Quantification of side-effects of beta-adrenoceptor blockers using visual analogue scales.

The antidepressant and anxiolytic efficacy of trazodone (100–200 mg daily), mianserin (60–120 mg daily) and diazepam (15–30 mg daily) was evaluated in ninety-three patients suffering from mild to moderate depression, with or without anxiety, over 6 weeks in a double-blind non-crossover general practice study. Efficacy was evaluated using the Hamilton Depression Rating Scale, Patient Self-Rating Visual Analogue scales, physician global assessments and the Zung Self-Rating Anxiety Scale. All three treatments significantly reduced symptoms of depression, as measured on the Hamilton Depression Rating Scale and the physician's assessment of Global Improvement. Trazodone was significantly superior to both mianserin and diazepam. As assessed using Visual Analogue Scales, trazodone was also shown to be significantly superior to diazepam in improving the patient's ability to concentrate and in reducing daytime tiredness. Although evidence of efficacy was found, there were no differences in activity between the treatment groups using the physician's assessment of Current Severity or on assessment of Therapeutic Effect. The treatments all caused a reduction in anxiety as assessed by the Zung Self-Rating Scale. The overall incidence of side-effects was similar between groups. For those side-effects considered to be significantly interfering with the patient's function, but not outweighing the therapeutic effect, a reduction of dosage was effective. Several patients complaining of drowsiness or lethargy as an unacceptable daytime side-effect were switched successfully from twice daily to night-time dosing. Significantly more patients with side-effects (outweighing therapeutic effect or in the presence of no improvement) were withdrawn from the mianserin group than from the trazodone or diazepam groups. Overall, the therapeutic efficacy in relation to the incidence of clinically significant side-effects, favoured trazodone for the treatment of general practice patients suffering from depression, with or without anxiety.

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Quantifying Side-Effects of Beta-Blockers: The Role of Visual Analogue Scales

Human Toxicology ◽

10.1177/096032718700600304 ◽

1987 ◽

Vol 6 (3) ◽

pp. 195-201 ◽

Cited By ~ 2

Author(s):

R.V. Lewis

Keyword(s):

Side Effects ◽

Muscle Fatigue ◽

Beta Blockers ◽

Hypertensive Patients ◽

Visual Analogue Scales ◽

Detailed Explanation ◽

Nonparametric Statistical Methods ◽

Nonparametric Statistical ◽

Analogue Scales

Beta-blockers are often prescribed for patients who are asymptomatic and for whom the benefits of therapy are likely to be small. Side-effects are therefore of great importance. Symptoms such as muscle fatigue and peripheral coldness are commonly associated with treatment with beta-blockers but these subjective phenomena are difficult to detect and quantify so that their prevalence and severity are uncertain. Conventional symptom questionnaires may be relatively insensitive and visual analogue scales (VAS), which permit interval quantification of subjective phenomena, may have some advantages. They appear to be able to detect the presence of tiredness of the legs and peripheral coldness among hypertensive patients taking beta-blockers and are more sensitive than descriptive or 'category' questionnaires. However, some patients find VAS hard to understand and a minority of patients score erratically for all symptoms. A most detailed explanation is of paramount importance. Scores derived from VAS surveys are not normally distributed and should be examined using nonparametric statistical methods; normalising transformations do not improve the sensitivity of the method.

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Side-effects of ?-blockers assessed using visual analogue scales

European Journal of Clinical Pharmacology ◽

10.1007/bf00543718 ◽

1985 ◽

Vol 28 (S1) ◽

pp. 93-96 ◽

Cited By ~ 6

Author(s):

R. V. Lewis ◽

P. R. Jackson ◽

L. E. Ramsay

Keyword(s):

Side Effects ◽

Visual Analogue Scales ◽

Analogue Scales

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Lormetazepam (Lorámet®): A Multicentre Assessment of its Efficacy and Acceptability as a Hypnotic in Out-Patients with Sleep Disturbances

Journal of International Medical Research ◽

10.1177/030006058301100601 ◽

1983 ◽

Vol 11 (6) ◽

pp. 325-332 ◽

Cited By ~ 3

Author(s):

R C Hill ◽

T V A Harry

Keyword(s):

Side Effects ◽

Multicentre Study ◽

Sleep Disturbances ◽

Prior Experience ◽

Sleep Pattern ◽

Diary Card ◽

Short Acting ◽

Visual Analogue Scales ◽

Time To Onset ◽

Analogue Scales

In an open, multicentre study, the short-acting benzodiazepine hypnotic lormetazepam (Loramet®) was administered nightly (1–2 mg p.o.) for a period of 7 nights to 665 out-patients with various types of sleep disturbances. The patients assessed the efficacy and acceptability of lormetazepam with the aid of a simple diary card and a set of visual analogue scales. The results showed that about 75% of the patients reported a significant improvement in their sleep pattern. The time to onset of sleep was decreased, the number of nocturnal wakings was reduced and the patients reported waking in the morning more refreshed and co-ordinated. The effects were significant after the first night and there were further significant improvements by the seventh night on the drug. In patients who had prior experience of other hypnotics, twice as many preferred lormetazepam to temazepam and three times as many preferred lormetazepam to nitrazepam. Nine patients withdrew from the study due to lack of efficacy and only fifteen patients dropped out following the occurrence of side-effects, mainly drowsiness and lightheadedness. It was concluded that lormetazepam is an effective and highly acceptable hypnotic in patients with sleep disturbances.

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A Multicentre Hospital Study to Compare the Hypnotic Efficacy of Loprazolam and Nitrazepam

Journal of International Medical Research ◽

10.1177/030006058401200402 ◽

1984 ◽

Vol 12 (4) ◽

pp. 229-237 ◽

Cited By ~ 4

Author(s):

C Joan McAlpine ◽

S I Ankier ◽

Catherine S C Elliott

Keyword(s):

Side Effects ◽

Subjective Evaluation ◽

Double Blind ◽

Visual Analogue Scales ◽

Parallel Group ◽

Significant Difference ◽

Hypnotic Efficacy ◽

Hospital Study ◽

Analogue Scales ◽

Single Blind

A multicentre, parallel group hospital study was carried out in 190 subjects with insomnia to compare the efficacy, incidence of hangover and the side-effects of loprazolam and nitrazepam. Following 2 nights single-blind phase on placebo, loprazolam (1·0 mg), nitrazepam (5·0 mg) or placebo was administered double-blind for 7 consecutive nights. Visual analogue scales and questions were used to rate efficacy. There was no statistically significant difference between loprazolam and nitrazepam for ‘ease of getting to sleep’, ‘restfulness of sleep’ and ‘depth of sleep’. Like nitrazepam, loprazolam diminished the number of periods of wakefulness and made it ‘easier to get to sleep again’. Subjective evaluation showed that hangover was not a feature of loprazolam. It did not affect morning alertness and patients thought they had improved balance and co-ordination while on this drug. These findings are in keeping with the evidence of other workers who have shown only minimal psychomotor impairment, if any, with loprazolam (1·0 mg). There was no statistically significant difference between treatments with respect to frequency or incidence of side-effects.

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