Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 9 de 9
Filter
1.
BMC Neurol ; 22(1): 474, 2022 Dec 12.
Article in English | MEDLINE | ID: mdl-36510237

ABSTRACT

BACKGROUND: Depressive symptoms are common in patients with Parkinson's disease and depression is a significant predictor of functional impairment, reduced quality of life and general well-being in Parkinson's disease. Despite the high prevalence of depression, evidence on the effectiveness and tolerability of antidepressants in this population is limited. The primary aim of this trial is to establish the clinical and cost effectiveness of escitalopram and nortriptyline for the treatment of depression in Parkinson's disease. METHODS: This is a multi-centre, double-blind, randomised placebo-controlled trial in 408 people with Parkinson's disease with subsyndromal depression, major depressive disorder or persistent depressive disorder and a Beck Depression Inventory-II (BDI-II) score of 14 or above. Participants will be randomised into one of three groups, receiving either escitalopram, nortriptyline or placebo for 12 months. Trial participation is face-to-face, hybrid or remote. The primary outcome measure is the BDI-II score following 8 weeks of treatment. Secondary outcomes will be collected at baseline, 8, 26 and 52 weeks and following withdrawal, including severity of anxiety and depression scores as well as Parkinson's disease motor severity, and ratings of non-motor symptoms, cognitive function, health-related quality of life, levodopa-equivalence dose, changes in medication, overall clinical effectiveness, capability, health and social care resource use, carer health-related quality of life, adverse effects and number of dropouts. DISCUSSION: This trial aims to determine the effectiveness of escitalopram and nortriptyline for reducing depressive symptoms in Parkinson's disease over 8 weeks, to provide information on the effect of these medications on anxiety and other non-motor symptoms in PD and on impact on patients and caregivers, and to examine their effect on change in motor severity. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03652870 Date of registration - 29th August 2018.


Subject(s)
Depressive Disorder, Major , Parkinson Disease , Humans , Parkinson Disease/complications , Parkinson Disease/drug therapy , Depressive Disorder, Major/drug therapy , Quality of Life , Escitalopram , Antidepressive Agents/therapeutic use , Nortriptyline/therapeutic use , Treatment Outcome , Double-Blind Method , Randomized Controlled Trials as Topic , Multicenter Studies as Topic
2.
Psychiatriki ; 23(2): 109-16, 2012.
Article in English | MEDLINE | ID: mdl-22796909

ABSTRACT

People with intellectual disability are at a greater risk of developing common mental disorders. In the United Kingdom, the National Institute for Health and Clinical Excellence guidelines recommend cognitive behavioural therapy (CBT) as the treatment of choice for such problems. Even though there is growing evidence that people with mild intellectual disability can benefit from CBT, there are no manuals to assist in the delivery of the treatment. Previously published material from journals and books describing both CBT in people with intellectual disability and the general population was reviewed to create the first draft. Further consultations with professionals and service users with intellectual disability on the content, accessibility and language that was used in the manual were carried out. Specific materials were developed for use in the therapy sessions and for homework. The manual, written for trained therapists, provides generic information about communication and thinking styles in people with mild intellectual disability and describes in detail how to conduct each session. It contains also contains the materials and a leaflet to help carers support the treatment. Manualised treatments are helpful in maintaining a consistent approach to treatment and may be more beneficial for hard to reach population groups.


Subject(s)
Cognitive Behavioral Therapy/methods , Intellectual Disability/therapy , Mental Disorders/therapy , Anxiety/psychology , Anxiety/therapy , Depression/psychology , Depression/therapy , Humans , Intellectual Disability/psychology , Mental Disorders/psychology , Referral and Consultation , Teaching Materials , Treatment Outcome
4.
Psychooncology ; 21(5): 563-9, 2012 May.
Article in English | MEDLINE | ID: mdl-21370309

ABSTRACT

UNLABELLED: Distress associated with cancer often presents with symptoms of depression and/or anxiety. Cognitive Behaviour Therapy (CBT) is one of the most effective psychological treatments. Complementary therapies, especially aromatherapy massage (AM), are also popular and alleviate anxiety. No studies have directly compared these two treatments. AIMS: The aim of this study is to (1) test the feasibility of recruitment into a randomised controlled trial of AM versus CBT in patients with cancer; (2) test and modify the intervention; (3) determine whether changes in outcomes were consistent with published data. METHODS: Patients at all stages of cancer, recruited from oncology outpatient clinics and screening eight or more for anxiety and/or depression on the HADS, were randomised to Treatment as Usual (TAU) plus up to eight sessions weekly of either AM or CBT, offered within 3 months. The POMS was collected at baseline and 3 and 6 months post baseline. RESULTS: Of those suitable, over 60% (39/63) participated (AM, n = 20; CBT, n = 19) and over 90% (36/39) were followed up. Both packages were well received. The preference was for AM, with more sessions were taken up; (Mean number sessions AM = 7.2 (SD 2.0) and CBT = 5.4 (SD 3.1); P<0.05). Significant improvements in POMS (Total Mood, depression and anxiety scores) occurred with both interventions. Between-group comparison showed a non-significant trend towards greater improvement in depression with CBT. CONCLUSIONS: Recruitment was feasible; the interventions acceptable and engagement with treatment was high. Improvements with both interventions were observed. The beneficial effects on depression with CBT appeared to be sustained.


