Note |
Here's what a group of anxious psychoneurotics (most with associated depressive symptoms) looked like untreated: [shows chart of psychiatric evaluation on a modified BPRS, with average scores of 17 patients - out of initial group of 21 patients - in a study for 26 or more days, showing 9 symptoms and scores from 1-5 from not present to extremely severe]. Here's what a group of anxious psychoneurotics (most with associated depressive symptoms) looked like after Valium (diazepam) and psychotherapy. [shows same graph as previous, with results from no treatment and results with treatment put on same chart]. Pretreatment evaluations were compared with those of the second and fourth week of treatment, yielding a cumulative "improvement" score for each patient, symptom and observation interval. A global assessment of the patient's emotional status was also made atr each rating period. In the course of a four-week trial, the investigator studied the effects of Valium (diazepam) in 21 psychoneurotic patients, all with marked anxiety and tension and most with associated depressive symptoms. The Valium daily dosage was 15mg in divided doses, throughout, except for two patients who required a doubling of daily dosage (30mg). The medication supplemented psychotherapy. The clinician rated patients' behavior on a modified Brief Psychiatric Scale before, during, and at the end of treatment. From the individual symptom ratings and the physician's global assessment, it appeared that the concomitant use of Valium and psychotherapy effectively reduced the severity of the anxiety and tension in most patients. The BPRS itself, it should be observed, was employed as a measure of response to therapy. It is not intended to, nor can it, suggest indications for specific medication. Of the 21 patients in the group at the outset, four discontinued treatment some time after the second week because of side effects. Eight patients, including the four who stopped medication, reported one or more side effects: 1 constipation; 7 drowsiness/sleepiness; 1 dry mouth; 3 fatigue-exhaustion; 1 gastrointestinal disturbance; 1 insomnia; 2 nervousness/jitteriness/restlessness; 1 nightmares; 1 unpleasant dreams; 1 vertigo. The patients studied are probably fairly typical of many of your outpatients with marked psychoneuroses. And from the clinical evidence reported over the past nine years, the response to the concomitant use of Valium and psychotherapy seen in this study would also appear to the typical. Valium's beneficial effects can be prompt and pronounced. In recommended dosage, it seldom dulls the sense or interferes with regular activities, although you should caution patients against driving or operating dangerous machinery during therapy. Valium is generally well tolerated: the most common side effects have been drowsiness, ataxia and fatigue. For individualized treatment, three convenient tablet strengths are available: 2 mg, 5mg, and 10mg. |