Year Books 1991

home *** CD-ROM | disk | FTP | other *** search
/ Year Books 1991 / Year Books 1991.iso / dp / 12 / 124.pkg < prev next >
Unknown | 1992-06-06 | 310.6 KB
open in:
MacOS 8.1 |
Win98 |
DOS
view JSON data |
view as text

This file was not able to be converted.
This format is not currently supported by dexvert.
Confidence	Program	Detection	Match Type	Support
`66%`	dexvert	OS/2 Installation Package `(archive/os2InstallPackage)`	ext	Supported
`1%`	dexvert	BeOS Installation Package `(archive/beOSInstallPackage)`	ext	Unsupported
`1%`	dexvert	Newton Package `(archive/newtonPackage)`	ext	Unsupported
`1%`	dexvert	Independence War 2 mod Package `(other/independenceWar2ModPackage)`	ext	Unsupported
`100%`	file	data	default
hex view
+--------+-------------------------+-------------------------+--------+--------+
|00000000| 1a 44 50 31 2e 31 00 00 | 00 00 00 00 00 05 64 00 |.DP1.1..|......d.|
|00000010| 00 00 16 00 00 00 30 30 | 00 00 00 01 9c 05 00 00 |......00|........|
|00000020| 11 08 00 00 30 31 00 00 | 00 01 ad 0d 00 00 68 13 |....01..|......h.|
|00000030| 00 00 30 32 00 00 00 01 | 15 21 00 00 18 0b 00 00 |..02....|.!......|
|00000040| 30 33 00 00 00 01 2d 2c | 00 00 48 0c 00 00 30 34 |03....-,|..H...04|
|00000050| 00 00 00 01 75 38 00 00 | 84 07 00 00 30 35 00 00 |....u8..|....05..|
|00000060| 00 01 f9 3f 00 00 6c 0a | 00 00 30 36 00 00 00 01 |...?..l.|..06....|
|00000070| 65 4a 00 00 1f 11 00 00 | 30 37 00 00 00 01 84 5b |eJ......|07.....[|
|00000080| 00 00 f1 08 00 00 30 38 | 00 00 00 01 75 64 00 00 |......08|....ud..|
|00000090| c0 0e 00 00 30 39 00 00 | 00 01 35 73 00 00 1a 0a |....09..|..5s....|
|000000a0| 00 00 31 30 00 00 00 01 | 4f 7d 00 00 ce 0d 00 00 |..10....|O}......|
|000000b0| 31 31 00 00 00 01 1d 8b | 00 00 d8 0a 00 00 31 32 |11......|......12|
|000000c0| 00 00 00 01 f5 95 00 00 | fb 0a 00 00 31 33 00 00 |........|....13..|
|000000d0| 00 01 f0 a0 00 00 94 0d | 00 00 31 34 00 00 00 01 |........|..14....|
|000000e0| 84 ae 00 00 bd 0b 00 00 | 31 35 00 00 00 01 41 ba |........|15....A.|
|000000f0| 00 00 37 0e 00 00 31 36 | 00 00 00 01 78 c8 00 00 |..7...16|....x...|
|00000100| 01 0b 00 00 31 37 00 00 | 00 01 79 d3 00 00 bd 09 |....17..|..y.....|
|00000110| 00 00 31 38 00 00 00 01 | 36 dd 00 00 96 09 00 00 |..18....|6.......|
|00000120| 31 39 00 00 00 01 cc e6 | 00 00 fc 0b 00 00 32 30 |19......|......20|
|00000130| 00 00 00 01 c8 f2 00 00 | 3b 0b 00 00 32 31 00 00 |........|;...21..|
|00000140| 00 01 03 fe 00 00 42 0c | 00 00 32 32 00 00 00 01 |......B.|..22....|
|00000150| 45 0a 01 00 f3 0c 00 00 | 32 33 00 00 00 01 38 17 |E.......|23....8.|
|00000160| 01 00 05 0c 00 00 32 34 | 00 00 00 01 3d 23 01 00 |......24|....=#..|
|00000170| b3 0a 00 00 32 35 00 00 | 00 01 f0 2d 01 00 4f 0a |....25..|...-..O.|
|00000180| 00 00 32 36 00 00 00 01 | 3f 38 01 00 03 0d 00 00 |..26....|?8......|
|00000190| 32 37 00 00 00 01 42 45 | 01 00 a4 0e 00 00 32 38 |27....BE|......28|
|000001a0| 00 00 00 01 e6 53 01 00 | 7c 0b 00 00 32 39 00 00 |.....S..||...29..|
|000001b0| 00 01 62 5f 01 00 3b 0e | 00 00 33 30 00 00 00 01 |..b_..;.|..30....|
|000001c0| 9d 6d 01 00 51 0a 00 00 | 33 31 00 00 00 01 ee 77 |.m..Q...|31.....w|
|000001d0| 01 00 9b 08 00 00 33 32 | 00 00 00 01 89 80 01 00 |......32|........|
|000001e0| 49 0b 00 00 33 33 00 00 | 00 01 d2 8b 01 00 98 0c |I...33..|........|
|000001f0| 00 00 33 34 00 00 00 01 | 6a 98 01 00 ea 0d 00 00 |..34....|j.......|
|00000200| 33 35 00 00 00 01 54 a6 | 01 00 13 0d 00 00 33 36 |35....T.|......36|
|00000210| 00 00 00 01 67 b3 01 00 | b6 0b 00 00 33 37 00 00 |....g...|....37..|
|00000220| 00 01 1d bf 01 00 a8 0a | 00 00 33 38 00 00 00 01 |........|..38....|
|00000230| c5 c9 01 00 ce 0c 00 00 | 33 39 00 00 00 01 93 d6 |........|39......|
|00000240| 01 00 a5 0e 00 00 34 30 | 00 00 00 01 38 e5 01 00 |......40|....8...|
|00000250| 37 0b 00 00 34 31 00 00 | 00 01 6f f0 01 00 e1 08 |7...41..|..o.....|
|00000260| 00 00 34 32 00 00 00 01 | 50 f9 01 00 b4 08 00 00 |..42....|P.......|
|00000270| 34 33 00 00 00 01 04 02 | 02 00 3b 0e 00 00 34 34 |43......|..;...44|
|00000280| 00 00 00 01 3f 10 02 00 | c0 11 00 00 34 35 00 00 |....?...|....45..|
|00000290| 00 01 ff 21 02 00 8d 0c | 00 00 34 36 00 00 00 01 |...!....|..46....|
|000002a0| 8c 2e 02 00 a6 0b 00 00 | 34 37 00 00 00 01 32 3a |........|47....2:|
|000002b0| 02 00 d9 0e 00 00 34 38 | 00 00 00 01 0b 49 02 00 |......48|.....I..|
|000002c0| 4a 0b 00 00 34 39 00 00 | 00 01 55 54 02 00 b6 0d |J...49..|..UT....|
|000002d0| 00 00 35 30 00 00 00 01 | 0b 62 02 00 f4 0e 00 00 |..50....|.b......|
|000002e0| 35 31 00 00 00 01 ff 70 | 02 00 10 0f 00 00 35 32 |51.....p|......52|
|000002f0| 00 00 00 01 0f 80 02 00 | ba 0d 00 00 35 33 00 00 |........|....53..|
|00000300| 00 01 c9 8d 02 00 8d 0c | 00 00 35 34 00 00 00 01 |........|..54....|
|00000310| 56 9a 02 00 56 0e 00 00 | 35 35 00 00 00 01 ac a8 |V...V...|55......|
|00000320| 02 00 17 0d 00 00 35 36 | 00 00 00 01 c3 b5 02 00 |......56|........|
|00000330| 38 0e 00 00 35 37 00 00 | 00 01 fb c3 02 00 5a 0c |8...57..|......Z.|
|00000340| 00 00 35 38 00 00 00 01 | 55 d0 02 00 e2 0d 00 00 |..58....|U.......|
|00000350| 35 39 00 00 00 01 37 de | 02 00 78 0b 00 00 36 30 |59....7.|..x...60|
|00000360| 00 00 00 01 af e9 02 00 | be 0d 00 00 36 31 00 00 |........|....61..|
|00000370| 00 01 6d f7 02 00 d8 0d | 00 00 36 32 00 00 00 01 |..m.....|..62....|
|00000380| 45 05 03 00 95 0b 00 00 | 36 33 00 00 00 01 da 10 |E.......|63......|
|00000390| 03 00 65 0b 00 00 36 34 | 00 00 00 01 3f 1c 03 00 |..e...64|....?...|
|000003a0| b2 0a 00 00 36 35 00 00 | 00 01 f1 26 03 00 ef 0e |....65..|...&....|
|000003b0| 00 00 36 36 00 00 00 01 | e0 35 03 00 52 0e 00 00 |..66....|.5..R...|
|000003c0| 36 37 00 00 00 01 32 44 | 03 00 19 0e 00 00 36 38 |67....2D|......68|
|000003d0| 00 00 00 01 4b 52 03 00 | 72 0d 00 00 36 39 00 00 |....KR..|r...69..|
|000003e0| 00 01 bd 5f 03 00 b1 0e | 00 00 37 30 00 00 00 01 |..._....|..70....|
|000003f0| 6e 6e 03 00 8f 0d 00 00 | 37 31 00 00 00 01 fd 7b |nn......|71.....{|
|00000400| 03 00 2f 0a 00 00 37 32 | 00 00 00 01 2c 86 03 00 |../...72|....,...|
|00000410| af 0b 00 00 37 33 00 00 | 00 01 db 91 03 00 08 0a |....73..|........|
|00000420| 00 00 37 34 00 00 00 01 | e3 9b 03 00 e5 10 00 00 |..74....|........|
|00000430| 37 35 00 00 00 01 c8 ac | 03 00 49 0b 00 00 37 36 |75......|..I...76|
|00000440| 00 00 00 01 11 b8 03 00 | 40 0c 00 00 37 37 00 00 |........|@...77..|
|00000450| 00 01 51 c4 03 00 0e 0b | 00 00 37 38 00 00 00 01 |..Q.....|..78....|
|00000460| 5f cf 03 00 05 0a 00 00 | 37 39 00 00 00 01 64 d9 |_.......|79....d.|
|00000470| 03 00 5f 0a 00 00 38 30 | 00 00 00 01 c3 e3 03 00 |.._...80|........|
|00000480| 6b 0c 00 00 38 31 00 00 | 00 01 2e f0 03 00 52 08 |k...81..|......R.|
|00000490| 00 00 38 32 00 00 00 01 | 80 f8 03 00 12 0c 00 00 |..82....|........|
|000004a0| 38 33 00 00 00 01 92 04 | 04 00 4c 0c 00 00 38 34 |83......|..L...84|
|000004b0| 00 00 00 01 de 10 04 00 | b9 11 00 00 38 35 00 00 |........|....85..|
|000004c0| 00 01 97 22 04 00 75 0c | 00 00 38 36 00 00 00 01 |..."..u.|..86....|
|000004d0| 0c 2f 04 00 f0 08 00 00 | 38 37 00 00 00 01 fc 37 |./......|87.....7|
|000004e0| 04 00 ef 0a 00 00 38 38 | 00 00 00 01 eb 42 04 00 |......88|.....B..|
|000004f0| 8a 0c 00 00 38 39 00 00 | 00 01 75 4f 04 00 12 0a |....89..|..uO....|
|00000500| 00 00 39 30 00 00 00 01 | 87 59 04 00 63 0c 00 00 |..90....|.Y..c...|
|00000510| 39 31 00 00 00 01 ea 65 | 04 00 24 0d 00 00 39 32 |91.....e|..$...92|
|00000520| 00 00 00 01 0e 73 04 00 | 5a 0b 00 00 39 33 00 00 |.....s..|Z...93..|
|00000530| 00 01 68 7e 04 00 ab 0b | 00 00 39 34 00 00 00 01 |..h~....|..94....|
|00000540| 13 8a 04 00 36 0f 00 00 | 39 35 00 00 00 01 49 99 |....6...|95....I.|
|00000550| 04 00 71 0c 00 00 39 36 | 00 00 00 01 ba a5 04 00 |..q...96|........|
|00000560| 8b 0c 00 00 39 37 00 00 | 00 01 45 b2 04 00 66 0e |....97..|..E...f.|
|00000570| 00 00 39 38 00 00 00 01 | ab c0 04 00 df 0b 00 00 |..98....|........|
|00000580| 39 39 00 00 00 01 8a cc | 04 00 c4 0d 00 00 00 00 |99......|........|
|00000590| 00 00 00 00 4e da 04 00 | 00 00 00 00 24 55 6e 69 |....N...|....$Uni|
|000005a0| 71 75 65 5f 49 44 7b 59 | 52 42 31 32 34 30 30 7d |que_ID{Y|RB12400}|
|000005b0| 0d 0a 24 54 69 74 6c 65 | 7b 41 6c 70 72 61 7a 6f |..$Title|{Alprazo|
|000005c0| 6c 61 6d 20 44 65 70 65 | 6e 64 65 6e 63 79 3a 20 |lam Depe|ndency: |
|000005d0| 20 55 73 65 20 6f 66 20 | 43 6c 6f 6e 61 7a 65 70 | Use of |Clonazep|
|000005e0| 61 6d 20 66 6f 72 20 57 | 69 74 68 64 72 61 77 61 |am for W|ithdrawa|
|000005f0| 6c 7d 0d 0a 24 41 75 74 | 68 6f 72 7b 0d 0a 50 61 |l}..$Aut|hor{..Pa|
|00000600| 74 74 65 72 73 6f 6e 2c | 20 4a 46 7d 0d 0a 24 41 |tterson,| JF}..$A|
|00000610| 66 66 69 6c 69 61 74 69 | 6f 6e 7b 48 61 72 72 79 |ffiliati|on{Harry|
|00000620| 20 53 20 54 72 75 6d 61 | 6e 20 4d 65 6d 20 56 65 | S Truma|n Mem Ve|
|00000630| 74 65 72 61 6e 73 20 48 | 6f 73 70 2c 20 43 6f 6c |terans H|osp, Col|
|00000640| 75 6d 62 69 61 2c 20 4d | 6f 7d 0d 0a 24 4a 6f 75 |umbia, M|o}..$Jou|
|00000650| 72 6e 61 6c 7b 53 6f 75 | 74 68 20 4d 65 64 20 4a |rnal{Sou|th Med J|
|00000660| 7d 0d 0a 24 56 6f 6c 75 | 6d 65 7b 38 31 7d 0d 0a |}..$Volu|me{81}..|
|00000670| 24 50 61 67 65 7b 38 33 | 30 2d 38 33 31 7d 0d 0a |$Page{83|0-831}..|
|00000680| 24 44 61 74 65 7b 38 33 | 36 2c 20 4a 75 6c 79 20 |$Date{83|6, July |
|00000690| 31 39 38 38 7d 0d 0a 24 | 59 42 56 6f 6c 7b 31 39 |1988}..$|YBVol{19|
|000006a0| 39 30 20 59 65 61 72 20 | 42 6f 6f 6b 20 6f 66 20 |90 Year |Book of |
|000006b0| 50 73 79 63 68 69 61 74 | 72 79 20 61 6e 64 20 41 |Psychiat|ry and A|
|000006c0| 70 70 6c 69 65 64 20 4d | 65 6e 74 61 6c 20 48 65 |pplied M|ental He|
|000006d0| 61 6c 74 68 7d 0d 0a 24 | 43 68 61 70 74 65 72 7b |alth}..$|Chapter{|
|000006e0| 37 2d 35 7d 0d 0a 24 59 | 42 45 64 69 74 6f 72 7b |7-5}..$Y|BEditor{|
|000006f0| 44 72 73 2e 20 54 61 6c | 62 6f 74 74 2c 20 46 72 |Drs. Tal|bott, Fr|
|00000700| 61 6e 63 65 73 2c 20 46 | 72 61 6e 63 65 73 2c 20 |ances, F|rances, |
|00000710| 46 72 65 65 64 6d 61 6e | 2c 20 4d 65 6c 74 7a 65 |Freedman|, Meltze|
|00000720| 72 2c 20 53 63 68 6f 77 | 61 6c 74 65 72 2c 20 61 |r, Schow|alter, a|
|00000730| 6e 64 20 59 75 64 6f 66 | 73 6b 79 7d 0d 0a 24 54 |nd Yudof|sky}..$T|
|00000740| 61 62 6c 65 7b 7d 0d 0a | 24 43 6f 6d 6d 65 6e 74 |able{}..|$Comment|
|00000750| 61 74 6f 72 7b 7d 0d 0a | 0d 0a 43 6f 70 79 72 69 |ator{}..|..Copyri|
|00000760| 67 68 74 20 28 63 29 20 | 59 65 61 72 62 6f 6f 6b |ght (c) |Yearbook|
|00000770| 20 4d 65 64 69 63 61 6c | 20 50 75 62 6c 69 73 68 | Medical| Publish|
|00000780| 65 72 73 2c 20 49 6e 63 | 2e 2c 20 31 39 39 30 0d |ers, Inc|., 1990.|
|00000790| 0a 0d 0a 31 39 39 30 20 | 59 65 61 72 20 42 6f 6f |...1990 |Year Boo|
|000007a0| 6b 20 6f 66 20 50 73 79 | 63 68 69 61 74 72 79 20 |k of Psy|chiatry |
|000007b0| 61 6e 64 20 41 70 70 6c | 69 65 64 20 4d 65 6e 74 |and Appl|ied Ment|
|000007c0| 61 6c 20 48 65 61 6c 74 | 68 20 28 52 29 0d 0a 0d |al Healt|h (R)...|
|000007d0| 0a 43 68 61 70 74 65 72 | 20 37 2d 2d 50 73 79 63 |.Chapter| 7--Psyc|
|000007e0| 68 6f 70 68 61 72 6d 61 | 63 6f 6c 6f 67 79 0d 0a |hopharma|cology..|
|000007f0| 0d 0a 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |..------|--------|
|00000800| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000810| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000820| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000830| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000840| 0d 0a 41 6c 70 72 61 7a | 6f 6c 61 6d 20 44 65 70 |..Alpraz|olam Dep|
|00000850| 65 6e 64 65 6e 63 79 3a | 20 20 55 73 65 20 6f 66 |endency:|  Use of|
|00000860| 20 43 6c 6f 6e 61 7a 65 | 70 61 6d 20 66 6f 72 20 | Clonaze|pam for |
|00000870| 57 69 74 68 64 72 61 77 | 61 6c 0d 0a 0d 0a 50 61 |Withdraw|al....Pa|
|00000880| 74 74 65 72 73 6f 6e 20 | 4a 46 0d 0a 28 48 61 72 |tterson |JF..(Har|
|00000890| 72 79 20 53 20 54 72 75 | 6d 61 6e 20 4d 65 6d 20 |ry S Tru|man Mem |
|000008a0| 56 65 74 65 72 61 6e 73 | 20 48 6f 73 70 2c 20 43 |Veterans| Hosp, C|
|000008b0| 6f 6c 75 6d 62 69 61 2c | 20 4d 6f 29 0d 0a 53 6f |olumbia,| Mo)..So|
|000008c0| 75 74 68 20 4d 65 64 20 | 4a 20 38 31 3a 38 33 30 |uth Med |J 81:830|
|000008d0| 2d 38 33 31 2c 20 38 33 | 36 2c 20 4a 75 6c 79 20 |-831, 83|6, July |
|000008e0| 31 39 38 38 0d 0a 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |1988..--|--------|
|000008f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000900| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000910| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000920| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000930| 2d 2d 2d 2d 0d 0a 0d 0a | 41 62 73 74 72 61 63 74 |----....|Abstract|
|00000940| 0d 0a 0d 0a 20 20 20 20 | 20 57 68 65 6e 20 70 61 |....    | When pa|
|00000950| 74 69 65 6e 74 73 20 61 | 72 65 20 62 65 69 6e 67 |tients a|re being|
|00000960| 20 74 72 65 61 74 65 64 | 20 66 6f 72 20 61 6c 70 | treated| for alp|
|00000970| 72 61 7a 6f 6c 61 6d 20 | 64 65 70 65 6e 64 65 6e |razolam |dependen|
|00000980| 63 79 2c 20 74 68 65 20 | 61 62 69 6c 69 74 79 20 |cy, the |ability |
|00000990| 74 6f 0d 0a 64 69 73 74 | 69 6e 67 75 69 73 68 20 |to..dist|inguish |
|000009a0| 62 65 74 77 65 65 6e 20 | 77 69 74 68 64 72 61 77 |between |withdraw|
|000009b0| 61 6c 20 73 79 6d 70 74 | 6f 6d 73 2c 20 77 68 69 |al sympt|oms, whi|
|000009c0| 63 68 20 6d 61 79 20 6d | 69 6d 69 63 20 61 6e 78 |ch may m|imic anx|
|000009d0| 69 65 74 79 20 73 74 61 | 74 65 73 2c 20 61 6e 64 |iety sta|tes, and|
|000009e0| 0d 0a 62 61 73 65 6c 69 | 6e 65 20 70 73 79 63 68 |..baseli|ne psych|
|000009f0| 6f 70 61 74 68 6f 6c 6f | 67 79 20 69 73 20 69 6d |opatholo|gy is im|
|00000a00| 70 6f 72 74 61 6e 74 2e | 20 20 43 65 72 74 61 69 |portant.|  Certai|
|00000a10| 6e 20 63 68 61 6e 67 65 | 73 20 69 6e 20 61 6e 78 |n change|s in anx|
|00000a20| 69 65 74 79 2c 20 73 6c | 65 65 70 2c 20 61 6e 64 |iety, sl|eep, and|
|00000a30| 0d 0a 63 6f 72 74 69 73 | 6f 6c 20 73 65 63 72 65 |..cortis|ol secre|
|00000a40| 74 69 6f 6e 20 68 61 76 | 65 20 62 65 65 6e 20 6c |tion hav|e been l|
|00000a50| 69 6e 6b 65 64 20 74 6f | 20 77 69 74 68 64 72 61 |inked to| withdra|
|00000a60| 77 61 6c 20 73 74 61 74 | 65 73 2e 20 20 54 68 65 |wal stat|es.  The|
|00000a70| 20 65 66 66 65 63 74 73 | 20 6f 66 0d 0a 63 6c 6f | effects| of..clo|
|00000a80| 6e 61 7a 65 70 61 6d 20 | 73 75 62 73 74 69 74 75 |nazepam |substitu|
|00000a90| 74 69 6f 6e 20 61 6e 64 | 20 72 61 70 69 64 20 77 |tion and| rapid w|
|00000aa0| 69 74 68 64 72 61 77 61 | 6c 20 6f 6e 20 74 68 65 |ithdrawa|l on the|
|00000ab0| 73 65 20 76 61 72 69 61 | 62 6c 65 73 20 77 65 72 |se varia|bles wer|
|00000ac0| 65 20 73 74 75 64 69 65 | 64 0d 0a 69 6e 20 31 30 |e studie|d..in 10|
|00000ad0| 20 6d 61 6c 65 20 69 6e | 70 61 74 69 65 6e 74 73 | male in|patients|
|00000ae0| 20 77 68 6f 20 68 61 64 | 20 72 65 63 65 69 76 65 | who had| receive|
|00000af0| 64 20 6d 61 69 6e 74 65 | 6e 61 6e 63 65 20 61 6c |d mainte|nance al|
|00000b00| 70 72 61 7a 6f 6c 61 6d | 20 74 68 65 72 61 70 79 |prazolam| therapy|
|00000b10| 20 66 6f 72 20 36 2d 32 | 30 0d 0a 6d 6f 6e 74 68 | for 6-2|0..month|
|00000b20| 73 2e 20 20 46 69 76 65 | 20 68 61 64 20 70 6f 73 |s.  Five| had pos|
|00000b30| 74 74 72 61 75 6d 61 74 | 69 63 20 73 74 72 65 73 |ttraumat|ic stres|
|00000b40| 73 20 64 69 73 6f 72 64 | 65 72 2c 20 32 20 68 61 |s disord|er, 2 ha|
|00000b50| 64 20 70 61 6e 69 63 20 | 64 69 73 6f 72 64 65 72 |d panic |disorder|
|00000b60| 2c 20 32 20 68 61 64 0d | 0a 62 69 70 6f 6c 61 72 |, 2 had.|.bipolar|
|00000b70| 20 61 66 66 65 63 74 69 | 76 65 20 64 69 73 6f 72 | affecti|ve disor|
|00000b80| 64 65 72 2c 20 61 6e 64 | 20 31 20 68 61 64 20 67 |der, and| 1 had g|
|00000b90| 65 6e 65 72 61 6c 69 7a | 65 64 20 61 6e 78 69 65 |eneraliz|ed anxie|
|00000ba0| 74 79 20 64 69 73 6f 72 | 64 65 72 2e 20 20 45 71 |ty disor|der.  Eq|
|00000bb0| 75 61 6c 0d 0a 64 6f 73 | 65 73 20 6f 66 20 63 6c |ual..dos|es of cl|
|00000bc0| 6f 6e 61 7a 65 70 61 6d | 20 77 65 72 65 20 73 75 |onazepam| were su|
|00000bd0| 62 73 74 69 74 75 74 65 | 64 20 66 6f 72 20 61 6c |bstitute|d for al|
|00000be0| 70 72 61 7a 6f 6c 61 6d | 2c 20 61 6e 64 20 63 6c |prazolam|, and cl|
