Showing papers on "Psychotropic drug published in 1978"

Time-Response Analysis of the Effect of Stimulant Medication on the Learning Ability of Children Referred for Hyperactivity

Abstract: This report introduces a method for obtaining behavioral time-response information for a short-acting psychotropic drug (methylphenidate [Ritalin]) that is widely used to treat behaviorally hyperactive children We used a laboratory learning task to document that between one and two hours after the administration of a single dose of methylphenidate, the drug exerts its maximum effect on performance in a learning task in the laboratory This effect on cognitive performance dissipates within the same day This rapid and transient effect of methylphenidate makes it possible to classify patients in a single day into those who respond favorably and those who respond adversely to the drug in terms of its effect on cognitive behavior

Psychotropic drugs, summer heat and humidity, and hyperpyrexia: a danger restated.

Abstract: The authors note an apparent unawareness of, as well as a paucity of recent literature pertaining to, hyperpyrexia as a complication of psychotropic drug treatment. They report a case of hyperpyrexia in a patient receiving psychotropic agents during a summer heat wave; massive muscle destruction (rhabdomyolysis) with myoglobinuria and acute renal failure make this case of particular interest. Causative mechanisms, preventive measures, and the benefits of prompt recognition and treatment of this condition are discussed.

Tardive dyskinesia and psychotropic drug history.

Abstract: The adult population of a large mental hospital was screened for tardive dyskinesia (TD). Approximately 11% of the hospital population showed signs of TD; females and the elderly were over-represented in the TD group. A representative sample of those with TD was selected and a control (non-TD) patient was chosen to match each of the TD subjects in age, sex, length of hospitalization, diagnosis, and race. The charts of these subjects were searched for any indices of brain damage and the complete psychotropic medication history was recorded. There was no difference between the TD and controls in the amount of psychotropics ingested, in the duration of administration, in the kinds of drugs, or in the organicity history. Women as a group, however, tended to have more polypharmacy than men. The role of neuroleptics in TD is discussed as well as other possible etiological factors.

Physical ill-health and psychotropic drug prescription--a review.

Abstract: This review collates evidence of substantial physical morbidity in patients who receive psychotropic drugs, and evidence that these drugs are not infrequently prescribed for patients with known physical illness. Minor tranquillizers are the psychotropic drugs most commonly prescribed, and the category of physical illness most likely to be associated with psychotropic medication is cardiovascular disease.

Acute endocrine profile of sulpiride in the human

Abstract: SUMMARY Normal men and normally menstruating women received i.m. injections of 0.1 to 4.0 mg/kg sulphide. This psychotropic drug induced a very rapid (already significant after 5 minutes) and sustained (still significant after 7 hours) elevation of prolactin (PRL) concentrations in all subjects with no consistent modification of LH and FSH. After injection of 4.0 mg/kg, there was similarly no modification of mean TSH concentrations in the women tested in the luteal phase, as well as of mean GH levels in men. Sulpiride prevented the inhibitory effect on PRL levels of 500 mg levodopa, administered orally simultaneously; levodopa administered 2 hours prior to sulpiride failed to counteract the PRL-stimulatory effect of sulpiride. Under chronic sulpiride-induced hyperprolactinaemia, levodopa exhibited however a very slight inhibitory effect on PRL concentrations. These data are in agreement with the hypothesis that sulpiride acts mainly at the pituitary level by blocking dopamine receptors of the lactotropes and support the concept that the menstrual cycle perturbations observed under chronic sulpiride administration result from hyperprolactinaemia itself or from a mechanism quite similar to that by which sulpiride induces hyperprolactinaemia.

Antianxiety Drugs: Clinical use in Psychiatry

Abstract: Each year, millions of patients visit physicians seeking relief from tensions, fears, worries, anxieties, and depression. Most physicians have found psychopharmacological agents, prescribed within the context of supportive, ventilating, or nonexploratory, as well as dynamic and insight-oriented psychotherapy, most useful for alleviating these disturbing emotions. Psychopharmacological agents do not, of course, represent a panacea for all neurotic ills. They do not, for example, directly affect the psychodynamic and environmental factors responsible for emotional problems; they do not directly affect the characterological or personality side of the patient (Joyce, 1971). By relieving the symptoms of anxiety, tension, and depression, however, they often render a patient less miserable and able to cope with intrapsychic and extrapsychic stress more appropriately.

Primary care treatment of emotional problems in an HMO.

