A Survey of Practising Psychiatrists' Views on Treatment of the Depressions

1986 ◽  
Vol 149 (6) ◽  
pp. 742-750 ◽  
Author(s):  
M. S. Armstrong ◽  
G. Andrews
Keyword(s):  
Quality Assurance ◽  
Drug Therapy ◽  
Random Sample ◽  
Electroconvulsive Therapy ◽  
Tricyclic Antidepressants ◽  
Endogenous Depression ◽  
Treatment Recommendations ◽  
Quality Assurance Project ◽  
Treatment Plans ◽  
Psychotic Features

The views of practising psychiatrists on treatment of the depressions were investigated as part of a Quality Assurance Project. A one in six random sample of all Australian psychiatrists was mailed a questionnaire. This asked for treatment recommendations for each of five case descriptions of patients with depression. Respondents were asked to code their treatment plans from a glossary listing possible treatments for depression: 85% of the sample responded. Tricyclic antidepressants were the treatment of choice for two cases of endogenous depression, electroconvulsive therapy (ECT) being recommended when psychotic features were present or when drug therapy had failed. Psychotherapies were the treatment of choice for cases with neurotic features, drugs being recommended when Improvement with psychotherapy did not occur.

A Treatment Outline for Depressive Disorders

1983 ◽  
Vol 17 (2) ◽  
pp. 129-146 ◽  
Keyword(s):  
Quality Assurance ◽  
Treatment Outcome ◽  
Electroconvulsive Therapy ◽  
Depressive Disorders ◽  
Meta Analysis ◽  
Antidepressant Drugs ◽  
Endogenous Depression ◽  
Government Support ◽  
Sources Of Information ◽  
Quality Assurance Project

With College and Government support the Quality Assurance Project is developing a series of explicit and detailed treatment outlines of major psychiatric disorders for use in peer review. Three sources of information are used: a meta-analysis of the treatment outcome literature, the opinions of a sample of practising psychiatrists and the views of a panel of nominated experts. The present outline concerns the treatment of depressive disorders. The three sources of information were in agreement that tricyclic and allied antidepressants were the treatments of choice for endogenous depression and were also to be considered in persistent neurotic depressions. Electroconvulsive therapy was recommended in patients with endogenous depression who were severely ill, troubled by hallucinations and delusions or for whom the antidepressant drugs had not proven effective. The psychotherapies, both dynamic and behavioural, were regarded as the treatments of choice in neurotic depression.

A Survey of Practising Psychiatrists' Views on the Treatment of Schizophrenia

1986 ◽  
Vol 149 (3) ◽  
pp. 357-364 ◽  
Author(s):  
S. Andrews ◽  
K. Vaughan ◽  
R. Harvey ◽  
G. Andrews
Keyword(s):  
Quality Assurance ◽  
Random Sample ◽  
Antipsychotic Drugs ◽  
Initial Response ◽  
Treatment Recommendations ◽  
Social Intervention ◽  
Response To Treatment ◽  
Supportive Psychotherapy ◽  
Quality Assurance Project

Practising psychiatrists' views about the treatment of schizophrenia were investigated as part of a Quality Assurance Project. A questionnaire which asked for treatment recommendations for each of four case descriptions of patients with schizophrenia was mailed to a one-in-six random sample of Australian psychiatrists; 90% responded. Psychiatrists almost uniformly advocated the use of antipsychotic drugs and usually recommended concurrent supportive psychotherapy or family/social intervention procedures. The recommendations varied systematically, according to the initial history obtained and to the initial response to treatment.

A Survey of Practising Psychiatrists' Views on the Treatment of Agoraphobia

1982 ◽  
Vol 16 (4) ◽  
pp. 225-233 ◽  
Author(s):  
Wayne Hall ◽  
Penny Weekes ◽  
Robin Harvey ◽  
Gavin Andrews
Keyword(s):  
Quality Assurance ◽  
Random Sample ◽  
Psychodynamic Psychotherapy ◽  
Treatment Recommendations ◽  
Quality Assurance Project

The views of practising psychiatrists on the treatment of agoraphobia were investigated as part of a Quality Assurance Project. A one in six random sample of psychiatrists was mailed a questionnaire. This asked for treatment recommendations for each of three case descriptions of patients with agoraphobia and respondents were asked to choose three treatments from a predetermined list of treatments. Eighty-six percent of the sample responded. Behavioural psychotherapy was recommended most often, usually in conjunction with psychodynamic psychotherapy. Recommendations varied across the three cases and were also marginally affected by the format of the question used to elicit them.

