scholarly journals Double-blind clonazepam vs placebo in panic disorder treatment

2000 ◽  
Vol 58 (4) ◽  
pp. 1025-1029 ◽  
Author(s):  
ALEXANDRE MARTINS VALENÇA ◽  
ANTONIO EGIDIO NARDI ◽  
ISABELLA NASCIMENTO ◽  
MARCO A. MEZZASALMA ◽  
FABIANA L. LOPES ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Rating Scale ◽  
Panic Attacks ◽  
Fixed Dose ◽  
Fisher Exact Test ◽  
Double Blind ◽  
Exact Test ◽  
Dsm Iv ◽  
Disorder Treatment ◽  
Hamilton Rating Scale

OBJECTIVE: To assess the effectiveness of clonazepam, in a fixed dose (2 mg/day), compared with placebo in the treatment of panic disorder patients. METHOD: 24 panic disorder patients with agoraphobia were randomly selected. The diagnosis was obtained using the structured clinical interview for DSM-IV . All twenty-four subjects were randomly assigned to either treatment with clonazepam (2 mg/day) or placebo, during 6 weeks. Efficacy assessments included: change from baseline in the number of panic attacks; CGI scores for panic disorder; Hamilton rating scale for anxiety; and panic associated symptoms scale. RESULTS: At the therapeutic endpoint, only one of 9 placebo patients (11.1%) were free of panic attacks, compared with 8 of 13 (61.5%) clonazepam patients (Fisher exact test; p=0,031). CONCLUSION: the results provide evidence for the efficacy of clonazepam in panic disorder patients.

scholarly journals Clomipramine and fluoxetine effects in the treatment of panic disorder

2003 ◽  
Vol 3 (3) ◽  
pp. 27-31 ◽  
Author(s):  
Semra Čavaljuga ◽  
Ifeta Ličanin ◽  
Elvedina Kapić ◽  
Dubravka Potkonjak
Keyword(s):  
Panic Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Rating Scale ◽  
Panic Attacks ◽  
Duration Of Treatment ◽  
Double Blind ◽  
Psychiatric Interview ◽  
Favourable Response ◽  
Double Blind Clinical Trial ◽  
History Of

Panic disorder (PD) is an acute psychobiologic reaction manifested by intense anxiety and panic attacks, that occur unpredictably with subjective sense of intense apprehension or terror, accompanied by temporary loss of the ability to plan, think, or reason and the intense desire to escape or flee the situation. Panic attacks may last from a few seconds to an hour or longer, Symptoms typically include, among others, palpitations, tachycardia, hypertension, chest pain, dyspnoea, and fear of loosing control or going crazy and vague feeling of imminent doom or death. Since pharmacotherapy of PD includes the administration of selective serotonin reuptake inhibitors and tricyclic antidepressants, the objective of this study was to perform a pilot double blind clinical trial designed to compare the effects of two studied drugs in the treatment of PD.A total number of 40 patients with a history of panic disorder were randomly assigned into two groups of 20 patients each. Hamilton anxiety rating scale and Standard Psychiatric Interview were methods for PD assessment. One group was treated with clomipramine hydrochloride (ANAFRANIL®) 75 mg/day and the other with fluoxetine (OXETIN®) 60 mg/day. Both drugs were administrated by mouth (PO) two times-a-day in equally divided doses for 6 weeks.Both studied agents produced similar antipanic effectiveness. Favourable response was achieved in 95% of patients treated with fluoxetine and 90% of patients treated with clomipramine. The onset of antipanic effects was quicker in all clomipramine treated patients, while fluox-etine produced more-favourable response in male patients. The duration of treatment with both antidepres-sants studied should be at least 10 weeks, instead of 6 weeks.

scholarly journals Progress Report on the Canadian Multicentre Trial of Tetrahydroaminoacridine with Lecithin in Alzheimer's Disease

1989 ◽  
Vol 16 (S4) ◽  
pp. 543-546 ◽  
Author(s):  
S. Gauthier ◽  
R. Bouchard ◽  
Y. Bacher ◽  
P. Bailey ◽  
H. Bergman ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Rating Scale ◽  
Fixed Dose ◽  
Symptomatic Therapy ◽  
Muscarinic Agonists ◽  
Double Blind ◽  
Disability Rating Scale ◽  
Functional Autonomy ◽  
Disability Rating