|00000bf0| 69 6e 69 63 61 6c 20 61 | 6e 64 20 62 69 6f 6c 6f |inical a|nd biolo|
|00000c00| 67 69 63 0d 0a 76 61 72 | 69 61 62 6c 65 73 20 77 |gic..var|iables w|
|00000c10| 65 72 65 20 61 73 73 65 | 73 73 65 64 2e 0d 0a 20 |ere asse|ssed... |
|00000c20| 20 20 20 20 57 69 74 68 | 64 72 61 77 61 6c 20 77 |    With|drawal w|
|00000c30| 61 73 20 61 63 63 6f 6d | 70 6c 69 73 68 65 64 20 |as accom|plished |
|00000c40| 69 6e 20 37 20 64 61 79 | 73 2e 20 20 41 6e 78 69 |in 7 day|s.  Anxi|
|00000c50| 65 74 79 20 61 6e 64 20 | 70 6c 61 73 6d 61 20 6c |ety and |plasma l|
|00000c60| 65 76 65 6c 73 20 6f 66 | 0d 0a 63 6f 72 74 69 73 |evels of|..cortis|
|00000c70| 6f 6c 20 77 65 72 65 20 | 6e 6f 74 20 73 69 67 6e |ol were |not sign|
|00000c80| 69 66 69 63 61 6e 74 6c | 79 20 64 69 66 66 65 72 |ificantl|y differ|
|00000c90| 65 6e 74 20 69 6e 20 74 | 68 65 20 77 69 74 68 64 |ent in t|he withd|
|00000ca0| 72 61 77 61 6c 20 70 65 | 72 69 6f 64 20 61 6e 64 |rawal pe|riod and|
|00000cb0| 20 74 68 65 0d 0a 70 6f | 73 74 77 69 74 68 64 72 | the..po|stwithdr|
|00000cc0| 61 77 61 6c 20 6d 65 64 | 69 63 61 74 69 6f 6e 2d |awal med|ication-|
|00000cd0| 66 72 65 65 20 70 65 72 | 69 6f 64 2e 0d 0a 20 20 |free per|iod...  |
|00000ce0| 20 20 20 41 20 63 6c 6f | 6e 61 7a 65 70 61 6d 20 |   A clo|nazepam |
|00000cf0| 73 75 62 73 74 69 74 75 | 74 69 6f 6e 20 72 65 67 |substitu|tion reg|
|00000d00| 69 6d 65 6e 20 66 6f 72 | 20 74 68 65 20 77 69 74 |imen for| the wit|
|00000d10| 68 64 72 61 77 61 6c 20 | 6f 66 20 61 6c 70 72 61 |hdrawal |of alpra|
|00000d20| 7a 6f 6c 61 6d 20 69 6e | 0d 0a 64 65 70 65 6e 64 |zolam in|..depend|
|00000d30| 65 6e 74 20 70 61 74 69 | 65 6e 74 73 20 69 73 20 |ent pati|ents is |
|00000d40| 65 66 66 65 63 74 69 76 | 65 20 61 6e 64 20 73 61 |effectiv|e and sa|
|00000d50| 66 65 2e 20 20 54 68 65 | 72 65 20 77 61 73 20 6e |fe.  The|re was n|
|00000d60| 6f 20 65 76 69 64 65 6e | 63 65 20 6f 66 20 61 6e |o eviden|ce of an|
|00000d70| 79 0d 0a 63 6c 69 6e 69 | 63 61 6c 20 6f 72 20 62 |y..clini|cal or b|
|00000d80| 69 6f 6c 6f 67 69 63 20 | 62 65 6e 7a 6f 64 69 61 |iologic |benzodia|
|00000d90| 7a 65 70 69 6e 65 20 77 | 69 74 68 64 72 61 77 61 |zepine w|ithdrawa|
|00000da0| 6c 20 73 79 6e 64 72 6f | 6d 65 2e 0d 0a 24 55 6e |l syndro|me...$Un|
|00000db0| 69 71 75 65 5f 49 44 7b | 59 52 42 31 32 34 30 31 |ique_ID{|YRB12401|
|00000dc0| 7d 0d 0a 24 54 69 74 6c | 65 7b 43 61 72 62 61 6d |}..$Titl|e{Carbam|
|00000dd0| 61 7a 65 70 69 6e 65 20 | 54 72 65 61 74 6d 65 6e |azepine |Treatmen|
|00000de0| 74 20 66 6f 72 20 42 65 | 6e 7a 6f 64 69 61 7a 65 |t for Be|nzodiaze|
|00000df0| 70 69 6e 65 20 57 69 74 | 68 64 72 61 77 61 6c 7d |pine Wit|hdrawal}|
|00000e00| 0d 0a 24 41 75 74 68 6f | 72 7b 0d 0a 52 69 65 73 |..$Autho|r{..Ries|
|00000e10| 2c 20 52 4b 0d 0a 52 6f | 79 2d 42 79 72 6e 65 2c |, RK..Ro|y-Byrne,|
|00000e20| 20 50 50 0d 0a 57 61 72 | 64 2c 20 4e 47 0d 0a 4e | PP..War|d, NG..N|
|00000e30| 65 70 70 65 2c 20 56 0d | 0a 43 75 6c 6c 69 73 6f |eppe, V.|.Culliso|
|00000e40| 6e 2c 20 53 7d 0d 0a 24 | 41 66 66 69 6c 69 61 74 |n, S}..$|Affiliat|
|00000e50| 69 6f 6e 7b 55 6e 69 76 | 20 6f 66 20 57 61 73 68 |ion{Univ| of Wash|
|00000e60| 69 6e 67 74 6f 6e 3b 20 | 48 61 72 62 6f 72 76 69 |ington; |Harborvi|
|00000e70| 65 77 20 4d 65 64 20 43 | 74 72 2c 20 53 65 61 74 |ew Med C|tr, Seat|
|00000e80| 74 6c 65 7d 0d 0a 24 4a | 6f 75 72 6e 61 6c 7b 41 |tle}..$J|ournal{A|
|00000e90| 6d 20 4a 20 50 73 79 63 | 68 69 61 74 72 79 7d 0d |m J Psyc|hiatry}.|
|00000ea0| 0a 24 56 6f 6c 75 6d 65 | 7b 31 34 36 7d 0d 0a 24 |.$Volume|{146}..$|
|00000eb0| 50 61 67 65 7b 35 33 36 | 2d 35 33 37 7d 0d 0a 24 |Page{536|-537}..$|
|00000ec0| 44 61 74 65 7b 41 70 72 | 69 6c 20 31 39 38 39 7d |Date{Apr|il 1989}|
|00000ed0| 0d 0a 24 59 42 56 6f 6c | 7b 31 39 39 30 20 59 65 |..$YBVol|{1990 Ye|
|00000ee0| 61 72 20 42 6f 6f 6b 20 | 6f 66 20 50 73 79 63 68 |ar Book |of Psych|
|00000ef0| 69 61 74 72 79 20 61 6e | 64 20 41 70 70 6c 69 65 |iatry an|d Applie|
|00000f00| 64 20 4d 65 6e 74 61 6c | 20 48 65 61 6c 74 68 7d |d Mental| Health}|
|00000f10| 0d 0a 24 43 68 61 70 74 | 65 72 7b 37 2d 36 7d 0d |..$Chapt|er{7-6}.|
|00000f20| 0a 24 59 42 45 64 69 74 | 6f 72 7b 44 72 73 2e 20 |.$YBEdit|or{Drs. |
|00000f30| 54 61 6c 62 6f 74 74 2c | 20 46 72 61 6e 63 65 73 |Talbott,| Frances|
|00000f40| 2c 20 46 72 61 6e 63 65 | 73 2c 20 46 72 65 65 64 |, France|s, Freed|
|00000f50| 6d 61 6e 2c 20 4d 65 6c | 74 7a 65 72 2c 20 53 63 |man, Mel|tzer, Sc|
|00000f60| 68 6f 77 61 6c 74 65 72 | 2c 20 61 6e 64 20 59 75 |howalter|, and Yu|
|00000f70| 64 6f 66 73 6b 79 7d 0d | 0a 24 54 61 62 6c 65 7b |dofsky}.|.$Table{|
|00000f80| 7d 0d 0a 24 43 6f 6d 6d | 65 6e 74 61 74 6f 72 7b |}..$Comm|entator{|
|00000f90| 44 2e 58 2e 20 46 72 65 | 65 64 6d 61 6e 2c 20 4d |D.X. Fre|edman, M|
|00000fa0| 2e 44 2e 7d 0d 0a 0d 0a | 43 6f 70 79 72 69 67 68 |.D.}....|Copyrigh|
|00000fb0| 74 20 28 63 29 20 59 65 | 61 72 62 6f 6f 6b 20 4d |t (c) Ye|arbook M|
|00000fc0| 65 64 69 63 61 6c 20 50 | 75 62 6c 69 73 68 65 72 |edical P|ublisher|
|00000fd0| 73 2c 20 49 6e 63 2e 2c | 20 31 39 39 30 0d 0a 0d |s, Inc.,| 1990...|
|00000fe0| 0a 31 39 39 30 20 59 65 | 61 72 20 42 6f 6f 6b 20 |.1990 Ye|ar Book |
|00000ff0| 6f 66 20 50 73 79 63 68 | 69 61 74 72 79 20 61 6e |of Psych|iatry an|
|00001000| 64 20 41 70 70 6c 69 65 | 64 20 4d 65 6e 74 61 6c |d Applie|d Mental|
|00001010| 20 48 65 61 6c 74 68 20 | 28 52 29 0d 0a 0d 0a 43 | Health |(R)....C|
|00001020| 68 61 70 74 65 72 20 37 | 2d 2d 50 73 79 63 68 6f |hapter 7|--Psycho|
|00001030| 70 68 61 72 6d 61 63 6f | 6c 6f 67 79 0d 0a 0d 0a |pharmaco|logy....|
|00001040| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001050| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001060| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001070| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001080| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 0d 0a |--------|------..|
|00001090| 43 61 72 62 61 6d 61 7a | 65 70 69 6e 65 20 54 72 |Carbamaz|epine Tr|
|000010a0| 65 61 74 6d 65 6e 74 20 | 66 6f 72 20 42 65 6e 7a |eatment |for Benz|
|000010b0| 6f 64 69 61 7a 65 70 69 | 6e 65 20 57 69 74 68 64 |odiazepi|ne Withd|
|000010c0| 72 61 77 61 6c 0d 0a 0d | 0a 52 69 65 73 20 52 4b |rawal...|.Ries RK|
|000010d0| 2c 20 52 6f 79 2d 42 79 | 72 6e 65 20 50 50 2c 20 |, Roy-By|rne PP, |
|000010e0| 57 61 72 64 20 4e 47 2c | 20 4e 65 70 70 65 20 56 |Ward NG,| Neppe V|
|000010f0| 2c 20 43 75 6c 6c 69 73 | 6f 6e 20 53 0d 0a 28 55 |, Cullis|on S..(U|
|00001100| 6e 69 76 20 6f 66 20 57 | 61 73 68 69 6e 67 74 6f |niv of W|ashingto|
|00001110| 6e 3b 20 48 61 72 62 6f | 72 76 69 65 77 20 4d 65 |n; Harbo|rview Me|
|00001120| 64 20 43 74 72 2c 20 53 | 65 61 74 74 6c 65 29 0d |d Ctr, S|eattle).|
|00001130| 0a 41 6d 20 4a 20 50 73 | 79 63 68 69 61 74 72 79 |.Am J Ps|ychiatry|
|00001140| 20 31 34 36 3a 35 33 36 | 2d 35 33 37 2c 20 41 70 | 146:536|-537, Ap|
|00001150| 72 69 6c 20 31 39 38 39 | 0d 0a 2d 2d 2d 2d 2d 2d |ril 1989|..------|
|00001160| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001170| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001180| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001190| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000011a0| 2d 2d 2d 2d 2d 2d 2d 2d | 0d 0a 0d 0a 41 62 73 74 |--------|....Abst|
|000011b0| 72 61 63 74 0d 0a 0d 0a | 20 20 20 20 20 4f 6e 65 |ract....|     One|
|000011c0| 20 72 65 73 65 61 72 63 | 68 20 74 65 61 6d 20 72 | researc|h team r|
|000011d0| 65 63 65 6e 74 6c 79 20 | 72 65 70 6f 72 74 65 64 |ecently |reported|
|000011e0| 20 74 68 65 20 75 73 65 | 20 6f 66 20 63 61 72 62 | the use| of carb|
|000011f0| 61 6d 61 7a 65 70 69 6e | 65 20 74 6f 0d 0a 66 61 |amazepin|e to..fa|
|00001200| 63 69 6c 69 74 61 74 65 | 20 77 69 74 68 64 72 61 |cilitate| withdra|
|00001210| 77 61 6c 20 66 72 6f 6d | 20 61 6c 70 72 61 7a 6f |wal from| alprazo|
|00001220| 6c 61 6d 20 69 6e 20 33 | 20 70 61 74 69 65 6e 74 |lam in 3| patient|
|00001230| 73 20 77 69 74 68 20 70 | 61 6e 69 63 20 64 69 73 |s with p|anic dis|
|00001240| 6f 72 64 65 72 20 77 68 | 6f 0d 0a 77 65 72 65 20 |order wh|o..were |
|00001250| 75 6e 61 62 6c 65 20 74 | 6f 20 74 6f 6c 65 72 61 |unable t|o tolera|
|00001260| 74 65 20 61 20 67 72 61 | 64 75 61 6c 20 74 61 70 |te a gra|dual tap|
|00001270| 65 72 69 6e 67 2e 20 20 | 4e 69 6e 65 20 61 64 64 |ering.  |Nine add|
|00001280| 69 74 69 6f 6e 61 6c 20 | 70 61 74 69 65 6e 74 73 |itional |patients|
|00001290| 20 77 65 72 65 0d 0a 67 | 69 76 65 6e 20 63 61 72 | were..g|iven car|
|000012a0| 62 61 6d 61 7a 65 70 69 | 6e 65 20 62 65 66 6f 72 |bamazepi|ne befor|
|000012b0| 65 20 72 61 70 69 64 20 | 64 69 73 63 6f 6e 74 69 |e rapid |disconti|
|000012c0| 6e 75 61 74 69 6f 6e 20 | 6f 66 20 62 65 6e 7a 6f |nuation |of benzo|
|000012d0| 64 69 61 7a 65 70 69 6e | 65 73 2e 0d 0a 20 20 20 |diazepin|es...   |
|000012e0| 20 20 54 68 65 20 6c 61 | 74 74 65 72 20 39 20 70 |  The la|tter 9 p|
|000012f0| 61 74 69 65 6e 74 73 20 | 77 65 72 65 20 68 6f 73 |atients |were hos|
|00001300| 70 69 74 61 6c 69 7a 65 | 64 20 6f 6e 20 61 20 70 |pitalize|d on a p|
|00001310| 73 79 63 68 69 61 74 72 | 69 63 20 77 61 72 64 20 |sychiatr|ic ward |
|00001320| 6f 72 20 69 6e 20 61 0d | 0a 70 72 69 76 61 74 65 |or in a.|.private|
|00001330| 20 73 75 62 73 74 61 6e | 63 65 20 61 62 75 73 65 | substan|ce abuse|
|00001340| 20 74 72 65 61 74 6d 65 | 6e 74 20 63 65 6e 74 65 | treatme|nt cente|
|00001350| 72 2e 20 20 46 69 76 65 | 20 68 61 64 20 61 20 64 |r.  Five| had a d|
|00001360| 69 61 67 6e 6f 73 69 73 | 20 6f 66 0d 0a 70 73 79 |iagnosis| of..psy|
|00001370| 63 68 6f 61 63 74 69 76 | 65 20 73 75 62 73 74 61 |choactiv|e substa|
|00001380| 6e 63 65 20 64 65 70 65 | 6e 64 65 6e 63 65 2c 20 |nce depe|ndence, |
|00001390| 32 20 68 61 64 20 70 61 | 6e 69 63 20 64 69 73 6f |2 had pa|nic diso|
|000013a0| 72 64 65 72 2c 20 31 20 | 68 61 64 20 70 61 6e 69 |rder, 1 |had pani|
|000013b0| 63 20 64 69 73 6f 72 64 | 65 72 0d 0a 61 6e 64 20 |c disord|er..and |
|000013c0| 64 65 70 72 65 73 73 69 | 6f 6e 2c 20 61 6e 64 20 |depressi|on, and |
|000013d0| 31 20 68 61 64 20 62 69 | 70 6f 6c 61 72 20 64 69 |1 had bi|polar di|
|000013e0| 73 6f 72 64 65 72 2e 0d | 0a 20 20 20 20 20 41 64 |sorder..|.     Ad|
|000013f0| 6d 69 6e 69 73 74 72 61 | 74 69 6f 6e 20 6f 66 20 |ministra|tion of |
|00001400| 63 61 72 62 61 6d 61 7a | 65 70 69 6e 65 20 77 61 |carbamaz|epine wa|
|00001410| 73 20 62 65 67 75 6e 20 | 62 65 66 6f 72 65 20 6f |s begun |before o|
|00001420| 72 20 63 6f 6e 63 75 72 | 72 65 6e 74 20 77 69 74 |r concur|rent wit|
|00001430| 68 0d 0a 64 69 73 63 6f | 6e 74 69 6e 75 61 74 69 |h..disco|ntinuati|
|00001440| 6f 6e 20 6f 66 20 62 65 | 6e 7a 6f 64 69 61 7a 65 |on of be|nzodiaze|
|00001450| 70 69 6e 65 2e 20 20 44 | 6f 73 65 73 20 61 6e 64 |pine.  D|oses and|
|00001460| 20 63 6f 6e 76 65 72 73 | 69 6f 6e 20 74 69 6d 65 | convers|ion time|
|00001470| 73 20 77 65 72 65 20 64 | 65 74 65 72 6d 69 6e 65 |s were d|etermine|
|00001480| 64 0d 0a 6f 6e 20 74 68 | 65 20 62 61 73 69 73 20 |d..on th|e basis |
|00001490| 6f 66 20 6f 62 73 65 72 | 76 65 64 20 77 69 74 68 |of obser|ved with|
|000014a0| 64 72 61 77 61 6c 20 73 | 79 6d 70 74 6f 6d 73 2c |drawal s|ymptoms,|
|000014b0| 20 77 69 74 68 20 6d 6f | 72 65 20 73 79 6d 70 74 | with mo|re sympt|
|000014c0| 6f 6d 73 20 70 72 6f 6d | 70 74 69 6e 67 0d 0a 68 |oms prom|pting..h|
|000014d0| 69 67 68 65 72 20 64 6f | 73 65 73 20 61 6e 64 20 |igher do|ses and |
|000014e0| 73 6c 6f 77 65 72 20 74 | 61 70 65 72 69 6e 67 2e |slower t|apering.|
|000014f0| 20 20 4e 6f 6e 65 20 6f | 66 20 74 68 65 20 70 61 |  None o|f the pa|
|00001500| 74 69 65 6e 74 73 20 6e | 65 65 64 65 64 20 62 65 |tients n|eeded be|
|00001510| 6e 7a 6f 64 69 61 7a 65 | 70 69 6e 65 0d 0a 73 75 |nzodiaze|pine..su|
|00001520| 70 70 6c 65 6d 65 6e 74 | 61 74 69 6f 6e 2c 20 61 |pplement|ation, a|
|00001530| 6e 64 20 6e 6f 6e 65 20 | 68 61 64 20 61 70 70 72 |nd none |had appr|
|00001540| 65 63 69 61 62 6c 65 20 | 77 69 74 68 64 72 61 77 |eciable |withdraw|
|00001550| 61 6c 20 73 79 6d 70 74 | 6f 6d 73 2e 20 20 53 6c |al sympt|oms.  Sl|
|00001560| 65 65 70 69 6e 67 0d 0a | 70 72 6f 62 6c 65 6d 73 |eeping..|problems|
|00001570| 2c 20 6e 6f 74 65 64 20 | 69 6e 20 6f 6e 6c 79 20 |, noted |in only |
|00001580| 31 20 63 61 73 65 2c 20 | 77 65 72 65 20 6d 69 6c |1 case, |were mil|
|00001590| 64 2e 0d 0a 20 20 20 20 | 20 54 68 65 73 65 20 66 |d...    | These f|
|000015a0| 69 6e 64 69 6e 67 73 20 | 70 72 6f 76 69 64 65 20 |indings |provide |
|000015b0| 66 75 72 74 68 65 72 20 | 65 76 69 64 65 6e 63 65 |further |evidence|
|000015c0| 20 6f 66 20 74 68 65 20 | 70 6f 73 73 69 62 6c 65 | of the |possible|
|000015d0| 20 75 73 65 66 75 6c 6e | 65 73 73 20 6f 66 0d 0a | usefuln|ess of..|
|000015e0| 63 61 72 62 61 6d 61 7a | 65 70 69 6e 65 20 69 6e |carbamaz|epine in|
|000015f0| 20 74 68 65 20 74 72 65 | 61 74 6d 65 6e 74 20 6f | the tre|atment o|
|00001600| 66 20 62 65 6e 7a 6f 64 | 69 61 7a 65 70 69 6e 65 |f benzod|iazepine|
|00001610| 20 77 69 74 68 64 72 61 | 77 61 6c 2e 20 20 44 69 | withdra|wal.  Di|
|00001620| 73 63 6f 6e 74 69 6e 75 | 61 74 69 6f 6e 0d 0a 6f |scontinu|ation..o|
|00001630| 66 20 62 65 6e 7a 6f 64 | 69 61 7a 65 70 69 6e 65 |f benzod|iazepine|
|00001640| 20 69 6e 20 74 68 69 73 | 20 67 72 6f 75 70 20 6f | in this| group o|
|00001650| 66 20 64 69 61 67 6e 6f | 73 74 69 63 61 6c 6c 79 |f diagno|stically|
|00001660| 20 68 65 74 65 72 6f 67 | 65 6e 65 6f 75 73 20 70 | heterog|eneous p|
|00001670| 61 74 69 65 6e 74 73 20 | 77 61 73 0d 0a 6d 6f 72 |atients |was..mor|
|00001680| 65 20 72 61 70 69 64 20 | 61 6e 64 20 62 65 74 74 |e rapid |and bett|
|00001690| 65 72 20 74 6f 6c 65 72 | 61 74 65 64 20 77 68 65 |er toler|ated whe|
|000016a0| 6e 20 63 61 72 62 61 6d | 61 7a 65 70 69 6e 65 20 |n carbam|azepine |
|000016b0| 77 61 73 20 61 64 6d 69 | 6e 69 73 74 65 72 65 64 |was admi|nistered|
|000016c0| 0d 0a 63 6f 6e 63 6f 6d | 69 74 61 6e 74 6c 79 20 |..concom|itantly |
|000016d0| 74 68 61 6e 20 67 72 61 | 64 75 61 6c 20 74 61 70 |than gra|dual tap|
|000016e0| 65 72 69 6e 67 20 61 6c | 6f 6e 65 2e 0d 0a 0d 0a |ering al|one.....|
|000016f0| 50 6f 73 74 2d 43 6f 6d | 6d 65 6e 74 0d 0a 0d 0a |Post-Com|ment....|
|00001700| 20 20 20 20 20 54 68 65 | 20 69 73 73 75 65 20 6f |     The| issue o|
|00001710| 66 20 64 69 73 63 6f 6e | 74 69 6e 75 61 74 69 6f |f discon|tinuatio|
|00001720| 6e 20 69 73 20 61 6c 73 | 6f 20 61 20 66 75 6e 63 |n is als|o a func|
|00001730| 74 69 6f 6e 20 6f 66 20 | 74 68 65 20 73 70 65 63 |tion of |the spec|
|00001740| 69 66 69 63 20 64 72 75 | 67 2e 0d 0a 54 68 65 20 |ific dru|g...The |
|00001750| 61 72 74 69 63 6c 65 73 | 20 72 65 76 69 65 77 65 |articles| reviewe|
|00001760| 64 20 69 6e 20 41 62 73 | 74 72 61 63 74 73 20 37 |d in Abs|tracts 7|
|00001770| 2d 35 20 61 6e 64 20 37 | 2d 36 20 64 69 73 63 75 |-5 and 7|-6 discu|
|00001780| 73 73 20 74 68 65 20 75 | 73 65 20 6f 66 20 73 68 |ss the u|se of sh|
|00001790| 6f 72 74 2d 61 63 74 69 | 6e 67 0d 0a 62 65 6e 7a |ort-acti|ng..benz|
|000017a0| 6f 64 69 61 7a 65 70 69 | 6e 65 73 20 76 73 2e 20 |odiazepi|nes vs. |
|000017b0| 6c 6f 6e 67 2d 61 63 74 | 69 6e 67 20 62 65 6e 7a |long-act|ing benz|
|000017c0| 6f 64 69 61 7a 65 70 69 | 6e 65 73 20 64 75 72 69 |odiazepi|nes duri|
|000017d0| 6e 67 20 77 69 74 68 64 | 72 61 77 61 6c 2c 20 61 |ng withd|rawal, a|
|000017e0| 6e 64 20 6e 6f 74 65 0d | 0a 74 68 61 74 20 77 69 |nd note.|.that wi|
|000017f0| 74 68 64 72 61 77 61 6c | 20 66 72 6f 6d 20 74 68 |thdrawal| from th|
|00001800| 65 20 73 68 6f 72 74 2d | 61 63 74 69 6e 67 20 64 |e short-|acting d|
|00001810| 72 75 67 20 69 73 20 75 | 73 75 61 6c 6c 79 20 6d |rug is u|sually m|
|00001820| 6f 72 65 20 64 69 66 66 | 69 63 75 6c 74 2c 20 61 |ore diff|icult, a|
|00001830| 74 20 6c 65 61 73 74 0d | 0a 73 75 62 6a 65 63 74 |t least.|.subject|
|00001840| 69 76 65 6c 79 2c 20 66 | 6f 72 20 74 68 65 20 70 |ively, f|or the p|
|00001850| 61 74 69 65 6e 74 2e 20 | 20 49 74 20 6f 75 67 68 |atient. | It ough|
|00001860| 74 20 74 6f 20 62 65 2c | 20 74 68 65 6f 72 65 74 |t to be,| theoret|
|00001870| 69 63 61 6c 6c 79 2c 20 | 62 65 63 61 75 73 65 20 |ically, |because |
|00001880| 74 68 65 73 65 0d 0a 61 | 72 65 20 77 68 61 74 20 |these..a|re what |
