Showing papers on "Psychotropic drug published in 1979"
TL;DR: Analysis of prescription rationales revealed that 44% of the psychotropic prescriptions were written for sleep, while 25% were given for nausea and vomiting; approximately 17% were attributed to psychological distress, and 12% were associated with diagnostic medical procedures.
Abstract: The present study examined the prescription practices concerning psychotropic drugs in 5 major oncology centers over a 6 month period. During the survey period 1579 patients were admitted to the collaborating institutions, and 51% of them were prescribed at least one psychotropic medication. Hypnotics were the most frequently prescribed drugs, accounting for 48% of total prescriptions, followed by anti-psychotics at 26% and anti-anxiety agents at 25%. Anti-depressant drugs accounted for only 1% of psychotropic prescriptions. Analysis of prescription rationales revealed that 44% of the psychotropic prescriptions were written for sleep, while 25% were given for nausea and vomiting; approximately 17% were attributed to psychological distress, and 12% were associated with diagnostic medical procedures. The overall rate of prescription was approximately 2 psychotropic drugs per patient per admission, with only 2% of prescriptions resulting in chart-documented side effects. At the level of individual compounds, 3 distinct drugs accounted for 72% of total prescriptions--flurazepam (33%), prochlorperazine (21%), and diazepam (17%).
135 citations
TL;DR: The pharmacokinetic behaviour of the psychotropic drug clobazam, a 1,5 benzodiazepine, and its metabolism were studied with the 14C-labelled compound in rats, dogs, monkeys and man.
Abstract: 1 The pharmacokinetic behaviour of the psychotropic drug clobazam, a 1,5 benzodiazepine, and its metabolism were studied with the 14C-labelled compound in rats, dogs, monkeys and man. The absorption was practically complete in all three animal species. Clobazam was not excreted in the unchanged form by all species. The main metabolite in plasma of monkeys, dogs and man was N-demethylclobazam. The metabolites were partially in the conjugated form.
2 The binding to serum proteins (concentration range 0.05-10 μg/ml serum) amounted to between 66% (in rats) and 85% (in man). The maximal levels of total radioactivity (original compound and metabolites) in blood were 0.24 ± 0.043 μg Equ/ml (2-4 h) in doses and 0.67-0.82 μg Equ/ml (0.5-1 h) in rhesus monkeys. These levels were markedly higher than those in rats with values of 0.064 ± 0.012 μg Equ/ml (~0.5 h). The elimination of radioactivity from blood occurred in two phases.
3 After repeated daily administration of oral doses, the 24-h blood levels accumulated in rats to about three times the initial value. In dogs the 24-h serum concentrations remained practically unchanged. Long-term treatment with clobazam in monkeys neither caused enzyme induction nor other processes retarding metabolism and elimination.
4 Both after a single oral and intravenous dose, more than two-thirds of the radioactivity administered to rats was excreted with the faeces. Dogs, however, excreted about three-quarters of the radioactivity with the urine, irrespective of the route of administration. In monkeys, the excretion also occurred mainly in the urine. In all three species, renal excretion was similarly rapid to that from blood or plasma.
5 Apart from gastro-intestinal tract, liver and kidneys, the distribution in rats and dogs was remarkably even within the range of maximal blood levels. In the rat brain, the concentration amounted to only one-third of that in the blood. Special accumulations were not found. In dogs, the concentration in the brain was as high as that in the blood.
6 In rats, kinetics and metabolism were not significantly changed by pregnancy.
7 For metabolism studies in the four species (man, monkey, dog and rat) urine and faeces (and in some cases also serum) were examined after a single dose or repeated administration. The number and kind of metabolites detected in the individual species were partially different. In autoradiographic studies, exceptionally up to 14 radioactive spots were found for clobazam.
8 The structures of the metabolites were elucidated by independent methods, mainly mass spectrometry. In addition to the original substance, eight metabolites were identified for clobazam amounting to 70-90% of the total number of metabolites, depending on the species.
The two most important chemical changes of clobazam during metabolism are dealkylation and hydroxylation. Dealkylation at nitrogen-(1), particularly pronounced in the species dog, does not differ between the 1,4- and 1,5-benzodiazepines. The difference in metabolism is only pronounced in oxidative decomposition.