ABSTRACT:Since the discovery of a significant depletion of acetylcholine in discrete areas of the brain of patients affected by Alzheimer's disease, attempts at symptomatic therapy have concentrated on acetylcholine supplementation, an approach that is based upon the efficacy of dopaminergic supplementation therapy for Parkinson's disease. Choline, then lecithin, used orally, failed to improve symptoms but the hypothesis that long-term choline supplementation might stabilize the course of Alzheimer's disease remains to be tested. Nerve growth factor may also offer that possibility. Bethanechol administered intracerebroventricularly did not help when a fixed dose was used but individual titration of more selective muscarinic agonists may prove more effective. In this article we report that tetrahydroaminoacridine (THA), given together with highly concentrated lecithin, appears to bring improvement in cognition and in functional autonomy using the Mini Mental State and the Rapid Disability Rating Scale-2 respectively, without change in behavior as reflected by the Behave-AD. Double-blind cross-over studies are in progress to establish its efficacy. Improvement in study design and means of assessment of cognition, functional autonomy and behavior have been made possible by these drug trials.

Fear of Autonomic Arousal and Use of Coping Strategies as Predictors of Agoraphobic Avoidance in Panic Disorder

1998 ◽  
Vol 15 (4) ◽  
pp. 228-236 ◽  
Author(s):  
Patricia Rayment ◽  
Jeff Richards
Keyword(s):  
Panic Disorder ◽  
Coping Strategies ◽  
Significant Proportion ◽  
Panic Attacks ◽  
Autonomic Arousal ◽  
Negative Cognitions ◽  
Considerable Controversy ◽  
Dsm Iv ◽  
Panic Symptoms ◽  
Behavioural Strategies

Despite the very significant proportion of people with panic disorder who have accompanying agoraphobia, there is considerable controversy about the variables that influence the development of this avoidance behaviour. This study investigated whether degree of avoidance is a function of extent of fear and prevalence of negative cognitions about autonomic arousal symptoms and whether the use of, and confidence in, behavioural strategies to cope with panic sensations also influences agoraphobic avoidance. Thirty-nine people who met DSM-IV criteria for panic disorder completed questionnaires measuring fear and negative cognitions about autonomic arousal and panic sensations, and a questionnaire measuring their use of largely behavioural strategies to cope with panic attacks. Fear of autonomic arousal and negative cognitions in response to the occurrence of these arousal symptoms were jointly related to situational avoidance. There was little relationship between the use of, and confidence in, panic coping strategies and less agoraphobic avoidance, although simply allowing panic symptoms to develop and pass predicted less avoidance. The results were interpreted as providing an empirical basis for treatment that reduces fear of panic sensations and allows their experience to be tolerated while preventing escape and avoidance of situations in which panic occurs. There was little evidence that additional teaching of behavioural coping strategies would be useful in reducing agoraphobic avoidance.

Paroxetine in the Treatment of Panic Disorder a Randomised, Double-Blind, Placebo-Controlled Study

1995 ◽  
Vol 167 (3) ◽  
pp. 374-379 ◽  
Author(s):  
S. Oehrberg ◽  
P. E. Christiansen ◽  
K. Behnke ◽  
A. L. Borup ◽  
B. Severin ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Cognitive Therapy ◽  
Panic Attacks ◽  
Controlled Study ◽  
Positive Trend ◽  
Double Blind ◽  
Treatment Groups ◽  
Efficacy Measures ◽  
The Mean ◽  
Primary Measure

BackgroundThis study compared the efficacy and tolerability of paroxetine with placebo in the treatment of panic disorder.MethodAfter three weeks of placebo, patients received 12 weeks of treatment with paroxetine (20, 40, or 60 mg) or placebo, and finally two weeks of placebo. Dosages were adjusted according to efficacy and tolerability. Standardised cognitive therapy was given to all patients. The primary measure of outcome was reduction in the number of panic attacks.ResultsAnalysis of the results showed statistically significant differences in favour of paroxetine between the two treatment groups in two out of the three primary measures of outcome, i.e. 50% reduction in total number of panic attacks and number of panic attacks reduced to one or zero over the study period. For the third measure of outcome, the mean change in the total number of attacks from baseline, there was a positive trend in favour of paroxetine. The results of the primary measures of outcome were strongly supported by the results of the secondary efficacy measures of outcome. In addition, paroxetine, at all doses, was very well tolerated.ConclusionParoxetine plus cognitive therapy was significantly more effective than placebo plus cognitive therapy in the treatment of panic disorder.