Abstract: Integrating mental health services into primary care should improve the availability, access, and delivery of psychiatric care to the whole population. Health maintenance organizations (HMOs) are settings for the development of integrated medical-mental health services. This paper reports findings of a project to evaluate a team collaborative model in an HMO. In this model, primary care clinicians carry major responsibility for emotional problems of their patients, and mental health clinicians collaborate with and support primary care clinicians as well as treat referred patients. Over a two-year study period, 15.7 per cent of all patients who visited the HMO presented a mental or emotional difficulty. When psychotropic drug prescriptions were used as an unobtrusive measure for estimating underenumeration, this prevalence figure rose to 19 per cent. Primary care clinicians treated an increasing proportion of the emotional problem demand, although this increase could not be attributed only to the establishment of the team collaborative model. Findings concerning the psychiatric problems treated and psychotropic drugs prescribed by primary care clinicians are also presented. We conclude that the primary care clinicians did assume major responsibility for emotional problem treatment when encouraged and supported through the team collaborative process and other organizational arrangements.

Psychotropic drugs and sidman avoidance in rats: IRT distribution changes

Abstract: The effects of d-amphetamine, caffeine, chlorpromazine, diazepam and and pentobarbital on Sidman avoidance responding (R-S interval, 30 sec; S-S interval, 3 sec) in rats, especially on the interresponse time (IRT) distribution, were studied. d-Amphetamine and caffeine increased the total number of responses. Short IRTs were increased, while longer ones were decreased. Chlorpromazine, diazepam and pentobarbital all increased the number of shocks delivered. After chlorpromazine, no marked change was observed in the total number of responses. However, response bursts and escape reponses increased, while IRTs between 3 and 30 sec decreased. After diazepam and pentobarbital, the burst response scarcely increased, and the IRTs in the 3-15 sec range decreased, while the IRTs longer than 33 sec increased. These changes were more marked after diazepam than after pentobarbital. Total number of responses was decreased by both drugs. The present results suggest that in utilizing the Sidman avoidance procedure for psychotropic drug assessment, changes in the IRT distribution give a more precise profile of the drug than is afforded by the total number of responses and shocks delivered.

Tardive Dyskinesia and Related Neurologic Disorders

Abstract: In 1957, Schonecker (1957) described oral dyskinesia in three patients treated with chlorpromazine. This publication was brief, but the three subjects unquestionably had the condition later to be known as tardive dyskinesia. Two years later, Sigwald and associates (1959) reported in great detail the most characteristic features of the buccal-lingual-masticatory syndrome in four patients who also had received chlorpromazine. In the following years, similar case reports from different countries appeared in the literature (Druckman et al., 1962; Stern, 1960; Kruse, 1960). Even though the new syndrome was conspicuous and often disabling, it seemed to be extraordinarily infrequent, considering the several million patients being treated with neuroleptics at that time. Furthermore, it was believed that only the elderly or persons with preexisting neurological disorder were the victims of this unusual drug reaction.

A multidimensional test approach for the description of the CNS activity of drugs in human pharmacology.

Abstract: In a double-blind cross-over trial ten healthy male volunteers were administered placebo as well as one representative of each of the four hypothetical psychotropic drug classes, antipsychotics, antidepressants, anxiolytics, and psychostimulants. The drugs were: 75 mg of chlorpromazine, 75 mg of amitriptyline, 10 mg of diazepam and 18 mg of dextroamphetamine sulfate. The effects of the compounds were assessed by pharmaco EEG, an adjective checklist, and a battery of psychological performance tests. The results demonstrate that the test model differentiates well between sedative and stimulatory drug effects. In addition, this multidimensional test approach discriminates adequately the effects of the various sedative drugs. The advantages and limitations of multidimensional test approaches for the description of psychotropic drugs along with the importance of employing such an approach for the development of psychotropic drugs are discussed.

Mental disorders in ulcerative colitis: suicide, divorce, psychosis, hospitalization for mental disease, alcoholism, and consumption of psychotropic drugs in 178 patients subjected to colectomy.

Abstract: The population in the Nordic countries is relatively homogenous. In 178 Norwegian patients subjected to colectomy for ulcerative colitis the frequencies of suicide, divorce, psychosis, and hospitalization for mental disorders, and consumption of psychotropic drugs, did not differ significantly from corresponding frequencies in the general population.

Comparative cardiovascular toxicity of trazodone and imipramine in the rat.

Abstract: Several authors have associated the cardiotoxicity of the tricyclic antidepressants with their capacity to potentiate the response to catecholamines. Trazodone is a psychotropic drug with a clinically proven antidepressant activity. It differs from the tricyclic antidepressants under several aspects (chemistry, pharmacology, mode and mechanism of action, etc.), including interactions with catecholamines. Contrary to the tricyclic antidepressants, it does not potentiate the response to catecholamines, but, instead, has an adrenolytic activity. We therefore decided to compare the cardiotoxicity of trazodone and of a tricyclic antidepressant, i.e. imipramine in the rat. The experiments were conducted on anaesthetized Long Evans rats, the drugs being administered by i.v. infusion until cardiac arrest occurred; ECG (lead II) and blood pressure (BP) were recorded at the same time. The primary effect of trazodone was its hypotensive action. ECG changes, consisting of a lengthening of the PR interval, were observed only when there was a marked drop in BP. The primary effect of imipramine, instead, consisted of disturbances in cardiac conduction. It is concluded that trazodone and imipramine produce different cardiovascular effects.

