Non-drug Factors Research Articles

Adverse Drug Reactions and Death

A study of 827 cases of adverse drug reactions (ADRs) in which autopsies were done was carried out to determine the relative frequency of drugs that caused adverse reactions, their sites of action, and the variety of pathologic processes induced by them. Because a variety of nondrug factors played critical roles in generating many of the ADRs, these 827 cases were divided into seven groups. Only one of these groups (25% of the total) met the criteria of ADRs in the usual definitional sense and were also lethal. The validity of the diagnoses of both the ADRs and the basic diseases being treated was strengthened by the addition of morphologic findings to the data base and by the use of an analytic algorithm that was specifically developed for and directed to the evaluation of ADRs.

DEMONSTRATION TO MEDICAL STUDENTS OF PLACEBO RESPONSES AND NON-DRUG FACTORS

A class experiment for medical students Summary was devised to demonstrate the influence of the placebo effect and non-drug factors on response to drugs. The subjects were conditioned to expect sedative or stimulant effects, but all received placebo in one or two blue or pink capsules. Predictions about the size and nature of the placebo response and influence of the non-drug factors were made before the experiment and discussed afterwards. Four of six predictions were fully confirmed. Drug- associated changes were reported by 30% of the subjects and were severe in 1 or 2 individuals. Two capsules produced more noticeable changes than one, and blue capsules were associated with more sedative effects than pink capsules. Students rated the experiment highly both as a learning experience and for its relevance to their future practice of medicine.

Meprobamate- Benactyzine (Deprol) and Placebo in Two Depressed Outpatient Populations

• In the recent psychopharmacological literatme socio-economi<: circumstances have taken a prominent place among the llon-specific cr non-drug factors which various clinical observations have indicated as significant in the outcome of psychopharmacological therapy. For example, drug responses in patients with similar diagnoses tend to vary according to the differences in symptom focus apparent between groups of higher and lower social status and economic means."" The aim of the present studv was to determine whether or not two groui)s of depressed patients, differing in many characteristics related to socio-economic background and psychopathology, would respond differently to Deprol (a combination of meprobamate and Iwnactyzine) than to placebo. Depml was chosen since it is being used clinically primarily in the treatment of mildly depressed outpatients frequently treated by the general practitioner;" it has been reported"'lo most valuable in the treatment of mild to moderate reactive depressions, often associated with situational anxieties, somatization, and other accompanying symptoms, and not in the treatment of more severe depressions. The present study was designed to compare drug and placebo responses in two groups of depressed outpatients, residing in two wideIv separate areas of the country and of distinctlv different socio-economic and ethnic backg..ounds. It was hypothesized that the

Psychopharmacological Treatment and Its Implications for Social Work

■ The universality of psychopharmacological treatment in the eare of the mentally ill requires that the social worker have a knowledge of the specific drugs used and their main areas of action, the side effects of medication, and the important nondrug factors affecting treatment outcome. The aim of this paper is to provide the basis for an orientation of the social worker to this treatment method. Drugs in common usage are categorized together with their target symptoms and possible side effects. ■

Drugs and Society

Describing the scientific disciplines and social framework related to drugs, this book is both timely and informative—timely, in that much of what the author discusses is currently being reviewed by the Food and Drug Administration and the National Academy of Sciences, National Research Council, and informative, in that readers can learn more about the totality of drug development and usage than is currently available in one volume. On research, the author describes traditional types of drug studies and the need for less repetition and more emphasis on newer methodologies designed to more accurately define drug and nondrug factors and predictions of response. He also discusses differences in the European and American approaches to discovery and testing and the relative roles taken by government, universities, and industry. On communications, he explains aspects of drug advertising and pharmaceutical representatives, the effectiveness and practicality of standard pharmacopoeia and handbooks, medical journals, and governmental

Some Comments on Non-Drug Factors In Psychiatric Drug Therapy

Some Comments on Non-Drug Factors In Psychiatric Drug Therapy

A controlled trial on the value of prochlorperazine, trifluoperazine and intensive group treatment.

The importance of non-drug factors in the response of patients treated with psychotropic agents has been widely commented upon in recent years, though very few investigations have been undertaken specifically to identify and study these factors and to determine their role in pharmacotherapy (Hamilton and Hordern, 1963).