9 In contrast to diazepam, the 4′ position of the phenyl ring of clobazam seems to be particularly favourable for introduction of a hydroxyl function. In dogs, hydroxylation at the 9 position plays an additional important role. It results in the formation of the metabolite 9-hydroxy-N-demethylclobazam by which this species is markedly distinguished from the other three species.
It is remarkable that clobazam is not hydroxylated at the 3-position. This is obviously a characteristic of the 1,5-benzodiazepines and helps to distinguish them from the 1,4-benzodiazepines such as diazepam.
75 citations
TL;DR: Methodological requirements for an adequate evaluation of psychotropic drug effects and appropriate procedures for their measurement are discussed and the results of comparative investigations concerning the action of Viloxazine, a new antidepressant drug, are illustrated.
Abstract: Dynamics and structure of EEG-patterning are highly sensitive indicators of psychotropic drug effects on the regulation of vigilance. Methodological requirements for an adequate evaluation of these effects and appropriate procedures for their measurement are discussed. The kind of information to be obtained by using these strategies is illustrated by the results of comparative investigations concerning the action of Viloxazine, a new antidepressant drug, on the resting activity and on the waking EEG during performance of various tracking tasks.
54 citations
TL;DR: It is suggested that CEEG is an important tool in predicting and describing psychotropic properties of compounds, and should routinely be used in psychotropic drug development.
Abstract: The EEG effects of twenty, clinically most frequently used psychotropic drugs and five placebos were studied in 75 male volunteers in five simultaneously designed basic studies. In each of the five studies single oral dosages of five drugs (well known representatives of neuroleptics, antidepressants, anxiolytics and psychostimulants, as well as placebos) were investigated in 15 subjects in a double-blind latin-square research design using the methods of the Quantitative Pharmaco-EEG. The results demonstrated that the therapeutically equivalent effective compounds also have similar effects on human EEG. With a classification rule, based on discriminant function 20, and with a classification rule, based on correlation statistics 19 of 25 compounds could be reclassified into correct clinical-therapeutic psychotropic drug groups. It is suggested that CEEG is an important tool in predicting and describing psychotropic properties of compounds, and should routinely be used in psychotropic drug development.
35 citations
TL;DR: The results show that specific individual neurologic soft signs are significantly more frequently present in schizophrenics than in either controls or in other psychiatric groups.
Abstract: SummaryIn earlier studies the authors have reported impairments of cortical function in the parietal and frontal lobes of schizophrenic patients. In this study these results are pursued. The performance of different groups of psychiatric patients with respect to individual neurological soft signs rather than combined cortical function scores, was studied. The potential influence of psychotropic drugs on the significant findings was also analyzed. The results show that specific individual neurologic soft signs are significantly more frequently present in schizophrenics than in either controls or in other psychiatric groups. Additionally, there was no statistical evidence of psychotropic drug effects on the findings.
30 citations
Journal Article•
TL;DR: It is estimated that between one-half to two-thirds of those on psychotropics were given the agents too liberally, especially among the disturbed epileptics who had received psychotropic and anticonvulsant simultaneously.
Abstract: A survey of psychotropic drug usage by questionnaires was conducted at 5 regional residential centers for the mentally subnormal in Eastern Ontario, Canada. Of the 2238 residents studied, 42% were given psychotropics, 27% anticonvulsants, and 11% a combination of both. Prolonged medication and polypharmacy were observed in all facilities. The therapeutic responses to psychotropic medication were generally poor, especially among the disturbed epileptics who had received psychotropic and anticonvulsant simultaneously. It is estimated that between one-half to two-thirds of those on psychotropics were given the agents too liberally.
28 citations
TL;DR: The prescription of psychotropic drugs at a multidoctor district health centre in northern Sweden in 1973, was analyzed by means of problemoriented medical records as mentioned in this paper, which showed that the drugs were prescribed for 11.3% of the patients and 90% not more than three.
