Showing papers on "Psychotropic drug published in 1981"

The short-term outcome of neurotic disorders in the community: the relation of remission to clinical factors and to "neutralizing' life events.

Abstract: A longitudinal study of neurotic disorder in the community showed that half the cases identified at first interview had remitted one month later. Remission was significantly related to four variables: recency of onset and of peak of the disorders, the occurrence of recent threatening life events and the occurrence of subsequent "neutralizing' life events. A neutralizing event was defined a priori as one which neutralized the impact of an earlier threatening life event or difficulty. One third of all remissions were caused by such an event. Remission of disorder was not significantly related to demographic variables, symptom severity, syndrome type, medical consultation or psychotropic drug prescription. The implications for neurotic disorder in the community are discussed, in particular its relation to life events and the favourable outcome in the absence of treatment.

Factors affecting the consumption of psychotropic drugs

Abstract: This paper presents some results from a survey conducted in West London in 1977. The 2-week prevalence of psychotropic drug consumption was found to be 10.9% and almost identical figure to that obtained in an earlier survey conducted 8 years previously. The reasons for the absence of the expected rise in prevalence of consumption are discussed. Consumption was found to be strongly associated with various measures of health, and there was a marked sex difference in drug consumption (females greater than males) which was independent of health.

Mortality Among Psychiatric Inpatients: Age-Adjusted Comparison of Populations Before and After Psychotropic Drug Era

Abstract: • Comparison of age-adjusted death rates for inpatient and general populations from three pre-drug era and one post-drug era samples revealed a progressive decline in mortality that was most marked among elderly men. When length of stay was considered, the post-drug era sample showed a 30% reduction in mortality among patients hospitalized less than one year and a 50% reduction among longer-stay patients. The findings fail to support an increased mortality risk associated with the use of psychotropic drugs but dramatize the increased need for psychiatric services resulting from the increased survival of patients, especially those with long-term hospital stays.

Renal Toxicity of Lithium

Abstract: Lithium is a valuable psychotropic drug, but its therapeutic index is low. As the lithium ion is almost exclusively eliminated by the kidneys, reduced renal lithium elimination may lead to increasing serum lithium levels and lithium intoxication. Since lithium intoxication may be complicated by acute renal insufficiency, which will further delay lithium elimination, a ‘vicious circle’ can be established. Fluid therapy of any kind has been shown to have only a very limited effect on renal lithium elimination during lithium intoxication. The most efficient method for eliminating lithium from the body is through haemodialysis treatment. Peritoneal dialysis is slower but also effective. Dialysis treatment has to be carried out long enough to ensure a serum lithium concentration of less than 1mmol/L after equilibrium between intracellular and plasma lithium is established.

The chemically abused child.

Abstract: The case of an 18-month-old child poisoned by her mother with chlorpromazine is described. Fifteen other cases of child poisoning have been previously reported. In all of these cases the assailant was the mother (who in 11 cases was described as mentally disturbed); in 14 cases the presenting sign was a change in the level of the child's consciousness; and in ten cases the agent was a psychotropic drug. These poisonings were always well planned and manipulative, usually of long duration (1 1/2 to 48 months), and often continued during hospitalization, but lacked homicidal intent. Three children died. It is suggested that this subgroup of child abuse be more rigidly defined and possibly be named "the chemically abused child." A higher degree of suspicion and alertness to this problem would increase the number of cases identified and the number of children who receive professional care. Language: en

The influence of rolipram on the central serotoninergic system.

Abstract: The influence of rolipram, a potential psychotropic drug, on the central serotoninergic system was studied. Rolipram was found to elicit the head twitch reaction in rats but not in mice. This effect was abolished by phenoxybenzamine, clonidine and morphine but not by cyproheptadine, metergoline and pizotifen. The antagonistic action of morphine was reversed by naloxone. Rolipram stimulated the flexor reflex of the hind limb in the spinal rat but this effect was blocked neither by cyproheptadine and pizotifen, nor by phenoxybenzamine. In rats kept at a high ambient temperature, rolipram induced slight hypothermia and did not affect the hyperthermia induced by fenfluramine. Rolipram produced also slight hypothermia in rabbits. Our results indicate that rolipram does not affect the central serotoninergic transmission but in some of its central effects (the head twitch reaction) the noradrenergic system and the opiate receptors seem to be involved.

