Regressive Est, Chlorpromazine, and Group Therapy in Treatment of Hospitalized Chronic Schizophrenics

King, Peter

doi:10.1176/ajp.115.4.354

Cited by 31 publications

(24 citation statements)

References 4 publications

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“…However, the overall number of trials reporting the randomization and allocation methods was low (18% and 10%, respectively). Also, eight trials were not double-blinded or single-blinded with external raters, four of them compared patients using pharmacological vs. non-pharmacological treatments (ECT, insulin therapy or psychotherapy) [31], [33], [37], [38]. One used a no-treatment arm [39], one was initially double-blinded but patients and physicians discovered the assignment because the pills taken differed in color, size and quantity for each arm [32], one had patients in one group doing weekly blood tests while the other group did not [35]; and in another study, patients knew their assignment groups [36].…”

Section: Resultsmentioning

confidence: 99%

“…The references for the articles added to our systematic review are: chlorpromazine [26], [29], [31]–[34], [37]–[39], [43], [66]–[80]; lithium [15], [30], [42], [81], [84]–[89], [92]–[97], [99]–[101], diazepam [25], [27], [41], [82], [83], [90], [91], risperidone [24], [28], [36], [123]–[127], [130], [131], clozapine [35], [98], [102], [103], [113], [121], [122], lamotrigine [40], [128], [129], [132]–[134], and fluoxetine [104]–[112], [114]–[120].…”

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confidence: 99%

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Changes in Clinical Trials Methodology Over Time: A Systematic Review of Six Decades of Research in Psychopharmacology

2010

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BackgroundThere have been many changes in clinical trials methodology since the introduction of lithium and the beginning of the modern era of psychopharmacology in 1949. The nature and importance of these changes have not been fully addressed to date. As methodological flaws in trials can lead to false-negative or false-positive results, the objective of our study was to evaluate the impact of methodological changes in psychopharmacology clinical research over the past 60 years.Methodology/Principal FindingsWe performed a systematic review from 1949 to 2009 on MEDLINE and Web of Science electronic databases, and a hand search of high impact journals on studies of seven major drugs (chlorpromazine, clozapine, risperidone, lithium, fluoxetine and lamotrigine). All controlled studies published 100 months after the first trial were included. Ninety-one studies met our inclusion criteria. We analyzed the major changes in abstract reporting, study design, participants' assessment and enrollment, methodology and statistical analysis. Our results showed that the methodology of psychiatric clinical trials changed substantially, with quality gains in abstract reporting, results reporting, and statistical methodology. Recent trials use more informed consent, periods of washout, intention-to-treat approach and parametric tests. Placebo use remains high and unchanged over time.Conclusions/SignificanceClinical trial quality of psychopharmacological studies has changed significantly in most of the aspects we analyzed. There was significant improvement in quality reporting and internal validity. These changes have increased study efficiency; however, there is room for improvement in some aspects such as rating scales, diagnostic criteria and better trial reporting. Therefore, despite the advancements observed, there are still several areas that can be improved in psychopharmacology clinical trials.

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Changes in Clinical Trials Methodology Over Time: A Systematic Review of Six Decades of Research in Psychopharmacology

2010

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“…Besides the aforementioned methodological problems, the nature of assignment to treatment groups, adequacy of treatment delivery, blindness, and reliability of clinical evaluations also precluded the formation of definitive conclusions. While the short-term outcome was equivalent or superior with antipsychotics relative to ECT [57][58][59][60][61], long-term outcome was possibly superior with ECT [62][63][64][65].…”

Section: Previous Studies On the Efficacy Of Ectmentioning

confidence: 99%

Electroconvulsive Therapy for Schizophrenia

Chanpattana¹

2007

CPSR

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The role of electroconvulsive therapy (ECT) in treating patients with schizophrenia remains unclear. This paper aims to determine whether ECT results in clinically meaningful benefit with regard to psychopathology, behavior and functioning for patients with schizophrenia, and whether variations in the practical administration of ECT influences outcome. Existing research in the field and the new information of research in patients with treatment-resistant schizophrenia (TRS) from Thailand are summarized. Independent of gender, duration of the current episode and severity of baseline negative symptoms predict outcome. Treatment results in marked improvement in positive symptoms, with an intermediate effect on affective symptoms, and no effect or worsening of negative symptoms. The combination of ECT and conventional antipsychotic drug is associated with better outcome than either ECT alone or antipsychotic drug alone during both acute and maintenance phases of treatment. This improvement is not only in psychopathology but also in quality of life and social functioning. Electrical stimulus doses 2-4 times the seizure threshold are likely to increase the speed of recovery with bilateral ECT. Thrice-weekly ECT elicits response faster than does twice-weekly ECT. Although this preliminary evidence supports the use of ECT in patients with TRS, the research base for its use is still inadequate and deserves better investigation.

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“…93,94 Prospective studies that compare ECT with neuroleptics in non-chronic patients with schizophrenia did not show any differences among groups. [95][96][97] Some studies, however, suggest that the combination of ECT and neuroleptics in this population results in a faster recovery than the isolate use of neuroleptics. 98,99 Former studies with acute schizophrenic patients did not show differences between ECT and simulated ECT.…”

Section: Efficacymentioning

confidence: 99%

Evidências da eficácia da eletroconvulsoterapia na prática psiquiátrica

Moser

Lobato

Belmonte-de-Abreu

2005

Rev. psiquiatr. Rio Gd. Sul

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A eletroconvulsoterapia (ECT) consiste em tratamento biológico ainda não amplamente utilizado na prática psiquiátrica, devido aos inúmeros fatores que contribuem para uma resistência acerca do método. Objetivando sustentar, com embasamento científico, o emprego da ECT, agregamos evidências de sua eficácia, indicações, contra-indicações e efeitos adversos, advindas dos principais ensaios clínicos randomizados e meta-análises disponíveis na literatura médica atual sobre o tema (PubMed/MEDLINE, Cochrane).

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Regressive Est, Chlorpromazine, and Group Therapy in Treatment of Hospitalized Chronic Schizophrenics

Cited by 31 publications

References 4 publications

Changes in Clinical Trials Methodology Over Time: A Systematic Review of Six Decades of Research in Psychopharmacology

Changes in Clinical Trials Methodology Over Time: A Systematic Review of Six Decades of Research in Psychopharmacology

Electroconvulsive Therapy for Schizophrenia

Evidências da eficácia da eletroconvulsoterapia na prática psiquiátrica

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