Abstract: The prescription of psychotropic drugs at a multidoctor district health centre in northern Sweden in 1973, was analysed by means of problemoriented medical records. Of the 22,000 inhabitants of the district 10,700 consulted the health centre. Psychotropic drugs were prescribed for 11.3% of the patients, corresponding to 5% of the inhabitants of the area. Sixty per cent of the patients received one psychotropic prescription and 90% not more than three. Two-thirds of prescriptions were for women. Hypnotics, sedatives and minor tranquillisers constituted 64% of all prescriptions, major tranquillisers 24% and antidepressants 12%. One fifth of the patients obtained drugs belonging to more than one of the major psychotropic groups during the year. Insomnia, psychoneurosis and depression made up two-thirds of the indications for psychotropic drug therapy. More than thirty different psychotropic drugs were prescribed for the two major indications. There was considerable variation in how the different doctors prescribed drugs for the same indication. Fifty-nine different drug products were prescribed, of which the commonest five constituted more than half of the total number. Individual doctors used from 22 to 38 different psychotropic drugs.
27 citations
TL;DR: An objective rule for the classification of psychotropic substances has been developed based on data from five basic studies simultaneously designed and performed and involving 75 healthy volunteers who ingested 20 different psychotropic drugs and 5 placebos in single oral dosages.
Abstract: An objective rule for the classification of psychotropic substances has been developed. Classification is based on data from five basic studies simultaneously designed and performed and involving 75 healthy volunteers who ingested 20 different psychotropic drugs and 5 placebos in single oral dosages. Each volunteer took one psychostimulant, one antidepressant, one neuroleptic, one minor tranquilizer and one placebo in a double-blind Latin square cross-over design. The variables were 6 frequency bands, based on power spectrum estimates and determined by factor analysis, plus total power in the 1.5-30.0 Hz range. An objective classification rule was established by multi-group (5 groups) linear discriminant analysis. Reclassification of the substances by the new rule yielded correct results for 17 out of 20 psychotropic drugs and 4 out of 5 placebos. Of placebos from various studies not used for the establishment of the classification rule, 7/9 were classified correctly. The validity of the rule for other classes of substances will have to be verified in independent studies.
27 citations
Journal Article•
TL;DR: Consultations for advice and psychotropic drug prescriptions were compared during one year, both before and after treatment, and were found to be reduced by over 50% following treatment.
Abstract: Thirty general practitioner consultations with patients with psychological problems referred to a clinical psychologist for behaviour therapy, were examined. Treatment was carried out wholly within the practice. Consultations for advice and psychotropic drug prescriptions were compared during one year, both before and after treatment, and were found to be reduced by over 50 per cent following treatment. Contact with clinical psychology services, therefore, considerably reduced the demand made by these patients for general practitioner time.
23 citations
TL;DR: Cardiac electrophysiologic studies are a useful technique in determining the interaction between psychotropic drugs and life-threatening arrhythmias; it may provide a means of identifying the patients with cardiac disease in whom administration of these agents may be fatal.
18 citations
TL;DR: Assays of drug levels in blood and of other biochemical characteristics of psychiatric patients are being proposed for clinical application, although their utility in practice remains uncertain.
Abstract: Assays ofdrug levels in blood and of other biochemnical c/iaracteristics ofpsvchiatric patients are being proposedfor clinical application , although their utility in practice remains uncertain. Exceptions are the assay ofblood levels ofanticonvulsants and of lithiummi lOfl . A ssavs ofantidepressant drugs may be especial/v helpful in the evaluation of unexpected responsesr in the avoidance ofuntvanted toxic effects (i,i(/ promise to permit more efficient predictions ofindit'idual requirements . A ssays of platelet MA 0 actii'itv or urinary MHPG excretion remain clinical/v less useful. Attempts to correlate blood levels ofantipsychotic agents tt'ith clinical effects have been disappointing, although netter assay lfl('thOds mna�'prove tiiore useful. THERE has been a striking growth in the development and proposed application of laboratory biochemical measurements in psychiatry. These measurements in- volve assays of blood levels of drug substances and their metabolites or of other metabolic variables-all of which might contribute to improved clinical treat- ment of patients with psychotropic drugs. The rate of appearance of new research and even commercial ap- plications of these measurements is so great, and is producing so much uncertainty for practicing physi- cians, that a briefoverview ofthe present clinical val- ue of such laboratory data is in order.
