Mianserin in the Prophylaxis of Suicidal Behaviour: a Double Blind Placebo Controlled Trial

Montgomery, D. B.; Montgomery, Stuart; Roy, Daniel

doi:10.1016/b978-0-08-027080-7.50130-0

Cited by 17 publications

(43 citation statements)

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“…All reports had been published, although two studies had not been published in full. 16 26 The full report of one trial was provided by the author in the form of an unpublished manuscript,16 and a detailed report of the other was obtained from conference proceedings 26. Four studies had been reported in more than one publication.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Deliberate self harm: systematic review of efficacy of psychosocial and pharmacological treatments in preventing repetition

Hawton¹,

Arensman²,

Townsend³

et al. 1998

BMJ

385

289

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The difference may be partly accounted for by the factors that influence infectivity of the two viruses. Hepatitis B is much more likely to be transmitted from mother to infant if there is a high concentration of the virus in the mother's blood. This explains the ethnic differences that are observed-for example, the transmission rate is over 70% in Chinese women but less than 10% in white women. This ethnic difference does not seem to apply to hepatitis C infection.Alcohol intake and obesity are both thought to be associated with more severe hepatitis C, although the exact interaction is unknown. Advanced liver disease, for example, is far worse in people infected with hepatitis C who also have a high alcohol intake than in those with a low intake. AbstractObjective: To identify and synthesise the findings from all randomised controlled trials that have examined the effectiveness of treatments of patients who have deliberately harmed themselves. Design: Systematic review of randomised controlled trials of psychosocial and physical treatments. Studies categorised according to type of treatment. When there was more than one investigation in a particular category a summary odds ratio was estimated with the Mantel-Haenszel method. Setting: Randomised trials available in electronic databases in 1996, in the Cochrane Controlled Trials Register in 1997, and from hand searching of journals to 1997. Subjects: Patients who had deliberately harmed themselves shortly before entry into the trials with information on repetition of behaviour. The included trials comprised 2452 randomised participants with outcome data. Main outcome measure: Repetition of self harm. Results: 20 trials reported repetition of self harm as an outcome variable, classified into 10 categories. Summary odds ratio (all for comparison with standard aftercare) indicated reduced repetition for problem solving therapy (0.73; 95% confidence interval 0.45 to 1.18) and for provision of an emergency contact card in addition to standard care (0.45; 0.19 to 1.07). The summary odds ratios were 0.83 (0.61 to 1.14) for trials of intensive aftercare plus outreach and 1.19 (0.53 to 2.67) for antidepressant treatment compared with placebo. Significantly reduced rates of further self harm were observed for depot flupenthixol versus placebo in multiple repeaters (0.09; 0.02 to 0.50) and for dialectical behaviour therapy versus standard aftercare (0.24; 0.06 to 0.93). Conclusion: There remains considerable uncertainty about which forms of psychosocial and physical treatments of patients who harm themselves are most effective. Further larger trials of treatments are needed.

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Section: Resultsmentioning

confidence: 99%

“…Four studies had been reported in more than one publication. 16 26 – 28 One further randomised controlled trial of patients who deliberately harmed themselves was identified, but this did not include repetition of deliberate self harm as an outcome variable 29. We were unable to obtain this information from the authors of this trial.…”

Section: Resultsmentioning

confidence: 99%

Deliberate self harm: systematic review of efficacy of psychosocial and pharmacological treatments in preventing repetition

Hawton¹,

Arensman²,

Townsend³

et al. 1998

BMJ

385

289

View full text Add to dashboard Cite

show abstract

“…A small placebo-controlled study reported a reduction in self-harming in patients receiving flupentixol (Montgomery 1979). However, a review of the use of medication in the management of self-harm (Hawton 2000) found no evidence for the benefit of antidepressants in the disorder.…”

Section: Medicationmentioning

confidence: 99%

Self-harm in adolescents

Wood¹

2009

Adv. psychiatr. treat

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SummarySelf-harm in adolescents is common and is increasing. It can present to professionals as a symptom of major mental health disturbance or it can form part of a cultural ‘norm’. This article reviews current knowledge about self-harm in 12- to 18-year-olds. Definitions of self-harming behaviour, epidemiological and aetiological factors, risk assessment and management of self-harming in various settings are discussed in terms of pragmatic clinical approaches and evidence-based practice.