|00001890| 6f 6e 65 20 6d 69 67 68 | 74 20 63 61 6c 6c 20 22 |one migh|t call "|
|000018a0| 68 69 74 2d 61 6e 64 2d | 72 75 6e 22 20 64 72 75 |hit-and-|run" dru|
|000018b0| 67 73 2e 20 20 54 68 61 | 74 20 69 73 2c 20 74 68 |gs.  Tha|t is, th|
|000018c0| 65 79 20 61 66 66 65 63 | 74 20 74 68 65 0d 0a 72 |ey affec|t the..r|
|000018d0| 65 63 65 70 74 6f 72 20 | 62 75 74 20 72 61 70 69 |eceptor |but rapi|
|000018e0| 64 6c 79 20 6c 65 61 76 | 65 20 69 74 2c 20 77 68 |dly leav|e it, wh|
|000018f0| 65 72 65 61 73 20 61 20 | 64 72 75 67 20 73 75 63 |ereas a |drug suc|
|00001900| 68 20 61 73 20 64 69 61 | 7a 65 70 61 6d 2c 20 77 |h as dia|zepam, w|
|00001910| 68 69 63 68 20 68 61 73 | 20 61 0d 0a 6c 6f 6e 67 |hich has| a..long|
|00001920| 20 68 61 6c 66 2d 6c 69 | 66 65 2c 20 74 65 6e 64 | half-li|fe, tend|
|00001930| 73 20 74 6f 20 62 61 74 | 68 65 20 74 68 65 20 72 |s to bat|he the r|
|00001940| 65 63 65 70 74 6f 72 20 | 6f 76 65 72 20 74 69 6d |eceptor |over tim|
|00001950| 65 20 61 6e 64 20 74 68 | 75 73 20 68 61 73 20 69 |e and th|us has i|
|00001960| 74 73 20 6f 77 6e 0d 0a | 22 62 75 69 6c 74 2d 69 |ts own..|"built-i|
|00001970| 6e 22 20 74 61 70 65 72 | 20 66 6f 72 20 61 20 6c |n" taper| for a l|
|00001980| 6f 6e 67 65 72 20 70 65 | 72 69 6f 64 2e 0d 0a 20 |onger pe|riod... |
|00001990| 20 20 20 20 50 68 79 73 | 69 63 69 61 6e 73 20 61 |    Phys|icians a|
|000019a0| 72 65 20 73 74 61 72 74 | 69 6e 67 20 74 6f 20 61 |re start|ing to a|
|000019b0| 70 70 6c 79 20 74 68 69 | 73 20 6b 6e 6f 77 6c 65 |pply thi|s knowle|
|000019c0| 64 67 65 2c 20 61 73 20 | 65 76 69 64 65 6e 63 65 |dge, as |evidence|
|000019d0| 64 20 62 79 20 74 68 65 | 20 75 73 65 0d 0a 6f 66 |d by the| use..of|
|000019e0| 20 63 6c 6f 6e 61 7a 65 | 70 61 6d 20 66 6f 72 20 | clonaze|pam for |
|000019f0| 74 72 65 61 74 6d 65 6e | 74 20 6f 66 20 74 68 65 |treatmen|t of the|
|00001a00| 20 77 69 74 68 64 72 61 | 77 61 6c 20 66 72 6f 6d | withdra|wal from|
|00001a10| 20 61 6c 70 72 61 7a 6f | 6c 61 6d 20 77 68 65 6e | alprazo|lam when|
|00001a20| 20 61 6e 64 20 69 66 20 | 74 68 61 74 0d 0a 62 65 | and if |that..be|
|00001a30| 63 6f 6d 65 73 20 61 20 | 70 72 6f 62 6c 65 6d 2e |comes a |problem.|
|00001a40| 20 20 54 68 69 73 20 69 | 73 20 74 61 6b 69 6e 67 |  This i|s taking|
|00001a50| 20 61 64 76 61 6e 74 61 | 67 65 20 6f 66 20 61 20 | advanta|ge of a |
|00001a60| 6c 6f 6e 67 20 68 61 6c | 66 2d 6c 69 66 65 20 64 |long hal|f-life d|
|00001a70| 72 75 67 20 74 6f 20 64 | 65 61 6c 0d 0a 77 69 74 |rug to d|eal..wit|
|00001a80| 68 20 74 68 65 20 65 66 | 66 65 63 74 73 20 6f 66 |h the ef|fects of|
|00001a90| 20 64 72 75 67 73 20 77 | 69 74 68 20 73 68 6f 72 | drugs w|ith shor|
|00001aa0| 74 65 72 20 68 61 6c 66 | 2d 6c 69 76 65 73 2e 0d |ter half|-lives..|
|00001ab0| 0a 20 20 20 20 20 54 68 | 65 20 75 73 65 20 6f 66 |.     Th|e use of|
|00001ac0| 20 61 20 6c 6f 6e 67 65 | 72 2d 61 63 74 69 6e 67 | a longe|r-acting|
|00001ad0| 20 64 72 75 67 20 74 68 | 61 74 20 63 61 6e 20 74 | drug th|at can t|
|00001ae0| 68 65 6e 20 62 65 20 74 | 61 70 65 72 65 64 20 69 |hen be t|apered i|
|00001af0| 73 20 6f 6e 65 20 61 70 | 70 72 6f 61 63 68 0d 0a |s one ap|proach..|
|00001b00| 69 6e 20 74 68 65 20 75 | 73 65 20 6f 66 20 70 68 |in the u|se of ph|
|00001b10| 61 72 6d 61 63 6f 6c 6f | 67 69 63 20 61 69 64 73 |armacolo|gic aids|
|00001b20| 20 74 6f 20 64 69 73 63 | 6f 6e 74 69 6e 75 61 74 | to disc|ontinuat|
|00001b30| 69 6f 6e 2e 20 20 41 6c | 74 65 72 6e 61 74 69 76 |ion.  Al|ternativ|
|00001b40| 65 73 20 73 75 63 68 20 | 61 73 0d 0a 63 61 72 62 |es such |as..carb|
|00001b50| 61 6d 61 7a 65 70 69 6e | 65 20 65 78 69 73 74 2e |amazepin|e exist.|
|00001b60| 20 20 43 61 72 62 61 6d | 61 7a 65 70 69 6e 65 20 |  Carbam|azepine |
|00001b70| 6d 61 79 20 62 65 20 61 | 20 68 65 6c 70 66 75 6c |may be a| helpful|
|00001b80| 20 61 64 6a 75 6e 63 74 | 20 69 6e 20 74 68 65 0d | adjunct| in the.|
|00001b90| 0a 64 69 73 63 6f 6e 74 | 69 6e 75 61 74 69 6f 6e |.discont|inuation|
|00001ba0| 20 6f 66 20 69 6e 74 65 | 72 6d 65 64 69 61 74 65 | of inte|rmediate|
|00001bb0| 20 68 61 6c 66 2d 6c 69 | 66 65 20 64 72 75 67 73 | half-li|fe drugs|
|00001bc0| 20 69 6e 20 73 6f 6d 65 | 20 69 6e 64 69 76 69 64 | in some| individ|
|00001bd0| 75 61 6c 73 20 61 6e 64 | 20 69 73 0d 0a 75 6e 64 |uals and| is..und|
|00001be0| 65 72 67 6f 69 6e 67 20 | 61 20 6d 61 6a 6f 72 20 |ergoing |a major |
|00001bf0| 6d 75 6c 74 69 63 6c 69 | 6e 69 63 20 74 72 69 61 |multicli|nic tria|
|00001c00| 6c 2c 20 74 68 65 20 6f | 75 74 63 6f 6d 65 20 6f |l, the o|utcome o|
|00001c10| 66 20 77 68 69 63 68 20 | 69 73 20 70 65 6e 64 69 |f which |is pendi|
|00001c20| 6e 67 2e 0d 0a 20 20 20 | 20 20 4d 6f 72 65 20 74 |ng...   |  More t|
|00001c30| 68 61 6e 20 70 68 61 72 | 6d 61 63 6f 6c 6f 67 69 |han phar|macologi|
|00001c40| 63 20 66 61 63 74 6f 72 | 73 20 64 65 74 65 72 6d |c factor|s determ|
|00001c50| 69 6e 65 20 74 72 6f 75 | 62 6c 65 73 6f 6d 65 20 |ine trou|blesome |
|00001c60| 73 79 6d 70 74 6f 6d 73 | 20 69 6e 0d 0a 64 69 73 |symptoms| in..dis|
|00001c70| 63 6f 6e 74 69 6e 75 61 | 74 69 6f 6e 2e 20 20 54 |continua|tion.  T|
|00001c80| 68 65 20 54 75 66 74 73 | 20 67 72 6f 75 70 20 70 |he Tufts| group p|
|00001c90| 6f 69 6e 74 73 20 6f 75 | 74 20 74 68 61 74 20 74 |oints ou|t that t|
|00001ca0| 68 65 72 65 20 69 73 20 | 61 20 77 69 64 65 20 72 |here is |a wide r|
|00001cb0| 61 6e 67 65 20 6f 66 0d | 0a 70 73 79 63 68 69 61 |ange of.|.psychia|
|00001cc0| 74 72 69 63 20 64 69 73 | 6f 72 64 65 72 73 20 66 |tric dis|orders f|
|00001cd0| 6f 75 6e 64 20 69 6e 20 | 62 65 6e 7a 6f 64 69 61 |ound in |benzodia|
|00001ce0| 7a 65 70 69 6e 65 20 75 | 73 65 72 73 2c 20 69 6e |zepine u|sers, in|
|00001cf0| 63 6c 75 64 69 6e 67 20 | 70 61 74 69 65 6e 74 73 |cluding |patients|
|00001d00| 20 77 68 6f 73 65 0d 0a | 70 73 79 63 68 6f 6c 6f | whose..|psycholo|
|00001d10| 67 69 63 61 6c 20 72 65 | 61 63 74 69 6f 6e 73 20 |gical re|actions |
|00001d20| 68 61 76 65 20 74 6f 20 | 62 65 20 6d 6f 6e 69 74 |have to |be monit|
|00001d30| 6f 72 65 64 2e 20 20 4f | 62 73 65 72 76 61 74 69 |ored.  O|bservati|
|00001d40| 6f 6e 20 6f 66 20 74 68 | 65 20 77 61 79 20 74 68 |on of th|e way th|
|00001d50| 65 73 65 0d 0a 69 6e 64 | 69 76 69 64 75 61 6c 73 |ese..ind|ividuals|
|00001d60| 20 75 73 65 20 74 68 65 | 20 65 66 66 65 63 74 73 | use the| effects|
|00001d70| 20 6f 66 20 74 68 65 20 | 64 72 75 67 2c 20 61 6e | of the |drug, an|
|00001d80| 64 20 74 68 65 20 77 61 | 79 20 74 68 65 79 20 75 |d the wa|y they u|
|00001d90| 73 65 20 6f 72 20 70 65 | 72 63 65 69 76 65 20 74 |se or pe|rceive t|
|00001da0| 68 65 0d 0a 65 66 66 65 | 63 74 73 20 6f 66 20 64 |he..effe|cts of d|
|00001db0| 72 75 67 20 64 69 73 63 | 6f 6e 74 69 6e 75 61 74 |rug disc|ontinuat|
|00001dc0| 69 6f 6e 2c 20 69 73 20 | 6e 65 63 65 73 73 61 72 |ion, is |necessar|
|00001dd0| 79 2e 20 20 54 68 65 72 | 65 20 61 72 65 20 74 77 |y.  Ther|e are tw|
|00001de0| 6f 20 70 6f 70 75 6c 61 | 74 69 6f 6e 73 3a 0d 0a |o popula|tions:..|
|00001df0| 4f 6e 65 2c 20 74 68 65 | 20 76 61 73 74 20 6d 61 |One, the| vast ma|
|00001e00| 6a 6f 72 69 74 79 2c 20 | 69 73 20 6e 6f 74 20 69 |jority, |is not i|
|00001e10| 6e 63 6c 69 6e 65 64 20 | 74 6f 77 61 72 64 20 64 |nclined |toward d|
|00001e20| 72 75 67 20 61 62 75 73 | 65 2c 20 61 6e 64 20 74 |rug abus|e, and t|
|00001e30| 68 65 20 6f 74 68 65 72 | 20 69 73 2e 0d 0a 54 68 |he other| is...Th|
|00001e40| 69 73 20 70 72 6f 70 65 | 6e 73 69 74 79 2c 20 77 |is prope|nsity, w|
|00001e50| 68 69 63 68 20 6d 61 79 | 20 62 65 20 75 6e 64 65 |hich may| be unde|
|00001e60| 74 65 63 74 65 64 2c 20 | 6c 69 65 73 20 62 65 68 |tected, |lies beh|
|00001e70| 69 6e 64 20 70 72 6f 62 | 6c 65 6d 73 20 77 69 74 |ind prob|lems wit|
|00001e80| 68 20 64 72 75 67 73 20 | 74 68 61 74 0d 0a 61 72 |h drugs |that..ar|
|00001e90| 65 20 74 61 67 67 65 64 | 20 22 69 61 74 72 6f 67 |e tagged| "iatrog|
|00001ea0| 65 6e 69 63 2e 22 20 20 | 48 65 6e 63 65 20 61 20 |enic."  |Hence a |
|00001eb0| 74 68 6f 72 6f 75 67 68 | 20 68 69 73 74 6f 72 79 |thorough| history|
|00001ec0| 2c 20 6f 66 74 65 6e 20 | 69 6e 63 6c 75 64 69 6e |, often |includin|
|00001ed0| 67 20 61 20 68 69 73 74 | 6f 72 79 0d 0a 66 72 6f |g a hist|ory..fro|
|00001ee0| 6d 20 69 6e 66 6f 72 6d | 61 6e 74 73 2c 20 6f 66 |m inform|ants, of|
|00001ef0| 20 68 6f 77 20 74 68 65 | 20 70 65 72 73 6f 6e 20 | how the| person |
|00001f00| 75 73 65 73 20 74 68 65 | 20 65 66 66 65 63 74 73 |uses the| effects|
|00001f10| 20 6f 66 20 61 6c 63 6f | 68 6f 6c 2c 20 6f 72 20 | of alco|hol, or |
|00001f20| 77 68 65 74 68 65 72 0d | 0a 74 68 65 79 20 68 61 |whether.|.they ha|
|00001f30| 76 65 20 73 6f 75 67 68 | 74 20 64 72 75 67 73 2c |ve sough|t drugs,|
|00001f40| 20 69 73 20 69 6d 70 6f | 72 74 61 6e 74 2e 20 20 | is impo|rtant.  |
|00001f50| 46 6f 72 20 74 68 65 20 | 6d 6f 73 74 20 70 61 72 |For the |most par|
|00001f60| 74 2c 20 70 65 72 73 6f | 6e 73 20 77 68 6f 20 68 |t, perso|ns who h|
|00001f70| 75 73 74 6c 65 0d 0a 64 | 72 75 67 73 20 6f 6e 20 |ustle..d|rugs on |
|00001f80| 74 68 65 20 73 74 72 65 | 65 74 20 63 6f 6e 73 74 |the stre|et const|
|00001f90| 69 74 75 74 65 20 74 68 | 65 20 67 72 65 61 74 65 |itute th|e greate|
|00001fa0| 73 74 20 70 6f 72 74 69 | 6f 6e 20 6f 66 20 74 68 |st porti|on of th|
|00001fb0| 65 20 70 6f 70 75 6c 61 | 74 69 6f 6e 20 6f 66 20 |e popula|tion of |
|00001fc0| 74 68 65 0d 0a 73 6f 2d | 63 61 6c 6c 65 64 20 62 |the..so-|called b|
|00001fd0| 65 6e 7a 6f 64 69 61 7a | 65 70 69 6e 65 20 61 62 |enzodiaz|epine ab|
|00001fe0| 75 73 65 72 73 2e 20 20 | 54 72 75 65 20 61 62 75 |users.  |True abu|
|00001ff0| 73 65 20 69 73 20 6f 74 | 68 65 72 77 69 73 65 20 |se is ot|herwise |
|00002000| 72 65 6c 61 74 69 76 65 | 6c 79 20 72 61 72 65 0d |relative|ly rare.|
|00002010| 0a 77 69 74 68 69 6e 20 | 6d 65 64 69 63 61 6c 20 |.within |medical |
|00002020| 70 72 61 63 74 69 63 65 | 2c 20 69 6e 20 77 68 69 |practice|, in whi|
|00002030| 63 68 20 75 73 65 20 69 | 73 20 62 61 73 65 64 20 |ch use i|s based |
|00002040| 6f 6e 20 73 6f 75 6e 64 | 20 64 69 61 67 6e 6f 73 |on sound| diagnos|
|00002050| 69 73 20 61 6e 64 20 65 | 76 69 64 65 6e 63 65 0d |is and e|vidence.|
|00002060| 0a 6f 66 20 69 6d 70 61 | 69 72 65 64 20 66 75 6e |.of impa|ired fun|
|00002070| 63 74 69 6f 6e 20 66 6f | 72 20 77 68 69 63 68 20 |ction fo|r which |
|00002080| 6d 65 64 69 63 61 74 69 | 6f 6e 20 69 73 20 69 6e |medicati|on is in|
|00002090| 64 69 63 61 74 65 64 2e | 20 20 54 68 65 20 70 72 |dicated.|  The pr|
|000020a0| 6f 62 6c 65 6d 20 69 73 | 20 74 6f 20 75 73 65 0d |oblem is| to use.|
|000020b0| 0a 63 6f 6d 6d 6f 6e 20 | 73 65 6e 73 65 20 69 6e |.common |sense in|
|000020c0| 20 6d 6f 6e 69 74 6f 72 | 69 6e 67 20 74 68 65 20 | monitor|ing the |
|000020d0| 74 72 65 61 74 6d 65 6e | 74 20 61 6e 64 20 74 6f |treatmen|t and to|
|000020e0| 20 73 63 72 65 65 6e 20 | 66 6f 72 20 70 6f 73 73 | screen |for poss|
|000020f0| 69 62 6c 65 20 6d 69 73 | 75 73 65 2e 0d 0a 2d 2d |ible mis|use...--|
|00002100| 44 2e 58 2e 20 46 72 65 | 65 64 6d 61 6e 2c 20 4d |D.X. Fre|edman, M|
|00002110| 2e 44 2e 0d 0a 24 55 6e | 69 71 75 65 5f 49 44 7b |.D...$Un|ique_ID{|
|00002120| 59 52 42 31 32 34 30 32 | 7d 0d 0a 24 54 69 74 6c |YRB12402|}..$Titl|
|00002130| 65 7b 4d 65 74 68 79 6c | 70 68 65 6e 69 64 61 74 |e{Methyl|phenidat|
|00002140| 65 2d 49 6e 64 75 63 65 | 64 20 49 6e 66 6f 72 6d |e-Induce|d Inform|
|00002150| 61 74 69 6f 6e 20 50 72 | 6f 63 65 73 73 69 6e 67 |ation Pr|ocessing|
|00002160| 20 44 79 73 66 75 6e 63 | 74 69 6f 6e 20 69 6e 20 | Dysfunc|tion in |
|00002170| 4e 6f 6e 73 63 68 69 7a | 6f 70 68 72 65 6e 69 63 |Nonschiz|ophrenic|
|00002180| 20 50 61 74 69 65 6e 74 | 73 7d 0d 0a 24 41 75 74 | Patient|s}..$Aut|
|00002190| 68 6f 72 7b 0d 0a 42 72 | 61 66 66 2c 20 44 4c 0d |hor{..Br|aff, DL.|
|000021a0| 0a 48 75 65 79 2c 20 4c | 7d 0d 0a 24 41 66 66 69 |.Huey, L|}..$Affi|
|000021b0| 6c 69 61 74 69 6f 6e 7b | 55 6e 69 76 20 6f 66 20 |liation{|Univ of |
|000021c0| 43 61 6c 69 66 6f 72 6e | 69 61 2c 20 53 61 6e 20 |Californ|ia, San |
|000021d0| 44 69 65 67 6f 7d 0d 0a | 24 4a 6f 75 72 6e 61 6c |Diego}..|$Journal|
|000021e0| 7b 41 72 63 68 20 47 65 | 6e 20 50 73 79 63 68 69 |{Arch Ge|n Psychi|
|000021f0| 61 74 72 79 7d 0d 0a 24 | 56 6f 6c 75 6d 65 7b 34 |atry}..$|Volume{4|
|00002200| 35 7d 0d 0a 24 50 61 67 | 65 7b 38 32 37 2d 38 33 |5}..$Pag|e{827-83|
|00002210| 32 7d 0d 0a 24 44 61 74 | 65 7b 53 65 70 74 65 6d |2}..$Dat|e{Septem|
|00002220| 62 65 72 20 31 39 38 38 | 7d 0d 0a 24 59 42 56 6f |ber 1988|}..$YBVo|
|00002230| 6c 7b 31 39 39 30 20 59 | 65 61 72 20 42 6f 6f 6b |l{1990 Y|ear Book|
|00002240| 20 6f 66 20 50 73 79 63 | 68 69 61 74 72 79 20 61 | of Psyc|hiatry a|
|00002250| 6e 64 20 41 70 70 6c 69 | 65 64 20 4d 65 6e 74 61 |nd Appli|ed Menta|
|00002260| 6c 20 48 65 61 6c 74 68 | 7d 0d 0a 24 43 68 61 70 |l Health|}..$Chap|
|00002270| 74 65 72 7b 37 2d 37 7d | 0d 0a 24 59 42 45 64 69 |ter{7-7}|..$YBEdi|
|00002280| 74 6f 72 7b 44 72 73 2e | 20 54 61 6c 62 6f 74 74 |tor{Drs.| Talbott|
|00002290| 2c 20 46 72 61 6e 63 65 | 73 2c 20 46 72 61 6e 63 |, France|s, Franc|
|000022a0| 65 73 2c 20 46 72 65 65 | 64 6d 61 6e 2c 20 4d 65 |es, Free|dman, Me|
|000022b0| 6c 74 7a 65 72 2c 20 53 | 63 68 6f 77 61 6c 74 65 |ltzer, S|chowalte|
|000022c0| 72 2c 20 61 6e 64 20 59 | 75 64 6f 66 73 6b 79 7d |r, and Y|udofsky}|
|000022d0| 0d 0a 24 54 61 62 6c 65 | 7b 7d 0d 0a 24 43 6f 6d |..$Table|{}..$Com|
|000022e0| 6d 65 6e 74 61 74 6f 72 | 7b 44 2e 58 2e 20 46 72 |mentator|{D.X. Fr|
|000022f0| 65 65 64 6d 61 6e 2c 20 | 4d 2e 44 2e 7d 0d 0a 0d |eedman, |M.D.}...|
|00002300| 0a 43 6f 70 79 72 69 67 | 68 74 20 28 63 29 20 59 |.Copyrig|ht (c) Y|
|00002310| 65 61 72 62 6f 6f 6b 20 | 4d 65 64 69 63 61 6c 20 |earbook |Medical |
|00002320| 50 75 62 6c 69 73 68 65 | 72 73 2c 20 49 6e 63 2e |Publishe|rs, Inc.|
|00002330| 2c 20 31 39 39 30 0d 0a | 0d 0a 31 39 39 30 20 59 |, 1990..|..1990 Y|
|00002340| 65 61 72 20 42 6f 6f 6b | 20 6f 66 20 50 73 79 63 |ear Book| of Psyc|
|00002350| 68 69 61 74 72 79 20 61 | 6e 64 20 41 70 70 6c 69 |hiatry a|nd Appli|
|00002360| 65 64 20 4d 65 6e 74 61 | 6c 20 48 65 61 6c 74 68 |ed Menta|l Health|
|00002370| 20 28 52 29 0d 0a 0d 0a | 43 68 61 70 74 65 72 20 | (R)....|Chapter |
|00002380| 37 2d 2d 50 73 79 63 68 | 6f 70 68 61 72 6d 61 63 |7--Psych|opharmac|
|00002390| 6f 6c 6f 67 79 0d 0a 0d | 0a 2d 2d 2d 2d 2d 2d 2d |ology...|.-------|
|000023a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000023b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000023c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000023d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000023e0| 2d 2d 2d 2d 2d 2d 2d 0d | 0a 4d 65 74 68 79 6c 70 |-------.|.Methylp|
|000023f0| 68 65 6e 69 64 61 74 65 | 2d 49 6e 64 75 63 65 64 |henidate|-Induced|
|00002400| 20 49 6e 66 6f 72 6d 61 | 74 69 6f 6e 20 50 72 6f | Informa|tion Pro|
|00002410| 63 65 73 73 69 6e 67 20 | 44 79 73 66 75 6e 63 74 |cessing |Dysfunct|
|00002420| 69 6f 6e 20 69 6e 20 4e | 6f 6e 73 63 68 69 7a 6f |ion in N|onschizo|
|00002430| 70 68 72 65 6e 69 63 0d | 0a 50 61 74 69 65 6e 74 |phrenic.|.Patient|
|00002440| 73 0d 0a 0d 0a 42 72 61 | 66 66 20 44 4c 2c 20 48 |s....Bra|ff DL, H|
|00002450| 75 65 79 20 4c 0d 0a 28 | 55 6e 69 76 20 6f 66 20 |uey L..(|Univ of |
|00002460| 43 61 6c 69 66 6f 72 6e | 69 61 2c 20 53 61 6e 20 |Californ|ia, San |
|00002470| 44 69 65 67 6f 29 0d 0a | 41 72 63 68 20 47 65 6e |Diego)..|Arch Gen|
|00002480| 20 50 73 79 63 68 69 61 | 74 72 79 20 34 35 3a 38 | Psychia|try 45:8|
|00002490| 32 37 2d 38 33 32 2c 20 | 53 65 70 74 65 6d 62 65 |27-832, |Septembe|
|000024a0| 72 20 31 39 38 38 0d 0a | 2d 2d 2d 2d 2d 2d 2d 2d |r 1988..|--------|
|000024b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000024c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000024d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000024e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000024f0| 2d 2d 2d 2d 2d 2d 0d 0a | 0d 0a 41 62 73 74 72 61 |------..|..Abstra|
|00002500| 63 74 0d 0a 0d 0a 20 20 | 20 20 20 54 6f 20 65 78 |ct....  |   To ex|
|00002510| 61 6d 69 6e 65 20 74 68 | 65 20 65 66 66 65 63 74 |amine th|e effect|
|00002520| 73 20 6f 66 20 6d 65 74 | 68 79 6c 70 68 65 6e 69 |s of met|hylpheni|
