Oxazepam: update 1989.

Oxazepam is an anxiolytic with established clinical efficacy. Compared to other benzodiazepines it may offer advantages in some patient populations, such as the elderly. Oxazepam has not been associated with more or different risks than other benzodiazepines, and there is no evidence that physiological dependence occurs more frequently with oxazepam than other benzodiazepines. Available evidence suggests that oxazepam may be associated with a lower risk of seizure-induction than lorazepam and alprazolam, and that compared to diazepam, oxazepam may have lower abuse potential.

Five to fifteen years' maintenance doxepin therapy.

The subject of this presentation is depression in patients with concomitant chronic disease. With this focus, it is perhaps easy to overlook the fact that, for many patients, depression is, in itself, a chronic condition requiring a long-term management strategy. The most familiar model of depression is that of an illness which, though it may have been present for a long period, is usually curable with an 8 to 12 month course of medication. An unknown number of depressed patients, however, may require long-term or maintenance antidepressant drug therapy. The definition, recognition, and management of chronic depression are briefly reviewed. An ongoing prospective study of the long term (5-15 years) use of doxepin indicates that this tricyclic antidepressant is feasible, efficacious, and safe in the treatment of judiciously selected and carefully monitored patients. Advantages of doxepin therapy include its lack of adverse interactions with prescription and non-prescription drugs taken by these patients and the high degree of safety seen in patients with concomitant cardiovascular and other physical disorders. Thus, doxepin appears to be a suitable drug for the long-term maintenance outpatient treatment of chronic depression.

Problems with orders for medication as needed.

The safety of an order for medication as needed depends on assumptions and knowledge that may or may not accompany that order. Physicians should consider carefully the need for prescribing potent medications on an as-needed basis for newly admitted patients, particularly if these patients have not been examined, their histories are unknown, and no diagnosis has been established. In addition, the language of such orders should leave as little as possible to chance. Interpretation of orders should not be left to the discretion of staff members who may be inexperienced in the administration of medications that require frequent monitoring and astute interpretation of side effects.

Is it anxiety or depression?

Physicians are often confronted with the problem of differentiating between depression and anxiety. In accumulated data on 500 patients with subsequent diagnosis and successful treatment of primary depression, only a few had had a tentative diagnosis of depression rather than anxiety. Failure to differentiate between depression and anxiety results in inappropriate and ineffective treatment.

Long-term treatment of chronic depression: 15-year experience with doxepin HCl.

The definition, recognition, and management of chronic depression are briefly reviewed. An ongoing prospective study of the long term (5-15 years) use of doxepin indicates that this tricyclic antidepressant is feasible, efficacious, and safe in the treatment of this population. Advantages of doxepin therapy include its lack of adverse interactions with prescription and non-prescription drugs taken by these patients and the high degree of safety seen in patients with concomitant cardiovascular and other physical disorders. Thus, doxepin appears to be an excellent choice in the long-term maintenance outpatient treatment of chronic depression.

Haloperidol: a quarter century of experience.

Research on haloperidol's pharmacokinetics, side effects, indications, and efficacy is reviewed. Issues related to high-dose therapy, rapid neuroleptization, intravenous administration, use in geriatric patients, and coadministration with lithium in mania are discussed. Overall, 25 years of experience have indicated that haloperidol can be used safely and effectively to manage a variety of psychiatric illnesses, so long as dosage and method of administration are adjusted to individual patients' needs. Research continues on the use of this drug, not only in psychiatry but in several other areas of medical practice.

The depressed office patient.

Depression is among the most common illnesses seen by the family physician. Untreated, it produces considerable morbidity and occasional mortality. By carefully listening not only to what the patient says, but how he says it, the physician gains valuable diagnostic information. Medication should be tailored to the patient's symptoms and medical background. An adequate dosage must be employed for several weeks to obtain a clinical response. Maintenance therapy is usually needed for six to 12 months.

Depot pipotiazine 1970-1982: a review.

In the past 14 years pipotiazine palmitate, the second oldest depot neuroleptic, has proven to be effective and safe in reducing and preventing resurgence of symptoms of acute and chronic psychoses, chiefly in schizophrenia. It is particularly valuable in the management of erratic ingestors and unreliable absorbers of oral neuroleptics. Clinical experience substantiates that pipotiazine palmitate therapy is best initiated at low doses (25 mg), and that the most effective maintenance dosage is 25 to 200 mg once a month. Pipotiazine palmitate has a low propensity to evoke extrapyramidal reactions; in fact, it causes the lowest incidence of EPS of all depot neuroleptics. Patients receiving pipotiazine palmitate seldom require concomitant antiparkinsonian medication. This review highlights other assets and liabilities of depot pipotiazine therapy.