Treatment of restless legs syndrome and periodic movements during sleep with L-dopa: a double-blind, controlled study.

Six patients with restless legs syndrome (RLS) and periodic movements during sleep (PMS) received placebo or L-dopa in a double-blind study. We recorded patients for 36 consecutive hours in the sleep laboratory during a baseline investigation and at the end of each treatment period. Daily evening questionnaires and a suggested immobilization test (SIT) performed at bedtime on each recording night documented the effect of L-dopa in RLS. A nocturnal EMG recording of the anterior tibialis muscles revealed the effect of L-dopa on PMS. L-Dopa proved effective in treating both RLS and PMS. Although not present in every patient, leg movements recorded during the SIT exhibited a clear periodicity. These observations support the hypothesis that RLS and PMS are two manifestations of the same central sensorimotor disorder.

Psychotrope and alcohol use by women: one or two populations?

From a telephone survey of 1,673 Montreal women, all consenting psychotrope users and randomly selected controls (N = 179) then were interviewed in their homes as to psychotropic drug and alcohol use. The results presented are based on these in-depth interviews. In the first phase of the analysis, the respondents were grouped according to whether they abstained from both alcohol and psychotropes, used alcohol alone, psychotropes alone, or both. The variables that distinguished these groups were determined by use of one-way analysis of variance. Some of these factors included age, level of education, anxiety, nervous tension, depression, subjective ratings of health, and responses to emotional upset. The second series of results involved correlation procedures to determine the covariates of alcohol and psychotrope use. Most significant of these findings were that psychotrope use was associated with anxiety, depression, and nervous tension, while alcohol use was not. Further, unlike alcohol use, psychotrope use was associated with a variety of coping techniques for dealing with emotional upset. The findings were interpreted to mean that there are two distinct populations.

Psychotropic drug use by women: demographic, lifestyle, and personality correlates.

From initial telephone interviews with a random population of 1187 francophone women, 179 women participated in a further three-hour person-to-person interview focusing on the use of psychotropic medications. Psychotrope users typically were older, in poorer health, and had a lower level of education than abstainers. They showed an increased prevalence of nervousness, anxiety, depression, and restlessness. Initial contact with psychotrope use was through their general practitioners after presentation of vague and ill-defined symptoms. Psychotropic drug use was found among housewives, especially those with children, and among those unemployed but desiring work. Personality profiles of psychotrope users showed that they think of themselves as failures and are more distressed, with significantly greater life changes. Users scored higher on "femininity" subscales, apparently reflecting dependent and nondefensive personality types. In addition, personality measures defined psychotrope users as precise, methodical, cautious, serious, unassertive, and modest. The incompleteness of present unidirectional models of psychotropic drug use are discussed. Suggestions for future research include encompassing the cognitive organization of the psychotrope user within the context of social, affective, and physician influences on this form of coping style.

Effect of patient demand for drugs on physician prescribing.

In a controlled setting with symptoms and demographic variables held constant, differences in physicians' ratings of symptoms, diagnosis and prescribing of drugs were explored in response to six videotaped patients of differing age groups who either demanded drugs or presented somatic complaints. There was a 1.2:1 ratio of prescriptions given to female versus male patients; demand for drugs resulted in significantly lower prescription rates, drugs prescribed, and multiple prescriptions; and those patients who presented somatic complaints received significantly higher amounts of minor tranquilizers. Older patients were prescribed a significantly greater number of drugs than younger patients, particularly in the antidepressant classification, and differences in symptom ratings but not in prescription rates were seen between male and female physicians.

Medical drug use by women: symptoms and change attributions.

Symptom groups of depression, psychic anxiety, somatic anxiety, and cognitive impairment; and attributions of symptom relief to either self or others were assessed with 179 French-speaking women who were using psychotropic drugs at different rates. Drug consumers reported significantly more often than abstainers that symptom relief results from efforts of others. Occasional users reported distress levels higher than both regular users and abstainers.

Psychotropic drug usage in Quebec urban women: pharmacological aspects.

Data on patterns of psychotropic drug use from a two-part study of Québec urban women are reported. Part I involved telephone interviews with 1187 women on their use of pain, sleep, and psychotropic medications. In Part II, 179 women participated in a further person-to-person interview. Areas covered included frequency and duration of use, efficacy of the product, dosage, presence of undesirable side effects, source of drug information, and the concomitant use of other medications. Diazepam and flurazepam (Valium and Dalmane) were the most frequently consumed psychotropes, with diazepam second only to aspirin as the most commonly used of all the medications. The majority of psychotropic users obtained the drug initially through a general practitioner for nonspecific health reasons, were satisfied with the efficacy of the drug, took the medication as directed, felt informed of the effects, and found no undesirable side effects. Multiple psychotrope use was not prevalent, and users of mood-modifiers were generally alcohol abstainers. The differences between the high and moderate users, including satisfaction with the psychotropes as well as initial dosages, are discussed along with comparative data from other similar drug studies. Findings lend credence to the hypothesis that the vague and ill-defined health problems precipitating a psychotropic prescription may in fact be economic, social, or psychological in origin.

Psychotropic drug use by women: characteristics of high consumers.

One thousand one hundred and eighty-seven women were interviewed concerning their use of psychotropic medication, health and visits to physicians, use of tobacco and alcohol, and life-style and general satisfaction. Subjects were categorized as high, moderate, and non-consumers of psychotropes; respectively, 5.5%, 22.6%, and 71.9% of the sample. High drug consumers typically were older, reported being in poorer health, visited physicians more frequently (and more frequently for undefined reasons), rated themselves as more unhappy, were less well educated, were more likely unemployed, smoked more but drank less alcohol, and were more likely unemployed, smoked more but drank less alcohol, and were more likely to have children than the moderate users or abstainers. The findings are shown to support in part the hypotheses that social and psychological problems of women are expressed vaguely and subsequently are more likely medicalized than those of men. The implications of these findings for drug prevention programs and future research are discussed.

Correlates of psychotropic drug use in women: interpersonal problem solving and depression.

Interpersonal problem solving ability was assessed in a community-based study with 179 French-speaking women who were consuming psychotropic drugs at varying frequencies. Significant differences were found between psychotrope consumers and nonconsumers in problem solving scores, with deficiencies in defining the problem characteristic of regular consumers. When subjects were separated on the basis of the Beck Depression Inventory scores, depressed women were differentiated only in their ability to generate alternatives and provide viable solutions to problems. The results are discussed in terms of difficulties with problem definition which might prompt a physician to prescribe, and the role of problem solving deficiencies in drug use maintenance.