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Query: UMLS:C0043352 (xerostomia)
 4,250 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The efficacy and safety of fluoxetine were compared with those of imipramine and of placebo in a 6-week randomized double-blind parallel study of patients with major depressive illness. Mean values for all efficacy measurements were improved over baseline with fluoxetine and imipramine treatment (p less than .001). More fluoxetine patients completed the study than did imipramine or placebo patients. Predominant adverse experiences reported by imipramine patients were dry mouth and dizziness/lightheadedness. Predominant adverse experiences reported by fluoxetine patients were drowsiness/sedation and excessive sweating. In a subsequent 48-week open-label study, the predominant adverse experience in the fluoxetine group was excessive sweating and in the imipramine group was still dry mouth. In this study, fluoxetine relieved the symptoms of major depressive illness effectively and significantly better than placebo and was better tolerated than imipramine.
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PMID:A comparison of fluoxetine, imipramine, and placebo in patients with major depressive disorder. 388 77

Hyoscine (scopolamine) is a competitive inhibitor of the muscarinic receptors of acetylcholine and it has been shown to be one of the most effective agents for preventing motion sickness. However, a relatively high incidence of side effects and a short duration of action has restricted the usefulness of this agent when administered orally or parenterally, and to counter this a novel transdermal preparation of hyoscine has been developed. Pharmacokinetic studies indicate that this new method for administering hyoscine controls the absorption process and the rate of drug entry into the systemic circulation over an extended period (72 hours), providing a means of delivery which is similar to a slow intravenous infusion. However, recent evidence suggests that the response to transdermal hyoscine treatment is variable and this may reflect pharmacokinetic differences between individuals. Controlled therapeutic trials have indicated that a single transdermal hyoscine patch is significantly superior to placebo and oral meclozine (meclizine) in preventing motion sickness. Trials comparing transdermal hyoscine with oral dimenhydrinate have failed to establish any significant differences in efficacy between the 2 drugs in small numbers of subjects, although there was always a more favourable trend towards the transdermal system. In patients with acute vertigo, transdermal hyoscine and oral meclozine were equally efficacious and both were significantly better than placebo in reducing the number of attacks of vertigo. Although transdermal hyoscine has been associated with a lower incidence of side effects than orally or parenterally administered hyoscine hydrobromide, adverse systemic effects have still been frequently reported. Most commonly cited have been dry mouth, drowsiness and impairment of ocular accommodation, including blurred vision and mydriasis (some ocular effects reported may be due to finger-to-eye contamination). Adverse central nervous system (CNS) effects, difficulty in urinating, rashes and erythema have been reported only occasionally. Thus, preliminary evidence suggests transdermal hyoscine may offer an effective and conveniently administered alternative for the prevention of motion-induced nausea and vomiting in certain situations. However, the duration of its clinical effectiveness, and its relative efficacy and tolerability compared with other agents needs to be confirmed in a few additional well-designed studies.
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PMID:Transdermal hyoscine (Scopolamine). A preliminary review of its pharmacodynamic properties and therapeutic efficacy. 388 52

The efficacy and safety of fluoxetine, a new antidepressant agent, were assessed in a double-blind, parallel, randomized study of 44 outpatients with major depressive disorder. Following a 1-week placebo period, patients were randomly assigned to either fluoxetine or amitriptyline for a period of 5 weeks. The mean maintenance dosages were 55 mg/day for fluoxetine and 159 mg/day for amitriptyline. Both drugs were effective in relieving the symptoms of depression. The most frequently reported side effects were nausea and nervousness for fluoxetine, and dry mouth, dizziness, and drowsiness for amitriptyline.
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PMID:A comparative trial of fluoxetine and amitriptyline in patients with major depressive disorder. 389 4