TL;DR: Activity recording revealed an important residual, behavioral effect of the drug which was not reflected in POMS reports of subjective feelings, suggesting that activity recording may provide a more sensitive measure for psychotropic drug effects.
Abstract: Sixteen male students received bedtime placebo and flurazepam 30 mg at home in a counter-balanced double-blind, crossover design. For 24 h after each treatment the subjects' spontaneous motor activity was recorded each 15 min with an unobtrusive actometer, worn as the subjects attended classes. The circadian activity curves were submitted to cosinor analyses. The 24 h post-flurazepam activity was a mean of 15.1% lower than post-placebo activity (P 0.01). The timing, or phase, of the rhythm was not shifted. Although the drug did not consistently modify reports of subjective feelings on the Profile of Mood States (POMS), 13 subjects correctly discriminated drug from placebo sessions (P<0.05). A bedtime dose of 30 mg of flurazepam appears to significantly reduce spontaneous human motility that night and during the next day. Activity recording revealed an important residual, behavioral effect of the drug which was not reflected in POMS reports of subjective feelings, suggesting that activity recording may provide a more sensitive measure for psychotropic drug effects.
01 Jan 1979
TL;DR: The total prescribing for patients aged over 65 years is reviewed, some examples linking the authors' psychotropic prescribing for the elderly to the relevant clinical indication are given and practice-based data are linked to therelevant clinical information within the computerised record system CLINICS.
Abstract: Most surveys of primary care prescribing have examined prescriptions without reference to the clinical situation. This is because prescription forms (EC10/FP10) have been examined after dispensing by the retail pharmacist. This includes the notable work of Parish and his colleagues (Parish et al 1976). Our data are practice-based and linked to the relevant clinical information within our computerised record system CLINICS (Clark, 1977). Skegg and his colleagues have shown (Skegg, Doll and Perry, 1977) that psychotropic drug prescribing rises sharply with age.In this survey I briefly review our total prescribing for patients aged over 65 years and give some examples linking our psychotropic prescribing for the elderly to the relevant clinical indication.
TL;DR: The analysis showed that the longer repeat prescribing had taken place the older the patient was likely to be and the less closely were they monitored by their general practitioner.
Abstract: Over 1000 repeat prescriptions of psychotropic drugs, which were given without the doctor seeing the patient, were analysed from a population of over 100 000 patients during a two-week period. The analysis showed that the longer repeat prescribing had taken place the older the patient was likely to be and the less closely were they monitored by their general practitioner.
TL;DR: In schizophrenic patients an improvement was observed in those cases who had improved biochemically, and in drug-resistant depressions there was a rapid and significant clinical improvement after piracetam co-administration, and this went in step with a significant rise in A TP levels.
Abstract: The purpose of this controlled clinical trial was to demonstrate possible correlations between changes in bioenergetic metabolism and psychotropic drug administration in the treatment of functional psychosis. The study included twenty-six patients, eleven with schizophrenia, three with chronic atypical depression and twelve with drug-resistant endogenous depressions. All patients were kept on continuous psychotropic medication for at least 3 weeks before starting the trial, and piracetam was given additionally in a fixed dosage of 2400 mg daily; the same number of identical capsules was given during the pre- and post-treatment placebo periods. Psycho-pathological evaluation of the patients was by the BPRS; clinical and biochemical data were evaluated statistically by the analysis of regression. The results show that in schizophrenic patients an improvement was observed in those cases who had improved biochemically, i.e. where the ATP values had increased. In drug-resistant depressions there was a rapid and significant clinical improvement after piracetam co-administration, and this went in step with a significant rise in ATP levels.
TL;DR: A follow-up chart review was undertaken of 100 consecutive patients seen in psychiatric consultation for whom psychotropic medication was recommended, finding most often no discernible reason for consultee disagreement could be found or inferred.
01 Jan 1979
TL;DR: Chronic administration of antidepressants led to a decrease in the density of βAR in rat brain, while psychomotor stimulants induce an enhancement ofβAR levels, and only desipramine, doxepin and amphetamine inhibited norepinephrine uptake.
Abstract: Chronic administration of antidepressants led to a decrease in the density of βAR in rat brain. In contrast, psychomotor stimulants induce an enhancement of βAR levels. Only desipramine, doxepin and amphetamine inhibited norepinephrine (NE) uptake. Although the level of NE may have an important role in controlling βAR density, this is not the only mechanism for the regulation of βAR concentration.
