Abstract:
:Successful discontinuation of therapeutic drugs requires patients to negotiate two potentially difficult phases. First, they must complete the drug discontinuation procedure itself, which may entail coping with rebound and withdrawal symptoms as well as anxiety due to stopping a treatment on which they depend psychologically. Second, they must maintain drug abstinence over time, despite possible exacerbations or recurrences of the disorder that the drug was treating. For optimal success, interventions aimed at assisting patients to discontinue drug use must address both of those tasks. Patients' ability to discontinue benzodiazepines seems to be strongly influenced by cognitive appraisals of the threat represented by symptoms and of their own competence to cope with it without medication. For problems of that kind, cognitive and behavioral techniques such as those developed for the treatment of panic disorder may be especially well-suited. Currently, the most successful approaches to benzodiazepine discontinuation include the following components: (1) assisting with initial drug discontinuation, educating patients about benzodiazepine dependence and withdrawal, and about the kinds of symptoms that can emerge as the drug dose is decreased, combined with a flexible drug taper conducted in supportive collaboration with the patient; and (2) dealing with exacerbations of the illness, and providing disorder-specific cognitive-behavioral treatment as an alternative to the resumption of pharmacotherapy. It seems to be crucial that the drug taper be completed before psychological treatment concludes.
journal_name
J Clin Psychopharmacoljournal_title
Journal of clinical psychopharmacologyauthors
Spiegel DAdoi
10.1097/00004714-199912002-00004subject
Has Abstractpub_date
1999-12-01 00:00:00pages
17S-22Sissue
6 Suppl 2eissn
0271-0749issn
1533-712Xjournal_volume
19pub_type
杂志文章,评审abstract:BACKGROUND:Dopaminergic dysfunction, namely, dopamine transporter (DAT) availability variations in patients with drug-naive schizophrenia after long-term treatment, is still not well understood. The aims of the study were to explore (i) whether the DAT availability in patients with drug-naive schizophrenia differed aft...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章
doi:10.1097/JCP.0000000000000632
更新日期:2017-02-01 00:00:00
abstract::The pharmacokinetic parameters of clozapine and its two main metabolites, N-desmethylclozapine (norclozapine, active metabolite) and clozapine N-oxide, were evaluated, after oral administration, in 19 patients with chronic schizophrenia. Plasma and red blood cell (RBC) drug concentrations were determined by high-perfo...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章
doi:10.1097/00004714-199812000-00010
更新日期:1998-12-01 00:00:00
abstract::In a double-blind, parallel groups study, 60 healthy student volunteers (29 men and 31 women, aged 19-22 years) were randomly allocated to receive placebo, 100 or 200 mg modafinil. Two hours later, in the early evening, they completed an extensive cognitive battery. The 3 groups did not differ in self-ratings of sleep...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.jcp.0000155816.21467.25
更新日期:2005-04-01 00:00:00
abstract::The optimal treatment for schizoaffective disorder (SCA) is not well established. In this initial 6-month open-label treatment period of a large, multiphase, relapse-prevention study, the efficacy and safety of paliperidone palmitate once-monthly (PP1M) injectable were evaluated in subjects with symptomatic SCA. Subje...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章
doi:10.1097/JCP.0000000000000535
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Anxiety symptoms frequently experienced by patients with a major neurocognitive disorder (NCD) are often treated with long-term benzodiazepines despite known adverse effects. Pregabalin has shown efficacy in generalized anxiety disorders but has not been studied in patients with a major NCD. The objective of...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章
doi:10.1097/JCP.0000000000001029
更新日期:2019-05-01 00:00:00
abstract::Despite a recognized need for the inclusion of women of childbearing age in drug studies, many such studies include only men. This practice is due mainly to the added risk of teratogenicity and to cyclic variations in the menstrual phase and hormonal state. The methodological and ethical problems associated with drug ...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章,评审
doi:
更新日期:1989-10-01 00:00:00
abstract::Previous studies with functional magnetic resonance imaging (fMRI) demonstrated a differential brain activity and connectivity after treatment with donepezil in Alzheimer's disease (AD) when compared to healthy elders. Importantly however, there are no available studies where the placebo or control group included comp...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章,随机对照试验