|00002530| 64 61 74 65 20 68 79 64 | 72 6f 63 68 6c 6f 72 69 |date hyd|rochlori|
|00002540| 64 65 20 6f 6e 20 69 6e | 66 6f 72 6d 61 74 69 6f |de on in|formatio|
|00002550| 6e 0d 0a 70 72 6f 63 65 | 73 73 69 6e 67 20 61 6e |n..proce|ssing an|
|00002560| 64 20 61 74 74 65 6e 74 | 69 6f 6e 2c 20 31 32 20 |d attent|ion, 12 |
|00002570| 6d 61 6c 65 20 70 73 79 | 63 68 69 61 74 72 69 63 |male psy|chiatric|
|00002580| 20 69 6e 70 61 74 69 65 | 6e 74 73 20 77 69 74 68 | inpatie|nts with|
|00002590| 20 6d 69 6e 6f 72 20 64 | 65 70 72 65 73 73 69 6f | minor d|epressio|
|000025a0| 6e 0d 0a 6f 72 20 70 65 | 72 73 6f 6e 61 6c 69 74 |n..or pe|rsonalit|
|000025b0| 79 20 64 69 73 6f 72 64 | 65 72 73 20 77 65 72 65 |y disord|ers were|
|000025c0| 20 67 69 76 65 6e 20 6d | 65 74 68 79 6c 70 68 65 | given m|ethylphe|
|000025d0| 6e 69 64 61 74 65 20 68 | 79 64 72 6f 63 68 6c 6f |nidate h|ydrochlo|
|000025e0| 72 69 64 65 2c 20 6f 78 | 61 7a 65 70 61 6d 2c 0d |ride, ox|azepam,.|
|000025f0| 0a 61 6e 64 20 70 6c 61 | 63 65 62 6f 20 69 6e 20 |.and pla|cebo in |
|00002600| 31 2d 77 65 65 6b 20 62 | 6c 6f 63 6b 73 20 69 6e |1-week b|locks in|
|00002610| 20 61 20 64 6f 75 62 6c | 65 2d 62 6c 69 6e 64 2c | a doubl|e-blind,|
|00002620| 20 72 61 6e 64 6f 6d 69 | 7a 65 64 20 64 65 73 69 | randomi|zed desi|
|00002630| 67 6e 2e 0d 0a 4d 65 74 | 68 79 6c 70 68 65 6e 69 |gn...Met|hylpheni|
|00002640| 64 61 74 65 20 69 6e 64 | 75 63 65 64 20 61 20 70 |date ind|uced a p|
|00002650| 61 74 74 65 72 6e 20 6f | 66 20 69 6e 66 6f 72 6d |attern o|f inform|
|00002660| 61 74 69 6f 6e 20 70 72 | 6f 63 65 73 73 69 6e 67 |ation pr|ocessing|
|00002670| 20 64 79 73 66 75 6e 63 | 74 69 6f 6e 0d 0a 73 69 | dysfunc|tion..si|
|00002680| 6d 69 6c 61 72 20 74 6f | 20 74 68 61 74 20 6f 62 |milar to| that ob|
|00002690| 73 65 72 76 65 64 20 69 | 6e 20 73 63 68 69 7a 6f |served i|n schizo|
|000026a0| 70 68 72 65 6e 69 63 20 | 70 61 74 69 65 6e 74 73 |phrenic |patients|
|000026b0| 2e 20 20 54 68 65 20 74 | 69 6d 65 20 63 6f 75 72 |.  The t|ime cour|
|000026c0| 73 65 20 6f 66 20 74 68 | 65 0d 0a 6f 62 73 65 72 |se of th|e..obser|
|000026d0| 76 65 64 20 64 65 66 69 | 63 69 74 73 20 69 6e 20 |ved defi|cits in |
|000026e0| 62 6f 74 68 20 73 63 68 | 69 7a 6f 70 68 72 65 6e |both sch|izophren|
|000026f0| 69 63 20 61 6e 64 20 6d | 65 74 68 79 6c 70 68 65 |ic and m|ethylphe|
|00002700| 6e 69 64 61 74 65 2d 69 | 6e 64 75 63 65 64 20 73 |nidate-i|nduced s|
|00002710| 74 61 74 65 73 20 77 61 | 73 0d 0a 68 69 67 68 6c |tates wa|s..highl|
|00002720| 79 20 63 6f 6d 70 61 74 | 69 62 6c 65 20 77 69 74 |y compat|ible wit|
|00002730| 68 20 74 68 65 20 74 65 | 6d 70 6f 72 61 6c 20 6d |h the te|mporal m|
|00002740| 61 70 70 69 6e 67 20 70 | 61 74 74 65 72 6e 20 6f |apping p|attern o|
|00002750| 66 20 6d 6f 6e 6f 61 6d | 69 6e 65 72 67 69 63 20 |f monoam|inergic |
|00002760| 6e 65 75 72 6f 6e 61 6c | 0d 0a 73 79 73 74 65 6d |neuronal|..system|
|00002770| 73 2e 0d 0a 20 20 20 20 | 20 4d 65 74 68 79 6c 70 |s...    | Methylp|
|00002780| 68 65 6e 69 64 61 74 65 | 2c 20 77 68 69 63 68 20 |henidate|, which |
|00002790| 69 6e 63 72 65 61 73 65 | 73 20 63 65 6e 74 72 61 |increase|s centra|
|000027a0| 6c 20 63 61 74 65 63 68 | 6f 6c 61 6d 69 6e 65 72 |l catech|olaminer|
|000027b0| 67 69 63 20 61 63 74 69 | 76 69 74 79 2c 0d 0a 69 |gic acti|vity,..i|
|000027c0| 6e 64 75 63 65 73 20 64 | 6f 73 65 2d 64 65 70 65 |nduces d|ose-depe|
|000027d0| 6e 64 65 6e 74 20 64 65 | 66 69 63 69 74 73 20 69 |ndent de|ficits i|
|000027e0| 6e 20 69 6e 66 6f 72 6d | 61 74 69 6f 6e 20 70 72 |n inform|ation pr|
|000027f0| 6f 63 65 73 73 69 6e 67 | 20 73 69 6d 69 6c 61 72 |ocessing| similar|
|00002800| 20 74 6f 20 74 68 6f 73 | 65 0d 0a 73 65 65 6e 20 | to thos|e..seen |
|00002810| 69 6e 20 73 63 68 69 7a | 6f 70 68 72 65 6e 69 63 |in schiz|ophrenic|
|00002820| 20 70 61 74 69 65 6e 74 | 73 2e 20 20 41 6c 74 68 | patient|s.  Alth|
|00002830| 6f 75 67 68 20 74 68 69 | 73 20 66 69 6e 64 69 6e |ough thi|s findin|
|00002840| 67 20 64 6f 65 73 20 6e | 6f 74 20 6c 69 6e 6b 0d |g does n|ot link.|
|00002850| 0a 64 6f 70 61 6d 69 6e | 65 72 67 69 63 20 74 6f |.dopamin|ergic to|
|00002860| 6e 65 20 70 65 72 20 73 | 65 20 77 69 74 68 20 74 |ne per s|e with t|
|00002870| 68 65 20 6f 62 73 65 72 | 76 65 64 20 69 6e 66 6f |he obser|ved info|
|00002880| 72 6d 61 74 69 6f 6e 20 | 70 72 6f 63 65 73 73 69 |rmation |processi|
|00002890| 6e 67 2d 61 74 74 65 6e | 74 69 6f 6e 61 6c 0d 0a |ng-atten|tional..|
|000028a0| 64 65 66 69 63 69 74 73 | 2c 20 69 74 20 73 74 72 |deficits|, it str|
|000028b0| 65 6e 67 74 68 65 6e 73 | 20 74 68 65 20 6c 69 6e |engthens| the lin|
|000028c0| 6b 61 67 65 20 6f 66 20 | 74 68 65 20 73 63 68 69 |kage of |the schi|
|000028d0| 7a 6f 70 68 72 65 6e 69 | 61 2d 69 6e 66 6f 72 6d |zophreni|a-inform|
|000028e0| 61 74 69 6f 6e 0d 0a 70 | 72 6f 63 65 73 73 69 6e |ation..p|rocessin|
|000028f0| 67 20 64 79 73 66 75 6e | 63 74 69 6f 6e 2d 61 6d |g dysfun|ction-am|
|00002900| 69 6e 65 72 67 69 63 20 | 6f 76 65 72 61 63 74 69 |inergic |overacti|
|00002910| 76 69 74 79 20 72 65 6c | 61 74 69 6f 6e 73 68 69 |vity rel|ationshi|
|00002920| 70 2e 0d 0a 0d 0a 50 6f | 73 74 2d 43 6f 6d 6d 65 |p.....Po|st-Comme|
|00002930| 6e 74 0d 0a 0d 0a 20 20 | 20 20 20 4d 61 6e 79 20 |nt....  |   Many |
|00002940| 70 73 79 63 68 69 61 74 | 72 69 73 74 73 20 75 73 |psychiat|rists us|
|00002950| 65 20 6d 65 74 68 79 6c | 70 68 65 6e 69 64 61 74 |e methyl|phenidat|
|00002960| 65 20 74 6f 20 61 75 67 | 6d 65 6e 74 20 74 68 65 |e to aug|ment the|
|00002970| 20 61 6e 74 69 64 65 70 | 72 65 73 73 61 6e 74 0d | antidep|ressant.|
|00002980| 0a 72 65 73 70 6f 6e 73 | 65 20 74 6f 20 74 72 69 |.respons|e to tri|
|00002990| 63 79 63 6c 69 63 20 61 | 6e 74 69 64 65 70 72 65 |cyclic a|ntidepre|
|000029a0| 73 73 61 6e 74 73 20 69 | 6e 20 70 61 74 69 65 6e |ssants i|n patien|
|000029b0| 74 73 20 77 68 6f 20 68 | 61 76 65 20 6e 6f 20 68 |ts who h|ave no h|
|000029c0| 69 73 74 6f 72 79 20 6f | 66 20 64 72 75 67 0d 0a |istory o|f drug..|
|000029d0| 6d 69 73 75 73 65 2e 20 | 20 57 68 61 74 65 76 65 |misuse. | Whateve|
|000029e0| 72 20 74 68 65 20 73 69 | 6d 69 6c 61 72 69 74 79 |r the si|milarity|
|000029f0| 20 74 6f 20 64 65 66 69 | 63 69 74 73 20 74 68 69 | to defi|cits thi|
|00002a00| 73 20 73 70 65 63 69 61 | 6c 69 7a 65 64 20 74 65 |s specia|lized te|
|00002a10| 63 68 6e 69 71 75 65 0d | 0a 72 65 76 65 61 6c 73 |chnique.|.reveals|
|00002a20| 20 69 6e 20 73 63 68 69 | 7a 6f 70 68 72 65 6e 69 | in schi|zophreni|
|00002a30| 63 20 70 61 74 69 65 6e | 74 73 2c 20 74 68 65 20 |c patien|ts, the |
|00002a40| 62 61 73 69 63 20 70 73 | 79 63 68 6f 70 68 61 72 |basic ps|ychophar|
|00002a50| 6d 61 63 6f 6c 6f 67 69 | 63 20 71 75 65 73 74 69 |macologi|c questi|
|00002a60| 6f 6e 20 69 73 0d 0a 68 | 6f 77 20 6d 65 74 68 79 |on is..h|ow methy|
|00002a70| 6c 70 68 65 6e 69 64 61 | 74 65 20 69 6d 70 72 6f |lphenida|te impro|
|00002a80| 76 65 73 20 61 74 74 65 | 6e 74 69 6f 6e 20 61 6e |ves atte|ntion an|
|00002a90| 64 20 66 6f 63 75 73 20 | 6e 6f 74 20 6f 6e 6c 79 |d focus |not only|
|00002aa0| 20 69 6e 20 74 68 65 20 | 61 74 74 65 6e 74 69 6f | in the |attentio|
|00002ab0| 6e 0d 0a 64 69 73 6f 72 | 64 65 72 73 20 62 75 74 |n..disor|ders but|
|00002ac0| 20 69 6e 20 74 68 65 20 | 73 6c 65 65 70 20 64 65 | in the |sleep de|
|00002ad0| 70 72 69 76 65 64 2e 20 | 20 57 69 74 68 69 6e 20 |prived. | Within |
|00002ae0| 34 35 20 6d 69 6e 75 74 | 65 73 20 6f 66 20 61 6e |45 minut|es of an|
|00002af0| 20 6f 72 61 6c 20 64 6f | 73 65 20 6f 6e 65 0d 0a | oral do|se one..|
|00002b00| 6d 61 79 20 73 65 65 20 | 61 20 62 72 69 65 66 20 |may see |a brief |
|00002b10| 69 6d 70 72 6f 76 65 6d | 65 6e 74 20 69 6e 20 6d |improvem|ent in m|
|00002b20| 61 6e 79 20 6e 65 75 72 | 6f 76 65 67 65 74 61 74 |any neur|ovegetat|
|00002b30| 69 76 65 20 73 79 6d 70 | 74 6f 6d 73 20 61 6e 64 |ive symp|toms and|
|00002b40| 20 69 6e 20 61 74 74 65 | 6e 74 69 6f 6e 0d 0a 61 | in atte|ntion..a|
|00002b50| 6e 64 20 63 6f 6e 63 65 | 6e 74 72 61 74 69 6f 6e |nd conce|ntration|
|00002b60| 20 69 6e 20 74 68 65 20 | 64 65 70 72 65 73 73 65 | in the |depresse|
|00002b70| 64 2e 20 20 48 6f 77 65 | 76 65 72 2c 20 74 68 65 |d.  Howe|ver, the|
|00002b80| 20 73 75 73 74 61 69 6e | 65 64 20 65 66 66 69 63 | sustain|ed effic|
|00002b90| 61 63 79 20 6f 66 0d 0a | 61 64 6a 75 6e 63 74 69 |acy of..|adjuncti|
|00002ba0| 76 65 20 6d 65 74 68 79 | 6c 70 68 65 6e 69 64 61 |ve methy|lphenida|
|00002bb0| 74 65 20 69 73 20 6e 6f | 74 20 61 74 20 61 6c 6c |te is no|t at all|
|00002bc0| 20 65 73 74 61 62 6c 69 | 73 68 65 64 2e 20 20 46 | establi|shed.  F|
|00002bd0| 75 72 74 68 65 72 6d 6f | 72 65 2c 0d 0a 72 65 73 |urthermo|re,..res|
|00002be0| 70 6f 6e 73 69 76 65 6e | 65 73 73 20 74 6f 20 74 |ponsiven|ess to t|
|00002bf0| 65 73 74 20 64 6f 73 65 | 73 20 6f 66 20 74 68 65 |est dose|s of the|
|00002c00| 20 64 72 75 67 20 73 65 | 65 6d 73 20 73 65 6c 65 | drug se|ems sele|
|00002c10| 63 74 69 76 65 2e 2d 2d | 44 2e 58 2e 20 46 72 65 |ctive.--|D.X. Fre|
|00002c20| 65 64 6d 61 6e 2c 20 4d | 2e 44 2e 0d 0a 24 55 6e |edman, M|.D...$Un|
|00002c30| 69 71 75 65 5f 49 44 7b | 59 52 42 31 32 34 30 33 |ique_ID{|YRB12403|
|00002c40| 7d 0d 0a 24 54 69 74 6c | 65 7b 43 6c 6f 6e 61 7a |}..$Titl|e{Clonaz|
|00002c50| 65 70 61 6d 20 54 72 65 | 61 74 6d 65 6e 74 20 6f |epam Tre|atment o|
|00002c60| 66 20 46 69 76 65 20 4c | 69 74 68 69 75 6d 2d 52 |f Five L|ithium-R|
|00002c70| 65 66 72 61 63 74 6f 72 | 79 20 50 61 74 69 65 6e |efractor|y Patien|
|00002c80| 74 73 20 57 69 74 68 20 | 42 69 70 6f 6c 61 72 20 |ts With |Bipolar |
|00002c90| 44 69 73 6f 72 64 65 72 | 7d 0d 0a 24 41 75 74 68 |Disorder|}..$Auth|
|00002ca0| 6f 72 7b 0d 0a 41 72 6f | 6e 73 6f 6e 2c 20 54 41 |or{..Aro|nson, TA|
|00002cb0| 0d 0a 53 68 75 6b 6c 61 | 2c 20 53 0d 0a 48 69 72 |..Shukla|, S..Hir|
|00002cc0| 73 63 68 6f 77 69 74 7a | 2c 20 4a 7d 0d 0a 24 41 |schowitz|, J}..$A|
|00002cd0| 66 66 69 6c 69 61 74 69 | 6f 6e 7b 53 74 61 74 65 |ffiliati|on{State|
|00002ce0| 20 55 6e 69 76 20 6f 66 | 20 4e 65 77 20 59 6f 72 | Univ of| New Yor|
|00002cf0| 6b 2c 20 53 74 6f 6e 79 | 20 42 72 6f 6f 6b 3b 20 |k, Stony| Brook; |
|00002d00| 56 41 20 4d 65 64 20 43 | 74 72 2c 20 4e 6f 72 74 |VA Med C|tr, Nort|
|00002d10| 68 70 6f 72 74 2c 20 4e | 59 7d 0d 0a 24 4a 6f 75 |hport, N|Y}..$Jou|
|00002d20| 72 6e 61 6c 7b 41 6d 20 | 4a 20 50 73 79 63 68 69 |rnal{Am |J Psychi|
|00002d30| 61 74 72 79 7d 0d 0a 24 | 56 6f 6c 75 6d 65 7b 31 |atry}..$|Volume{1|
|00002d40| 34 36 7d 0d 0a 24 50 61 | 67 65 7b 37 37 2d 38 30 |46}..$Pa|ge{77-80|
|00002d50| 7d 0d 0a 24 44 61 74 65 | 7b 4a 61 6e 75 61 72 79 |}..$Date|{January|
|00002d60| 20 31 39 38 39 7d 0d 0a | 24 59 42 56 6f 6c 7b 31 | 1989}..|$YBVol{1|
|00002d70| 39 39 30 20 59 65 61 72 | 20 42 6f 6f 6b 20 6f 66 |990 Year| Book of|
|00002d80| 20 50 73 79 63 68 69 61 | 74 72 79 20 61 6e 64 20 | Psychia|try and |
|00002d90| 41 70 70 6c 69 65 64 20 | 4d 65 6e 74 61 6c 20 48 |Applied |Mental H|
|00002da0| 65 61 6c 74 68 7d 0d 0a | 24 43 68 61 70 74 65 72 |ealth}..|$Chapter|
|00002db0| 7b 37 2d 38 7d 0d 0a 24 | 59 42 45 64 69 74 6f 72 |{7-8}..$|YBEditor|
|00002dc0| 7b 44 72 73 2e 20 54 61 | 6c 62 6f 74 74 2c 20 46 |{Drs. Ta|lbott, F|
|00002dd0| 72 61 6e 63 65 73 2c 20 | 46 72 61 6e 63 65 73 2c |rances, |Frances,|
|00002de0| 20 46 72 65 65 64 6d 61 | 6e 2c 20 4d 65 6c 74 7a | Freedma|n, Meltz|
|00002df0| 65 72 2c 20 53 63 68 6f | 77 61 6c 74 65 72 2c 20 |er, Scho|walter, |
|00002e00| 61 6e 64 20 59 75 64 6f | 66 73 6b 79 7d 0d 0a 24 |and Yudo|fsky}..$|
|00002e10| 54 61 62 6c 65 7b 7d 0d | 0a 24 43 6f 6d 6d 65 6e |Table{}.|.$Commen|
|00002e20| 74 61 74 6f 72 7b 7d 0d | 0a 0d 0a 43 6f 70 79 72 |tator{}.|...Copyr|
|00002e30| 69 67 68 74 20 28 63 29 | 20 59 65 61 72 62 6f 6f |ight (c)| Yearboo|
|00002e40| 6b 20 4d 65 64 69 63 61 | 6c 20 50 75 62 6c 69 73 |k Medica|l Publis|
|00002e50| 68 65 72 73 2c 20 49 6e | 63 2e 2c 20 31 39 39 30 |hers, In|c., 1990|
|00002e60| 0d 0a 0d 0a 31 39 39 30 | 20 59 65 61 72 20 42 6f |....1990| Year Bo|
|00002e70| 6f 6b 20 6f 66 20 50 73 | 79 63 68 69 61 74 72 79 |ok of Ps|ychiatry|
|00002e80| 20 61 6e 64 20 41 70 70 | 6c 69 65 64 20 4d 65 6e | and App|lied Men|
|00002e90| 74 61 6c 20 48 65 61 6c | 74 68 20 28 52 29 0d 0a |tal Heal|th (R)..|
|00002ea0| 0d 0a 43 68 61 70 74 65 | 72 20 37 2d 2d 50 73 79 |..Chapte|r 7--Psy|
|00002eb0| 63 68 6f 70 68 61 72 6d | 61 63 6f 6c 6f 67 79 0d |chopharm|acology.|
|00002ec0| 0a 0d 0a 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |...-----|--------|
|00002ed0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002ee0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002ef0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002f00| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002f10| 2d 0d 0a 43 6c 6f 6e 61 | 7a 65 70 61 6d 20 54 72 |-..Clona|zepam Tr|
|00002f20| 65 61 74 6d 65 6e 74 20 | 6f 66 20 46 69 76 65 20 |eatment |of Five |
|00002f30| 4c 69 74 68 69 75 6d 2d | 52 65 66 72 61 63 74 6f |Lithium-|Refracto|
|00002f40| 72 79 20 50 61 74 69 65 | 6e 74 73 20 57 69 74 68 |ry Patie|nts With|
|00002f50| 20 42 69 70 6f 6c 61 72 | 20 44 69 73 6f 72 64 65 | Bipolar| Disorde|
|00002f60| 72 0d 0a 0d 0a 41 72 6f | 6e 73 6f 6e 20 54 41 2c |r....Aro|nson TA,|
|00002f70| 20 53 68 75 6b 6c 61 20 | 53 2c 20 48 69 72 73 63 | Shukla |S, Hirsc|
|00002f80| 68 6f 77 69 74 7a 20 4a | 0d 0a 28 53 74 61 74 65 |howitz J|..(State|
|00002f90| 20 55 6e 69 76 20 6f 66 | 20 4e 65 77 20 59 6f 72 | Univ of| New Yor|
|00002fa0| 6b 2c 20 53 74 6f 6e 79 | 20 42 72 6f 6f 6b 3b 20 |k, Stony| Brook; |
|00002fb0| 56 41 20 4d 65 64 20 43 | 74 72 2c 20 4e 6f 72 74 |VA Med C|tr, Nort|
|00002fc0| 68 70 6f 72 74 2c 20 4e | 59 29 0d 0a 41 6d 20 4a |hport, N|Y)..Am J|
|00002fd0| 20 50 73 79 63 68 69 61 | 74 72 79 20 31 34 36 3a | Psychia|try 146:|
|00002fe0| 37 37 2d 38 30 2c 20 4a | 61 6e 75 61 72 79 20 31 |77-80, J|anuary 1|
|00002ff0| 39 38 39 0d 0a 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |989..---|--------|
|00003000| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003010| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003020| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003030| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003040| 2d 2d 2d 0d 0a 0d 0a 41 | 62 73 74 72 61 63 74 0d |---....A|bstract.|
|00003050| 0a 0d 0a 20 20 20 20 20 | 43 6c 6f 6e 61 7a 65 70 |...     |Clonazep|
|00003060| 61 6d 2c 20 61 6e 20 61 | 6e 74 69 63 6f 6e 76 75 |am, an a|nticonvu|
|00003070| 6c 73 61 6e 74 20 64 72 | 75 67 20 61 70 70 72 6f |lsant dr|ug appro|
|00003080| 76 65 64 20 66 6f 72 20 | 75 73 65 20 69 6e 20 6d |ved for |use in m|
|00003090| 79 6f 63 6c 6f 6e 69 63 | 20 61 6e 64 0d 0a 70 65 |yoclonic| and..pe|
|000030a0| 74 69 74 20 6d 61 6c 20 | 73 65 69 7a 75 72 65 20 |tit mal |seizure |
|000030b0| 64 69 73 6f 72 64 65 72 | 73 2c 20 68 61 73 20 73 |disorder|s, has s|
|000030c0| 68 6f 77 6e 20 70 72 6f | 6d 69 73 65 20 69 6e 20 |hown pro|mise in |
|000030d0| 74 68 65 20 74 72 65 61 | 74 6d 65 6e 74 20 6f 66 |the trea|tment of|
|000030e0| 20 61 63 75 74 65 0d 0a | 6d 61 6e 69 61 2e 20 48 | acute..|mania. H|
|000030f0| 6f 77 65 76 65 72 2c 20 | 69 74 73 20 65 66 66 69 |owever, |its effi|
|00003100| 63 61 63 79 20 69 6e 20 | 74 72 65 61 74 69 6e 67 |cacy in |treating|
|00003110| 20 62 69 70 6f 6c 61 72 | 20 64 69 73 6f 72 64 65 | bipolar| disorde|
|00003120| 72 20 77 69 74 68 20 70 | 73 79 63 68 6f 74 69 63 |r with p|sychotic|
|00003130| 0d 0a 66 65 61 74 75 72 | 65 73 20 61 6e 64 20 61 |..featur|es and a|
|00003140| 73 20 61 20 6d 61 69 6e | 74 65 6e 61 6e 63 65 20 |s a main|tenance |
|00003150| 6d 65 64 69 63 61 74 69 | 6f 6e 20 69 6e 20 62 69 |medicati|on in bi|
|00003160| 70 6f 6c 61 72 20 64 69 | 73 6f 72 64 65 72 20 69 |polar di|sorder i|
|00003170| 73 20 75 6e 63 6c 65 61 | 72 2e 20 20 41 6e 0d 0a |s unclea|r.  An..|
|00003180| 6f 70 65 6e 2c 20 70 72 | 6f 73 70 65 63 74 69 76 |open, pr|ospectiv|
|00003190| 65 20 74 72 69 61 6c 20 | 6f 66 20 6d 61 69 6e 74 |e trial |of maint|
|000031a0| 65 6e 61 6e 63 65 20 74 | 72 65 61 74 6d 65 6e 74 |enance t|reatment|
|000031b0| 20 77 69 74 68 20 63 6c | 6f 6e 61 7a 65 70 61 6d | with cl|onazepam|