Diazepam and halazepam in anxiety: some prognostic indicators.

Abstract: A multiple step-search regression procedure was applied to data obtained with 37 diazepam and 42 halazepam treated anxious outpatients. Good treatment outcome was predicted for those patients who reported a more adequate family adjustment, the presence of precipitating stress, and who either had no prior psychotropic drug treatment, or if they had received such treatment, had experienced a good response. Probably of greatest interest to the practicing clinician was the observation that patients high in initial anxiety but low in initial interpersonal problems improved the most with both medications. Differential drug effects indicated halazepam to do particularly poorly in less anxious patients and in those patients given a good prognosis by the doctor. Diazepam response was much less affected by these variables. It is speculated that the excessive sedating effect of the daily halazepam dosage (160 mg/d) used in this study may explain these differential drug effects. In the dosages employed, namely, diazepam 20 mg/d and halazepam 160 mg/d, diazepam produced the more consistent anti-anxiety effects. The indication that halazepam 160 mg/d was more effective than diazepam 20 mg/d in the initially sicker patients, while of interest, is probably simply a dose-related phenomenon, indicating that diazepam 20 mg/d was too low a daily dosage for severely anxious patients, a fact well known by most clinicians.

Neuropharmacology and Aging

Abstract: It is difficult to discuss the subject of the neuropharmacology of aging when it is well known that we presently have very few agents which can be classified as such. Many psychotropic drugs are used in the elderly, either to treat specific neuropsychiatric disorders, or in an attempt to treat the signs and symptoms associated with the “organic brain syndromes.” In the former cases the therapeutic approach is straightforward provided appropriate precautions and hazards specific to the elderly be recognized (1–3). It is in the latter cases, the “organic brain syndromes,” where pharmacological intervention has met essentially without success, and where the greatest need exists for the development of newer therapeutic agents.

[Double blind study on maprotiline, an example of a multidimensional psychopharmacologic experiment (author's transl)].

Abstract: Antidepressive therapy with maprotiline was accompanied by blood level determinations psychological clinical and electroencephalographical assessments. It was the aim of the study to introduce objective methods in psychotropic drug therapy and to look for a relationship between blood level and clinical outcome, EEG and psychological data. We found a "therapeutical window" of blood levels between 300 to 600 ng/ml of maprotiline (oral dose of 75 or 150 mg per day). There is also a relationship between clinical outcome rated by the Hamilton-Depression-Scale and the d2-cancellation-test.

The Level of Use

Abstract: A view has been expressed recently in both British medical189, 190 and lay191 publications that there is an undesirable and increasing use of psychotropic drugs. In the light of the existence of some risk (however small) of benzodiazepine dependence it is relevant to examine this view.

Organic Treatment of the Elderly

Abstract: Although clinical gerontology is a relatively new area of specialization, psychologists who practice in this field are committed to treatment goals which are similar to other areas of clinical psychology. Therapeutic goals, in a very general and ideal sense, are: to minimize the patient’s suffering, to improve behavior, to lessen interpersonal friction, and to assist the patient in taking pleasurable interest in his or her environment. To achieve these goals a combination of methods may be necessary. One method which is often used is psychopharmacology, the treatment of the emotionally disturbed with psychotropic medications. Even though psychologists do not prescribe medications, it is important for them to know what the various medications are, how they are used, what precautions should be taken in giving medications, and how medications affect behavior.

Psychotropic Prescription Medication in Vietnam

Abstract: : Army physicians (primary care physicians and psychiatrists) performing out-patient services for troops on duty in Vietnam were surveyed in mid-1967. Two Navy psychiatrists were also included in the survey. All were asked to report information on the psychotropic drug prescriptions they wrote during the immediately preceeding 30-day period. Less than 50 per cent of the 256 physicians who were sent questionnaires returned them. From the available data an estimate of 12.5 per cent per year was derived for the psychotropic drug prescription rate. The drugs were used to treat a wide range of conditions the most frequent of which were (a) gastroenteritis (by the primary care group) and (b) anxiety (by both physician groups). Depression was infrequently listed as the presenting condition. Primary care physicians differed from psychiatrists on several prescription variables. The drugs were perceived by the prescribers as being quite efficacious for most of the conditions treated.