Long-term psychotropic drug-taking and the process of withdrawal

Abstract: Perceived efficacy and reliance on psychotropic drugs is explored in a sample of mainly long-term consumers. A comparison of past and present users elucidates some of the factors involved in prolonged usage and the experiences of those who withdraw from the medication.

Pharmacological evaluation of 2-(4-methylaminobutoxy)diphenylmethane hydrochloride (MCI-2016), a new psychotropic drug with antidepressant activity.

Abstract: Pharmacological properties of 2-(4-methylamino-butoxy)-diphenylmethane hydrochloride (MCI-2016) were examined in comparison with those of other antidepressants. MCI-2016 significantly antagonized the hypothermia and depression-like syndrome produced by reserpine injection. Furthermore, the drug exhibited such activities as antitetrabenazine and anti-cataleptic actions, and potentiation of the behavioural excitation induced by yohimbine, methamphetamine and L-dopa. MCI-2016 showed a definite suppressive effect on muricidal activity in olfactory bulb removed rats and the long-term isolation-induced fighting in mice without causing apparent motor disturbance. Judging from the effects of the drug on in vitro response to noradrenaline (NA) and serotonin (5-HT), and on p-chloramphetamine-induced hypermotility, it is suggested that MCI-2016 is a selective potentiator of NA presumably due to an inhibition of NA uptake. Anticholinergic and sedative actions of MCI-2016 were considerably weaker than those of amitriptyline and imipramine. Acute toxicity of MCI-2016 was the weakest among the drugs tested. These pharmacological profiles may suggest a potential clinical utility of MCI-2016 as a new psychotropic agent having an antidepressant activity.

Amitriptyline and perphenazine (Triptafen DA) in chronic pain

Abstract: One-hundred and twenty patients with chronic pain, who had all failed to obtain relief with traditional medical treatment, were given a standard psychotropic drug mixture consisting of amitriptyline 25 mg and perphenazine 2 mg. Of those who completed 2 months of treatment, 33.68% were pain free, while 8.3% had unacceptable side-effects. The best results were obtained in patients with postherpetic neuralgia and postoperative scar pain.

Cyclical variation in psychotropic drug prescription

Abstract: In this study it is shown that drug prescription is subject to cyclical variation throughout the year, but that the patterns of variation for different types of drug are different. Some of the reasons for, and the implications of, this finding are discussed.

Drug-Induced Tardive Dyskinesia

Abstract: Drug-induced tardive dyskinesia, which occurs in the course of long-term administration of psychotropic drugs, especially neuroleptics, and persists for years even after drug removal, began to be reported in the late 1950s. Since then, more than 100 investigations on this subjects have been described. And it is estimated that 10 to 30 percent of long-term hospitalized psychiatric patients in Europe and North America exhibit tardive dyskinesia, whereas 5 to 20 percent of patients exhibit this syndrome in Japan. These findings suggest that the manifestation of tardive dyskinesia will become a serious problem in the investigation of psychotropic drug treatment. The author presents a review of the symptomatology, etiological factors, differential diagnosis, prognosis, and management of this syndrome. Results of the author's studies in the cross-national survey and on the reversibility of tardive dyskinesia are also described. In connection with biochemical theory of the etiology of tardive dyskinesia, a variety of therapeutic investigations have been carried out, but no successful therapy could be found among them. Therefore, the author stresses that the early diagnosis of dyskinetic symptoms, possible removal of responsible drugs, and preventive care in daily psychotropic drug treatment are regarded as extremely important in the management of this syndrome.

Toxicology and Side-Effects of Anxiolytics

Abstract: Although we tend to regard anxiety as a product of twentieth century living, anxiety, stress, and tension in their various forms must have been with man throughout his entire history. Indeed, as early as about 380 B.C., a statement was made by Plato in The Republic associating anxiety with a disease state: “Man is always fancying that he is being made ill, and is in constant anxiety about the state of his body” (Jowett, 1952). William Heberden also associated anxiety with disease in his celebrated lecture on angina pectoris to the Royal College of Physicians of London in 1768 (Heberden, 1772). During the last 50 years, thousands of papers have appeared in medical and scientific journals and dozens, if not hundreds, of books and monographs have been published on the pervasive subject of anxiety. “Indeed, anxiety has become the cornerstone of both psychosomatic medicine and psychiatric theory and practice” (Lief, 1967).

