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Biomedical subjects

M Lader

Publications and source records attributed to M Lader.

At least 145 records · Page 8Linked to original sources
PubMed1981

Benzodiazepine withdrawal phenomena.

A withdrawal syndrome is described in 10 patients who claimed to be unable to discontinue benzodiazepines. A high dose group took the equivalent of a mean of 135 mg diazepam/day, and the normal dose group of 20 mg/day. Associated with the gradual reduction of medication was the emergence of severe symptoms of anxiety as well as sensory intolerance, perceptual disturbances and weight loss. The withdrawal syndrome subsided after 2 weeks and was similar in both groups of patients. EEG changes were detected on withdrawal opposite to those known to be associated with initiation of diazepam treatment. The measures tended to revert to the baseline after a drug-free period. One reason why chronic users of diazepam experience difficulty in stopping medication may be the development of a withdrawal syndrome even after moderate dosage.

Adult↗
PubMed1981

Diazepam, propranolol and their combination in the management of chronic anxiety.

The therapeutic benefit of combining propranolol with diazepam over either of these drugs given alone was tested in a placebo-controlled crossover study with twenty-four chronically anxious out-patients. The combination was generally more effective than diazepam. Diazepam was more effective than placebo or propranolol. A reduction in the resting pulse rate by propranolol of more than 7.5 beats per minute resulted in a greater therapeutic response to this drug, alone and in combination. Lesser degrees of pathology responded better to treatment. Psychological factors in treatment showed themselves to be important in moderating pharmacological response. Chronically anxious patients generally derived little benefit from continued anti-anxiety treatment.

Adult↗
PubMed1980

Habituation of physiological responses in anxiety.

In the first study, 20 male and 20 female volunteers were studied under threat-of-shock and no-threat conditions with respect to anxiety levels, skin conductance, EEG auditory evoked response, and alpha-blocking variables. The threat-of-shock increased anxiety levels, skin conductance level, and fluctuations. The P300 component of the AER was greater in anxious individuals and habituation of the alpha-blocking response was retarded. In the second study, 12 anxious patients were compared with 12 normal subjects under threat-of-shock and 12 normal subjects under no-threat. Anxiety was associated with increased skin conductance fluctuations, larger P300 AER components, and impaired habituation of the alpha response.

Adult↗
PubMed1979

Psychological performance in anxious patients treated with diazepam.

1. After each week of a flexible dosage treatment with either diazepam, amylobarbitone or placebo anxious patients were assessed by a comprehensive battery of psychiatrist's ratings, subjective tests and psychological performance tasks to detect the clinical and psychological effects of the drugs. 2. Self rated anxiety and insomnia were improved significantly by diazepam, while amylobarbitone improved only the self rated insomnia. 3. An impairment of performance relative to placebo was detected on two performance tasks after the barbiturate and on six performance tasks after the benzodiazepine. 4. The patient's reported level of anxiety under each treatment condition was related to the performance on the five tasks showing drug effects, thus confirming the postulated inverted U-shape relationship between drive and performance.

Adult↗
PubMed1979

A comparison of the clinical and psychological effects of diazepam and amylobarbitone in anxious patients.

1. Twenty-four anxious inpatients were treated with diazepam, amylobarbitone sodium and placebo in flexible dosage for 1 week. They each received all three treatments according to a fully-balanced design, using double-blind procedures. 2. The clinical and the psychological effects of the drugs were assessed by the comprehensive battery of psychiatrist's ratings, subjective and psychological tests before treatment and at the end of each week of treatment. The tests included self-rating of anxiolytic and hypnotic effects, reaction-time, card sorting, coding and cancellation tasks, arithmetic and tappin. 3. Diazepam improved significantly subjective anxiety and insomnia, while amylobarbitone improved only the self-rated quality of sleep. Occasion effects were absent on clinical measures, indicating that the patients did not respond to non-specific temporal factors. Performance on motor tasks improved over time because of the expected practice effect, but an impairment relative to placebo was detected on two motor tests after the barbiturate and on four other tests with a cognitive component after the benzodiazepine.

Adult↗
PubMed1979

Effects of anxiety on attitudes--a semantic differential study.

Eighteen female out-patients suffering from chronic anxiety states and 25 normal women matched for age filled in an anxiety inventory and completed semantic differential forms on 21 concepts grouped into four areas: characters, locations, human interactions and abstractions. Each concept was rated on 15 scales grouped into four types: evaluation, activity-potency, sex evaluation and danger. The normal subjects were divided into high anxiety and low anxiety subgroups on the basis of their trait anxiety scores. Anxious patients rated themselves with lower self-esteem and confidence. They reacted with apprehension to unfamiliar locations and perceived danger in other people. Sexual activity and the human body were viewed negatively. Anxious patients' apprehension were particularly raised by vague abstractions.

Adult↗
PubMed1979

Sleep and hypnotics.

Sleep is an enigma and the clinical importance of disturbed sleep is not clear. Much has been learnt in the past 25 years of the physiology of normal and abnormal sleep. Complaints of insomnia can be related to several causes--normal extreme patterns, psychiatric, physical, specific and drug-related. The treatment of insomnia is essentially that of the primary condition. Hypnotics have a limited role and their use should always be carefully considered.

Adult↗
PubMed1979

Drug concentrations in neuropsychiatry: alternative approaches.

The practical value of measuring plasma concentrations is to optimize treatment in order to attain the best balance in each particular patient between wanted clinical therapeutic effects and unwanted adverse and side-effects. This increase in treatment efficacy can be concurrent--that is, the treatment is monitored and the dosage changed as necessary--or predictive, where the results of a test dose can be used to calculate the appropriate dosage. Wanted effects include: (1) the attainment of adequate drug concentrations for the minimum period of time necessary, as in the use of antibiotics; (2) the suppression of symptoms, as in the use of the benzodiazepines in anxiety states; (3) the use of drugs to improve function, e.g. levodopa in Parkinsonism; (4) drugs are used to prevent episodes of illness; and (5) complex suppression of symptoms, as with the antidepressives and antipsychotics. The biological alternatives to plasma level monitoring depend on establishing an empirical relationship between the putative monitor and the clinical response. Such measures avoid the problem of estimation of drug concentration at the receptor. Examples include monoamine oxidase activity in platelets, the uptake of amines into platelets, neuroendocrine measures such as prolactin concentrations, the electroencephalogram, and peripheral measures such as pulse rate, pupil size and tremor.

Biogenic Amines↗