|000031c0| 2c 20 77 61 73 0d 0a 75 | 6e 64 65 72 74 61 6b 65 |, was..u|ndertake|
|000031d0| 6e 20 69 6e 20 33 20 77 | 6f 6d 65 6e 20 61 6e 64 |n in 3 w|omen and|
|000031e0| 20 32 20 6d 65 6e 20 61 | 67 65 64 20 33 31 2d 35 | 2 men a|ged 31-5|
|000031f0| 32 20 79 65 61 72 73 20 | 77 68 6f 20 68 61 64 20 |2 years |who had |
|00003200| 62 65 65 6e 20 68 6f 73 | 70 69 74 61 6c 69 7a 65 |been hos|pitalize|
|00003210| 64 20 61 6e 0d 0a 61 76 | 65 72 61 67 65 20 6f 66 |d an..av|erage of|
|00003220| 20 35 20 74 69 6d 65 73 | 20 66 6f 72 20 70 72 65 | 5 times| for pre|
|00003230| 76 69 6f 75 73 20 65 70 | 69 73 6f 64 65 73 20 6f |vious ep|isodes o|
|00003240| 66 20 72 65 63 75 72 72 | 65 6e 74 20 70 73 79 63 |f recurr|ent psyc|
|00003250| 68 6f 74 69 63 20 6d 61 | 6e 69 61 2c 0d 0a 64 65 |hotic ma|nia,..de|
|00003260| 6c 75 73 69 6f 6e 61 6c | 20 64 65 70 72 65 73 73 |lusional| depress|
|00003270| 69 6f 6e 2c 20 6f 72 20 | 70 73 79 63 68 6f 74 69 |ion, or |psychoti|
|00003280| 63 20 6d 69 78 65 64 20 | 6d 61 6e 69 61 2e 20 20 |c mixed |mania.  |
|00003290| 46 6f 75 72 20 70 61 74 | 69 65 6e 74 73 20 68 61 |Four pat|ients ha|
|000032a0| 64 20 72 65 63 65 69 76 | 65 64 0d 0a 65 6c 65 63 |d receiv|ed..elec|
|000032b0| 74 72 6f 63 6f 6e 76 75 | 6c 73 69 76 65 20 74 68 |troconvu|lsive th|
|000032c0| 65 72 61 70 79 20 28 45 | 43 54 29 20 66 6f 72 20 |erapy (E|CT) for |
|000032d0| 74 72 65 61 74 6d 65 6e | 74 20 6f 66 20 72 65 66 |treatmen|t of ref|
|000032e0| 72 61 63 74 6f 72 79 20 | 6d 61 6e 69 61 20 6f 72 |ractory |mania or|
|000032f0| 0d 0a 64 65 70 72 65 73 | 73 69 6f 6e 2e 0d 0a 20 |..depres|sion... |
|00003300| 20 20 20 20 41 6c 6c 20 | 35 20 68 61 64 20 68 69 |    All |5 had hi|
|00003310| 73 74 6f 72 69 65 73 20 | 6f 66 20 72 65 6c 61 70 |stories |of relap|
|00003320| 73 65 20 61 74 20 74 68 | 65 72 61 70 65 75 74 69 |se at th|erapeuti|
|00003330| 63 20 6c 65 76 65 6c 73 | 20 6f 66 20 6c 69 74 68 |c levels| of lith|
|00003340| 69 75 6d 20 61 6c 6f 6e | 65 2c 0d 0a 61 6e 64 20 |ium alon|e,..and |
|00003350| 32 20 68 61 64 20 61 6c | 73 6f 20 72 65 6c 61 70 |2 had al|so relap|
|00003360| 73 65 64 20 61 66 74 65 | 72 20 61 64 6a 75 6e 63 |sed afte|r adjunc|
|00003370| 74 69 76 65 20 64 6f 73 | 65 73 20 6f 66 20 63 61 |tive dos|es of ca|
|00003380| 72 62 61 6d 61 7a 65 70 | 69 6e 65 2e 20 20 41 6c |rbamazep|ine.  Al|
|00003390| 6c 20 35 20 68 61 64 0d | 0a 72 65 71 75 69 72 65 |l 5 had.|.require|
|000033a0| 64 20 61 64 6a 75 6e 63 | 74 69 76 65 20 6e 65 75 |d adjunc|tive neu|
|000033b0| 72 6f 6c 65 70 74 69 63 | 20 74 72 65 61 74 6d 65 |roleptic| treatme|
|000033c0| 6e 74 20 69 6e 20 61 64 | 64 69 74 69 6f 6e 20 74 |nt in ad|dition t|
|000033d0| 6f 20 6c 69 74 68 69 75 | 6d 20 74 6f 20 6d 61 69 |o lithiu|m to mai|
|000033e0| 6e 74 61 69 6e 0d 0a 65 | 75 74 68 79 6d 69 61 20 |ntain..e|uthymia |
|000033f0| 61 6e 64 20 68 61 64 20 | 72 65 6c 61 70 73 65 64 |and had |relapsed|
|00003400| 20 6d 6f 72 65 20 74 68 | 61 6e 20 6f 6e 63 65 20 | more th|an once |
|00003410| 64 75 72 69 6e 67 20 6e | 65 75 72 6f 6c 65 70 74 |during n|eurolept|
|00003420| 69 63 20 74 61 70 65 72 | 69 6e 67 2e 20 20 46 6f |ic taper|ing.  Fo|
|00003430| 75 72 0d 0a 70 61 74 69 | 65 6e 74 73 20 62 65 67 |ur..pati|ents beg|
|00003440| 61 6e 20 63 6c 6f 6e 61 | 7a 65 70 61 6d 20 74 68 |an clona|zepam th|
|00003450| 65 72 61 70 79 20 61 66 | 74 65 72 20 61 20 6d 65 |erapy af|ter a me|
|00003460| 61 6e 20 6f 66 20 38 20 | 6d 6f 6e 74 68 73 20 6f |an of 8 |months o|
|00003470| 66 20 73 74 61 62 6c 65 | 20 65 75 74 68 79 6d 69 |f stable| euthymi|
|00003480| 61 2e 0d 0a 4e 65 75 72 | 6f 6c 65 70 74 69 63 20 |a...Neur|oleptic |
|00003490| 72 65 67 69 6d 65 6e 73 | 20 77 65 72 65 20 74 61 |regimens| were ta|
|000034a0| 70 65 72 65 64 20 69 6e | 20 74 68 65 20 66 69 72 |pered in| the fir|
|000034b0| 73 74 20 33 20 77 65 65 | 6b 73 20 6f 66 20 63 6c |st 3 wee|ks of cl|
|000034c0| 6f 6e 61 7a 65 70 61 6d | 20 74 68 65 72 61 70 79 |onazepam| therapy|
|000034d0| 2e 0d 0a 20 20 20 20 20 | 54 68 72 65 65 20 6f 66 |...     |Three of|
|000034e0| 20 74 68 65 20 35 20 70 | 61 74 69 65 6e 74 73 20 | the 5 p|atients |
|000034f0| 65 78 70 65 72 69 65 6e | 63 65 64 20 63 6c 69 6e |experien|ced clin|
|00003500| 69 63 61 6c 6c 79 20 73 | 69 67 6e 69 66 69 63 61 |ically s|ignifica|
|00003510| 6e 74 20 73 69 64 65 20 | 65 66 66 65 63 74 73 0d |nt side |effects.|
|00003520| 0a 66 72 6f 6d 20 63 6c | 6f 6e 61 7a 65 70 61 6d |.from cl|onazepam|
|00003530| 2c 20 6d 6f 73 74 6c 79 | 20 64 72 6f 77 73 69 6e |, mostly| drowsin|
|00003540| 65 73 73 20 61 6e 64 20 | 66 65 65 6c 69 6e 67 73 |ess and |feelings|
|00003550| 20 6f 66 20 62 65 69 6e | 67 20 73 6c 6f 77 65 64 | of bein|g slowed|
|00003560| 20 64 6f 77 6e 2c 20 77 | 68 69 63 68 0d 0a 6c 69 | down, w|hich..li|
|00003570| 6d 69 74 65 64 20 74 68 | 65 20 6d 61 78 69 6d 61 |mited th|e maxima|
|00003580| 6c 20 74 69 74 72 61 74 | 69 6f 6e 20 6f 66 20 74 |l titrat|ion of t|
|00003590| 68 65 20 64 72 75 67 2e | 20 20 54 68 65 20 34 20 |he drug.|  The 4 |
|000035a0| 70 61 74 69 65 6e 74 73 | 20 77 68 6f 20 72 65 63 |patients| who rec|
|000035b0| 65 69 76 65 64 0d 0a 6c | 69 74 68 69 75 6d 2d 63 |eived..l|ithium-c|
|000035c0| 6c 6f 6e 61 7a 65 70 61 | 6d 20 63 6f 6d 62 69 6e |lonazepa|m combin|
|000035d0| 61 74 69 6f 6e 73 20 72 | 65 6d 61 69 6e 65 64 20 |ations r|emained |
|000035e0| 65 75 74 68 79 6d 69 63 | 20 66 6f 72 20 6f 6e 6c |euthymic| for onl|
|000035f0| 79 20 31 30 2d 31 35 20 | 77 65 65 6b 73 3b 20 74 |y 10-15 |weeks; t|
|00003600| 68 65 0d 0a 66 69 66 74 | 68 20 70 61 74 69 65 6e |he..fift|h patien|
|00003610| 74 2c 20 77 68 6f 20 72 | 65 63 65 69 76 65 64 20 |t, who r|eceived |
|00003620| 63 6c 6f 6e 61 7a 65 70 | 61 6d 20 61 6c 6f 6e 65 |clonazep|am alone|
|00003630| 2c 20 72 65 6c 61 70 73 | 65 64 20 61 66 74 65 72 |, relaps|ed after|
|00003640| 20 32 20 77 65 65 6b 73 | 2e 20 20 46 75 6c 6c 0d | 2 weeks|.  Full.|
|00003650| 0a 61 66 66 65 63 74 69 | 76 65 20 73 79 6d 70 74 |.affecti|ve sympt|
|00003660| 6f 6d 73 20 64 65 76 65 | 6c 6f 70 65 64 20 77 69 |oms deve|loped wi|
|00003670| 74 68 69 6e 20 61 20 66 | 65 77 20 64 61 79 73 2e |thin a f|ew days.|
|00003680| 20 20 54 68 72 65 65 20 | 70 61 74 69 65 6e 74 73 |  Three |patients|
|00003690| 20 6e 65 65 64 65 64 0d | 0a 72 65 68 6f 73 70 69 | needed.|.rehospi|
|000036a0| 74 61 6c 69 7a 61 74 69 | 6f 6e 2e 20 20 54 77 6f |talizati|on.  Two|
|000036b0| 20 62 65 63 61 6d 65 20 | 73 75 69 63 69 64 61 6c | became |suicidal|
|000036c0| 2c 20 61 6e 64 20 31 20 | 6d 61 64 65 20 61 20 73 |, and 1 |made a s|
|000036d0| 75 69 63 69 64 65 20 61 | 74 74 65 6d 70 74 2e 20 |uicide a|ttempt. |
|000036e0| 20 41 6c 6c 20 6f 66 0d | 0a 74 68 65 20 72 65 6c | All of.|.the rel|
|000036f0| 61 70 73 65 73 20 77 65 | 72 65 20 70 73 79 63 68 |apses we|re psych|
|00003700| 6f 74 69 63 2e 20 20 46 | 6f 75 72 20 70 61 74 69 |otic.  F|our pati|
|00003710| 65 6e 74 73 20 65 76 65 | 6e 74 75 61 6c 6c 79 20 |ents eve|ntually |
|00003720| 72 65 73 70 6f 6e 64 65 | 64 20 74 6f 0d 0a 72 65 |responde|d to..re|
|00003730| 69 6e 73 74 69 74 75 74 | 69 6f 6e 20 6f 66 20 74 |institut|ion of t|
|00003740| 68 65 20 6c 69 74 68 69 | 75 6d 2d 6e 65 75 72 6f |he lithi|um-neuro|
|00003750| 6c 65 70 74 69 63 20 72 | 65 67 69 6d 65 6e 2c 20 |leptic r|egimen, |
|00003760| 61 6e 64 20 31 20 72 65 | 71 75 69 72 65 64 20 61 |and 1 re|quired a|
|00003770| 6e 6f 74 68 65 72 0d 0a | 63 6f 75 72 73 65 20 6f |nother..|course o|
|00003780| 66 20 45 43 54 2e 20 20 | 54 68 65 20 73 74 75 64 |f ECT.  |The stud|
|00003790| 79 20 77 61 73 20 74 65 | 72 6d 69 6e 61 74 65 64 |y was te|rminated|
|000037a0| 20 70 72 65 6d 61 74 75 | 72 65 6c 79 20 61 66 74 | prematu|rely aft|
|000037b0| 65 72 20 74 68 65 20 66 | 69 66 74 68 20 70 61 74 |er the f|ifth pat|
|000037c0| 69 65 6e 74 0d 0a 72 65 | 6c 61 70 73 65 64 2e 0d |ient..re|lapsed..|
|000037d0| 0a 20 20 20 20 20 54 68 | 65 20 75 73 65 66 75 6c |.     Th|e useful|
|000037e0| 6e 65 73 73 20 6f 66 20 | 63 6c 6f 6e 61 7a 65 70 |ness of |clonazep|
|000037f0| 61 6d 20 61 73 20 61 20 | 70 72 6f 70 68 79 6c 61 |am as a |prophyla|
|00003800| 78 69 73 20 69 6e 20 6c | 69 74 68 69 75 6d 2d 72 |xis in l|ithium-r|
|00003810| 65 73 69 73 74 61 6e 74 | 0d 0a 62 69 70 6f 6c 61 |esistant|..bipola|
|00003820| 72 20 70 61 74 69 65 6e | 74 73 20 77 69 74 68 20 |r patien|ts with |
|00003830| 61 20 68 69 73 74 6f 72 | 79 20 6f 66 20 70 73 79 |a histor|y of psy|
|00003840| 63 68 6f 74 69 63 20 6d | 61 6e 69 61 20 6f 72 20 |chotic m|ania or |
|00003850| 64 65 6c 75 73 69 6f 6e | 61 6c 20 64 65 70 72 65 |delusion|al depre|
|00003860| 73 73 69 6f 6e 20 69 73 | 0d 0a 64 6f 75 62 74 66 |ssion is|..doubtf|
|00003870| 75 6c 2e 0d 0a 24 55 6e | 69 71 75 65 5f 49 44 7b |ul...$Un|ique_ID{|
|00003880| 59 52 42 31 32 34 30 34 | 7d 0d 0a 24 54 69 74 6c |YRB12404|}..$Titl|
|00003890| 65 7b 43 61 72 62 61 6d | 61 7a 65 70 69 6e 65 20 |e{Carbam|azepine |
|000038a0| 56 73 2e 20 4c 69 74 68 | 69 75 6d 20 69 6e 20 74 |Vs. Lith|ium in t|
|000038b0| 68 65 20 54 72 65 61 74 | 6d 65 6e 74 20 61 6e 64 |he Treat|ment and|
|000038c0| 20 50 72 6f 70 68 79 6c | 61 78 69 73 20 6f 66 20 | Prophyl|axis of |
|000038d0| 4d 61 6e 69 61 7d 0d 0a | 24 41 75 74 68 6f 72 7b |Mania}..|$Author{|
|000038e0| 0d 0a 4c 75 73 7a 6e 61 | 74 2c 20 52 4d 0d 0a 4d |..Luszna|t, RM..M|
|000038f0| 75 72 70 68 79 2c 20 44 | 50 0d 0a 4e 75 6e 6e 2c |urphy, D|P..Nunn,|
|00003900| 20 43 4d 48 7d 0d 0a 24 | 41 66 66 69 6c 69 61 74 | CMH}..$|Affiliat|
|00003910| 69 6f 6e 7b 52 6f 79 61 | 6c 20 53 6f 75 74 68 20 |ion{Roya|l South |
|00003920| 48 61 6e 74 73 20 48 6f | 73 70 2c 20 53 6f 75 74 |Hants Ho|sp, Sout|
|00003930| 68 61 6d 70 74 6f 6e 2c | 20 45 6e 67 6c 61 6e 64 |hampton,| England|
|00003940| 7d 0d 0a 24 4a 6f 75 72 | 6e 61 6c 7b 42 72 20 4a |}..$Jour|nal{Br J|
|00003950| 20 50 73 79 63 68 69 61 | 74 72 79 7d 0d 0a 24 56 | Psychia|try}..$V|
|00003960| 6f 6c 75 6d 65 7b 31 35 | 33 7d 0d 0a 24 50 61 67 |olume{15|3}..$Pag|
|00003970| 65 7b 31 39 38 2d 32 30 | 34 7d 0d 0a 24 44 61 74 |e{198-20|4}..$Dat|
|00003980| 65 7b 41 75 67 75 73 74 | 20 31 39 38 38 7d 0d 0a |e{August| 1988}..|
|00003990| 24 59 42 56 6f 6c 7b 31 | 39 39 30 20 59 65 61 72 |$YBVol{1|990 Year|
|000039a0| 20 42 6f 6f 6b 20 6f 66 | 20 50 73 79 63 68 69 61 | Book of| Psychia|
|000039b0| 74 72 79 20 61 6e 64 20 | 41 70 70 6c 69 65 64 20 |try and |Applied |
|000039c0| 4d 65 6e 74 61 6c 20 48 | 65 61 6c 74 68 7d 0d 0a |Mental H|ealth}..|
|000039d0| 24 43 68 61 70 74 65 72 | 7b 37 2d 39 7d 0d 0a 24 |$Chapter|{7-9}..$|
|000039e0| 59 42 45 64 69 74 6f 72 | 7b 44 72 73 2e 20 54 61 |YBEditor|{Drs. Ta|
|000039f0| 6c 62 6f 74 74 2c 20 46 | 72 61 6e 63 65 73 2c 20 |lbott, F|rances, |
|00003a00| 46 72 61 6e 63 65 73 2c | 20 46 72 65 65 64 6d 61 |Frances,| Freedma|
|00003a10| 6e 2c 20 4d 65 6c 74 7a | 65 72 2c 20 53 63 68 6f |n, Meltz|er, Scho|
|00003a20| 77 61 6c 74 65 72 2c 20 | 61 6e 64 20 59 75 64 6f |walter, |and Yudo|
|00003a30| 66 73 6b 79 7d 0d 0a 24 | 54 61 62 6c 65 7b 7d 0d |fsky}..$|Table{}.|
|00003a40| 0a 24 43 6f 6d 6d 65 6e | 74 61 74 6f 72 7b 7d 0d |.$Commen|tator{}.|
|00003a50| 0a 0d 0a 43 6f 70 79 72 | 69 67 68 74 20 28 63 29 |...Copyr|ight (c)|
|00003a60| 20 59 65 61 72 62 6f 6f | 6b 20 4d 65 64 69 63 61 | Yearboo|k Medica|
|00003a70| 6c 20 50 75 62 6c 69 73 | 68 65 72 73 2c 20 49 6e |l Publis|hers, In|
|00003a80| 63 2e 2c 20 31 39 39 30 | 0d 0a 0d 0a 31 39 39 30 |c., 1990|....1990|
|00003a90| 20 59 65 61 72 20 42 6f | 6f 6b 20 6f 66 20 50 73 | Year Bo|ok of Ps|
|00003aa0| 79 63 68 69 61 74 72 79 | 20 61 6e 64 20 41 70 70 |ychiatry| and App|
|00003ab0| 6c 69 65 64 20 4d 65 6e | 74 61 6c 20 48 65 61 6c |lied Men|tal Heal|
|00003ac0| 74 68 20 28 52 29 0d 0a | 0d 0a 43 68 61 70 74 65 |th (R)..|..Chapte|
|00003ad0| 72 20 37 2d 2d 50 73 79 | 63 68 6f 70 68 61 72 6d |r 7--Psy|chopharm|
|00003ae0| 61 63 6f 6c 6f 67 79 0d | 0a 0d 0a 2d 2d 2d 2d 2d |acology.|...-----|
|00003af0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003b00| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003b10| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003b20| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003b30| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 0d 0a 43 61 72 62 61 |--------|-..Carba|
|00003b40| 6d 61 7a 65 70 69 6e 65 | 20 56 73 2e 20 4c 69 74 |mazepine| Vs. Lit|
|00003b50| 68 69 75 6d 20 69 6e 20 | 74 68 65 20 54 72 65 61 |hium in |the Trea|
|00003b60| 74 6d 65 6e 74 20 61 6e | 64 20 50 72 6f 70 68 79 |tment an|d Prophy|
|00003b70| 6c 61 78 69 73 20 6f 66 | 20 4d 61 6e 69 61 0d 0a |laxis of| Mania..|
|00003b80| 0d 0a 4c 75 73 7a 6e 61 | 74 20 52 4d 2c 20 4d 75 |..Luszna|t RM, Mu|
|00003b90| 72 70 68 79 20 44 50 2c | 20 4e 75 6e 6e 20 43 4d |rphy DP,| Nunn CM|
|00003ba0| 48 0d 0a 28 52 6f 79 61 | 6c 20 53 6f 75 74 68 20 |H..(Roya|l South |
|00003bb0| 48 61 6e 74 73 20 48 6f | 73 70 2c 20 53 6f 75 74 |Hants Ho|sp, Sout|
|00003bc0| 68 61 6d 70 74 6f 6e 2c | 20 45 6e 67 6c 61 6e 64 |hampton,| England|
|00003bd0| 29 0d 0a 42 72 20 4a 20 | 50 73 79 63 68 69 61 74 |)..Br J |Psychiat|
|00003be0| 72 79 20 31 35 33 3a 31 | 39 38 2d 32 30 34 2c 20 |ry 153:1|98-204, |
|00003bf0| 41 75 67 75 73 74 20 31 | 39 38 38 0d 0a 2d 2d 2d |August 1|988..---|
|00003c00| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003c10| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003c20| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003c30| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003c40| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 0d 0a 0d 0a 41 |--------|---....A|
|00003c50| 62 73 74 72 61 63 74 0d | 0a 0d 0a 20 20 20 20 20 |bstract.|...     |
|00003c60| 54 68 65 20 72 65 6c 61 | 74 69 76 65 20 76 61 6c |The rela|tive val|
|00003c70| 75 65 20 6f 66 20 6c 69 | 74 68 69 75 6d 20 61 6e |ue of li|thium an|
|00003c80| 64 20 63 61 72 62 61 6d | 61 7a 65 70 69 6e 65 20 |d carbam|azepine |
|00003c90| 69 6e 20 74 68 65 20 74 | 72 65 61 74 6d 65 6e 74 |in the t|reatment|
|00003ca0| 20 6f 66 20 6d 61 6e 69 | 61 0d 0a 77 61 73 20 65 | of mani|a..was e|
|00003cb0| 78 61 6d 69 6e 65 64 20 | 69 6e 20 61 20 64 6f 75 |xamined |in a dou|
|00003cc0| 62 6c 65 2d 62 6c 69 6e | 64 20 73 74 75 64 79 20 |ble-blin|d study |
|00003cd0| 6f 66 20 35 34 20 6d 61 | 6e 69 63 20 70 61 74 69 |of 54 ma|nic pati|
|00003ce0| 65 6e 74 73 20 61 64 6d | 69 74 74 65 64 20 74 6f |ents adm|itted to|
|00003cf0| 20 61 6e 20 61 63 75 74 | 65 0d 0a 70 73 79 63 68 | an acut|e..psych|
|00003d00| 69 61 74 72 69 63 20 75 | 6e 69 74 2e 20 20 54 68 |iatric u|nit.  Th|
|00003d10| 65 20 65 66 66 65 63 74 | 73 20 6f 66 20 74 72 65 |e effect|s of tre|
|00003d20| 61 74 6d 65 6e 74 20 77 | 65 72 65 20 61 73 73 65 |atment w|ere asse|
|00003d30| 73 73 65 64 20 61 74 20 | 36 20 77 65 65 6b 73 20 |ssed at |6 weeks |
|00003d40| 61 6e 64 20 75 70 20 74 | 6f 0d 0a 31 20 79 65 61 |and up t|o..1 yea|
|00003d50| 72 2e 20 20 22 52 65 73 | 63 75 65 22 20 6d 65 64 |r.  "Res|cue" med|
|00003d60| 69 63 61 74 69 6f 6e 20 | 77 61 73 20 61 6c 6c 6f |ication |was allo|
|00003d70| 77 65 64 20 77 68 65 6e | 20 6e 65 65 64 65 64 2e |wed when| needed.|
|00003d80| 0d 0a 20 20 20 20 20 45 | 6c 65 76 65 6e 20 70 61 |..     E|leven pa|
|00003d90| 74 69 65 6e 74 73 20 67 | 69 76 65 6e 20 63 61 72 |tients g|iven car|
|00003da0| 62 61 6d 61 7a 65 70 69 | 6e 65 20 61 6e 64 20 31 |bamazepi|ne and 1|
|00003db0| 30 20 67 69 76 65 6e 20 | 6c 69 74 68 69 75 6d 20 |0 given |lithium |
|00003dc0| 64 72 6f 70 70 65 64 20 | 6f 75 74 2e 20 20 4e 6f |dropped |out.  No|
|00003dd0| 0d 0a 73 74 61 74 69 73 | 74 69 63 61 6c 6c 79 20 |..statis|tically |
|00003de0| 73 69 67 6e 69 66 69 63 | 61 6e 74 20 64 69 66 66 |signific|ant diff|
|00003df0| 65 72 65 6e 63 65 73 20 | 69 6e 20 6f 75 74 63 6f |erences |in outco|
|00003e00| 6d 65 73 20 77 65 72 65 | 20 66 6f 75 6e 64 20 62 |mes were| found b|
|00003e10| 65 74 77 65 65 6e 20 74 | 68 65 20 32 0d 0a 74 72 |etween t|he 2..tr|
|00003e20| 65 61 74 6d 65 6e 74 20 | 67 72 6f 75 70 73 2c 20 |eatment |groups, |
|00003e30| 62 75 74 20 63 61 72 62 | 61 6d 61 7a 65 70 69 6e |but carb|amazepin|
|00003e40| 65 20 61 70 70 65 61 72 | 65 64 20 74 6f 20 62 65 |e appear|ed to be|