Sixty out-patients with different nosological types of depression were assigned at random to three different treatment groups and were treated under double-blind conditions for 6 weeks. Two groups received diclofensine in capsules of either 15 or 25 mg, and a third group received capsules with imipramine 25 mg. The dosage schedule provided an initial dose of 2 capsules/day which was to be gradually increased up to a maximum dose of 9 capsules/day. The daily mean dosages actually given over the entire trial period were 64.0 mg diclofensine for group I, 97.6 mg diclofensine for group II, and 102.9 mg imipramine for group III. All treatment groups showed a good improvement of the patients' clinical states within the 6-week period, but the imipramine-treated patients improved more slowly than the diclofensine-treated patients. This was demonstrated by the mean total scores of the Hamilton Depression Rating Scale (HDRS). Evaluation of different factors of the HDRS yielded differences between the two drugs in favour of diclofensine for the factor 'inhibition' from the end of week 1 until the end of week 3 and for the factor 'somatic complaints' during week 3. Side effects were - dose dependently - less frequent, less severe, and lasted shorter in the diclofensine-treated patients than in the imipramine-treated ones. The most frequently reported side effects in the diclofensine-treated patients were dry mouth, insomnia, dizziness, and agitation. In the imipramine group side effects were mainly dry mouth, tremor, dizziness, and sleepiness. In conclusion, this study shows an impressively faster onset of efficacy of diclofensine over imipramine, a finding which should be replicated by further studies.
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PMID:Diclofensine and imipramine. A double-blind comparative trial in depressive out-patients. 391 58

This study assessed the antihypertensive efficacy and side effects of clonidine administered transdermally. Twenty-five patients with mild to moderate essential hypertension (seated diastolic blood pressure 95-120 mm Hg with diuretic therapy alone) controlled with oral diuretic plus oral clonidine were enrolled. Transdermal clonidine was substituted for oral clonidine and titrated until adequate blood pressure control (seated diastolic blood pressure less than 90 mm Hg) was attained. At the end of titration, seated morning blood pressure averaged 129/90 +/- 15/5 mm Hg (mean +/- standard deviation) compared to 136/96 +/- 13/7 mm Hg (p less than 0.01/0.001) during oral clonidine administration. Standing morning blood pressure was also lower during transdermal than oral therapy (131/94 +/- 16/5 vs 136/99 +/- 14/7, p less than 0.05/0.001). Afternoon blood pressures (at peak effect of oral dose) were virtually identical during oral and transdermal therapy in both seated and standing positions. Typical side effects of oral clonidine, including dry mouth, drowsiness, and sexual dysfunction, were reduced during transdermal therapy. There was less morning-to-afternoon variability of blood pressure control and plasma clonidine concentrations during transdermal than during oral therapy. One patient left the study because of drowsiness and two because of skin reactions to the transdermal skin patch. Mild transient local skin irritation occurred frequently. Transdermal clonidine plus a diuretic is an effective treatment for mild to moderate essential hypertension, improves compliance and reduces side effects of therapy.
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PMID:Transdermal administration of clonidine: a new approach to antihypertensive therapy. 395 4

We have evaluated the effectiveness of antihypertensive therapy for predominant systolic hypertension in 55 patients, aged 61 to 76 years, with untreated systolic blood pressures of at least 160 mm Hg and diastolic blood pressures less than 100 mm Hg. In this retrospective analysis, 41 of the patients had been treated with the centrally acting agent guanabenz (average dose 24 +/- 14 [SD] mg daily) given alone, and 14 had received a combination of guanabenz (17 +/- 10 mg daily) and hydrochlorothiazide (60 +/- 30 mg daily). After six months of therapy, each regimen significantly decreased both systolic and diastolic blood pressures. Moreover, there were no differences between the two treatment regimens in their antihypertensive efficacy, and there was no evidence of orthostatic effects. In both treatment groups, approximately 50% of the patients had excellent therapeutic responses (decrease in supine systolic blood pressure of at least 20 mm Hg). The main side effects of treatment were drowsiness and dry mouth, though these tended to be mild and of short duration. Thus, in predominant systolic hypertension in elderly patients, guanabenz, either alone or in combination with a diuretic, appears to be an effective and well tolerated form of treatment.
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PMID:Treatment of hypertension in the elderly. 395 44

Centrally acting agents and the beta-adrenergic antagonists represent two classes of antihypertensive agents recommended for initial monotherapy. Comparisons of the efficacy and safety of the centrally acting agent, guanabenz, with those of propranolol and pindolol in patients with mild to moderately severe hypertension, are reported. In the guanabenz versus propranolol study, mean supine blood pressure decreased by 19/15 mm Hg for 44 guanabenz-treated patients and by 17/15 mm Hg for 52 propranolol-treated patients who completed 6 months of therapy. In the guanabenz versus pindolol study, the mean decrease in supine blood pressure was 17/14 mm Hg for the 12 patients treated with guanabenz and 21/15 mm Hg for the 13 patients who received pindolol and completed 2 months of therapy. If the patients who discontinued therapy for drug-related reasons are considered, the percentages of patients with clinically satisfactory blood pressure reductions were 59% for the guanabenz group versus 62% for the propranolol group and 79% for guanabenz-treated patients versus 64% for pindolol-treated patients. Although adverse effects, including dry mouth, drowsiness, and weakness, were more common among guanabenz-treated patients, these effects generally were mild and became less frequent with continued therapy. The therapeutic efficacy and safety of guanabenz were similar to those of the two beta-adrenergic blocking drugs, propranolol and pindolol. Guanabenz therapy decreased serum total cholesterol (p less than 0.05), whereas propranolol therapy decreased HDL cholesterol (p less than 0.05). Thus, guanabenz did not produce serum lipid abnormalities that may be associated with increased cardiovascular risk.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparison of a centrally acting antihypertensive agent and beta-adrenergic blocking agents for the treatment of hypertension. 608 30