Subject(s)
Aromatherapy/methods , Cognitive Behavioral Therapy/methods , Massage/methods , Neoplasms/psychology , Neoplasms/therapy , Stress, Psychological/therapy , Adult , Aged , Anxiety/therapy , Depression/therapy , Feasibility Studies , Female , Humans , Male , Middle Aged , Palliative Care/methods , Patient Selection , Pilot Projects , Treatment Outcome
5.
Drug Alcohol Rev ; 16(4): 339-47, 1997 Dec.
Article in English | MEDLINE | ID: mdl-16203447

ABSTRACT

Of 1728 patients attending a regional drug and alcohol clinic, 202 were considered at risk of hepatitis C virus (HCV). Forty-nine per cent (99/202) agreed to testing-67% (67) were HCV antibody positive. Age and a history of needle sharing was the significant factor associated with positive HCV status. Patients on methadone maintenance medication were more-likely to have been HCV positive, but significantly (p = 0.005) less likely to have shared needles in the previous year. Seventy-three per cent (49/67) attended for follow-up at a "liver clinic". Fifty per cent were infected with genotype 1a. Eighteen patients were biopsied and all were abnormal, ranging from mild hepatitis to severe fibrotic hepatitis. Attendance for medical follow-up was poor, which emphasizes the importance of preventative measures such as methadone maintenance programmes for reducing the spread of HCV.

6.
J Psychopharmacol ; 10(4): 303-8, 1996 Jan.
Article in English | MEDLINE | ID: mdl-22302978

ABSTRACT

A five-year retrospective study investigating the effects of psychotropic medication on first seizure length was undertaken on 109 patients who received 131 courses of electroconvulsive therapy (ECT). Bilateral ECT was administered under methohexitone anaesthesia. Induction of a seizure was successful in 105 patients. Stepwise linear regression analysis showed that except for selective serotonin reuptake inhibitors (SSRIs) seizure length was not affected by psychotropic medication, SSRIs were associated with prolonged seizure length (p=0.0012). Less than one-third of the subjects had drugs with anticonvulsant properties omitted before treatment. Drugs with anticonvulsant properties did not shorten seizure length. Though this study suggests that SSRIs may prolong fit length, further clarification of the predictors for seizure duration is required.

8.
Br J Psychiatry ; 163: 386-93, 1993 Sep.
Article in English | MEDLINE | ID: mdl-8104653

ABSTRACT

The fatal toxicity indices of benzodiazepines during the 1980s were calculated from national prescribing data and mortality statistics. The overall rate was 5.9 deaths per million prescriptions for benzodiazepines taken alone or with alcohol only, anxiolytics being less toxic than hypnotics. Diazepam appeared more toxic than average among anxiolytics (P < 0.05), and flurazepam and temazepam more toxic than average among hypnotics (both P < 0.001). It was shown that the finding for diazepam was probably explained by concurrent use of alcohol, which implies that other anxiolytics may be safer in cases where there is alcohol misuse; but the greater toxicity of flurazepam and temazepam remained unexplained. Benzodiazepines are indeed much less toxic than the barbiturates they superseded, but they are not innocuous and temazepam in particular requires further evaluation.


Subject(s)
Anti-Anxiety Agents/poisoning , Cause of Death , Drug Overdose/mortality , Adolescent , Adult , Age Factors , Aged , Alcohol Drinking/adverse effects , Alcohol Drinking/mortality , Benzodiazepines , Confidence Intervals , Cross-Sectional Studies , Female , Humans , Hypnotics and Sedatives/poisoning , Incidence , Male , Middle Aged , Sex Factors , United Kingdom/epidemiology
9.
Rev Fr Odontostomatol ; 17(8): 1081-94, 1970 Oct.
Article in French | MEDLINE | ID: mdl-5276530

Subject(s)
Child , Child, Preschool , Humans
SELECTION OF CITATIONS
SEARCH DETAIL
...