Method for treating depression and other maladies by means of patient-created symptom graphs

• US 4,346,697 A
• Filed: 03/05/1979
• Issued: 08/31/1982
• Est. Priority Date: 03/05/1979
• Status: Expired due to Term

• Current Assignee: Kopel H. Cohen
• Original Assignee: Kopel H. Cohen
• Inventors: Cohen, Kopel H.
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): KRUTER, JEROME
• Application Number:
  US06/017,109
• Time in Patent Office: 1,275 Days
• Field of Search: 283/1 A, 283/1 R, 128/1 R, 128/630, 35/17, 35/48 A, 35/48 R, 35/22 R, 35/24 R, 434/262
• US Class Current: 604/500
• CPC Class Codes: A61B 90/90 Identification means for patients or instruments, e.g. tags

Abstract

The invention relates to a patient symptom chart on which symptom related graphs are created by the patient and a process of using these graphs in the treatment of various maladies including depression. Decision point plans or charts can also be used by the consulting physician in conjunction with the patient created graphs.

Claims

1. A method for treating patients suffering from depression by means of the controlled administration of antidepressant medication comprising the steps of:

a. administering to a patient suffering from depression an antidepressant drug on a daily basis for a first dosage period set by the practitioner, and in conjunction with the administration of said antidepressant drug during said first dosage period;

b. administering to said patient suffering from depression a patient-completable symptom chart comprising a plurality of symptom fields, each symptom field corresponding to a particular symptom of depression, and

c. said symptom fields being arranged sequentially on said chart, and

d. each of said symptom fields including a series of printed symptom indicatives, with said symptom indicatives each corresponding to a particular degree of a related symptom and said symptom field including symptom indicatives ranging from an extreme manifestation of the symptom, to symptom indicatives indicating improvement in patient condition relative to said extreme symptom, to a positive symptom indicative indicating minimum manifestation of said symptom, and

e. said symptom indicatives being arranged in said symptom field in a progressive sequence with the indicative relating to said extreme manifestation being at one end of said sequence, symptoms indicating improvement in said patient condition following said extreme symptom in said progressive sequence and said positive symptom being located at the other extremity of said progressive sequence, and

f. a patient-markable graph field arranged in association with each of said symptom fields on said patient-completable symptom chart;

said graph field including a series of columns with the number of said columns in said graph field being at least equal to the number of days covered by said first dosage period, and

g. each of said columns including zone means for receiving a patient-applied indication, with each of said printed symptom indicatives having a zone means in correspondence therewith in each column of said graph field, and

h. said patient assesses his symptoms during said first dosage period by the step of applying an indication in said zone means which corresponds to the symptom indicative most closely corresponding to said patient'"'"'s assessment of his symptoms on each treatment date over said first dosage period, said patient thereby creating a graphical representation of said patient'"'"'s symptoms on said symptom chart; and

i. wherein upon the completion of said first dosage period, on the basis of said practitioner'"'"'s assessment of the graph created on said symptom chart by said patient during said first dosage period, said practitioner increases the originally administered dosage of antidepressant drug to be taken by said patient or said practitioner maintains said dosage of antidepressant drug to be taken by said patient at said originally administered dosage level, said dosage of said antidepressant drug being increased when said patient-created graph shows no improvement in said symptoms associated with said patient'"'"'s depression, and said dosage of antidepressant drug being maintained at said originally administered level when the slope of the line on said patient-markable graph field is upward or shows improvement in said symptoms associated with said patient'"'"'s depression;

j. the administration of said patient-completable chart in combination with said antidepressant drug providing a positive therapeutic effect.

2. The method according to claim 1 wherein said antidepressant medication is a tricyclic antidepressant drug.

3. The method according to claim 1 wherein said symptom chart further includes a medication schedule field comprising a plurality of columns with each of said columns being associated with date indicia and antidepressant medication dosage indicia, and each of said medication schedule field columns being aligned with said patient-markable graph field columns;

and in further association with said medication schedule field columns, patient-markable zone for receiving an indication of the medication self-administered by said patient on said treatment date.

4. The method according to claims 1, 2 or 3 wherein said patient-mrkable graph field at the end of said first dosage period indicates improvement short of complete remission in said symptoms of depression, then said dosage of antidepressant medication administered during said first dosage period is administered for a second dosage period in combination with said patient-completable symptom chart having said graph field columns for each date of said second dosage period, said second dosage period continuing until said graph on said patient-completable symptom chart indicates that said patient suffering from depression is in full remission from said symptoms of depression, and thereafter said patient is maintained on said antidepressant drug for a third dosage period.

5. The method according to claims 1, 2 or 3 wherein at the end of said first dosage period said patient-completable chart indicates no improvement in patient symptoms, then over a second dosage period the dosage of said andidepressant medication is progressively increased by incremental amounts above the dosage administered during said first dosage period, and in combination therewith said patient-completable symptom chart is administered to said patient having a graph field column for each date of said second dosage period, said antidepressant medication dosage being progressively increased during said second dosage period until said graph on said patient-completable symptom chart indicates that said patient is responding to said antidepressant medication, said medication dosage level producing said response during said second dosage period is continued during a third dosage period until said patient is in full remission from said symptoms of depression, and thereafter said patient is maintained on said antidepressant medication.