|00003e50| 20 73 6c 69 67 68 74 6c | 79 20 6c 65 73 73 20 65 | slightl|y less e|
|00003e60| 66 66 65 63 74 69 76 65 | 20 61 73 0d 0a 61 20 74 |ffective| as..a t|
|00003e70| 72 65 61 74 6d 65 6e 74 | 20 66 6f 72 20 61 63 75 |reatment| for acu|
|00003e80| 74 65 20 6d 61 6e 69 61 | 20 61 6e 64 20 6d 6f 72 |te mania| and mor|
|00003e90| 65 20 65 66 66 65 63 74 | 69 76 65 20 61 73 20 70 |e effect|ive as p|
|00003ea0| 72 6f 70 68 79 6c 61 78 | 69 73 2e 0d 0a 20 20 20 |rophylax|is...   |
|00003eb0| 20 20 54 68 65 20 72 65 | 73 75 6c 74 73 20 73 75 |  The re|sults su|
|00003ec0| 67 67 65 73 74 20 74 68 | 61 74 20 6c 69 74 68 69 |ggest th|at lithi|
|00003ed0| 75 6d 20 73 68 6f 75 6c | 64 20 72 65 6d 61 69 6e |um shoul|d remain|
|00003ee0| 20 74 68 65 20 73 74 61 | 6e 64 61 72 64 20 6d 61 | the sta|ndard ma|
|00003ef0| 69 6e 74 65 6e 61 6e 63 | 65 0d 0a 74 72 65 61 74 |intenanc|e..treat|
|00003f00| 6d 65 6e 74 20 66 6f 72 | 20 6d 61 6e 69 63 2d 64 |ment for| manic-d|
|00003f10| 65 70 72 65 73 73 69 76 | 65 20 70 61 74 69 65 6e |epressiv|e patien|
|00003f20| 74 73 2c 20 62 75 74 20 | 63 61 72 62 61 6d 61 7a |ts, but |carbamaz|
|00003f30| 65 70 69 6e 65 20 69 73 | 20 61 20 75 73 65 66 75 |epine is| a usefu|
|00003f40| 6c 0d 0a 61 6c 74 65 72 | 6e 61 74 69 76 65 2c 20 |l..alter|native, |
|00003f50| 70 61 72 74 69 63 75 6c | 61 72 6c 79 20 66 6f 72 |particul|arly for|
|00003f60| 20 6d 65 6e 20 77 69 74 | 68 20 70 72 65 64 6f 6d | men wit|h predom|
|00003f70| 69 6e 61 6e 74 6c 79 20 | 65 75 70 68 6f 72 69 63 |inantly |euphoric|
|00003f80| 20 6f 72 20 67 72 61 6e | 64 69 6f 73 65 0d 0a 6d | or gran|diose..m|
|00003f90| 6f 6f 64 2e 20 20 4d 6f | 72 65 20 72 65 73 65 61 |ood.  Mo|re resea|
|00003fa0| 72 63 68 20 69 73 20 6e | 65 65 64 65 64 20 6f 6e |rch is n|eeded on|
|00003fb0| 20 70 72 65 64 69 63 74 | 6f 72 73 20 6f 66 20 69 | predict|ors of i|
|00003fc0| 6e 64 69 76 69 64 75 61 | 6c 20 72 65 73 70 6f 6e |ndividua|l respon|
|00003fd0| 73 69 76 65 6e 65 73 73 | 20 74 6f 0d 0a 6c 69 74 |siveness| to..lit|
|00003fe0| 68 69 75 6d 20 61 6e 64 | 20 63 61 72 62 61 6d 61 |hium and| carbama|
|00003ff0| 7a 65 70 69 6e 65 2e 0d | 0a 24 55 6e 69 71 75 65 |zepine..|.$Unique|
|00004000| 5f 49 44 7b 59 52 42 31 | 32 34 30 35 7d 0d 0a 24 |_ID{YRB1|2405}..$|
|00004010| 54 69 74 6c 65 7b 41 64 | 64 69 6e 67 20 4c 69 74 |Title{Ad|ding Lit|
|00004020| 68 69 75 6d 20 43 61 72 | 62 6f 6e 61 74 65 20 74 |hium Car|bonate t|
|00004030| 6f 20 43 61 72 62 61 6d | 61 7a 65 70 69 6e 65 3a |o Carbam|azepine:|
|00004040| 20 20 41 6e 74 69 6d 61 | 6e 69 63 20 45 66 66 69 |  Antima|nic Effi|
|00004050| 63 61 63 79 20 69 6e 20 | 54 72 65 61 74 6d 65 6e |cacy in |Treatmen|
|00004060| 74 2d 52 65 73 69 73 74 | 61 6e 74 20 4d 61 6e 69 |t-Resist|ant Mani|
|00004070| 61 7d 0d 0a 24 41 75 74 | 68 6f 72 7b 0d 0a 4b 72 |a}..$Aut|hor{..Kr|
|00004080| 61 6d 6c 69 6e 67 65 72 | 2c 20 4b 47 0d 0a 50 6f |amlinger|, KG..Po|
|00004090| 73 74 2c 20 52 4d 7d 0d | 0a 24 41 66 66 69 6c 69 |st, RM}.|.$Affili|
|000040a0| 61 74 69 6f 6e 7b 4e 61 | 74 6c 20 49 6e 73 74 20 |ation{Na|tl Inst |
|000040b0| 6f 66 20 4d 65 6e 74 61 | 6c 20 48 65 61 6c 74 68 |of Menta|l Health|
|000040c0| 2c 20 42 65 74 68 65 73 | 64 61 2c 20 4d 64 7d 0d |, Bethes|da, Md}.|
|000040d0| 0a 24 4a 6f 75 72 6e 61 | 6c 7b 41 63 74 61 20 50 |.$Journa|l{Acta P|
|000040e0| 73 79 63 68 69 61 74 72 | 20 53 63 61 6e 64 7d 0d |sychiatr| Scand}.|
|000040f0| 0a 24 56 6f 6c 75 6d 65 | 7b 37 39 7d 0d 0a 24 50 |.$Volume|{79}..$P|
|00004100| 61 67 65 7b 33 37 38 2d | 33 38 35 7d 0d 0a 24 44 |age{378-|385}..$D|
|00004110| 61 74 65 7b 41 70 72 69 | 6c 20 31 39 38 39 7d 0d |ate{Apri|l 1989}.|
|00004120| 0a 24 59 42 56 6f 6c 7b | 31 39 39 30 20 59 65 61 |.$YBVol{|1990 Yea|
|00004130| 72 20 42 6f 6f 6b 20 6f | 66 20 50 73 79 63 68 69 |r Book o|f Psychi|
|00004140| 61 74 72 79 20 61 6e 64 | 20 41 70 70 6c 69 65 64 |atry and| Applied|
|00004150| 20 4d 65 6e 74 61 6c 20 | 48 65 61 6c 74 68 7d 0d | Mental |Health}.|
|00004160| 0a 24 43 68 61 70 74 65 | 72 7b 37 2d 31 30 7d 0d |.$Chapte|r{7-10}.|
|00004170| 0a 24 59 42 45 64 69 74 | 6f 72 7b 44 72 73 2e 20 |.$YBEdit|or{Drs. |
|00004180| 54 61 6c 62 6f 74 74 2c | 20 46 72 61 6e 63 65 73 |Talbott,| Frances|
|00004190| 2c 20 46 72 61 6e 63 65 | 73 2c 20 46 72 65 65 64 |, France|s, Freed|
|000041a0| 6d 61 6e 2c 20 4d 65 6c | 74 7a 65 72 2c 20 53 63 |man, Mel|tzer, Sc|
|000041b0| 68 6f 77 61 6c 74 65 72 | 2c 20 61 6e 64 20 59 75 |howalter|, and Yu|
|000041c0| 64 6f 66 73 6b 79 7d 0d | 0a 24 54 61 62 6c 65 7b |dofsky}.|.$Table{|
|000041d0| 7d 0d 0a 24 43 6f 6d 6d | 65 6e 74 61 74 6f 72 7b |}..$Comm|entator{|
|000041e0| 7d 0d 0a 0d 0a 43 6f 70 | 79 72 69 67 68 74 20 28 |}....Cop|yright (|
|000041f0| 63 29 20 59 65 61 72 62 | 6f 6f 6b 20 4d 65 64 69 |c) Yearb|ook Medi|
|00004200| 63 61 6c 20 50 75 62 6c | 69 73 68 65 72 73 2c 20 |cal Publ|ishers, |
|00004210| 49 6e 63 2e 2c 20 31 39 | 39 30 0d 0a 0d 0a 31 39 |Inc., 19|90....19|
|00004220| 39 30 20 59 65 61 72 20 | 42 6f 6f 6b 20 6f 66 20 |90 Year |Book of |
|00004230| 50 73 79 63 68 69 61 74 | 72 79 20 61 6e 64 20 41 |Psychiat|ry and A|
|00004240| 70 70 6c 69 65 64 20 4d | 65 6e 74 61 6c 20 48 65 |pplied M|ental He|
|00004250| 61 6c 74 68 20 28 52 29 | 0d 0a 0d 0a 43 68 61 70 |alth (R)|....Chap|
|00004260| 74 65 72 20 37 2d 2d 50 | 73 79 63 68 6f 70 68 61 |ter 7--P|sychopha|
|00004270| 72 6d 61 63 6f 6c 6f 67 | 79 0d 0a 0d 0a 2d 2d 2d |rmacolog|y....---|
|00004280| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004290| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000042a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000042b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000042c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 0d 0a 41 64 64 |--------|---..Add|
|000042d0| 69 6e 67 20 4c 69 74 68 | 69 75 6d 20 43 61 72 62 |ing Lith|ium Carb|
|000042e0| 6f 6e 61 74 65 20 74 6f | 20 43 61 72 62 61 6d 61 |onate to| Carbama|
|000042f0| 7a 65 70 69 6e 65 3a 20 | 20 41 6e 74 69 6d 61 6e |zepine: | Antiman|
|00004300| 69 63 20 45 66 66 69 63 | 61 63 79 20 69 6e 0d 0a |ic Effic|acy in..|
|00004310| 54 72 65 61 74 6d 65 6e | 74 2d 52 65 73 69 73 74 |Treatmen|t-Resist|
|00004320| 61 6e 74 20 4d 61 6e 69 | 61 0d 0a 0d 0a 4b 72 61 |ant Mani|a....Kra|
|00004330| 6d 6c 69 6e 67 65 72 20 | 4b 47 2c 20 50 6f 73 74 |mlinger |KG, Post|
|00004340| 20 52 4d 0d 0a 28 4e 61 | 74 6c 20 49 6e 73 74 20 | RM..(Na|tl Inst |
|00004350| 6f 66 20 4d 65 6e 74 61 | 6c 20 48 65 61 6c 74 68 |of Menta|l Health|
|00004360| 2c 20 42 65 74 68 65 73 | 64 61 2c 20 4d 64 29 0d |, Bethes|da, Md).|
|00004370| 0a 41 63 74 61 20 50 73 | 79 63 68 69 61 74 72 20 |.Acta Ps|ychiatr |
|00004380| 53 63 61 6e 64 20 37 39 | 3a 33 37 38 2d 33 38 35 |Scand 79|:378-385|
|00004390| 2c 20 41 70 72 69 6c 20 | 31 39 38 39 0d 0a 2d 2d |, April |1989..--|
|000043a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000043b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000043c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000043d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000043e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 0d 0a 0d 0a |--------|----....|
|000043f0| 41 62 73 74 72 61 63 74 | 0d 0a 0d 0a 20 20 20 20 |Abstract|....    |
|00004400| 20 4c 69 74 68 69 75 6d | 20 61 6e 64 20 63 61 72 | Lithium| and car|
|00004410| 62 61 6d 61 7a 65 70 69 | 6e 65 20 75 73 65 64 20 |bamazepi|ne used |
|00004420| 61 6c 6f 6e 65 20 61 72 | 65 20 65 66 66 65 63 74 |alone ar|e effect|
|00004430| 69 76 65 20 69 6e 20 74 | 72 65 61 74 69 6e 67 20 |ive in t|reating |
|00004440| 61 63 75 74 65 0d 0a 6d | 61 6e 69 61 2c 20 62 75 |acute..m|ania, bu|
|00004450| 74 20 73 6f 6d 65 20 70 | 61 74 69 65 6e 74 73 20 |t some p|atients |
|00004460| 64 6f 20 6e 6f 74 20 72 | 65 73 70 6f 6e 64 20 61 |do not r|espond a|
|00004470| 64 65 71 75 61 74 65 6c | 79 20 74 6f 20 65 69 74 |dequatel|y to eit|
|00004480| 68 65 72 20 6f 66 20 74 | 68 65 6d 2e 20 20 54 68 |her of t|hem.  Th|
|00004490| 65 0d 0a 65 66 66 69 63 | 61 63 79 20 6f 66 20 6c |e..effic|acy of l|
|000044a0| 69 74 68 69 75 6d 20 73 | 75 70 70 6c 65 6d 65 6e |ithium s|upplemen|
|000044b0| 74 61 74 69 6f 6e 20 6f | 66 20 63 61 72 62 61 6d |tation o|f carbam|
|000044c0| 61 7a 65 70 69 6e 65 20 | 77 61 73 20 61 73 73 65 |azepine |was asse|
|000044d0| 73 73 65 64 20 69 6e 20 | 37 20 6d 61 6e 69 63 0d |ssed in |7 manic.|
|000044e0| 0a 70 61 74 69 65 6e 74 | 73 20 70 72 65 76 69 6f |.patient|s previo|
|000044f0| 75 73 6c 79 20 72 65 66 | 72 61 63 74 6f 72 79 20 |usly ref|ractory |
|00004500| 74 6f 20 6c 69 74 68 69 | 75 6d 20 61 6c 6f 6e 65 |to lithi|um alone|
|00004510| 20 77 68 6f 20 73 74 69 | 6c 6c 20 73 68 6f 77 65 | who sti|ll showe|
|00004520| 64 20 73 75 62 73 74 61 | 6e 74 69 61 6c 0d 0a 64 |d substa|ntial..d|
|00004530| 65 67 72 65 65 73 20 6f | 66 20 6d 61 6e 69 61 20 |egrees o|f mania |
|00004540| 61 66 74 65 72 20 73 65 | 76 65 72 61 6c 20 77 65 |after se|veral we|
|00004550| 65 6b 73 20 6f 66 20 64 | 6f 75 62 6c 65 2d 62 6c |eks of d|ouble-bl|
|00004560| 69 6e 64 20 74 72 65 61 | 74 6d 65 6e 74 20 77 69 |ind trea|tment wi|
|00004570| 74 68 0d 0a 63 61 72 62 | 61 6d 61 7a 65 70 69 6e |th..carb|amazepin|
|00004580| 65 2e 20 41 6c 6c 20 37 | 20 6d 65 74 20 74 68 65 |e. All 7| met the|
|00004590| 20 44 53 4d 2d 49 49 49 | 20 63 72 69 74 65 72 69 | DSM-III| criteri|
|000045a0| 61 20 66 6f 72 20 6d 61 | 6a 6f 72 20 61 66 66 65 |a for ma|jor affe|
|000045b0| 63 74 69 76 65 20 64 69 | 73 6f 72 64 65 72 2e 0d |ctive di|sorder..|
|000045c0| 0a 20 20 20 20 20 41 66 | 74 65 72 20 61 20 70 6c |.     Af|ter a pl|
|000045d0| 61 63 65 62 6f 20 70 65 | 72 69 6f 64 20 74 72 65 |acebo pe|riod tre|
|000045e0| 61 74 6d 65 6e 74 20 77 | 69 74 68 20 63 61 72 62 |atment w|ith carb|
|000045f0| 61 6d 61 7a 65 70 69 6e | 65 2c 20 32 30 30 2d 34 |amazepin|e, 200-4|
|00004600| 30 30 20 6d 67 2f 64 61 | 79 2c 20 77 61 73 0d 0a |00 mg/da|y, was..|
|00004610| 62 65 67 75 6e 20 6f 6e | 20 61 20 62 6c 69 6e 64 |begun on| a blind|
|00004620| 20 62 61 73 69 73 20 61 | 6e 64 20 73 6c 6f 77 6c | basis a|nd slowl|
|00004630| 79 20 69 6e 63 72 65 61 | 73 65 64 20 75 6e 74 69 |y increa|sed unti|
|00004640| 6c 20 63 6c 69 6e 69 63 | 61 6c 20 72 65 73 70 6f |l clinic|al respo|
|00004650| 6e 73 65 20 6f 63 63 75 | 72 72 65 64 2c 0d 0a 73 |nse occu|rred,..s|
|00004660| 69 64 65 20 65 66 66 65 | 63 74 73 20 73 75 70 65 |ide effe|cts supe|
|00004670| 72 76 65 6e 65 64 2c 20 | 6f 72 20 61 20 64 6f 73 |rvened, |or a dos|
|00004680| 65 20 6f 66 20 31 2c 36 | 30 30 20 6d 67 2f 64 61 |e of 1,6|00 mg/da|
|00004690| 79 20 77 61 73 20 72 65 | 61 63 68 65 64 2e 20 20 |y was re|ached.  |
|000046a0| 4c 69 74 68 69 75 6d 0d | 0a 63 61 72 62 6f 6e 61 |Lithium.|.carbona|
|000046b0| 74 65 20 77 61 73 20 62 | 65 67 75 6e 20 6f 6e 20 |te was b|egun on |
|000046c0| 61 20 62 6c 69 6e 64 20 | 62 61 73 69 73 20 61 6e |a blind |basis an|
|000046d0| 64 20 77 61 73 20 73 75 | 62 73 74 69 74 75 74 65 |d was su|bstitute|
|000046e0| 64 20 66 6f 72 20 70 6c | 61 63 65 62 6f 20 61 74 |d for pl|acebo at|
|000046f0| 20 64 6f 73 65 73 0d 0a | 6f 66 20 33 30 30 2d 36 | doses..|of 300-6|
|00004700| 30 30 20 6d 67 2f 64 61 | 79 2e 20 20 54 68 69 73 |00 mg/da|y.  This|
|00004710| 20 77 61 73 20 73 6c 6f | 77 6c 79 20 69 6e 63 72 | was slo|wly incr|
|00004720| 65 61 73 65 64 20 75 6e | 74 69 6c 20 63 6c 69 6e |eased un|til clin|
|00004730| 69 63 61 6c 20 72 65 73 | 70 6f 6e 73 65 0d 0a 6f |ical res|ponse..o|
|00004740| 63 63 75 72 72 65 64 2c | 20 73 69 64 65 20 65 66 |ccurred,| side ef|
|00004750| 66 65 63 74 73 20 73 75 | 70 65 72 76 65 6e 65 64 |fects su|pervened|
|00004760| 2c 20 6f 72 20 61 20 70 | 6c 61 73 6d 61 20 6c 65 |, or a p|lasma le|
|00004770| 76 65 6c 20 6f 66 20 30 | 2e 37 2d 31 2e 32 20 6d |vel of 0|.7-1.2 m|
|00004780| 45 71 2f 4c 20 77 61 73 | 0d 0a 72 65 61 63 68 65 |Eq/L was|..reache|
|00004790| 64 2e 0d 0a 20 20 20 20 | 20 53 69 78 20 70 61 74 |d...    | Six pat|
|000047a0| 69 65 6e 74 73 20 28 38 | 36 25 29 20 69 6d 70 72 |ients (8|6%) impr|
|000047b0| 6f 76 65 64 2c 20 35 20 | 68 61 64 20 63 6f 6d 70 |oved, 5 |had comp|
|000047c0| 6c 65 74 65 20 72 65 73 | 6f 6c 75 74 69 6f 6e 20 |lete res|olution |
|000047d0| 6f 66 20 6d 61 6e 69 61 | 2e 20 20 4e 6f 6e 65 20 |of mania|.  None |
|000047e0| 6f 66 0d 0a 74 68 65 20 | 70 61 74 69 65 6e 74 73 |of..the |patients|
|000047f0| 20 62 65 63 61 6d 65 20 | 64 65 70 72 65 73 73 65 | became |depresse|
|00004800| 64 2e 20 20 54 68 65 20 | 6d 65 61 6e 20 6d 61 6e |d.  The |mean man|
|00004810| 69 61 20 72 61 74 69 6e | 67 73 20 64 72 6f 70 70 |ia ratin|gs dropp|
|00004820| 65 64 20 66 72 6f 6d 20 | 34 2e 35 20 69 6e 20 74 |ed from |4.5 in t|
|00004830| 68 65 0d 0a 6c 61 73 74 | 20 77 65 65 6b 20 6f 66 |he..last| week of|
|00004840| 20 63 61 72 62 61 6d 61 | 7a 65 70 69 6e 65 20 6d | carbama|zepine m|
|00004850| 6f 6e 6f 74 68 65 72 61 | 70 79 20 74 6f 20 31 2e |onothera|py to 1.|
|00004860| 39 20 69 6e 20 74 68 65 | 20 74 68 69 72 64 20 77 |9 in the| third w|
|00004870| 65 65 6b 20 6f 66 0d 0a | 73 75 70 70 6c 65 6d 65 |eek of..|suppleme|
|00004880| 6e 74 61 74 69 6f 6e 20 | 77 69 74 68 20 6c 69 74 |ntation |with lit|
|00004890| 68 69 75 6d 20 63 61 72 | 62 6f 6e 61 74 65 2e 20 |hium car|bonate. |
|000048a0| 20 54 68 65 20 6d 65 61 | 6e 20 64 6f 73 65 20 6f | The mea|n dose o|
|000048b0| 66 20 6c 69 74 68 69 75 | 6d 20 63 61 72 62 6f 6e |f lithiu|m carbon|
|000048c0| 61 74 65 20 69 6e 0d 0a | 74 68 65 20 66 69 72 73 |ate in..|the firs|
|000048d0| 74 20 77 65 65 6b 20 6f | 66 20 63 6f 6d 62 69 6e |t week o|f combin|
|000048e0| 61 74 69 6f 6e 20 74 72 | 65 61 74 6d 65 6e 74 2c |ation tr|eatment,|
|000048f0| 20 31 2c 30 30 37 20 6d | 67 2f 64 61 79 20 77 61 | 1,007 m|g/day wa|
|00004900| 73 20 69 6e 63 72 65 61 | 73 65 64 20 74 6f 20 31 |s increa|sed to 1|
|00004910| 2c 31 37 31 0d 0a 6d 67 | 2f 64 61 79 20 69 6e 20 |,171..mg|/day in |
|00004920| 74 68 65 20 73 65 63 6f | 6e 64 20 77 65 65 6b 2e |the seco|nd week.|
|00004930| 0d 0a 20 20 20 20 20 49 | 66 20 74 68 65 73 65 20 |..     I|f these |
|00004940| 66 69 6e 64 69 6e 67 73 | 20 61 72 65 20 73 75 70 |findings| are sup|
|00004950| 70 6f 72 74 65 64 20 62 | 79 20 6f 74 68 65 72 20 |ported b|y other |
|00004960| 73 74 75 64 69 65 73 2c | 20 61 74 74 65 6e 74 69 |studies,| attenti|
|00004970| 6f 6e 20 73 68 6f 75 6c | 64 20 62 65 0d 0a 67 69 |on shoul|d be..gi|
|00004980| 76 65 6e 20 74 6f 20 77 | 68 65 74 68 65 72 20 70 |ven to w|hether p|
|00004990| 61 74 69 65 6e 74 73 20 | 77 68 6f 20 72 65 71 75 |atients |who requ|
|000049a0| 69 72 65 20 63 6f 6d 62 | 69 6e 61 74 69 6f 6e 20 |ire comb|ination |
|000049b0| 74 68 65 72 61 70 79 20 | 68 61 76 65 20 61 20 73 |therapy |have a s|
|000049c0| 75 62 74 79 70 65 20 6f | 66 0d 0a 62 69 70 6f 6c |ubtype o|f..bipol|
|000049d0| 61 72 20 61 66 66 65 63 | 74 69 76 65 20 64 69 73 |ar affec|tive dis|
|000049e0| 6f 72 64 65 72 20 74 68 | 61 74 20 69 73 20 72 65 |order th|at is re|
|000049f0| 73 69 73 74 61 6e 74 20 | 74 6f 20 62 6f 74 68 20 |sistant |to both |
|00004a00| 61 67 65 6e 74 73 20 61 | 6c 6f 6e 65 20 66 72 6f |agents a|lone fro|
|00004a10| 6d 20 6f 6e 73 65 74 0d | 0a 6f 66 20 64 69 73 65 |m onset.|.of dise|
|00004a20| 61 73 65 2c 20 6f 72 20 | 77 68 65 74 68 65 72 20 |ase, or |whether |
|00004a30| 74 68 69 73 20 72 65 73 | 69 73 74 61 6e 63 65 20 |this res|istance |
|00004a40| 65 76 6f 6c 76 65 73 20 | 77 69 74 68 20 74 68 65 |evolves |with the|
|00004a50| 20 63 6f 75 72 73 65 20 | 6f 66 20 69 6c 6c 6e 65 | course |of illne|
|00004a60| 73 73 2e 0d 0a 24 55 6e | 69 71 75 65 5f 49 44 7b |ss...$Un|ique_ID{|
|00004a70| 59 52 42 31 32 34 30 36 | 7d 0d 0a 24 54 69 74 6c |YRB12406|}..$Titl|
|00004a80| 65 7b 44 6f 75 62 6c 65 | 62 6c 69 6e 64 20 45 76 |e{Double|blind Ev|
|00004a90| 61 6c 75 61 74 69 6f 6e | 20 6f 66 20 74 68 65 20 |aluation| of the |
|00004aa0| 41 6e 74 69 6d 61 6e 69 | 63 20 50 72 6f 70 65 72 |Antimani|c Proper|
|00004ab0| 74 69 65 73 20 6f 66 20 | 43 61 72 62 61 6d 61 7a |ties of |Carbamaz|
|00004ac0| 65 70 69 6e 65 20 61 73 | 20 61 20 43 6f 6d 65 64 |epine as| a Comed|
|00004ad0| 69 63 61 74 69 6f 6e 20 | 74 6f 20 48 61 6c 6f 70 |ication |to Halop|
|00004ae0| 65 72 69 64 6f 6c 7d 0d | 0a 24 41 75 74 68 6f 72 |eridol}.|.$Author|