Sertraline in the treatment of panic disorder

1998 ◽  
Vol 173 (1) ◽  
pp. 54-60 ◽  
Author(s):  
Peter D. Londborg ◽  
Robert Wolkow ◽  
Ward T. Smith ◽  
Eugene Duboff ◽  
Donald England ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Adverse Events ◽  
Drop Out ◽  
Panic Attacks ◽  
Efficacy And Safety ◽  
Serious Adverse Events ◽  
Double Blind ◽  
Hamilton Anxiety Scale ◽  
Higher Doses ◽  
Clinical Global Impression Improvement

BackgroundThis study compared the efficacy and safety of sertraline to placebo in treating panic disorder.Method178 out-patients with panic disorder who exhibited at least four panic attacks during the four weeks prior to screening and three during the two weeks of lead-in were randomly assigned to 12 weeks of double-blind treatment with sertraline (50, 100 or 200 mg) or placebo.ResultsSertraline was superior to placebo in reducing the number of panic attacks, situational attacks, unexpected attacks, limited symptom attacks, and time spent worrying (all P < 0.01) and the Hamilton Anxiety Scale (P < 0.05), although Clinical Global Impression (Improvement) did not significantly differentiate groups at 12 weeks and at end-point. No serious adverse events were associated with sertraline. No dose relationship was found for adverse events; overall drop-out rates were not different for sertraline or placebo, although more sertraline-treated subjects discontinued for adverse events, typically early in the study. Only dry mouth and ejaculation failure (primarily ejaculation delay) were associated significantly with sertraline. Conclusions Sertraline was effective and safe in reducing panic attacks. Higher doses were no more effective than the 50 mg dose.

scholarly journals Granisetron versus Granisetron-Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Pediatric Strabismus Surgery: A Randomized Double-Blind Trial

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Renu Sinha ◽  
Dilip Shende ◽  
Souvik Maitra ◽  
Neeraj Kumar ◽  
Bikash Ranjan Ray ◽  
...  
Keyword(s):  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Complete Response ◽  
Strabismus Surgery ◽  
Nausea And Vomiting ◽  
Fisher Exact Test ◽  
Double Blind ◽  
Exact Test ◽  
Oculocardiac Reflex ◽  
Significant Difference

Aim.Efficacy of granisetron and combination of granisetron and dexamethasone was evaluated for prevention of postoperative nausea and vomiting (PONV) in children undergoing elective strabismus surgery.Methods.A total of 136 children (1–15 years) were included. Children received either granisetron (40 mcg/kg) [group G] or combination of granisetron (40 mcg/kg) and dexamethasone (150 mcg/kg) [group GD]. Intraoperative fentanyl requirement and incidence and severity of oculocardiac reflex were assessed. PONV severity was assessed for first 24 hours and if score was >2, it was treated with metoclopramide. Postoperative analgesia was administered with intravenous fentanyl and ibuprofen.Results.The demographic profile, muscles operated, and fentanyl requirement were comparable. Complete response to PONV in first 24 hours was observed in 75% (51/68) of children in group G and 76.9% (50/65) of children in group GD, which was comparable statistically (p=0.96, Fisher exact test; OR 1.11, 95% CI 0.50, 2.46). Incidence of PONV between 0 and 24 hours was comparable. One child in group G required rescue antiemetic in first 24 hours and none of the children had severe PONV in group GD. There was no significant difference in incidence or severity of oculocardiac reflex.Conclusion.Dexamethasone did not increase efficacy of granisetron for prevention of PONV in elective pediatric strabismus surgery. Registration number of clinical trial wasCTRI/2009/091/001000.

Spa Therapy in Anxiety Disorder in a 8 Week Comparative and Randomized Multicentre Study on 237 Patients

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
O. Dubois
Keyword(s):  
Anxiety Disorder ◽  
Multicentre Study ◽  
Rating Scale ◽  
Therapy Group ◽  
Spa Therapy ◽  
Generalized Anxiety ◽  
Generalized Anxiety Disorders ◽  
Spa Treatment ◽  
Dsm Iv ◽  
Hamilton Rating Scale

We compared spa therapy-like balneotherapy treatment with Paroxetine by means of a multicentre, comparative, randomized 8-week study. At least 200 patients fitting the diagnosed criteria of generalized anxiety disorder (DSM IV) were to be recruited. They were carried out by an independent, fully-trained and specialized assessor.The total score on the HAM-A scale (Hamilton Rating Scale for Anxiety) was the main measure for efficiency.There were 237 patients altogether attending in ambulatory who were admitted into the 4 French centres and joined the protocol. 117 were divided up by drawing lots into the Spa Therapy group and 120 into the Paroxetine group.All 207 patients were able to be assessed at W8. The HAM-A scores at W8 showed significant improvement in the Spa Therapy group compared to the Paroxetine group (t = 3.04 p≤ 0.0001). Remission and the rate of improvement (superior or equal to 50%) were markedly higher in the Spa Therapy group.Other analyses stemming from this assessment enrich the results, with complemetary information on the importance of a spa treatment course prescribed in a psychiatric aim.In conclusion, the Spa Therapy-based Balneotherapy treatment is one that has shown specific efficiency in generalized anxiety disorders. Its profile of being well-tolerated and well-accepted by the patients may enable to introduce it regularly in GAD, particularly for people who are resistent to, dependent on or have difficulty in tolerating pharmacology or psychotherapy treatments.

