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Biomedical subjects

M Mavissakalian

Publications and source records attributed to M Mavissakalian.

At least 37 records · Page 2Linked to original sources
PubMed1986

Agoraphobia: relative and combined effectiveness of therapist-assisted in vivo exposure and imipramine.

Sixty-two chronically agoraphobic patients completed a controlled study to assess the effects of 1) imipramine up to 200 mg/day (mean = 130 mg/day), 2) 12 weekly therapist-assisted in vivo exposure sessions (flooding), and 3) imipramine plus flooding. The control group received systematic therapeutic instructions for self-directed in vivo exposure (programmed practice). Clinical measures of global severity, phobia, panic, anxiety, depression, and behavioral performance tests were administered before treatment and at Weeks 4, 8, and 12 of treatment. Results revealed significant improvement in all groups on all measures over the course of treatment; almost a third of the control patients showed marked improvement. Imipramine had significant effects on improvement of phobias and markedly increased clinical response rates in patients receiving 150-200 mg/day. Less chronicity and severity of condition also predicted better clinical outcome. Flooding had limited effects above and beyond programmed practice, and no imipramine-flooding interactions effects were found.

Adult↗
PubMed1985

Tricyclic antidepressants in obsessive-compulsive disorder: antiobsessional or antidepressant agents? II.

The authors explored the relationship between the antiobsessional and antidepressant effects of tricyclic drugs in primary obsessive-compulsive disorders. Study 1 consisted of a controlled 12-week trial with clomipramine (N = 7) and placebo (N = 5); study 2 analyzed the pooled data from 15 patients uniformly selected and treated with either clomipramine or imipramine. Although the antiobsessional and antidepressant effects of the drugs covaried, their antidepressant action was not a prerequisite for their antiobsessional effect. The findings suggest that clomipramine and probably imipramine possess specific antiobsessive effects that are at least partially independent of their antidepressant effects.

Adult↗
PubMed1985

Imipramine in the treatment of agoraphobia: dose-response relationships.

The authors examined dose-response relationships in 62 agoraphobic patients receiving either imipramine or placebo under double-blind conditions in conjunction with behavioral interventions. At the end of 12 weeks, patients treated with imipramine had improved significantly more than placebo patients. Results revealed that the beneficial therapeutic effect of imipramine was dose dependent and suggested that optimal response in agoraphobia may require doses of 150 mg/day or more. The results also indicated that side effects can significantly interfere with the buildup of optimal dose in agoraphobic patients treated with imipramine. The authors briefly discuss the implications of these findings for clinical practice and future research.

Agoraphobia↗
PubMed1984

The relationship of plasma imipramine and N-desmethylimipramine to improvement in agoraphobia.

Plasma tricyclic concentrations were assessed in 15 agoraphobic patients receiving combined imipramine and behavioral treatments. Imipramine but not N-desmethylimipramine plasma levels were found to significantly correlate with improvement. The results suggest that imipramine's effect in agoraphobia might be mediated predominantly through the serotonergic action of the parent drug. There was also suggestive evidence for differential antipanic and antiphobic-antidepressant effects. Implications for future studies of the mechanism of action of drug effects in agoraphobia are discussed.

Adult↗
PubMed1983

Tricyclic antidepressants in obsessive-compulsive disorder. Antiobsessional or antidepressant agents?

The response to tricyclic antidepressants of eight obsessive-compulsive patients was assessed at pretreatment and at 4, 8, and 12 weeks of treatment, with the aim of delineating differential rates of improvement, or desynchrony, between the various symptoms. Change in obsessive-compulsive symptoms paralleled change in depression and anxiety, suggesting a global beneficial effect of the drugs. The analysis of individual data also revealed this synchronous pattern of change, with significant improvement, in responders, occurring within the first 4 weeks of treatment. Furthermore, responders had higher initial Hamilton depression ratings compared to nonresponders. These results do not lend support to the claim that tricyclics possess specific antiobsessional effect which is independent of their antidepressant effect. The limitations of a purely symptomatic approach in exploring the mode of action of antidepressants in obsessive-compulsive disorder is briefly discussed.

Adolescent↗
PubMed1983

Mitral valve prolapse and agoraphobia.

Of 46 female agoraphobic patients, three had definite and four had probable mitral valve prolapse--a total prevalence of only 15%. There were no significant differences between patients with mitral valve prolapse and the rest of the sample on demographic and clinical variables, nor did the groups differ significantly on measures of psychological symptoms assessed before and after treatment. These negative findings support recent reports indicating that agoraphobia associated with mitral valve prolapse may be indistinguishable from agoraphobia without mitral valve prolapse.

Adolescent↗
PubMed1983

Pharmacological treatment of agoraphobia: imipramine versus imipramine with programmed practice.

Eighteen agoraphobic patients with randomly assigned to 12 week treatment with imipramine (I) or imipramine and programmed in-vivo exposure practice (I+BT) to investigate the contribution of behavioural instructions to the clinical effects of pharmacotherapy. Significantly greater improvement on phobic measures was found in the I+BT group compared to the I group. Differences were less marked on measures of panic and anxiety. The results suggest that imipramine possesses an antiphobic effect which can be substantially enhanced with programmed practice. Controlled large-scale investigations of the pharmacological and instructional effects of the phamacotherapy of agoraphobia are needed for a definitive evaluation of the specific antiphobic effect of antidepressant drugs.

Adult↗
PubMed1982

Pharmacologic treatment of anxiety disorders.

The benzodiazepines and the beta-adrenergic blockers are effective in the treatment of anxiety neurosis (generalized anxiety disorder and panic disorder) but offer little help in the treatment of agoraphobia and obsessive-compulsive disorders. The antidepressants are often effective in agoraphobia and obsessive-compulsive disorders, and the evidence suggests that their antipanic and antiobsessional effects may be independent of their antidepressant properties. There is suggestive evidence linking the antiobsessional effect to a specific neurotransmitter (serotonin) system.

Adrenergic beta-Antagonists↗