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Biomedical subjects

M R Liebowitz

Publications and source records attributed to M R Liebowitz.

At least 199 records · Page 11Linked to original sources
PubMed1985

Treatment of social phobia with atenolol.

Social phobia is the least well studied phobic disorder of those included in DSM-III. Reports from the British literature indicate that the condition is a distinct one that usually begins in adolescence and affects males more often than females. Patients characteristically complain of somatic symptoms and a fear of humiliation when confronted with specific social stimuli. Ten social phobic patients were openly treated with the cardioselective, peripherally active beta-adrenergic blocking drug atenolol. Five patients had complete response and four had moderate response. Side effects were minimal. Atenolol appears to work in social phobic patients by reducing autonomic nervous system response to phobic stimuli.

Adult↗
PubMed1985

Lactate infusions in obsessive-compulsive disorder.

Panic attacks followed sodium lactate infusions in one of seven patients with obsessive-compulsive disorder and 26 of 48 patients with panic disorder or agoraphobia with panic attacks. This suggests that lactate-induced panic is specific to the latter groups.

Adult↗
PubMed1985

Specificity of lactate infusions in social phobia versus panic disorders.

Lactate infusions produced panic attacks in one of 15 patients with social phobia, four of nine with agoraphobia, and 10 of 20 with panic disorder in a blind study. The proportion of patients with social phobia who panicked in response to lactate was significantly lower than that of patients with agoraphobia or panic disorder. These findings lend validity to the DSM-III classification of anxiety states. They also suggest that the pathophysiology of social phobia differs from that of disorders characterized by spontaneous panic attacks.

Adult↗
PubMed1985

Imipramine in the treatment of panic disorder and its complications.

The recognition of the efficacy of imipramine for treating panic disorder and its complications has had major implications for clinical practice, diagnostic classification, theoretic understanding, and research strategies in the anxiety disorders. It has also resulted in benefit for a great number of affected individuals and promises to yield even greater relief of suffering as the findings become more widely disseminated.

Agoraphobia↗
PubMed1984

Phenelzine v imipramine in atypical depression. A preliminary report.

Sixty patients meeting specific criteria for atypical depression completed six weeks of double-blind, randomly assigned treatment with phenelzine sulfate, imipramine hydrochloride, or placebo. The overall response rates were 67% with phenelzine, 43% with imipramine, and 29% with placebo. At week 6, phenelzine was superior to placebo on many measures, while the superiority of imipramine to placebo was confined to several variables. Phenelzine was superior to imipramine on the interpersonal sensitivity and paranoia factors of the 90-item Hopkins Symptom Checklist, with trends toward superiority on several other measures, while imipramine was not differentially superior on any measure. Atypical depressive patients with a history of spontaneous panic attacks and hysteroid dysphoric patients both showed extremely low rates of response to placebo and high rates of response to phenelzine. Conversely, those without panic or hysteroid dysphoric features responded equally to all three treatments. Responders to pheneizine also had greater platelet monoamine oxidase inhibition while receiving drug therapy than did nonresponders. Completion of the 120-patient sample will allow more detailed analyses.

Adolescent↗
PubMed1984

The tyramine challenge test as a marker for melancholia.

A previous study reported that unipolar depressives excrete significantly lower amounts of urinary tyramine-O-sulfate following oral administration of a tyramine hydrochloride load than do normal control subjects. This study replicates and extends those findings by showing that within the heterogeneous group of unipolar depressives, patients with melancholia and bipolar patients with a history of melancholia manifest a tyramine excretion deficit. A small subgroup of medication-free patients in remission from episodes of melancholia had abnormally low tyramine sulfate excretion levels while they were euthymic, supporting the suggestion that reduced tyramine sulfate excretion following oral tyramine loading is a trait marker for depression. Further study of the role of trace amines in affective illness is warranted. Clinical application is not warranted until further evaluation of the sensitivity, specificity, and reproducibility of this oral tyramine challenge test.

Adult↗
PubMed1984

Lactate provocation of panic attacks. I. Clinical and behavioral findings.

To assess the pharmacologic and phenomenologic comparability of lactate-induced and naturally occurring panic attacks, patients meeting DSM-III criteria for panic disorder or agoraphobia with panic attacks were infused with 0.5M racemic sodium lactate before and after successful drug treatment. Lactate-induced and naturally occurring panic attacks were symptomatically similar. Following treatment, the patients' response to lactate did not differ from that of normal controls, whereas the pretreatment panic rate was much higher. These data suggest that lactate acts, by as yet unidentified mechanisms, to trigger the same panic attacks as occur spontaneously in vulnerable persons.

Adult↗
PubMed1984

l-Deprenyl in atypical depressives.