A Controlled Comparison of Simulated and Real ECT

1978 ◽  
Vol 133 (6) ◽  
pp. 514-519 ◽  
Author(s):  
J. Lambourn ◽  
D. Gill
Keyword(s):  
Rating Scale ◽  
Muscle Relaxation ◽  
Control Treatment ◽  
Treatment Procedure ◽  
Double Blind ◽  
Convulsive Therapy ◽  
Pre Treatment ◽  
Controlled Evaluation ◽  
Electro Convulsive Therapy ◽  
Hamilton Rating Scale

SummaryTwo groups of 16 patients with depressive psychosis took part in a controlled evaluation of electro-convulsive therapy (ECT). One group received six brief pulse unilateral shocks under conventional anaesthesia and muscle relaxation; the second group underwent the same procedure without receiving shocks. Outcome was assessed by a separate investigator using the Hamilton Rating Scale for Depression under double-blind conditions. The results showed that this form of ECT was only superior to the control treatment for one item in the scale, a finding which could have occurred by chance. The results suggest that the ECT pre-treatment procedure has an important therapeutic effect. This casts some doubt on current views of the effectiveness of electro-convulsive therapy in general, and of brief pulse unilateral ECT in particular.

A Controlled Study of Cognitive Behaviour Therapy with Buspirone or Placebo in Panic Disorder with Agoraphobia

1995 ◽  
Vol 167 (5) ◽  
pp. 635-641 ◽  
Author(s):  
Jean Cottraux ◽  
Ivan-Druon Note ◽  
Charly Cungi ◽  
Patrick Légeron ◽  
François Heim ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Multicentre Study ◽  
Cognitive Behaviour Therapy ◽  
Group Analysis ◽  
Panic Attacks ◽  
Controlled Study ◽  
Behaviour Therapy ◽  
Short Term ◽  
Double Blind ◽  
Cognitive Behaviour

BackgroundThis multicentre study compared a 16-week buspirone treatment with placebo in patients presenting with panic disorder with agoraphobia and also receiving cognitive behaviour therapy (CBT).MethodDouble-blind testing was maintained until week 68, but not tested; 91 patients were included; 14 placebo-responders excluded; 77 patients randomised; 48 reached week 16 and 41 reached week 68.ResultsAt week 16, within-group analysis showed significant improvements in agoraphobia, panic attacks, and depression in both groups. Generalised anxiety improved only in CBT + buspirone. Between-group comparisons showed buspirone to have an effect on generalised anxiety and agoraphobia. Changes in degree of agoraphobia and depression were correlated in subjects on CBT + buspirone only. A significantly higher proportion of women, and of subjects showing high avoidance dropped out. Positive expectations regarding medication predicted success in both groups. At week 68, improvement was retained without significant buspirone effect.ConclusionBuspirone enhanced the effects of cognitive behaviour therapy on generalised anxiety and agoraphobia in the short term.

Pharmacological Treatment of Depression in Cancer Patients

1996 ◽  
Vol 169 (4) ◽  
pp. 440-443 ◽  
Author(s):  
Kees Van Heeringen ◽  
Milana Zivkov
Keyword(s):  
Cancer Patients ◽  
Rating Scale ◽  
Controlled Study ◽  
Systematic Research ◽  
Cancer Stage ◽  
Efficacy And Safety ◽  
Double Blind ◽  
Patients With Cancer ◽  
Treatment Of Depression ◽  
Hamilton Rating Scale

BackgroundDepression has a reported mean prevalence of 24% in patients diagnosed with cancer. However, little systematic research on the efficacy of antidepressants in patients with cancer has been performed.MethodThe efficacy and safety of mianserin were studied in 55 depressed women with breast cancer (stage I or II and without known metastases), in a randomised, double-blind, six-week, placebo-controlled study.ResultsStatistically significant differences in the decrease in score from baseline on the Hamilton Rating Scale for Depression and the number of responders, favouring mianserin, were present after 28 and 42 days of treatment Significantly more placebo-treated patients prematurely terminated the study due to lack of efficacy while the safety profile of mianserin was similar to that of placebo.ConclusionsTreatment with mianserin resulted in a significant improvement in depressive symptoms in cancer patients, and was well tolerated.

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