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“…In 1983, Montgomery et al 13 compared 30 mg/day of mianserin to placebo in a 6-month, RCT of 38 individuals with a personality disorder and a history of a suicidal act causing hospitalization. They found no significant difference in outcome between the groups.…”

Section: Mianserinmentioning

confidence: 99%

The Efficacy of Pharmacotherapy for Borderline Personality Disorder: A Review of the Available Randomized Controlled Trials

Francois¹,

Roth²,

Klingman³

2015

Psychiatric Annals

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Although there are no medications approved by the US Food and Drug Administration for the treatment of borderline personality disorder (BPD), polypharmacy is commonly encountered in individuals with BPD. This review summarizes the results of randomized controlled trials on the efficacy of pharmacologic agents in BPD. Pharmacotherapy in BPD is an adjunctive treatment aimed at stabilizing symptoms and behavior in a crisis situation, and it should be avoided whenever possible. Further studies are needed, including large, randomized controlled trials with long-term follow up, to examine the efficacy of psychiatric medications in patients with BPD. ANTIDEPRESSANTS Selective Serotonin Reuptake InhibitorsSalzman et al. 7 described the results of a 13-week, double-blind, placebocontrolled study of the effects of fluoxetine on anger in patients with BPD or BPD traits. Thirteen patients received fluoxetine and nine received placebo. All patients began with a single 20-mg capsule or identical placebo, and doses were titrated up to a maximum of 60 mg/day. The authors found a reduction in anger among the fluoxetine recipients but no reduction in depression.In 2004, the therapeutic effect of fluoxetine added to dialectical behavior therapy (DBT) for the treatment of BPD was examined by Simpson et al. 8 in a 12-week, randomized, doubleblind, placebo-controlled study. Of the 20 patients that completed treatment, 9 were randomly assigned to receive up to 40 mg/day of fluoxetine and 11 were randomly assigned to placebo. The result showed no significant group differences in scores from pretreatment to posttreatment on any measure. Rinne et al.9 conducted a doubleblind, placebo-controlled, randomized trial of fluvoxamine (mean dose 150 mg/day) for 6 weeks followed by a blind half-crossover for 6 weeks and an open follow-up for another 12 weeks in 38 women with BPD. Fluvoxamine improved rapid mood shifts (standardized mean changes [SMD], -0.646) but not impulsivity and aggression.Jariani et al. 10 compared sertraline (50-100 mg/day) to olanzapine (5-10 mg/day) for the treatment of BPD in 120 patients on methadone maintenance therapy for heroin dependence who were also diagnosed as having BPD. The results (evaluation of Symptom Checklist-90 questionnaire before treatment and in the 4th, 8th, and 12th weeks of treatment) indicated that both drugs could generally ameliorate depression, anxiety, hypersensitivity in interpersonal relationships, aggression, obsession, and somatization symptoms in a 12-week treatment. Sertraline was more effective in decreasing symptoms of depression, hypersensitivity in interpersonal relationships, and obsession. Olanzapine was more useful for anxiety, aggression, and paranoia symptoms. There was no difference in decreasing somatization symptoms between both drugs. In regard to selfmutilation, there was a significant difference in the olanzapine group.

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Mianserin in the Prophylaxis of Suicidal Behaviour: a Double Blind Placebo Controlled Trial

Cited by 17 publications

References 1 publication

Deliberate self harm: systematic review of efficacy of psychosocial and pharmacological treatments in preventing repetition

Deliberate self harm: systematic review of efficacy of psychosocial and pharmacological treatments in preventing repetition

Self-harm in adolescents

The Efficacy of Pharmacotherapy for Borderline Personality Disorder: A Review of the Available Randomized Controlled Trials

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