doi:10.1097/JCP.0b013e3182825bfd
更新日期:2013-04-01 00:00:00
abstract::The objective of this study was to compare the efficacy of the alpha-2a agonist guanfacine with that of dextroamphetamine for the treatment of adult attention-deficit/hyperactivity disorder (ADHD). Seventeen adult outpatients who met DSM-IV criteria for ADHD participated in a double-blind, placebo-controlled, crossove...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004714-200104000-00015
更新日期:2001-04-01 00:00:00
abstract::Serum neuroleptic activity by radioreceptor assay and prolactin concentration were measured every 6 months for 2 years in 105 male schizophrenic outpatients. The patients took a variety of neuroleptics at clinically determined doses. As expected, when four dissimilar neuroleptics were examined together, there was no s...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章
doi:
更新日期:1989-10-01 00:00:00
abstract:AIMS:The aim of this study was the evaluation of the possible relationship between pharmacokinetics and the safety of aripiprazole as well as its influence on blood pressure (BP), heart rate (HR), and corrected QT (QTc) interval. METHODS:The study population comprised 157 healthy volunteers from 6 bioequivalence clini...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章
doi:10.1097/JCP.0000000000000577
更新日期:2016-12-01 00:00:00
abstract:CONTEXT:Major depressive disorder causes significant morbidity and mortality. Current therapies fail to fully treat both emotional and physical symptoms of major depressive disorder. OBJECTIVE:To evaluate duloxetine, a dual reuptake inhibitor of serotonin and norepinephrine, on improvement of emotional and painful phy...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/01.jcp.0000132448.65972.d9
更新日期:2004-08-01 00:00:00
abstract::Recognition of social anxiety disorder (social phobia) as a common and disabling condition has led to new advances in its pharmacotherapy. Limitations with selective seroton reuptake inhibitors (side effects) and behavior therapy (scarcity of trained therapists), coupled with the tendency for patients with the disorde...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.jcp.0000150227.61501.00
更新日期:2005-02-01 00:00:00
abstract:BACKGROUND:Pharmacokinetic-pharmacodynamic (PK/PD) models were developed to describe the relationship between the time course of paliperidone plasma concentrations and the risk of relapse of schizophrenia symptoms following administration of paliperidone palmitate 1-month (PP1M) and 3-month (PP3M) long-acting injectabl...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/JCP.0000000000001137
更新日期:2019-11-01 00:00:00
abstract::Lithium alone or in combination with other psychotherapeutic drugs has long been the gold standard of management for bipolar disorder (BD). Recognition of its limitations in the acute and chronic management of BD has led to the development of alternative therapies. One such approach involves the use of antiepileptic d...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章,评审
doi:10.1097/00004714-200212000-00010
更新日期:2002-12-01 00:00:00
abstract::The objective of this study was twofold: (1) to describe the effects of risperidone on the quantitative electroencephalogram (EEG) in schizophrenic patients and (2) to explore the relationships between EEG changes and clinical improvement. The subjects were nine male schizophrenic patients participating in a placebo-c...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1993-10-01 00:00:00
abstract::Plasma pemoline levels were measured in 6- to 12-year-old, severely hyperactive males coincident with onset of abnormal involuntary movements. Acute exposure to pemoline (2 mg/kg orally) was associated with choreoathetoid movements of face, limbs, and trunk in five of 20 subjects in an acute study of pemoline pharmaco...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章
doi:10.1097/00004714-198904000-00010
更新日期:1989-04-01 00:00:00
abstract::An antidepressant for use in the patient receiving concomitant drug treatment, over-the-counter medications, or herbal products should lack cytochrome P-450 (CYP) 3A4 inductive or inhibitory activity to provide the least likelihood of a drug-drug interaction. This study addresses the potential of 4 diverse antidepress...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.jcp.0000104908.75206.26
更新日期:2004-02-01 00:00:00
abstract::Alprazolam kinetics following a single 1.0-mg oral dose of alprazolam were compared between seven dialysis-dependent patients with chronic renal failure and seven healthy controls matched for age, sex, and weight. There were no significant differences between patients and controls in alprazolam half-life (11.5 vs. 11....
