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Obsessive-compulsive disorder treatment response to clomipramine hydrochloride and influence of affective disturbance
Panic and Anxiety Disorders
BIOL PSYCHIATRY 1989;25:184A-193A
191A
388 LACTATE-INDUCED PANIC IN ALCOHOLICS Deborah S. Cowley, Carl F. Jensen, Donald J. Johannessen Seattle, WA
Alcoholics have an increased prevalence of panic and anxiety disorders. To determine the biological similarity of panic states in alcoholics and non-alcoholics, we performed lactate infusions in non-alcoholic patients with panic disorder (PD; N = 16), and abstinent alcoholics with (ALCP; N = 12), and without (ALC; N = 10) panic attacks. Subjects received 10 cc/kg 0.5 molar sodium lactate over 20 minutes. PD and ALCP subjects had similar rates of lactate-induced panic (eight of 16 versus five of 12; X2 = 0.2, df = 1, p = ns) while ALC subjects had a lower response rate than either of the other two groups (0 of 10; X2 = 7.3, df = 2, p < .03). These findings suggest that panic states in alcoholics resemble those in PD patients, at least in their lactate vulnerability. Heart rate, symptom scores, and anxiety ratings in the three groups will be compared and the usefulness of lactate infusion as a diagnostic test in alcoholics will be discussed.
389 OBSESSIVE-COMPULSIVE DISORDER TREATMENT RESPONSE TO CLOMIPRAMINE HYDROCHLORIDE INFLUENCE OF AFFECTIVE DISTURBANCE D. Fogelson, R. Katz, J. DeVeaugh-Geiss, P. Landau
AND
Santa Monica, CA, and Summit, NJ
Protocols 59 and 61 are double-blind trials of clomipramine hydrochloride (Anafranil) versus placebo in the treatment of DSM-III defined Obsessive-Compulsive Disorder @CD). Herein we examine three potential interrelationships of affective disturbance, as measured by the Hamilton Depression Rating Scale (HDRS) and factor analysis derived subscales, and Obsessive-Compulsive Disorder, as measured by the YaleBrown Obsessive Compulsive Scale (Y-BOCS). The following are examined specifically: the relationship of HDRS score (and subscales) to Y-BOCS Score at baseline; the relationship of HDRS change and change in OCD symptoms following treatment with clomipramine; and the relationship of HDRS factor loadings and factor loadings for other depressive and anxiety disorders.
390 EFFECTS OF DIAZEPAM ON PERFORMANCE: RELATIONSHIP TO DOSE, DURATION OF TREATMENT AND ANXIETY Nunzio Pomara, Dennis Deptula, Robert I. Block, Rajkumar Singh, David J. Greenblatt Orangeburg, NY
In spite of the widespread use of benzodiazepines in the elderly, there are few studies of their effects on task performance in elderly subjects. While several studies have examined effects of single doses on healthy young, these findings may not be relevant to clinical practice in which elderly patients are treated with multiple doses. Consequently, we conducted an NIMH sponsored, double-blind study of the acute effects of a single diazepam dose and the chronic effects of 21 days of treatment in both young and elderly. Forty-five normal young subjects (ages 19-35) and 45 normal
BIOL PSYCHIATRY 1989;25:184A-193A
191A
388 LACTATE-INDUCED PANIC IN ALCOHOLICS Deborah S. Cowley, Carl F. Jensen, Donald J. Johannessen Seattle, WA
Alcoholics have an increased prevalence of panic and anxiety disorders. To determine the biological similarity of panic states in alcoholics and non-alcoholics, we performed lactate infusions in non-alcoholic patients with panic disorder (PD; N = 16), and abstinent alcoholics with (ALCP; N = 12), and without (ALC; N = 10) panic attacks. Subjects received 10 cc/kg 0.5 molar sodium lactate over 20 minutes. PD and ALCP subjects had similar rates of lactate-induced panic (eight of 16 versus five of 12; X2 = 0.2, df = 1, p = ns) while ALC subjects had a lower response rate than either of the other two groups (0 of 10; X2 = 7.3, df = 2, p < .03). These findings suggest that panic states in alcoholics resemble those in PD patients, at least in their lactate vulnerability. Heart rate, symptom scores, and anxiety ratings in the three groups will be compared and the usefulness of lactate infusion as a diagnostic test in alcoholics will be discussed.
389 OBSESSIVE-COMPULSIVE DISORDER TREATMENT RESPONSE TO CLOMIPRAMINE HYDROCHLORIDE INFLUENCE OF AFFECTIVE DISTURBANCE D. Fogelson, R. Katz, J. DeVeaugh-Geiss, P. Landau
AND
Santa Monica, CA, and Summit, NJ
Protocols 59 and 61 are double-blind trials of clomipramine hydrochloride (Anafranil) versus placebo in the treatment of DSM-III defined Obsessive-Compulsive Disorder @CD). Herein we examine three potential interrelationships of affective disturbance, as measured by the Hamilton Depression Rating Scale (HDRS) and factor analysis derived subscales, and Obsessive-Compulsive Disorder, as measured by the YaleBrown Obsessive Compulsive Scale (Y-BOCS). The following are examined specifically: the relationship of HDRS score (and subscales) to Y-BOCS Score at baseline; the relationship of HDRS change and change in OCD symptoms following treatment with clomipramine; and the relationship of HDRS factor loadings and factor loadings for other depressive and anxiety disorders.
390 EFFECTS OF DIAZEPAM ON PERFORMANCE: RELATIONSHIP TO DOSE, DURATION OF TREATMENT AND ANXIETY Nunzio Pomara, Dennis Deptula, Robert I. Block, Rajkumar Singh, David J. Greenblatt Orangeburg, NY
In spite of the widespread use of benzodiazepines in the elderly, there are few studies of their effects on task performance in elderly subjects. While several studies have examined effects of single doses on healthy young, these findings may not be relevant to clinical practice in which elderly patients are treated with multiple doses. Consequently, we conducted an NIMH sponsored, double-blind study of the acute effects of a single diazepam dose and the chronic effects of 21 days of treatment in both young and elderly. Forty-five normal young subjects (ages 19-35) and 45 normal