|00004af0| 7b 0d 0a 4d 6f 6c 6c 65 | 72 2c 20 48 2d 4a 0d 0a |{..Molle|r, H-J..|
|00004b00| 4b 69 73 73 6c 69 6e 67 | 2c 20 57 0d 0a 52 69 65 |Kissling|, W..Rie|
|00004b10| 68 6c 2c 20 54 0d 0a 42 | 61 75 6d 6c 2c 20 4a 0d |hl, T..B|auml, J.|
|00004b20| 0a 42 69 6e 7a 2c 20 55 | 0d 0a 57 65 6e 64 74 2c |.Binz, U|..Wendt,|
|00004b30| 20 47 7d 0d 0a 24 41 66 | 66 69 6c 69 61 74 69 6f | G}..$Af|filiatio|
|00004b40| 6e 7b 54 65 63 68 6e 69 | 63 61 6c 20 55 6e 69 76 |n{Techni|cal Univ|
|00004b50| 2c 20 4d 75 6e 69 63 68 | 3b 20 43 69 62 61 20 47 |, Munich|; Ciba G|
|00004b60| 65 69 67 79 2c 20 46 72 | 61 6e 6b 66 75 72 74 2c |eigy, Fr|ankfurt,|
|00004b70| 20 57 65 73 74 20 47 65 | 72 6d 61 6e 79 7d 0d 0a | West Ge|rmany}..|
|00004b80| 24 4a 6f 75 72 6e 61 6c | 7b 50 72 6f 67 20 4e 65 |$Journal|{Prog Ne|
|00004b90| 75 72 6f 70 73 79 63 68 | 6f 70 68 61 72 6d 61 63 |uropsych|opharmac|
|00004ba0| 6f 6c 20 42 69 6f 6c 20 | 50 73 79 63 68 69 61 74 |ol Biol |Psychiat|
|00004bb0| 72 79 7d 0d 0a 24 56 6f | 6c 75 6d 65 7b 31 33 7d |ry}..$Vo|lume{13}|
|00004bc0| 0d 0a 24 50 61 67 65 7b | 31 32 37 2d 31 33 36 7d |..$Page{|127-136}|
|00004bd0| 0d 0a 24 44 61 74 65 7b | 31 39 38 39 7d 0d 0a 24 |..$Date{|1989}..$|
|00004be0| 59 42 56 6f 6c 7b 31 39 | 39 30 20 59 65 61 72 20 |YBVol{19|90 Year |
|00004bf0| 42 6f 6f 6b 20 6f 66 20 | 50 73 79 63 68 69 61 74 |Book of |Psychiat|
|00004c00| 72 79 20 61 6e 64 20 41 | 70 70 6c 69 65 64 20 4d |ry and A|pplied M|
|00004c10| 65 6e 74 61 6c 20 48 65 | 61 6c 74 68 7d 0d 0a 24 |ental He|alth}..$|
|00004c20| 43 68 61 70 74 65 72 7b | 37 2d 31 31 7d 0d 0a 24 |Chapter{|7-11}..$|
|00004c30| 59 42 45 64 69 74 6f 72 | 7b 44 72 73 2e 20 54 61 |YBEditor|{Drs. Ta|
|00004c40| 6c 62 6f 74 74 2c 20 46 | 72 61 6e 63 65 73 2c 20 |lbott, F|rances, |
|00004c50| 46 72 61 6e 63 65 73 2c | 20 46 72 65 65 64 6d 61 |Frances,| Freedma|
|00004c60| 6e 2c 20 4d 65 6c 74 7a | 65 72 2c 20 53 63 68 6f |n, Meltz|er, Scho|
|00004c70| 77 61 6c 74 65 72 2c 20 | 61 6e 64 20 59 75 64 6f |walter, |and Yudo|
|00004c80| 66 73 6b 79 7d 0d 0a 24 | 54 61 62 6c 65 7b 7d 0d |fsky}..$|Table{}.|
|00004c90| 0a 24 43 6f 6d 6d 65 6e | 74 61 74 6f 72 7b 44 2e |.$Commen|tator{D.|
|00004ca0| 58 2e 20 46 72 65 65 64 | 6d 61 6e 2c 20 4d 2e 44 |X. Freed|man, M.D|
|00004cb0| 2e 7d 0d 0a 0d 0a 43 6f | 70 79 72 69 67 68 74 20 |.}....Co|pyright |
|00004cc0| 28 63 29 20 59 65 61 72 | 62 6f 6f 6b 20 4d 65 64 |(c) Year|book Med|
|00004cd0| 69 63 61 6c 20 50 75 62 | 6c 69 73 68 65 72 73 2c |ical Pub|lishers,|
|00004ce0| 20 49 6e 63 2e 2c 20 31 | 39 39 30 0d 0a 0d 0a 31 | Inc., 1|990....1|
|00004cf0| 39 39 30 20 59 65 61 72 | 20 42 6f 6f 6b 20 6f 66 |990 Year| Book of|
|00004d00| 20 50 73 79 63 68 69 61 | 74 72 79 20 61 6e 64 20 | Psychia|try and |
|00004d10| 41 70 70 6c 69 65 64 20 | 4d 65 6e 74 61 6c 20 48 |Applied |Mental H|
|00004d20| 65 61 6c 74 68 20 28 52 | 29 0d 0a 0d 0a 43 68 61 |ealth (R|)....Cha|
|00004d30| 70 74 65 72 20 37 2d 2d | 50 73 79 63 68 6f 70 68 |pter 7--|Psychoph|
|00004d40| 61 72 6d 61 63 6f 6c 6f | 67 79 0d 0a 0d 0a 2d 2d |armacolo|gy....--|
|00004d50| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004d60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004d70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004d80| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004d90| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 0d 0a 44 6f |--------|----..Do|
|00004da0| 75 62 6c 65 62 6c 69 6e | 64 20 45 76 61 6c 75 61 |ubleblin|d Evalua|
|00004db0| 74 69 6f 6e 20 6f 66 20 | 74 68 65 20 41 6e 74 69 |tion of |the Anti|
|00004dc0| 6d 61 6e 69 63 20 50 72 | 6f 70 65 72 74 69 65 73 |manic Pr|operties|
|00004dd0| 20 6f 66 20 43 61 72 62 | 61 6d 61 7a 65 70 69 6e | of Carb|amazepin|
|00004de0| 65 20 61 73 20 61 0d 0a | 43 6f 6d 65 64 69 63 61 |e as a..|Comedica|
|00004df0| 74 69 6f 6e 20 74 6f 20 | 48 61 6c 6f 70 65 72 69 |tion to |Haloperi|
|00004e00| 64 6f 6c 0d 0a 0d 0a 4d | 6f 6c 6c 65 72 20 48 2d |dol....M|oller H-|
|00004e10| 4a 2c 20 4b 69 73 73 6c | 69 6e 67 20 57 2c 20 52 |J, Kissl|ing W, R|
|00004e20| 69 65 68 6c 20 54 2c 20 | 42 61 75 6d 6c 20 4a 2c |iehl T, |Bauml J,|
|00004e30| 20 42 69 6e 7a 20 55 2c | 20 57 65 6e 64 74 20 47 | Binz U,| Wendt G|
|00004e40| 0d 0a 28 54 65 63 68 6e | 69 63 61 6c 20 55 6e 69 |..(Techn|ical Uni|
|00004e50| 76 2c 20 4d 75 6e 69 63 | 68 3b 20 43 69 62 61 20 |v, Munic|h; Ciba |
|00004e60| 47 65 69 67 79 2c 20 46 | 72 61 6e 6b 66 75 72 74 |Geigy, F|rankfurt|
|00004e70| 2c 20 57 65 73 74 20 47 | 65 72 6d 61 6e 79 29 0d |, West G|ermany).|
|00004e80| 0a 50 72 6f 67 20 4e 65 | 75 72 6f 70 73 79 63 68 |.Prog Ne|uropsych|
|00004e90| 6f 70 68 61 72 6d 61 63 | 6f 6c 20 42 69 6f 6c 20 |opharmac|ol Biol |
|00004ea0| 50 73 79 63 68 69 61 74 | 72 79 20 31 33 3a 31 32 |Psychiat|ry 13:12|
|00004eb0| 37 2d 31 33 36 2c 20 31 | 39 38 39 0d 0a 2d 2d 2d |7-136, 1|989..---|
|00004ec0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004ed0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004ee0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004ef0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004f00| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 0d 0a 0d 0a 41 |--------|---....A|
|00004f10| 62 73 74 72 61 63 74 0d | 0a 0d 0a 20 20 20 20 20 |bstract.|...     |
|00004f20| 43 61 72 62 61 6d 61 7a | 65 70 69 6e 65 20 69 73 |Carbamaz|epine is|
|00004f30| 20 63 75 72 72 65 6e 74 | 6c 79 20 74 68 65 20 6d | current|ly the m|
|00004f40| 6f 73 74 20 69 6d 70 6f | 72 74 61 6e 74 20 61 6c |ost impo|rtant al|
|00004f50| 74 65 72 6e 61 74 69 76 | 65 20 74 6f 20 6e 65 75 |ternativ|e to neu|
|00004f60| 72 6f 6c 65 70 74 69 63 | 0d 0a 64 72 75 67 73 20 |roleptic|..drugs |
|00004f70| 66 6f 72 20 74 72 65 61 | 74 69 6e 67 20 70 61 74 |for trea|ting pat|
|00004f80| 69 65 6e 74 73 20 77 69 | 74 68 20 6d 61 6e 69 63 |ients wi|th manic|
|00004f90| 20 70 73 79 63 68 6f 73 | 65 73 2c 20 61 6e 64 20 | psychos|es, and |
|00004fa0| 6f 66 74 65 6e 20 69 74 | 20 69 73 20 67 69 76 65 |often it| is give|
|00004fb0| 6e 20 61 73 20 61 0d 0a | 63 6f 2d 6d 65 64 69 63 |n as a..|co-medic|
|00004fc0| 61 74 69 6f 6e 20 77 69 | 74 68 20 61 20 6e 65 75 |ation wi|th a neu|
|00004fd0| 72 6f 6c 65 70 74 69 63 | 20 61 67 65 6e 74 2e 20 |roleptic| agent. |
|00004fe0| 20 54 6f 20 64 65 74 65 | 72 6d 69 6e 65 20 77 68 | To dete|rmine wh|
|00004ff0| 65 74 68 65 72 20 63 61 | 72 62 61 6d 61 7a 65 70 |ether ca|rbamazep|
|00005000| 69 6e 65 0d 0a 61 6e 64 | 20 68 61 6c 6f 70 65 72 |ine..and| haloper|
|00005010| 69 64 6f 6c 20 69 6e 20 | 63 6f 6d 62 69 6e 61 74 |idol in |combinat|
|00005020| 69 6f 6e 20 61 72 65 20 | 6d 6f 72 65 20 65 66 66 |ion are |more eff|
|00005030| 65 63 74 69 76 65 20 74 | 68 61 6e 20 68 61 6c 6f |ective t|han halo|
|00005040| 70 65 72 69 64 6f 6c 20 | 61 6c 6f 6e 65 2c 20 32 |peridol |alone, 2|
|00005050| 30 0d 0a 70 61 74 69 65 | 6e 74 73 20 77 69 74 68 |0..patie|nts with|
|00005060| 20 61 20 64 69 61 67 6e | 6f 73 69 73 20 6f 66 20 | a diagn|osis of |
|00005070| 61 63 75 74 65 20 6d 61 | 6e 69 61 20 6f 72 20 73 |acute ma|nia or s|
|00005080| 63 68 69 7a 6f 6d 61 6e | 69 63 20 73 79 6e 64 72 |chizoman|ic syndr|
|00005090| 6f 6d 65 20 70 61 72 74 | 69 63 69 70 61 74 65 64 |ome part|icipated|
|000050a0| 0d 0a 69 6e 20 61 20 64 | 6f 75 62 6c 65 2d 62 6c |..in a d|ouble-bl|
|000050b0| 69 6e 64 2c 20 72 61 6e | 64 6f 6d 69 7a 65 64 20 |ind, ran|domized |
|000050c0| 73 74 75 64 79 2e 20 20 | 45 6c 65 76 65 6e 20 77 |study.  |Eleven w|
|000050d0| 65 72 65 20 74 72 65 61 | 74 65 64 20 66 6f 72 20 |ere trea|ted for |
|000050e0| 33 20 77 65 65 6b 73 20 | 77 69 74 68 20 32 34 0d |3 weeks |with 24.|
|000050f0| 0a 6d 67 20 6f 66 20 68 | 61 6c 6f 70 65 72 69 64 |.mg of h|aloperid|
|00005100| 6f 6c 20 61 6e 64 20 36 | 30 30 20 6d 67 20 6f 66 |ol and 6|00 mg of|
|00005110| 20 63 61 72 62 61 6d 61 | 7a 65 70 69 6e 65 20 70 | carbama|zepine p|
|00005120| 65 72 20 64 61 79 3b 20 | 39 20 77 65 72 65 20 74 |er day; |9 were t|
|00005130| 72 65 61 74 65 64 20 77 | 69 74 68 20 74 68 65 0d |reated w|ith the.|
|00005140| 0a 73 61 6d 65 20 64 6f | 73 65 20 6f 66 20 68 61 |.same do|se of ha|
|00005150| 6c 6f 70 65 72 69 64 6f | 6c 20 69 6e 20 63 6f 6d |loperido|l in com|
|00005160| 62 69 6e 61 74 69 6f 6e | 20 77 69 74 68 20 61 20 |bination| with a |
|00005170| 70 6c 61 63 65 62 6f 2e | 20 20 41 64 64 69 74 69 |placebo.|  Additi|
|00005180| 6f 6e 61 6c 20 74 72 65 | 61 74 6d 65 6e 74 0d 0a |onal tre|atment..|
|00005190| 77 69 74 68 20 6c 65 76 | 6f 6d 65 70 72 6f 6d 61 |with lev|omeproma|
|000051a0| 7a 69 6e 65 20 77 61 73 | 20 70 65 72 6d 69 74 74 |zine was| permitt|
|000051b0| 65 64 20 69 6e 20 62 6f | 74 68 20 67 72 6f 75 70 |ed in bo|th group|
|000051c0| 73 2e 0d 0a 20 20 20 20 | 20 54 68 65 20 63 6f 75 |s...    | The cou|
|000051d0| 72 73 65 20 6f 66 20 6d | 65 61 6e 20 76 61 6c 75 |rse of m|ean valu|
|000051e0| 65 73 20 6f 66 20 74 68 | 65 20 6d 61 6e 69 63 20 |es of th|e manic |
|000051f0| 73 63 6f 72 65 73 20 73 | 68 6f 77 65 64 20 61 20 |scores s|howed a |
|00005200| 68 69 67 68 6c 79 20 73 | 69 67 6e 69 66 69 63 61 |highly s|ignifica|
|00005210| 6e 74 0d 0a 61 6e 74 69 | 6d 61 6e 69 63 20 65 66 |nt..anti|manic ef|
|00005220| 66 65 63 74 20 69 6e 20 | 62 6f 74 68 20 67 72 6f |fect in |both gro|
|00005230| 75 70 73 2e 20 20 54 68 | 65 72 65 20 77 61 73 20 |ups.  Th|ere was |
|00005240| 6e 6f 20 61 64 76 61 6e | 74 61 67 65 20 74 6f 20 |no advan|tage to |
|00005250| 63 6f 2d 6d 65 64 69 63 | 61 74 69 6f 6e 20 77 69 |co-medic|ation wi|
|00005260| 74 68 0d 0a 63 61 72 62 | 61 6d 61 7a 65 70 69 6e |th..carb|amazepin|
|00005270| 65 20 77 68 65 6e 20 63 | 6f 6d 70 61 72 65 64 20 |e when c|ompared |
|00005280| 77 69 74 68 20 68 61 6c | 6f 70 65 72 69 64 6f 6c |with hal|operidol|
|00005290| 20 6d 6f 6e 6f 74 68 65 | 72 61 70 79 2e 20 20 4f | monothe|rapy.  O|
|000052a0| 6e 6c 79 20 74 68 65 20 | 73 6d 61 6c 6c 65 72 0d |nly the |smaller.|
|000052b0| 0a 61 6d 6f 75 6e 74 20 | 6f 66 20 6c 65 76 6f 6d |.amount |of levom|
|000052c0| 65 70 72 6f 6d 61 7a 69 | 6e 65 20 75 73 65 64 20 |epromazi|ne used |
|000052d0| 62 79 20 74 68 65 20 70 | 61 74 69 65 6e 74 73 20 |by the p|atients |
|000052e0| 77 68 6f 20 72 65 63 65 | 69 76 65 64 20 62 6f 74 |who rece|ived bot|
|000052f0| 68 20 68 61 6c 6f 70 65 | 72 69 64 6f 6c 0d 0a 61 |h halope|ridol..a|
|00005300| 6e 64 20 63 61 72 62 61 | 6d 61 7a 65 70 69 6e 65 |nd carba|mazepine|
|00005310| 20 67 61 76 65 20 65 76 | 69 64 65 6e 63 65 20 6f | gave ev|idence o|
|00005320| 66 20 61 6e 20 61 6e 74 | 69 6d 61 6e 69 63 20 65 |f an ant|imanic e|
|00005330| 66 66 65 63 74 20 6f 66 | 20 74 68 65 20 63 6f 2d |ffect of| the co-|
|00005340| 6d 65 64 69 63 61 74 69 | 6f 6e 2e 0d 0a 50 61 74 |medicati|on...Pat|
|00005350| 69 65 6e 74 73 20 77 69 | 74 68 20 70 75 72 65 20 |ients wi|th pure |
|00005360| 6d 61 6e 69 63 20 70 73 | 79 63 68 6f 73 65 73 20 |manic ps|ychoses |
|00005370| 73 65 65 6d 65 64 20 74 | 6f 20 62 65 6e 65 66 69 |seemed t|o benefi|
|00005380| 74 20 66 72 6f 6d 20 63 | 61 72 62 61 6d 61 7a 65 |t from c|arbamaze|
|00005390| 70 69 6e 65 20 61 73 20 | 61 6e 0d 0a 61 64 6a 75 |pine as |an..adju|
|000053a0| 6e 63 74 20 74 6f 20 68 | 61 6c 6f 70 65 72 69 64 |nct to h|aloperid|
|000053b0| 6f 6c 2e 0d 0a 20 20 20 | 20 20 4d 61 72 6b 65 64 |ol...   |  Marked|
|000053c0| 20 73 79 6d 70 74 6f 6d | 20 72 65 64 75 63 74 69 | symptom| reducti|
|000053d0| 6f 6e 20 77 61 73 20 6f | 62 73 65 72 76 65 64 20 |on was o|bserved |
|000053e0| 69 6e 20 70 61 74 69 65 | 6e 74 73 20 75 6e 64 65 |in patie|nts unde|
|000053f0| 72 20 62 6f 74 68 20 74 | 72 65 61 74 6d 65 6e 74 |r both t|reatment|
|00005400| 0d 0a 63 6f 6e 64 69 74 | 69 6f 6e 73 2e 20 20 54 |..condit|ions.  T|
|00005410| 68 65 20 73 74 75 64 79 | 20 63 6f 75 6c 64 20 6e |he study| could n|
|00005420| 6f 74 20 70 72 6f 76 65 | 20 61 6e 20 61 6e 74 69 |ot prove| an anti|
|00005430| 6d 61 6e 69 63 20 65 66 | 66 65 63 74 20 6f 66 20 |manic ef|fect of |
|00005440| 63 6f 2d 6d 65 64 69 63 | 61 74 69 6f 6e 0d 0a 77 |co-medic|ation..w|
|00005450| 69 74 68 20 63 61 72 62 | 61 6d 61 7a 65 70 69 6e |ith carb|amazepin|
|00005460| 65 20 62 65 63 61 75 73 | 65 20 61 64 64 69 74 69 |e becaus|e additi|
|00005470| 6f 6e 61 6c 20 6d 65 64 | 69 63 61 74 69 6f 6e 20 |onal med|ication |
|00005480| 77 69 74 68 20 6c 65 76 | 6f 6d 65 70 72 6f 6d 61 |with lev|omeproma|
|00005490| 7a 69 6e 65 20 77 61 73 | 0d 0a 61 64 6d 69 6e 69 |zine was|..admini|
|000054a0| 73 74 65 72 65 64 20 67 | 65 6e 65 72 6f 75 73 6c |stered g|enerousl|
|000054b0| 79 2c 20 64 65 70 65 6e | 64 69 6e 67 20 6f 6e 20 |y, depen|ding on |
|000054c0| 63 6c 69 6e 69 63 61 6c | 20 6e 65 65 64 73 2e 20 |clinical| needs. |
|000054d0| 20 54 68 65 20 61 6e 74 | 69 6d 61 6e 69 63 20 65 | The ant|imanic e|
|000054e0| 66 66 65 63 74 20 6f 66 | 0d 0a 63 61 72 62 61 6d |ffect of|..carbam|
|000054f0| 61 7a 65 70 69 6e 65 20 | 74 68 75 73 20 68 61 64 |azepine |thus had|
|00005500| 20 74 6f 20 62 65 20 64 | 65 72 69 76 65 64 20 62 | to be d|erived b|
|00005510| 79 20 63 6f 6d 70 61 72 | 69 6e 67 20 74 68 65 20 |y compar|ing the |
|00005520| 64 69 66 66 65 72 65 6e | 63 65 73 20 69 6e 20 74 |differen|ces in t|
|00005530| 68 65 0d 0a 61 64 64 69 | 74 69 6f 6e 61 6c 20 6d |he..addi|tional m|
|00005540| 65 64 69 63 61 74 69 6f | 6e 20 77 69 74 68 20 6c |edicatio|n with l|
|00005550| 65 76 6f 70 72 6f 6d 61 | 7a 69 6e 65 2c 20 74 68 |evoproma|zine, th|
|00005560| 65 20 61 6d 6f 75 6e 74 | 20 6f 66 20 77 68 69 63 |e amount| of whic|
|00005570| 68 20 77 61 73 20 6d 75 | 63 68 20 73 6d 61 6c 6c |h was mu|ch small|
|00005580| 65 72 0d 0a 69 6e 20 74 | 68 65 20 67 72 6f 75 70 |er..in t|he group|
|00005590| 20 74 68 61 74 20 72 65 | 63 65 69 76 65 64 20 63 | that re|ceived c|
|000055a0| 61 72 62 61 6d 61 7a 65 | 70 69 6e 65 2e 0d 0a 0d |arbamaze|pine....|
|000055b0| 0a 50 6f 73 74 2d 43 6f | 6d 6d 65 6e 74 0d 0a 0d |.Post-Co|mment...|
|000055c0| 0a 20 20 20 20 20 53 65 | 76 65 72 61 6c 20 72 65 |.     Se|veral re|
|000055d0| 63 65 6e 74 20 72 65 76 | 69 65 77 73 20 6f 66 20 |cent rev|iews of |
|000055e0| 6c 69 74 68 69 75 6d 20 | 72 65 70 72 65 73 65 6e |lithium |represen|
|000055f0| 74 20 61 20 73 75 6d 6d | 61 72 79 20 6f 66 20 61 |t a summ|ary of a|
|00005600| 20 67 65 6e 65 72 61 74 | 69 6f 6e 27 73 0d 0a 65 | generat|ion's..e|
|00005610| 78 70 65 72 69 65 6e 63 | 65 2e 20 20 41 62 73 74 |xperienc|e.  Abst|
|00005620| 72 61 63 74 73 20 37 2d | 38 2d 2d 37 2d 31 31 20 |racts 7-|8--7-11 |
|00005630| 72 65 76 69 65 77 20 61 | 72 74 69 63 6c 65 73 20 |review a|rticles |
|00005640| 63 6f 76 65 72 69 6e 67 | 20 76 61 72 69 6f 75 73 |covering| various|
|00005650| 20 6d 65 74 68 6f 64 73 | 20 6f 66 0d 0a 74 72 65 | methods| of..tre|
|00005660| 61 74 69 6e 67 20 6d 61 | 6e 69 61 20 61 6e 64 20 |ating ma|nia and |
|00005670| 6d 69 78 65 64 20 6d 61 | 6e 69 61 20 28 77 69 74 |mixed ma|nia (wit|
|00005680| 68 20 63 6f 6e 63 6f 6d | 69 74 61 6e 74 20 64 65 |h concom|itant de|
|00005690| 70 72 65 73 73 69 76 65 | 20 73 79 6d 70 74 6f 6d |pressive| symptom|
|000056a0| 61 74 6f 6c 6f 67 79 29 | 0d 0a 61 6e 64 20 63 6f |atology)|..and co|
|000056b0| 6d 70 61 72 69 6e 67 20 | 61 63 75 74 65 20 61 6e |mparing |acute an|
|000056c0| 74 69 6d 61 6e 69 63 20 | 61 67 65 6e 74 73 2e 20 |timanic |agents. |
|000056d0| 20 54 68 65 73 65 20 70 | 61 70 65 72 73 20 65 76 | These p|apers ev|
|000056e0| 61 6c 75 61 74 65 20 63 | 6f 6d 70 61 72 61 74 69 |aluate c|omparati|
|000056f0| 76 65 0d 0a 74 72 69 61 | 6c 73 20 6f 66 20 63 61 |ve..tria|ls of ca|
|00005700| 72 62 61 6d 61 7a 65 70 | 69 6e 65 20 76 73 2e 20 |rbamazep|ine vs. |
|00005710| 68 61 6c 6f 70 65 72 69 | 64 6f 6c 2c 20 63 61 72 |haloperi|dol, car|
|00005720| 62 61 6d 61 7a 65 70 69 | 6e 65 20 61 73 20 61 6e |bamazepi|ne as an|
|00005730| 20 61 64 6a 75 6e 63 74 | 20 74 6f 0d 0a 6c 69 74 | adjunct| to..lit|
|00005740| 68 69 75 6d 2c 20 61 6e | 64 20 61 20 63 6f 6d 70 |hium, an|d a comp|
|00005750| 61 72 61 74 69 76 65 20 | 74 72 69 61 6c 20 6f 66 |arative |trial of|
|00005760| 20 63 61 72 62 61 6d 61 | 7a 65 70 69 6e 65 20 76 | carbama|zepine v|
|00005770| 73 2e 20 6c 69 74 68 69 | 75 6d 20 69 6e 20 74 68 |s. lithi|um in th|