Electroconvulsive Therapy in Denmark

1976 ◽  
Vol 128 (3) ◽  
pp. 241-245 ◽  
Author(s):  
Erik Roeder ◽  
Joergen Heshe
Keyword(s):  
Electroconvulsive Therapy ◽  
Tricyclic Antidepressants ◽  
Endogenous Depression ◽  
Fiscal Year ◽  
Reactive Depression ◽  
Indications For Treatment

SummaryDuring the fiscal year 1 April 1972 to 31 March 1973, 22,210 ECT treatments in 3,438 series were given in Denmark (6.46 treatments per series). Indications for treatment were: endogenous depression, acute delirium, mania, hysterical psychosis, reactive depression and schizophrenia. Unilateral ECT was used in more than half of the departments concerned. Two treatments were given weekly. The types of apparatus and anaesthesia techniques used are described. One death, which had questionable relation to the ECT, was reported, and other complications were few and mild. The advantages of ECT compared to tricyclic antidepressants are described, including the higher percentage of remissions or improvements in the treatment of endogenous depressions (about 80 per cent for ECT compared to about 60 per cent for tricyclic antidepressants). Little risk was found in out-patient administration of ECT. With present techniques and unilateral placement of electrodes out-patient ECT may be recommended for wider use than before.

QUALITY ASSURANCE OF DRUG THERAPY IN HOSPITALS:

1979 ◽  
Vol 1 (2) ◽  
pp. 46-47 ◽  
Author(s):  
C. G. Berbatis ◽  
G. M. Eckert ◽  
F. G. Neale ◽  
J. P. Rothwell
Keyword(s):  
Quality Assurance ◽  
Drug Therapy

Fluoxetine Efficacy vs Comparative Drugs: An Overview

1988 ◽  
Vol 153 (S3) ◽  
pp. 51-58 ◽  
Author(s):  
Malcolm Lader
Keyword(s):  
Side Effects ◽  
Tricyclic Antidepressants ◽  
Antipsychotic Agents ◽  
Synaptic Cleft ◽  
Endogenous Depression ◽  
Acute Effects ◽  
Anticholinergic Effects ◽  
The Past ◽  
Chronic Effects ◽  
Clinical Action

The tricyclic antidepressants (TCAs) were discovered accidentally by pharmaceutical chemists seeking first, better antihistamines and then antipsychotic agents. Careful clinical assessment revealed the antidepressant properties and suggested that the closer the patient resembled the classical textbook description of ‘endogenous’ depression, the more likely was an adequate clinical response to occur (Kuhn, 1958). However, it was quickly realised that the TCAs possess a plethora of side-effects, particularly sedation and symptoms related to their anticholinergic effects.Despite much research over the past 25 years, it is unclear how TCAs effect clinical improvement. The two main neurotransmitters involved in some way are noradrenaline (Schildkraut, 1965) and 5-hydroxytryptamine (5-HT; serotonin; Van Praag, 1977). It was proposed that TCAs acted by blocking the reuptake of one or other or both of these neurotransmitters, thereby increasing their concentration in the synaptic cleft. However, as well as these acute effects, chronic effects, such as a decrease in the number of central beta-adrenoceptors (‘down-regulation’) occur, and these are probably more relevant to the clinical action.

scholarly journals Neuroleptic malignant syndrome: a case responding to electroconvulsive therapy plus bupropion

2018 ◽  
Author(s):  
Quintí Foguet-Boreu ◽  
Montse Coll-Negre ◽  
Montse Serra-Millàs ◽  
Miquel Cavalleria-Verdaguer
Keyword(s):  
Neuroleptic Malignant Syndrome ◽  
Electroconvulsive Therapy ◽  
Potential Role ◽  
Caucasian Woman ◽  
Concomitant Treatment ◽  
Pharmacological Treatments ◽  
Severe Motor ◽  
Autonomic Instability ◽  
History Of ◽  
Psychotic Features

Neuroleptic malignant syndrome (NMS) is a severe motor syndrome occurring as a consequence of neuroleptic treatment. We present a case of a 67-year-old Caucasian woman with a history of a major depressive disorder with psychotic features. During her third hospital admission, symptoms of autonomic instability, hyperpyrexia, severe extrapyramidal side effects, and delirium appeared, suggesting NMS due to concomitant treatment with risperidone and quetiapine, among other drugs. Despite several consecutive pharmacological treatments (lorazepam, bromocriptine and amantadine) and prompt initiation of electroconvulsive therapy (ECT), clinical improvement was observed only after combining bupropion with ECT. The symptoms that had motivated the admission gradually remitted and the patient was discharged home. Bupropion increases dopaminergic activity in both the nucleus accumbens and the prefrontal cortex. Therefore, from a physiopathological standpoint, bupropion has a potential role in treating NMS. However, there is scarce evidence supporting this approach and therefore future cases should be carefully considered.

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