outcomes.

Adult↗
PubMed1985

Behavioral and emotional factors and treatment responses in a study of anovulatory infertile women.

In a controlled treatment study of 49 anovulatory infertile women, responses to clomiphene citrate (CC) and placebo treatments were compared and associations of behavioral and emotional factors with treatment responses were investigated. In the first treatment series, ovulation occurred in 20 of 24 women in the CC group and 8 of 22 women in the placebo group. Pregnancy was achieved by 11 women during CC treatment and 3 women during placebo treatment. Overall, 28 women completed the protocol and 21 withdrew. Those who achieved pregnancy (n = 14) did not differ significantly from the ovulation-only group (n = 22) on pretreatment measures of emotional, behavioral, and personality factors including the Hopkins Symptom Checklist (HSCL-90), Eysenck Personality Inventory, Langner Screening Scale, Mood Analog Scale, Social Adjustment Scale, Mooney Problem Checklist, and the Minnesota Multiphasic Personality Inventory (MMPI). Conclusions were that a placebo response was observed in both ovulation and pregnancy, but psychologic factors as measured in this sample were not associated with these treatment outcomes.

Adult↗
PubMed1985

Early treatment response in anxious outpatients treated with diazepam.

Two hundred and two moderately chronic psychiatric outpatients, all suffering from anxiety of at least moderate severity and all diagnosable as cases of Generalized Anxiety Disorder, participated in a single-blind 6-week trial of diazepam (15-40 mg/day). The trial was preceded by a 1 week placebo washout, and provided for evaluation visits after 1, 2, 4 and 6 weeks of diazepam treatment. Patients were divided into High, Medium and Low Initial Improvers using 1 week change in Hamilton Anxiety Scale total score to assign patients to three subgroups of equal size. These groups did not differ significantly on those demographic factors and attributes of illness history which were documented, nor on assessments of symptom and illness severity, and mode of intake. Examination of a number of patient and physician assessments of illness severity revealed that the High group had the greatest 6-week improvement, the Low group the least. During the first week, the High group attained 86%, the Medium group, 65%, and the Low group, 29% of its full 6-week drug response. Diazepam dose levels were lowest for the High group and highest for the Low group. Placebo response was least for the High group and greatest for the Low group. An attempt to find distinctive attributes of the three initial improvement groups was unsuccessful.

Adult↗
PubMed1985

Comparison of two dosage regimens of fluoxetine in major depression.

The effect of dose frequency on fluoxetine efficacy and safety was evaluated in a double-blind study in patients with major depressive disorder. The patients received fluoxetine once a day (in the morning) or twice a day (in the morning and at noon). There were no significant differences between the two groups in the mean measures of efficacy, all of which showed significant improvement over baseline (p less than .001). Adverse experience profiles were not significantly different, with nervousness/anxiety predominating in both groups. In the subsequent 48-week open-label study, the percentage of patients reporting adverse experiences decreased greatly.

Adult↗