|00005780| 65 0d 0a 70 72 6f 70 68 | 79 6c 61 78 69 73 20 6f |e..proph|ylaxis o|
|00005790| 66 20 6d 61 6e 69 61 2e | 0d 0a 20 20 20 20 20 54 |f mania.|..     T|
|000057a0| 68 65 20 72 6f 6c 65 20 | 66 6f 72 20 63 61 72 62 |he role |for carb|
|000057b0| 61 6d 61 7a 65 70 69 6e | 65 20 63 6f 6e 74 69 6e |amazepin|e contin|
|000057c0| 75 65 73 20 74 6f 20 62 | 65 20 72 65 66 69 6e 65 |ues to b|e refine|
|000057d0| 64 2e 20 20 49 74 20 61 | 70 70 65 61 72 73 20 74 |d.  It a|ppears t|
|000057e0| 6f 20 62 65 0d 0a 71 75 | 69 74 65 20 68 65 6c 70 |o be..qu|ite help|
|000057f0| 66 75 6c 20 69 6e 20 6d | 61 6e 69 63 20 70 61 74 |ful in m|anic pat|
|00005800| 69 65 6e 74 73 2c 20 62 | 6f 74 68 20 61 63 75 74 |ients, b|oth acut|
|00005810| 65 6c 79 20 61 6e 64 20 | 66 6f 72 20 70 72 6f 70 |ely and |for prop|
|00005820| 68 79 6c 61 78 69 73 2e | 0d 0a 55 6e 66 6f 72 74 |hylaxis.|..Unfort|
|00005830| 75 6e 61 74 65 6c 79 2c | 20 74 68 69 73 20 64 6f |unately,| this do|
|00005840| 65 73 20 6e 6f 74 20 73 | 65 65 6d 20 74 6f 20 62 |es not s|eem to b|
|00005850| 65 20 74 72 75 65 20 6f | 66 20 6f 74 68 65 72 20 |e true o|f other |
|00005860| 61 76 61 69 6c 61 62 6c | 65 20 63 6f 6d 70 6f 75 |availabl|e compou|
|00005870| 6e 64 73 2e 0d 0a 43 6c | 6f 6e 61 7a 65 70 61 6d |nds...Cl|onazepam|
|00005880| 2c 20 69 6e 20 70 61 72 | 74 69 63 75 6c 61 72 2c |, in par|ticular,|
|00005890| 20 68 61 73 20 70 72 6f | 76 65 6e 20 74 6f 20 62 | has pro|ven to b|
|000058a0| 65 20 68 65 6c 70 66 75 | 6c 20 69 6e 20 74 68 65 |e helpfu|l in the|
|000058b0| 20 61 63 75 74 65 20 74 | 72 65 61 74 6d 65 6e 74 | acute t|reatment|
|000058c0| 20 6f 66 0d 0a 6d 61 6e | 69 61 2c 20 65 73 70 65 | of..man|ia, espe|
|000058d0| 63 69 61 6c 6c 79 20 69 | 6e 20 70 61 74 69 65 6e |cially i|n patien|
|000058e0| 74 73 20 77 68 6f 2c 20 | 66 6f 72 20 77 68 61 74 |ts who, |for what|
|000058f0| 65 76 65 72 20 72 65 61 | 73 6f 6e 2c 20 63 61 6e |ever rea|son, can|
|00005900| 6e 6f 74 20 74 6f 6c 65 | 72 61 74 65 0d 0a 6e 65 |not tole|rate..ne|
|00005910| 75 72 6f 6c 65 70 74 69 | 63 73 2e 20 20 54 68 69 |urolepti|cs.  Thi|
|00005920| 73 20 70 6f 77 65 72 66 | 75 6c 20 62 65 6e 7a 6f |s powerf|ul benzo|
|00005930| 64 69 61 7a 65 70 69 6e | 65 20 61 70 70 65 61 72 |diazepin|e appear|
|00005940| 73 20 74 6f 20 62 65 20 | 61 73 20 63 6c 69 6e 69 |s to be |as clini|
|00005950| 63 61 6c 6c 79 0d 0a 65 | 66 66 65 63 74 69 76 65 |cally..e|ffective|
|00005960| 20 69 6e 20 61 63 75 74 | 65 20 6d 61 6e 69 61 20 | in acut|e mania |
|00005970| 61 73 20 6c 6f 72 61 7a | 65 70 61 6d 20 69 73 2e |as loraz|epam is.|
|00005980| 20 43 6f 6d 70 61 72 65 | 64 20 77 69 74 68 20 6c | Compare|d with l|
|00005990| 6f 72 61 7a 65 70 61 6d | 2c 20 68 6f 77 65 76 65 |orazepam|, howeve|
|000059a0| 72 2c 0d 0a 63 6c 6f 6e | 61 7a 65 70 61 6d 20 68 |r,..clon|azepam h|
|000059b0| 61 73 20 61 20 64 69 73 | 61 64 76 61 6e 74 61 67 |as a dis|advantag|
|000059c0| 65 20 69 6e 20 74 68 61 | 74 20 69 74 20 63 61 6e |e in tha|t it can|
|000059d0| 6e 6f 74 20 62 65 20 67 | 69 76 65 6e 20 69 6e 74 |not be g|iven int|
|000059e0| 72 61 6d 75 73 63 75 6c | 61 72 6c 79 2e 0d 0a 4e |ramuscul|arly...N|
|000059f0| 65 76 65 72 74 68 65 6c | 65 73 73 2c 20 69 74 20 |everthel|ess, it |
|00005a00| 68 61 73 20 74 68 65 20 | 61 64 76 61 6e 74 61 67 |has the |advantag|
|00005a10| 65 20 6f 66 20 61 20 76 | 65 72 79 20 6c 6f 6e 67 |e of a v|ery long|
|00005a20| 20 68 61 6c 66 2d 6c 69 | 66 65 2c 20 77 68 69 63 | half-li|fe, whic|
|00005a30| 68 20 65 6c 69 6d 69 6e | 61 74 65 73 0d 0a 74 68 |h elimin|ates..th|
|00005a40| 65 20 72 61 70 69 64 20 | 64 61 69 6c 79 20 70 65 |e rapid |daily pe|
|00005a50| 61 6b 73 20 61 6e 64 20 | 74 72 6f 75 67 68 73 20 |aks and |troughs |
|00005a60| 74 68 61 74 20 61 72 65 | 20 61 73 73 6f 63 69 61 |that are| associa|
|00005a70| 74 65 64 20 77 69 74 68 | 20 73 68 6f 72 74 65 72 |ted with| shorter|
|00005a80| 2d 61 63 74 69 6e 67 0d | 0a 63 6f 6d 70 6f 75 6e |-acting.|.compoun|
|00005a90| 64 73 20 73 75 63 68 20 | 61 73 20 6c 6f 72 61 7a |ds such |as loraz|
|00005aa0| 65 70 61 6d 2e 20 20 42 | 6f 74 68 20 64 72 75 67 |epam.  B|oth drug|
|00005ab0| 73 20 63 61 6e 20 73 75 | 62 73 74 69 74 75 74 65 |s can su|bstitute|
|00005ac0| 20 65 66 66 65 63 74 69 | 76 65 6c 79 20 66 6f 72 | effecti|vely for|
|00005ad0| 0d 0a 6e 65 75 72 6f 6c | 65 70 74 69 63 73 20 69 |..neurol|eptics i|
|00005ae0| 6e 20 74 68 65 20 61 63 | 75 74 65 20 6d 61 6e 61 |n the ac|ute mana|
|00005af0| 67 65 6d 65 6e 74 20 6f | 66 20 6d 61 6e 69 61 2c |gement o|f mania,|
|00005b00| 20 62 75 74 20 63 6c 6f | 6e 61 7a 65 70 61 6d 20 | but clo|nazepam |
|00005b10| 69 73 20 6e 6f 74 20 65 | 66 66 65 63 74 69 76 65 |is not e|ffective|
|00005b20| 0d 0a 61 73 20 6d 61 69 | 6e 74 65 6e 61 6e 63 65 |..as mai|ntenance|
|00005b30| 20 74 68 65 72 61 70 79 | 20 62 65 63 61 75 73 65 | therapy| because|
|00005b40| 20 69 74 20 6c 61 63 6b | 73 20 69 6e 74 72 69 6e | it lack|s intrin|
|00005b50| 73 69 63 20 61 6e 74 69 | 64 65 70 72 65 73 73 61 |sic anti|depressa|
|00005b60| 6e 74 0d 0a 61 63 74 69 | 76 69 74 79 2e 2d 2d 44 |nt..acti|vity.--D|
|00005b70| 2e 58 2e 20 46 72 65 65 | 64 6d 61 6e 2c 20 4d 2e |.X. Free|dman, M.|
|00005b80| 44 2e 0d 0a 24 55 6e 69 | 71 75 65 5f 49 44 7b 59 |D...$Uni|que_ID{Y|
|00005b90| 52 42 31 32 34 30 37 7d | 0d 0a 24 54 69 74 6c 65 |RB12407}|..$Title|
|00005ba0| 7b 48 79 70 65 72 70 61 | 72 61 74 68 79 72 6f 69 |{Hyperpa|rathyroi|
|00005bb0| 64 69 73 6d 2c 20 48 79 | 70 6f 74 68 79 72 6f 69 |dism, Hy|pothyroi|
|00005bc0| 64 69 73 6d 2c 20 61 6e | 64 20 49 6d 70 61 69 72 |dism, an|d Impair|
|00005bd0| 65 64 20 52 65 6e 61 6c | 20 46 75 6e 63 74 69 6f |ed Renal| Functio|
|00005be0| 6e 20 41 66 74 65 72 20 | 31 30 20 74 6f 20 32 30 |n After |10 to 20|
|00005bf0| 20 59 65 61 72 73 20 6f | 66 20 4c 69 74 68 69 75 | Years o|f Lithiu|
|00005c00| 6d 20 54 72 65 61 74 6d | 65 6e 74 7d 0d 0a 24 41 |m Treatm|ent}..$A|
|00005c10| 75 74 68 6f 72 7b 0d 0a | 53 74 61 6e 63 65 72 2c |uthor{..|Stancer,|
|00005c20| 20 48 43 0d 0a 46 6f 72 | 62 61 74 68 2c 20 4e 7d | HC..For|bath, N}|
|00005c30| 0d 0a 24 41 66 66 69 6c | 69 61 74 69 6f 6e 7b 43 |..$Affil|iation{C|
|00005c40| 6c 61 72 6b 65 20 49 6e | 73 74 20 6f 66 20 50 73 |larke In|st of Ps|
|00005c50| 79 63 68 69 61 74 72 79 | 3b 20 54 6f 72 6f 6e 74 |ychiatry|; Toront|
|00005c60| 6f 20 47 65 6e 20 48 6f | 73 70 7d 0d 0a 24 4a 6f |o Gen Ho|sp}..$Jo|
|00005c70| 75 72 6e 61 6c 7b 41 72 | 63 68 20 49 6e 74 65 72 |urnal{Ar|ch Inter|
|00005c80| 6e 20 4d 65 64 7d 0d 0a | 24 56 6f 6c 75 6d 65 7b |n Med}..|$Volume{|
|00005c90| 31 34 39 7d 0d 0a 24 50 | 61 67 65 7b 31 30 34 32 |149}..$P|age{1042|
|00005ca0| 2d 31 30 34 35 7d 0d 0a | 24 44 61 74 65 7b 4d 61 |-1045}..|$Date{Ma|
|00005cb0| 79 20 31 39 38 39 7d 0d | 0a 24 59 42 56 6f 6c 7b |y 1989}.|.$YBVol{|
|00005cc0| 31 39 39 30 20 59 65 61 | 72 20 42 6f 6f 6b 20 6f |1990 Yea|r Book o|
|00005cd0| 66 20 50 73 79 63 68 69 | 61 74 72 79 20 61 6e 64 |f Psychi|atry and|
|00005ce0| 20 41 70 70 6c 69 65 64 | 20 4d 65 6e 74 61 6c 20 | Applied| Mental |
|00005cf0| 48 65 61 6c 74 68 7d 0d | 0a 24 43 68 61 70 74 65 |Health}.|.$Chapte|
|00005d00| 72 7b 37 2d 31 32 7d 0d | 0a 24 59 42 45 64 69 74 |r{7-12}.|.$YBEdit|
|00005d10| 6f 72 7b 44 72 73 2e 20 | 54 61 6c 62 6f 74 74 2c |or{Drs. |Talbott,|
|00005d20| 20 46 72 61 6e 63 65 73 | 2c 20 46 72 61 6e 63 65 | Frances|, France|
|00005d30| 73 2c 20 46 72 65 65 64 | 6d 61 6e 2c 20 4d 65 6c |s, Freed|man, Mel|
|00005d40| 74 7a 65 72 2c 20 53 63 | 68 6f 77 61 6c 74 65 72 |tzer, Sc|howalter|
|00005d50| 2c 20 61 6e 64 20 59 75 | 64 6f 66 73 6b 79 7d 0d |, and Yu|dofsky}.|
|00005d60| 0a 24 54 61 62 6c 65 7b | 7d 0d 0a 24 43 6f 6d 6d |.$Table{|}..$Comm|
|00005d70| 65 6e 74 61 74 6f 72 7b | 7d 0d 0a 0d 0a 43 6f 70 |entator{|}....Cop|
|00005d80| 79 72 69 67 68 74 20 28 | 63 29 20 59 65 61 72 62 |yright (|c) Yearb|
|00005d90| 6f 6f 6b 20 4d 65 64 69 | 63 61 6c 20 50 75 62 6c |ook Medi|cal Publ|
|00005da0| 69 73 68 65 72 73 2c 20 | 49 6e 63 2e 2c 20 31 39 |ishers, |Inc., 19|
|00005db0| 39 30 0d 0a 0d 0a 31 39 | 39 30 20 59 65 61 72 20 |90....19|90 Year |
|00005dc0| 42 6f 6f 6b 20 6f 66 20 | 50 73 79 63 68 69 61 74 |Book of |Psychiat|
|00005dd0| 72 79 20 61 6e 64 20 41 | 70 70 6c 69 65 64 20 4d |ry and A|pplied M|
|00005de0| 65 6e 74 61 6c 20 48 65 | 61 6c 74 68 20 28 52 29 |ental He|alth (R)|
|00005df0| 0d 0a 0d 0a 43 68 61 70 | 74 65 72 20 37 2d 2d 50 |....Chap|ter 7--P|
|00005e00| 73 79 63 68 6f 70 68 61 | 72 6d 61 63 6f 6c 6f 67 |sychopha|rmacolog|
|00005e10| 79 0d 0a 0d 0a 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |y....---|--------|
|00005e20| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005e30| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005e40| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005e50| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005e60| 2d 2d 2d 0d 0a 48 79 70 | 65 72 70 61 72 61 74 68 |---..Hyp|erparath|
|00005e70| 79 72 6f 69 64 69 73 6d | 2c 20 48 79 70 6f 74 68 |yroidism|, Hypoth|
|00005e80| 79 72 6f 69 64 69 73 6d | 2c 20 61 6e 64 20 49 6d |yroidism|, and Im|
|00005e90| 70 61 69 72 65 64 20 52 | 65 6e 61 6c 20 46 75 6e |paired R|enal Fun|
|00005ea0| 63 74 69 6f 6e 20 41 66 | 74 65 72 20 31 30 20 74 |ction Af|ter 10 t|
|00005eb0| 6f 0d 0a 32 30 20 59 65 | 61 72 73 20 6f 66 20 4c |o..20 Ye|ars of L|
|00005ec0| 69 74 68 69 75 6d 20 54 | 72 65 61 74 6d 65 6e 74 |ithium T|reatment|
|00005ed0| 0d 0a 0d 0a 53 74 61 6e | 63 65 72 20 48 43 2c 20 |....Stan|cer HC, |
|00005ee0| 46 6f 72 62 61 74 68 20 | 4e 0d 0a 28 43 6c 61 72 |Forbath |N..(Clar|
|00005ef0| 6b 65 20 49 6e 73 74 20 | 6f 66 20 50 73 79 63 68 |ke Inst |of Psych|
|00005f00| 69 61 74 72 79 3b 20 54 | 6f 72 6f 6e 74 6f 20 47 |iatry; T|oronto G|
|00005f10| 65 6e 20 48 6f 73 70 29 | 0d 0a 41 72 63 68 20 49 |en Hosp)|..Arch I|
|00005f20| 6e 74 65 72 6e 20 4d 65 | 64 20 31 34 39 3a 31 30 |ntern Me|d 149:10|
|00005f30| 34 32 2d 31 30 34 35 2c | 20 4d 61 79 20 31 39 38 |42-1045,| May 198|
|00005f40| 39 0d 0a 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |9..-----|--------|
|00005f50| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005f60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005f70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005f80| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005f90| 2d 0d 0a 0d 0a 41 62 73 | 74 72 61 63 74 0d 0a 0d |-....Abs|tract...|
|00005fa0| 0a 20 20 20 20 20 54 68 | 65 20 70 72 6f 6c 6f 6e |.     Th|e prolon|
|00005fb0| 67 65 64 20 75 73 65 20 | 6f 66 20 6c 69 74 68 69 |ged use |of lithi|
|00005fc0| 75 6d 20 63 61 72 62 6f | 6e 61 74 65 20 74 6f 20 |um carbo|nate to |
|00005fd0| 74 72 65 61 74 20 70 61 | 74 69 65 6e 74 73 20 77 |treat pa|tients w|
|00005fe0| 69 74 68 20 6d 61 6e 69 | 63 0d 0a 64 65 70 72 65 |ith mani|c..depre|
|00005ff0| 73 73 69 6f 6e 20 68 61 | 73 20 72 65 73 75 6c 74 |ssion ha|s result|
|00006000| 65 64 20 69 6e 20 61 6e | 20 69 6e 63 72 65 61 73 |ed in an| increas|
|00006010| 69 6e 67 20 6e 75 6d 62 | 65 72 20 6f 66 20 72 65 |ing numb|er of re|
|00006020| 70 6f 72 74 73 20 6f 66 | 20 70 6f 74 65 6e 74 69 |ports of| potenti|
|00006030| 61 6c 0d 0a 64 65 6c 65 | 74 65 72 69 6f 75 73 20 |al..dele|terious |
|00006040| 65 66 66 65 63 74 73 20 | 6f 6e 20 6d 61 6a 6f 72 |effects |on major|
|00006050| 20 6f 72 67 61 6e 20 73 | 79 73 74 65 6d 73 2e 20 | organ s|ystems. |
|00006060| 20 41 74 20 31 20 63 65 | 6e 74 65 72 20 69 6e 63 | At 1 ce|nter inc|
|00006070| 72 65 61 73 69 6e 67 20 | 6c 61 62 6f 72 61 74 6f |reasing |laborato|
|00006080| 72 79 0d 0a 65 76 69 64 | 65 6e 63 65 20 6f 66 20 |ry..evid|ence of |
|00006090| 70 61 72 61 74 68 79 72 | 6f 69 64 20 61 6e 64 20 |parathyr|oid and |
|000060a0| 6b 69 64 6e 65 79 20 70 | 61 74 68 6f 6c 6f 67 79 |kidney p|athology|
|000060b0| 20 77 61 73 20 6e 6f 74 | 65 64 2e 20 20 54 68 79 | was not|ed.  Thy|
|000060c0| 72 6f 69 64 2c 20 72 65 | 6e 61 6c 2c 20 61 6e 64 |roid, re|nal, and|
|000060d0| 0d 0a 70 61 72 61 74 68 | 79 72 6f 69 64 20 66 75 |..parath|yroid fu|
|000060e0| 6e 63 74 69 6f 6e 20 77 | 61 73 20 69 6e 76 65 73 |nction w|as inves|
|000060f0| 74 69 67 61 74 65 64 20 | 69 6e 20 31 39 20 70 61 |tigated |in 19 pa|
|00006100| 74 69 65 6e 74 73 20 77 | 68 6f 20 68 61 64 20 62 |tients w|ho had b|
|00006110| 65 65 6e 20 72 65 63 65 | 69 76 69 6e 67 0d 0a 6c |een rece|iving..l|
|00006120| 69 74 68 69 75 6d 20 63 | 61 72 62 6f 6e 61 74 65 |ithium c|arbonate|
|00006130| 20 74 68 65 72 61 70 79 | 20 66 6f 72 20 31 30 2d | therapy| for 10-|
|00006140| 32 30 20 79 65 61 72 73 | 2e 0d 0a 20 20 20 20 20 |20 years|...     |
|00006150| 45 69 67 68 74 20 70 61 | 74 69 65 6e 74 73 2c 20 |Eight pa|tients, |
|00006160| 6f 72 20 34 32 25 2c 20 | 61 6e 20 75 6e 75 73 75 |or 42%, |an unusu|
|00006170| 61 6c 6c 79 20 68 69 67 | 68 20 69 6e 63 69 64 65 |ally hig|h incide|
|00006180| 6e 63 65 2c 20 68 61 64 | 20 6c 61 62 6f 72 61 74 |nce, had| laborat|
|00006190| 6f 72 79 0d 0a 65 76 69 | 64 65 6e 63 65 20 6f 66 |ory..evi|dence of|
|000061a0| 20 68 79 70 65 72 70 61 | 72 61 74 68 79 72 6f 69 | hyperpa|rathyroi|
|000061b0| 64 69 73 6d 2e 20 20 4f | 66 20 74 68 65 20 33 20 |dism.  O|f the 3 |
|000061c0| 70 61 74 69 65 6e 74 73 | 20 77 68 6f 20 75 6e 64 |patients| who und|
|000061d0| 65 72 77 65 6e 74 20 70 | 61 72 61 74 68 79 72 6f |erwent p|arathyro|
|000061e0| 69 64 0d 0a 73 75 72 67 | 65 72 79 2c 20 32 20 68 |id..surg|ery, 2 h|
|000061f0| 61 64 20 68 79 70 65 72 | 70 6c 61 73 69 61 20 61 |ad hyper|plasia a|
|00006200| 6e 64 20 31 20 68 61 64 | 20 61 20 73 6f 6c 69 74 |nd 1 had| a solit|
|00006210| 61 72 79 20 61 64 65 6e | 6f 6d 61 2e 20 20 55 6e |ary aden|oma.  Un|
|00006220| 75 73 75 61 6c 20 66 65 | 61 74 75 72 65 73 20 6f |usual fe|atures o|
|00006230| 66 0d 0a 6c 69 74 68 69 | 75 6d 2d 69 6e 64 75 63 |f..lithi|um-induc|
|00006240| 65 64 20 68 79 70 65 72 | 70 61 72 61 74 68 79 72 |ed hyper|parathyr|
|00006250| 6f 69 64 69 73 6d 20 77 | 65 72 65 20 6f 62 73 65 |oidism w|ere obse|
|00006260| 72 76 65 64 2c 20 69 6e | 63 6c 75 64 69 6e 67 20 |rved, in|cluding |
|00006270| 6c 6f 77 20 75 72 69 6e | 61 72 79 0d 0a 63 61 6c |low urin|ary..cal|
|00006280| 63 69 75 6d 20 65 78 63 | 72 65 74 69 6f 6e 20 61 |cium exc|retion a|
|00006290| 6e 64 20 74 68 65 20 61 | 62 73 65 6e 63 65 20 6f |nd the a|bsence o|
|000062a0| 66 20 6e 65 70 68 72 6f | 6c 69 74 68 69 61 73 69 |f nephro|lithiasi|
|000062b0| 73 2c 20 6e 6f 72 6d 61 | 6c 20 75 72 69 6e 61 72 |s, norma|l urinar|
|000062c0| 79 20 63 79 63 6c 69 63 | 0d 0a 61 64 65 6e 6f 73 |y cyclic|..adenos|
|000062d0| 69 6e 65 20 6d 6f 6e 6f | 70 68 6f 73 70 68 61 74 |ine mono|phosphat|
|000062e0| 65 20 65 78 63 72 65 74 | 69 6f 6e 2c 20 61 6e 64 |e excret|ion, and|
|000062f0| 20 6e 6f 72 6d 61 6c 20 | 70 6c 61 73 6d 61 20 69 | normal |plasma i|
|00006300| 6e 6f 72 67 61 6e 69 63 | 20 70 68 6f 73 70 68 61 |norganic| phospha|
|00006310| 74 65 2e 0d 0a 45 69 67 | 68 74 20 70 61 74 69 65 |te...Eig|ht patie|
|00006320| 6e 74 73 20 6e 65 65 64 | 65 64 20 74 72 65 61 74 |nts need|ed treat|
|00006330| 6d 65 6e 74 20 66 6f 72 | 20 68 79 70 6f 74 68 79 |ment for| hypothy|
|00006340| 72 6f 69 64 69 73 6d 2e | 20 20 54 68 72 65 65 20 |roidism.|  Three |
|00006350| 28 31 36 25 29 20 68 61 | 64 20 69 6d 70 61 69 72 |(16%) ha|d impair|
|00006360| 65 64 0d 0a 6b 69 64 6e | 65 79 20 66 75 6e 63 74 |ed..kidn|ey funct|
|00006370| 69 6f 6e 2e 0d 0a 20 20 | 20 20 20 4c 6f 6e 67 20 |ion...  |   Long |
|00006380| 74 65 72 6d 20 6c 69 74 | 68 69 75 6d 20 74 72 65 |term lit|hium tre|
|00006390| 61 74 6d 65 6e 74 20 69 | 73 20 61 73 73 6f 63 69 |atment i|s associ|
|000063a0| 61 74 65 64 20 77 69 74 | 68 20 61 6e 20 75 6e 75 |ated wit|h an unu|
|000063b0| 73 75 61 6c 6c 79 20 68 | 69 67 68 0d 0a 69 6e 63 |sually h|igh..inc|
|000063c0| 69 64 65 6e 63 65 20 6f | 66 20 68 79 70 65 72 70 |idence o|f hyperp|
|000063d0| 61 72 61 74 68 79 72 6f | 69 64 69 73 6d 2e 20 20 |arathyro|idism.  |
|000063e0| 41 6c 74 68 6f 75 67 68 | 20 74 68 65 73 65 20 66 |Although| these f|
|000063f0| 69 6e 64 69 6e 67 73 20 | 64 6f 20 6e 6f 74 0d 0a |indings |do not..|
+--------+-------------------------+-------------------------+--------+--------+
Only 25.0 KB of data is shown above.