01 Jan 1979
TL;DR: During recent years the authors have seen startling increases in the manufacture, distribution, prescription and cost of psychotropic drugs.
Abstract: During recent years we have seen startling increases in the manufacture, distribution, prescription and cost of psychotropic drugs. Many figures have been quoted from Department of Health and Social Security and other sources (for example Trethowan, 1975) to illustrate these increases. The figures quoted are often said to be out of proportion to the prevalence of the psychiatric disorders for which they are prescribed. This, however, cannot be accepted as a statement of fact, because the prevalence of mental illness in general, let alone that of specific psychiatric disorders that call for drug treatment, is not known. The figures are, none the less, suggestive.
Dissertation•
01 Jan 1979
TL;DR: A sensitive radioenzymatic assay was developed which couples the formation of the "catecholamphetamine" to rapid O-methylation by catechol-O-methyltransferase in the presence of [3H]-methyl-S-adenosylmethionine.
Abstract: Amphetamine is a sympathomimetic and psychotropic drug which is extensively metabolized in liver and in brain. One of its major metabolites, p-hydroxyamphetamine, is accumulated by cortical and striatal synaptosomes. In order to learn whether p-hydroxyamphetamine can be further metabolized to a catecholamine, a sensitive radioenzymatic assay was developed which couples the formation of the "catecholamphetamine" to rapid O-methylation by catechol-O-methyltransferase in the presence of [3H]-methyl-S-adenosylmethionine. Rat brain microsomes contain a cytochrome P-450-dependent monooxygenase which synthesizes catecholamphetamine from p-hydroxyamphetamine. The formation of this catechol metabolite may be involved in the development of tolerance in chronic amphetamine use.
TL;DR: The solid state structure of the hydrofumarate salt of 5,5-dimethyl-10-(4-methylpiperazinyl)-1O,11-dihydro-5 H -dibenzo[ b, f ]silepin (II), a silicon analog of perathiepin (I) in which divalent sulfur is replaced by the (CH 3 ) 2 Si moiety, has been determined by X-ray diffraction methods as mentioned in this paper.
TL;DR: Fifty psychiatrists were shown advertisements from two professional journals in which the names of products had been deleted and subjects were queried regarding aesthetic appeal, informational content, and product identification.
Abstract: Fifty psychiatrists were shown advertisements from two professional journals in which the names of products had been deleted. Subjects were queried regarding aesthetic appeal, informational content, and product identification. Generally, few ads were admired or found informative, and few drugs were identified despite wide exposure of some ads. The roles of pictorial content, text, and media exposure are discussed.
01 Jan 1979
TL;DR: A recent review of the literature on the psychological assessment of the effects of L-dopa revealed the reports to be not only divergent but also often contradictory, some research workers finding that L -dopa had no effect on intellectual functions as such, others reporting an improvement, with a third group claiming that it produced deterioration as mentioned in this paper.
Abstract: The assessment of the effects of psychotropic drugs is a difficult problem in any age group. A recent review (Elithorn, Lunzer and Weinman, 1975) of the literature on the psychological assessment of the effects of L-dopa revealed the reports to be not only divergent but also often contradictory, some research workers finding that L-dopa had no effect on intellectual functions as such, others reporting an improvement, with a third group claiming that it produced deterioration. Some limited experimental work, using the techniques described below, combined with the review of the literature enabled these authors to conclude with some degree of certainty that the main effect of L-dopa on intellectual functions could be related to its stimulant action on mood and its arousal or alerting effect.
01 Jan 1979
TL;DR: In this paper, the acute efficacy of single oral dosages of 20 psychotropic drugs, 5 neuroleptics, 5 anxiolytics, 5 antidepressants and 5 psychostimulants plus 5 placebos has been tested in 5 basic studies simultaneously designed and performed and involving 75 healthy male volunteers.