We investigated the antidepressant efficacy of l-deprenyl (selegiline), a selective monoamine oxidase B inhibitor (MAOI), in a six-week open trial of 17 patients with atypical depression. Such patients have previously been shown to benefit from nonselective MAOIs such as phenelzine sulfate. Ten patients (59%) responded to l-deprenyl, but nine required dosages above the 10 to 20 mg/day used in previous investigations. l-Deprenyl was superior to six weeks of placebo administered to diagnostically similar patients in a separate double-blind study. In contrast with previous findings with pheneizine, responders to l-deprenyl differed from nonresponders by having lower baseline anxiety ratings. Even at high dosages, there appeared to be fewer side effects with l-deprenyl than with nonselective MAOIs.

Adult↗
PubMed1984

Cortisol response to dextroamphetamine stimulation in depressed outpatients.

Endogenously depressed inpatients often fail to release cortisol following intravenous (i.v.) amphetamine, unlike nondepressed control subjects. We therefore assessed the ability of i.v. dextroamphetamine, 0.15 mg/kg, to induce cortisol release in 64 depressed outpatients diagnosed according to Research Diagnostic Criteria (RDC). After dextroamphetamine challenge, more patients with major depression failed to release substantial cortisol (30%) than those without major depression (5%). Major depressives with endogenous subtype failed to release cortisol (38%) more frequently than those without endogenous depression (23%), but this difference was not significant. After baseline cortisol, sex, and weight loss were controlled for in a regression analysis, however, RDC diagnosis of major depression or endogenous subtype did not account for significant additional variance in cortisol release. In outpatients, abnormal cortisol response to amphetamine may be more closely related to baseline cortisol, sex, and history of weight loss than to RDC subtype of depression.

Adult↗
PubMed1984

Mianserin versus amitriptyline for depression: a double-blind 6-week trial.

34 patients who met the research diagnostic criteria for major depressive disorder as defined by Spitzer et al. [Archs gen. Psychiat. 35: 773-782, 1978] completed a double-blind 6-week trial of mianserin versus amitriptyline following 1 week of single-blind placebo washout. After 2 weeks of dose build-up, patients took 150 mg/day of mianserin or 300 mg/day of amitriptyline throughout the next 4 weeks. At week 6, 63% of mianserin patients and 73% of amitriptyline patients were rated as responders; this difference is not statistically significant. No clinically meaningful differences between drugs were observed with respect to number or severity of side effects as reported by either patient or physician. Overall, mianserin was found to be equivalent to amitriptyline in terms of efficacy, patient tolerance and ease of administration.

Adolescent↗
PubMed1984

Hypoglycemia and panic attacks.

Many patients with panic disorder believe hypoglycemia causes their symptoms. Of 10 patients with panic disorder given sodium lactate to induce panic, none had evidence of low blood sugar levels when they began to experience anxiety symptoms.

Adolescent↗
PubMed1984

Insulin levels during lactate infusion.

To determine whether the lactate-induced panic of patients with panic attacks results from hyperinsulinism balanced by epinephrine-enhanced gluconeogenesis, the authors measured 10 subjects' insulin levels exactly when the lactate-induced attacks began. The insulin levels were normal.

Adult↗
PubMed1984

Response to hyperventilation in a group of patients with panic disorder.

Twelve patients with DSM-III diagnoses of panic disorder and four normal volunteers were studied during hyperventilation of room air and increased ventilation stimulated by 5% CO2. Patients also underwent sodium lactate infusion. Eight of the patients had a panic attack during sodium lactate infusion, seven during CO2 inhalation, and three during room-air hyperventilation. Since CO2 increases the firing of the locus ceruleus, and since sodium lactate infusion is known to increase cerebral CO2, these findings are consistent with other evidence implicating the locus ceruleus in panic anxiety.

Adult↗
PubMed1984

Effects of naloxone on patients with panic attacks.

To determine whether endogenous opiates are involved in panic anxiety, the authors challenged 12 patients with panic attacks with intravenous naloxone hydrochloride alone or combined with sodium lactate. Naloxone did not produce panic attacks or alter responses to lactate.

Adult↗
PubMed1984

Psychopharmacologic validation of atypical depression.

Sixty patients meeting specific criteria for atypical depression completed 6 weeks of double-blind, randomly assigned treatment with phenelzine, imipramine, or placebo. Patients who had a history of spontaneous panic attacks or hysteriod dysphoric features showed extremely low placebo-response rates, moderate responses to imipramine, and high rates of response to phenelzine. Conversely, patients without such features responded moderately well to all three treatments. Based on preliminary data, MAOI-specific atypical depression does appear to exist, although in more delimited forms than previously recognized.

Adolescent↗