Clinical significance of neuroleptic plasma level monitoring

Abstract: Every time the clinical significance of neuroleptic plasma level monitoring is discussed in congresses or seminars, two opposite opinions are encountered. On the one side, there are physicians and scientists who think that neuroleptic plasma level monitoring is only an interesting, but expensive, intellectual exercise which has very little to do with the treatment or the management of the psychotic patient; on the other side, there are physicians and scientists who believe that neuroleptic plasma level monitoring may be a useful tool for a more rational and safer therapeutic approach to psychiatry. Such a situation has apparently crystallized for at least six years, with no real dialogue between the two parties and a growing scepticism towards the possible value of therapeutic drug monitoring in psychiatry, as documented by a recent editorial (Editorial, 1979). This fact is highly regrettable because the field of neuroleptics appears as the only one which has not yet taken advantage of the increased knowledge on drug utilization and prescription brought about by the development of clinical pharmacology.

Temazepam versus nitrazepam: a comparative trial in the treatment of sleep disturbances.

Abstract: Introduction Short-acting benzodiazepines are often the first choice drugs in the pharmacological treatment of insomnia, particularly in subjects who live a normal daily working life. Day-time sedation, which impairs mental and physical performance, is in fact one of the major drawbacks of benzodiazepines with a longer half-life. Recently temazepam, one of the shortacting benzodiazepines, has been made available for therapeutic use as a 1% solution in polyethileneglicole (PEG) supplied in soft gelatin capsules. Its pharmacokinetic profile makes it particularly suitable as a sleepinducing agent. The mean plasma levels reach 80% of the peak value as soon as 20 minutes after oral administration, and the drug has a half-life of 6-8 hours (Fucceila 1979). It is eliminated in the urine as the g1ucuronide, forming virtually no active metabolites. On the basis of its pharmacokinetic pattern, with the administration selectivity commonly used in the treatment of insomnia, no cumulation phenomena are usually observed (Fuccella 1979). At the therapeutic dosage, the drug does not give rise to much detectable hang-over the next day (Hindmarch 1975, Hindmarch 1976, Fowler 1977), and even in geriatric patients it appears well tolerated and relatively free from 'morning-after' effects (Middleton 1978). The main aim of this study was to assess the sleep-inducing activity of temazepam and any residual sedation it caused, in comparison with nitrazepam, still a widely used and well documented hypnotic drug. Material and Methods To be eligiblefor the trial, subjects had to have sleep disturbances involving difficulty in falling asleep (onset of sleep longer than 45 minutes) and/or early awakening or mixed type insomnia. Patients with hepatic or renal failure, painful conditions which might interfere with sleep, or the need for concomitant major psychotropic drug or anticonvulsant treatment were excluded. Pregnant women were also not included. Thirty-six subjects were selected, nineteen males and seventeen females, mean age 44·5 years (range 30-59 years). Thirty per cent of these subjects suffered from moderately severe sleep disturbance, and the rest suffered from slight sleep disturbance. The main complaint on admission was the difficulty in falling asleep, the average time required being 65 minutes (range 50-120); the total duration of sleep was on average 6 hours (range 5-7). Only three of these patients were already receiving sleep-inducing or anxiolytic drugs, and these were withdrawn the day before starting the trial. In none of these patients was insomnia a symptom of psychiatric disease, and they were all in hospital for internal medical disorders, mainly involving the cardiovascular system. Basic therapy for these ailments remained unchanged throughout this study. All participants gave their informed consent to taking part in the trial. The three treatments under investigation, namely 20 mg temazepam in soft gelatin capsules", 5 mg nitrazepam in

[The use of electrophysiological techniques to project typical psychotropic drug effects: some examples (author's transl)].