Clinical Pharmacokinetics of Selected Psychotropic Drugs

Abstract: The study of pharmacokinetics is intended to provide information about the dynamics of the various factors which determine the proportion of a given dose of a drug which will become available at specific receptor sites to produce a therapeutic or a toxic effect. In a generalized overview of the subject, Levine (1973) notes that these factors include (1) the rate and extent of absorption from the site of application; (2) the rate and extent of distribution to various tissues and fluids; (3) the rate of biotransformation to active or inactive metabolites; and (4) the rate of excretion from the body. These processes are a function of the physiochemical properties of the drug (e.g., lipid solubility and molecular weight) and of the physiologic status of the patient. As will be seen, this latter aspect is determined not only by intervening pathologic processes, but also to a great extent by normal interindividual variability in parameters such as the proportion of drug bound to plasma proteins, the rate of hepatic blood flow, and the activity of enzymatic processes responsible for biotransformation.

Pharmacological studies on CS-430, a new psychotropic agent.

Abstract: 10-Bromo-11b-(2-fluorophenyl)-2,3,7,11b-tetrahydrooxazolo[3,2-d][1,4]benzodiazepin-6(5H)-one (CS-430) is a new psychotropic drug and has the following properties. The compound showed sleep-inducing effect at both 0.2 and 5 mg/kg (p.o.) in cynomolgus monkeys or at 3 mg/kg (p.o.) in rats. CS-430 showed selective conflict attenuating in rats or anticonvulsant effects in mice. Furthermore, CS-430 blocked non-discriminated (Sidman) avoidance response without severe impairment of the motor function but not discriminated (shuttle-box) avoidance response in rats. CS-430 also blocked selectively electroshock-induced fighting behavior of mice but not isolation-induced fighting behavior of mice and muricidal behavior induced by ablation of the olfactory bulbs. In addition, CS-430 produced specific potentiation of chlorprothixene-induced sleep and particular potentiation of thiopental sleep in mice. These effects of CS-430 were similar to those of nitrazepam, but differed from those of phenobarbital. The effect of CS-430 on the motor function was roughly 1/2 as potent as that of nitrazepam in the various tests.

Psychotropic drug induced male infertility: a case report.

Abstract: This is a case report of a 35-year old man whose fertility status was severely impaired by a past history of bilateral testicular torsion use of numerous psychotropic drugs and the presence of a left varicocele. A moderate improvement in the semen quality occurred following discontinuation of the medications but a significant reponse was not evident until a varicocelectomy was performed. Thereafter repeated semen analyses revealed normal findings except for a marked depression of sperm motility when the patient took Norpramin a psychoactive drug. Seminal factors were consistently normal when this medication was withheld. Ultimately when the patient agreed not to take the Norpramin for 9 months his semen quality remained normal and his wife conceived and delivered a normal male child. (authors)

Frequency of psychotropic drug prescribing for children in Tampere, Finland

Abstract: The purpose of the present study was to determine the frequency with which psychotropic drugs are prescribed for children under 10 years of age in outpatient care in Finland. This frequency was estimated from the reimbursements paid by the Social Insurance Office of Tampere City in 1974. Every third psychotropic drug prescribed for children born in 1965-74 was included. This resulted in 319 children with 375 psychotropic drug prescriptions. About 4% of children under 10 years old in the Tampere area had received within one years's time one or more psychotropic drugs in outpatient care. About half of the psychotropic drugs were prescribed by general practitioners. Sedatives were the most frequently prescribed drugs, especially in the younger are groups. Antidepressants and antiepileptics were common in the older age groups. The most commonly specified indications were fever and restlessness.

Seven Neurons of Psychopharmacology: Adaptive Regulation in Biogenic Amine Neurons

Abstract: The mind of the medical clinician, no less than that of the researcher, travels often to models of physiological function. Although he knows such cartoonlike, mechanistic scenarios to be less than perfect, they serve to organize his observations. Vague discomfort arises when one must make such models explicit, for we know there is evidence missing for many steps in their pictorial development and the false steps we must knowingly take to ensure their continuity. Likewise, I didn’t enjoy the news that the mathematical models used to predict the tides for the next ten years had nothing to do with the mechanisms of tide formation, or the fact that Wall Street chartists often don’t know anything about the companies the stock prices of which they predict. Chloral hydrate does not decompose to chloroform in the body, even though a century ago this explanatory model predicted much of its clinical pharmacology: latency, duration, interactions with other drugs, and effects of overdose. The bromides are not antiepileptic because they reduce the frequency of masturbation, although that was the reason given for their first use.

Carpipramine and drug addiction

Abstract: This study is related to the therapeutic effects of Carpipramine in conditions of pharmacodependance to opiates. The withdrawal in 47 subjects by decreased doses of methadone, clinically presenting 42 amotivational syndroms and 5 depressions. On the other hand, 3 withdrawal trials using chimiotherapy, including Carpipramine, failed. Carpipramine seems to have an important disinhibitory effect in amotivational syndrom and tolerance is excellent. Lack of desire for this psychotropic drug makes its use safe by drug addicts.