The safety and antihypertensive efficacy of guanabenz and hydrochlorothiazide (HCTZ) were compared in a 6-month multicenter, double-blind study involving 147 patients. Average daily dosages of guanabenz varied during the study period from 16 to 31 mg, and mean daily dosages of HCTZ varied from 50 to 75 mg. Mean supine diastolic blood pressure (SDBP) decreased from 100 to 85 mm Hg for 33 guanabenz-treated patients (p less than 0.001) and from 99 to 83 mm Hg for 41 HCTZ-treated patients (p less than 0.001) who completed 6 months of treatment. Clinically significant individual decreases in SDBP were observed for 85% of the patients in both treatment groups at 6 months. Mild side effects, which included dry mouth and drowsiness, were reported more frequently by guanabenz-treated patients than by HCTZ-treated patients (p less than 0.01). Among HCTZ-treated patients, statistically significant mean increases from baseline values were noted for uric acid, serum glutamic oxaloacetic transaminase, carbon dioxide, hemoglobin, and blood urea nitrogen levels, whereas mean decreases were observed for potassium and chloride levels. The only clinically significant change in mean laboratory values for the guanabenz group was a decrease of 16 mg/dl in total serum cholesterol (p less than 0.01). The electrolyte and metabolic disturbances associated with HCTZ treatment may lead to increased cardiovascular risk and thus negate or reduce the benefits of successful blood pressure control. A decrease in serum cholesterol levels and a reduction in blood pressure, however, are effects that have been associated with reduced cardiovascular risk. Thus guanabenz therapy may have a more beneficial effect on overall cardiovascular risk than HCTZ therapy.
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PMID:Step-one antihypertensive therapy: a comparison of a centrally acting agent and a diuretic. 608 39

Alprazolam is a triazolobenzodiazepine, a derivative of the benzodiazepines. Comparison studies of alprazolam and diazepam or chlordiazepoxide in patients suffering from clinical anxiety secondary to anxiety neurosis or chronic alcohol withdrawal suggest an equal efficacy of those agents. Studies examining the use of alprazolam for the treatment of "primary depression" suggest that it is as effective as imipramine in the treatment of exogenous (reactive) depression. Although alprazolam may be effective in patients with exogenous depression, no extrapolation can be made to the treatment of endogenous depression. Mechanisms of action have not been fully elucidated, but probably are similar to those of other benzodiazepines. Peak blood levels are reached in 0.7-1.6 hours and the elimination half-life after steady state is approximately 19 hours. Daily dosages established from clinical studies ranged from 1 to 6 mg. Clinically, alprazolam appears to be ten times more potent than diazepam. Drowsiness, headaches, lightheadedness, dry mouth, and depression appear to be the most common side effects of the drug. It is concluded that alprazolam offers no striking therapeutic advantage over currently marketed benzodiazepines.
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PMID:Alprazolam (Xanax, the Upjohn Company). 611 42

The anxiolytic properties of nabilone, a synthetic cannabinoid resembling the natural cannabinoids, were studied in 25 outpatients suffering from anxiety. The drug was compared with a placebo in a double-blind manner over a 28-day treatment period. Patients were seen weekly by the physician and were rated by the Hamilton Rating Scale for Anxiety and the Patient's Global Evaluation as well as by patient-rated evaluations. The results of the study showed a dramatic improvement in anxiety in the nabilone group when compared with placebo (P less than 0.001). Side effects reported were dry mouth, dry eyes, and drowsiness. Patients did not report any of the subjective "altered state" experience of marihuana.
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PMID:The efficacy and safety of nabilone (a synthetic cannabinoid) in the treatment of anxiety. 611 75


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