Abstract: A long existing hypothesis, i.e. that the EEG effects, in lead O2A2, of typical psychotropic drugs are substance class specific, when given as single oral dosages to healthy volunteers, is discussed. Using the technique of pharmacoelectroencephalograhpy, five typical representatives of neuroleptics, anxiolytics, antidepressives, psychostimulants (Fig. 2) as well as placebo were investigated in 75 volunteers, each receiving one representative of each substance class in a double blind 5-fach change over latin square design (Fig. 3). A five minute EEG record for lead O2A2 was obtained pre, 1 h and 3 hrs post drug intake unter RR (Relaxed Recording) conditions. Typical samples of th EEG records are shown in Figs. 4--7. Parametrisation was done using power spectrum analysis. Then 3 x 7 target variables were formed--six relative power values in predetermined frequency bands and the total power between 1.5 and 30.0 Hz for 3 occasions of measurement (Fig. 4--7). Using a (five-group) linear discriminant analysis the substance effects on the EEG were transformed into 5 probability measures for the five substance classes (Fig. 4--7). The present paper should provide a demonstration of some typical examples, using single subjects, of the projection of substance effects onto an electrophysiological level using a vector of 21 components (7 target variables for 3 occasions of measurement) as can be seen from Table 1. Furthermore, the transformation into probability measures of the five substance classes are shown in Table 2. Table 3 shows five examples of projections of substance effects, which do not fit into the classifications to which they belong. An attempt is made to explain, whether single target variables from the power spectrum can contribute differently to the discrimination between single substances of different substance classes. Within the accepted system of 4 psychotropic drug classes, the following variables seem to be of importance: a) The benzodiazepine anxiolytics show a marked increase in beta F1 (12.0--18.0 Hz) power and activity and, related to sedation, an increase in delta F-power and a decrease in alpha-power; b) The psychostimulants of the amphetamine type show an increase in total power and alpha-power, an increase in the power of the frequency ranges near to the alpha-band (slow beta, fast theta) and a decrease in delta F (1.5--5.5 Hz)-power, when delta F-power is high in the pre-values, indicating a stabilization in vigilance; c) The neuroleptics show a marked increase in theta F (5.5--8.5 Hz)-power, some increase in the delta F--and a decrease in the beta F1-and beta F3-power; d) Tricyclic antidepressants show an interaction between delta F-theta F-, alpha- and beta-power, in the sense of a dissociative shift in vigilance.

Experimental Behavioral Pharmacology of Gerontopsychopharmacological Agents

Abstract: The above motto expresses the choice of the subject matter for this chapter. The authors are not going to discuss rejuvenating cures, nor elixirs or drugs claimed to be effective accordingly. Nor — other than incidentally — will the important scientific achievements in the knowledge of tissue, cellular, and metabolic age-related changes or possible drugs interactions at that level be dealt with. Those aspects of ageing are beyond the scope of this chapter and also beyond that of the authors’ own competence.

Educating Social Workers about the Use of Chemotherapy and Other Treatment Modalities.

Abstract: This paper surveys the relevant literature on the usage and effectiveness of chemotherapy and other treatment modalities, preparatory to assessing the actual administration and monitoring of psychotropic drug treatment with severely mentally ill adolescents. The intent is to evaluate the quality of the evidence, to uncover gaps in knowledge, and to provide a rationale for standardization in chemotherapeutic treatment preferences and/or in combination with treatment forms, in-depth research design, and methodology, and ultimately, to question the extent of reliance on chemotherapy for effective and prompt treatment and rehabilitation of severe mental illness in adolescents.

Drug Treatment of Phantom and Stump Pain

Abstract: Every amputee with postamputation pain asks how to control it: Pain is his main problem. Among current practices for treating pain, there are groups of medicaments that appear sufficiently effective. Of course, we must consider individual response to drugs, psychological repercussions of long-lasting pain, as well as the time-consuming observations and interactions of patient and physician. Concerning acute or persistent pain, patient and physician must agree on how to fight it: This is a basic requirement.

Psychopharmacology in Medical Practice—The Benefits and the Risks

Abstract: Psychopharmacology has become a major approach to treatment in primary medical care. However, combined psychiatric and medical illness can give rise to some challenging diagnostic problems. Furthermore, drug treatment of patients with such illnesses can involve important drug-disease interactions and drug-drug interactions. One should keep in mind the issues that arise when an emotionally troubled patient would benefit from a psychotropic drug but a concurrent medical illness complicates this treatment. An awareness of both the medical and psychiatric issues involved may make successful treatment possible.