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章
doi:
更新日期:1986-10-01 00:00:00
abstract::Many drugs, including alcohol and stimulants, demonstrably increase sociability and verbal interaction and are recreationally consumed in social settings. One drug, 3,4-methylenedioxymethamphetamine (MDMA, ecstasy), seems to produce its prosocial effects by increasing plasma oxytocin levels, and the oxytocin system ha...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章,随机对照试验
doi:10.1097/JCP.0000000000000314
更新日期:2015-06-01 00:00:00
abstract::This discussion focuses on three basic areas relevant to tardive dyskinesia (TD). The first area includes an overview of some specific acts of negligence that have been the basis for successful malpractice cases involving TD. Some of these acts of negligence include inappropriate assessment of the patient, failure to ...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章,评审
doi:10.1097/00004714-198808001-00014
更新日期:1988-08-01 00:00:00
abstract::A case of treatment-resistant catatonic stupor responding to combined lithium-neuroleptic medications is described. As there are no reports in the literature of combined lithium-neuroleptic medications being effective for this potentially life-threatening disorder, the course of recovery is detailed and the risks and ...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章
doi:
更新日期:1985-06-01 00:00:00
abstract::In normal subjects after a single oral dose, haloperidol half-life has been reported to range 14.5-36.7 hours (or up to 1.5 days). After chronic administration, half-lives of up to 21 days have been reported. The objective of this study was to evaluate specific factors that might account for differences in haloperidol...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.jcp.0000145340.53417.ca
更新日期:2004-12-01 00:00:00
abstract::There have been many attempts to find predictors of the therapeutic response to the clomipramine treatment of obsessive-compulsive disorder. The majority of studies have failed to identify such predictors. Possible reasons for this failure include the small sample size of most studies, samples homogeneous with respect...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:
更新日期:1994-08-01 00:00:00
abstract:BACKGROUND:Some studies have shown that low dose of neuroleptic addition to ongoing antiobsessive treatment might be effective in treatment resistant obsessive-compulsive disorder (OCD). The primary purpose of this study was to evaluate the efficacy of low-dose quetiapine in clomipramine and serotonin reuptake inhibito...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章
doi:10.1097/01.jcp.0000088900.24613.f2
更新日期:2003-10-01 00:00:00
abstract::A role for serotonin in season affective disorder (SAD) has been explored with a variety of serotonergic pharmacologic agents. The authors initially hypothesized that metergoline, a nonspecific serotonin antagonist, would exacerbate depressive symptoms. In a small, open-label pilot study, the authors observed the oppo...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004714-200204000-00018
更新日期:2002-04-01 00:00:00
abstract::This study was designed to investigate the relationship between subjective and objective effects of a benzodiazepine on the one hand, and the rate of increase of plasma concentration on the other. The pharmacokinetic variables of 10 normal volunteers were calculated following a single intravenous bolus injection of 1 ...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1984-02-01 00:00:00
abstract:PURPOSE:The antidepressant venlafaxine is largely O-desmethylated by CYP2D6, whereas CYP2C19 mediates an alternative metabolic route of venlafaxine through N-desmethylation. The aim of this study was to investigate the combined effect of genotype-predicted CYP2D6 and CYP2C19 phenotypes on serum concentrations of venlaf...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章
doi:10.1097/JCP.0000000000001174
更新日期:2020-03-01 00:00:00
abstract::In this review, the physiologic and pharmacologic effects of tricyclic antidepressants are discussed as they apply to an overdose situation. Systemic arterial hypotension is a frequent occurrence in major overdoses. Occasionally conventional resuscitative measures such as crystalloid or colloid infusion are inadequate...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章,评审
doi:10.1097/00004714-199010060-00005
更新日期:1990-12-01 00:00:00
abstract::Methamphetamine has become a major public health issue globally, particularly in the United States. Despite this, no effective pharmacotherapy for methamphetamine abuse has been developed to date. This 6-week, open-label pilot clinical trial examined the safety and tolerability of modafinil up to 400 mg/d in 8 methamp...
journal_title:Journal of clinical psychopharmacology
pub_type: 临床试验,杂志文章
doi:10.1097/JCP.0b013e3181b591e0
更新日期:2009-10-01 00:00:00
abstract:PURPOSE:Clozapine-associated myocarditis (CAM) is a serious complication, mostly occurring in the first month of treatment. Public mental health in South Australia introduced a screening protocol in 2011 using baseline and weekly C-reactive protein and troponin. The aim of this study was to assess protocol adherence an...
journal_title:Journal of clinical psychopharmacology
pub_type: 杂志文章
doi:10.1097/JCP.0000000000001193
更新日期:2020-05-01 00:00:00