Abstract: The acute efficacy of single oral dosages of 20 psychotropic drugs, 5 neuroleptics, 5 anxiolytics, 5 antidepressants and 5 psychostimulants plus 5 placebos has been tested in 5 basic studies simultaneously designed and performed and involving 75 healthy male volunteers. Each study was done in a Latin square double-blind design with 15 subjects, each receiving one placebo and one compound of each of the four clinical therapeutic psychotropic drug classes. Three 5-minute EEG recordings (pre, 1 hr. and 3 hr. post drug intake) are taken to represent the drug effects. The differences in drug efficacy were tested by multivariate analysis of variance using 3 × 7 power spectrum estimates selected from these 3 EEG recordings. 14 of the 20 substances could be distinguished from placebo at a 5%, 16 at a 10% level. In order to demonstrate the results visually, examples of the mean relative power estimates as well as the standard q-score profiles of the 7 variables at three times are given. All 7 variables selected contribute to the differences between the drugs. However, some variables seem to be more specific for a defined drug class than others:υ = 5.5 – 8.5 Hz for the neuroleptics, β1F = 12.0 – 18.0 Hz for the anxiolytics, α1F = 8.5 – 10.5 Hz for the psychostimulants and a combination of δF = 1.5 – 3.5 Hz, lF and α1F for the antidepressants.
TL;DR: In these days of economic stringency, above all in the National Health Service, it might be worth mentioning that the course of oral methionine that the authors recommend in these circumstances will attract a charge of some 80p whereas the corresponding course of N-acetylcysteine as a "special intravenous preparation (Parvolex, Duncan Flockhart)" will cost more than £30.
Abstract: of them,4 we suggest, is irrelevant and another two, from signatories to this letter,5 (i did in honesty mention this as a possibility without substantiating it with any evidence. In fact, in all our work with oral methionine in paracetamol poisoning we have never found any toxicity from it whatsoever. In conclusion, we are happy to leave it to your readers to make up their own minds on the facts before them. After all, it is almost a question of \"you pays your money and takes your choice.\" In these days of economic stringency, above all in the National Health Service, it might be worth mentioning that the course of oral methionine that we recommend in these circumstances will attract a charge of some 80p whereas the corresponding course of N-acetylcysteine as a \"special intravenous preparation (Parvolex, Duncan Flockhart)\" will cost more than £30.
Book•
01 Jan 1979
TL;DR: Reading new frontiers in psychotropic drug research is a good habit; you can develop this habit to be such interesting way to be one of guidance of your life.
Abstract: Will reading habit influence your life? Many say yes. Reading new frontiers in psychotropic drug research is a good habit; you can develop this habit to be such interesting way. Yeah, reading habit will not only make you have any favourite activity. It will be one of guidance of your life. When reading has become a habit, you will not make it as disturbing activities or as boring activity. You can gain many benefits and importances of reading.
01 Jan 1979
TL;DR: A confusional state is a happening which may be transient or may become permanent, in which an individual is forgetful and disorientated in time, space and person, and the effect of drugs in either causing or treating them will hinge on their action on this target organ.
Abstract: A confusional state is a happening which may be transient or may become permanent, in which an individual is forgetful and disorientated in time, space and person. It may be associated with behavioural disturbance varying from apathy or obtundity to delirium or mania. Such states are encountered frequently in elderly patients due to a broad spectrum of clinical causes. They are episodes of acute malfunction of the brain. The effect of drugs in either causing or treating them will, therefore, hinge on their action on this target organ.
Journal Article•
01 Jan 1979
TL;DR: In this paper, a short review of the few published articles correlating drug leyels, EEG measurements and/or clinical rating scales is presented, and the challenge and difficulties of such multicentric and interdisciplinary studies are discussed.
Abstract: Methodological problems are first presented: interactions between factors influencing psychotropic drug administration and the subject, choice of EEG measurements and difficulties of assessing behavioral or clinical changes. A short review is then presented of the few published articles correlating drug leyels, EEG measurements and/or clinical rating scales. Anxiolytics usually enhance EEG beta activity. Thymoleptics enhance slow and fast activities and we have correlated this EEG profile with chlorimipramine plasma level. Neuroleptics enhance slow activities. In six schizophrenic patients being treated by increasing doses of haloperidol, plasma levels were correlated with left/right ratio of fast EEG beta activity recorded from posterior areas. Challenge and difficulties of such multicentric and interdisciplinary studies are discussed.