6. The method according to claim 4 wherein during a final dosage period said maintenance dosage of antidepressant medication is gradually reduced until said patient is withdrawn from medication, wherein said patient does not have a family history of depression or a history of short intervals between depressive disorders.

7. The method according to climas 1 or 2 wherein each patient is treated under the direction of a treating practitioner and wherein a plurality of patients are treated by a plurality of practitioners in accordance with the metod of claims 1 or 2, wherein each of said patient-completable graphs upon being completed by the patients who have been treated, are collected and the data therefrom compiled, said compilation providing an indication of the responses of said plurality of patients to said treatment.

8. The method according to claims 1 or 2 wherein said symptom field comprises the symptom which is mood and the progressive sequence of symptom indicatives:

happy most of the time, happy more than sad or blue, said or blue more than happy, sad or blue most of the time, sad or blue all of the time, so sad I couldn'"'"'t stand it;

the symptom which is sleep and the progressive sequence of symptom indicatives;

slept really well and awoke rested, slept all night but woke up tired, awoke but went back to sleep, slept without waking but awoke very early, awoke and couldn'"'"'t go back to sleep, slept too much;

the symptom which is appetite and the progressive sequence of symptom indicatives;

ate normally and enjoyed it, ate less but enjoyed it, ate normally but didn'"'"'t enjoy it, ate less and didn'"'"'t enjoy it, ate very little, didn'"'"'t eat anything, ate too much;

the symptom which is energy and the progressive sequence of symptom indicatives;

great energy, normal energy, less than normal energy, tired easily, drained of energy all day, too tired to move;

the symptom which is ability of thick and make decisions and the progressive sequence of symptom indicatives;

mentally sharp all day, mentally dull at times, mentally dull but could function, mental dullness interfered with function, could barely function, so mentally dull I couldn'"'"'t do anything;

the symptom which is ability to carry on today and the progressive sequence of symptom indicatives;

on top of everything, did as well as most people, tried my best but things went wrong, disappointed in my mistakes, blamed myself for everything wrong, sure things will never improve;

the symptom which is enjoyment of the day and the progressive sequence of symptom indicatives;

everything was fun, enjoyed most of the day, felt good at least once, tried to stay involved but had little enjoyment, nothing was fun though I tried to stay involved, avoided all people and activities I used to enjoy.

9. The method according to claims 1 or 2 wherein said symptom fields relate to the depression associated symptoms mood, sleep, appetite, energy, thought, guilt/outlook, and enjoyment.

10. A method for treating patients suffering from anxiety by means of the controlled administration of antianxiety medication comprising the steps of:

a. administering to a patient suffering from anxiety, an antianxiety drug on a daily basis for a first dosage period set by the practitioner and in conjunction with the administration of said antianxiety drug during said first dosage period set by the practitioner;

b. administering to said patient suffering from anxiety, a patient-completable symptom chart comprising a plurality of symptom fields, each symptom field corresponding to a particular symptom of anxiety,

c. said symptom fields being arranged sequentially on said chart, and

d. each of said symptom fieles including a series of printed symptom indicatives, said symptom indicatives each corresponding to a particular degree of a related symptom, and each of said symptom fields including symptom indicatives ranging from an extreme manifestation of the symptom to symptom indicatives indicating improvement in patient condition relative to said extreme symptom, to a positive symptom indicative indicating minimum manifestation of said symptom,

e. said symptom indicatives being arranged in said symptom field in a progressive sequence with the indicative relating to said extreme manifestation being at one end of said sequence, symptoms indicating improvements in said patient condition following said extreme symptom in said progressive sequence and said positive symptom being located at the other extremity of said progressive sequence, and

f. a patient-markable graph field arranged in association with each of said symptom fields on said patient-completable symptom chart, said graph fields including a series of columns with the number of said columns in said graph field being at least equal to the number of days covered by said first dosage period, and

g. each of said columns including zone means for a patient-applied indication, with each of said printed symptom indicatives having a zone means in correspondence therewith in each column of said graph field; and

h. said patient assesses his symptoms during said first dosage period by the step of applying an indication in said zone means which corresponds to the symptom indicative most closely corresponding to said patient'"'"'s assessment of his symptoms on each treatment date over said first dosage period, said patient thereby creating a graphical representation of said patient'"'"'s symptoms on said symptom chart; and

i. wherein upon the completion of said first dosage period, on the basis of said practitioner'"'"'s assessment of the graph created on said symptom chart by said patient during said first dosage period, said practitioner increases the originally administered dosage of antianxiety drug to be taken by said patient or said practitioner maintains said dosage of antianxiety drug to be taken by said patient at said originally administered dosage level, said dosage of said antianxiety drug being increased when said patient-created graph shows no improvement in said symptoms associated with said patient'"'"'s anxiety, and the dosage of said antianxiety drug being maintained at said originally administered dosage level when the slope of the line on said patient-markable graph field is upward or shows improvement in said symptoms associated with said patient'"'"'s anxiety;

j. the administration of said patient-completable chart in combination with said antianxiety drug providing a positive therapeutic effect.

11. The method according to claim 10 wherein said symptom chart further includes a medication schedule field comprising a plurality of columns with each of said columns being associated with date indicia and medication dosage indicia and each of said medication schedule field columns being aligned with the patient-markable graph field columns;

and in further association with said medication schedule field columns, a patient-markable zone for receiving an indication of medication self-administered by said patent on said date.