This study assessed cardiac rate and rhythm by ambulatory monitoring in 23 patients with panic disorder or agoraphobia with panic attacks. The patients had a higher than normal mean daily density of ventricular premature complexes (VPCs), but complex ventricular arrhythmias were uncommon. Heart rate was greater during panic intervals than during asymptomatic periods. The prevalence of arrhythmias within symptomatic intervals was similar during panic, partial panic, and anxiety and was significantly higher than during asymptomatic intervals. However, most panic episodes had no arrhythmias, and arrhythmias during panic intervals were simple VPCs.
The authors report results of an 8-week, open trial of desipramine in 42 patients with DSM-III-R dysthymia with a concurrent diagnosis of major depression ("double" depression) and 33 patients with dysthymia who had no other depressive diagnosis ("pure" dysthymia). Either complete or partial remission was achieved by 70% of the patients with "pure" dysthymia. This compared favorably with but was not significantly different from results in the "double" depression group.
Residents given a specialized 4-hour course in managing extrapyramidal syndromes prescribed significantly lower neuroleptic doses and were more skilled at diagnosis of extrapyramidal syndromes than residents given standard psychopharmacology training. The results suggest that focused training in extrapyramidal syndromes should be part of residency curricula.
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