Showing papers on "Psychotropic drug published in 1983"

Family roles, structure, and stressors in relation to sex differences in obtaining psychotropic drugs.

Abstract: Although it is well-documented that women are more likely than men to use prescribed psychotropic drugs, there are conflicting explanations of this pattern. The purpose of this paper is to examine this sex difference in relation to three theoretical perspectives: (1) the sex-role theory, (2) social support theory, and (3) stress theory. Data from the National Medical Care Expenditure Survey confirm that women were more likely than men to obtain a psychotropic drug. The data also showed that for both men and women, the likelihood of obtaining a psychotropic drug is influenced by family role responsibilities, family structure, and stressful events. However, women had a significantly higher likelihood of use than men under similar family circumstances. When sociodemographic and health-statuslaccess-to-care variables were controlled, the association for men between family circumstances and obtaining a psychotropic drug disappeared. For women, however, certain family role responsibilities, structures, and stressful events significantly affected the likelihood of obtaining a psychotropic drug even when sociodemographic and health-statuslaccess-to-care variables were controlled.

Histamine Receptors in Brain

Abstract: While mounting evidence is elevating histamine to the category of a putative neurotransmitter, its explicit functions in brain remain as unclear as those of most other putative neurotransmitters. Evidence has been reviewed (Green et al., 1978a; Schwartz, 1979, Schwartz et al., 1980a,b; Hough and Green, 1980) that it may function in arousal, locomotor activity, regulation of hunger and thirst, emesis, thermoregulation, and the elaboration of hormones, most persuasively, of prolactin and the antidiuretic hormone. There is also evidence, too rich to review here, that histamine may alter the formation, release, or activities of other endogenous substances. As provocative as many of these observations are, they remain to be integrated into coherent hypotheses, as do observations on other biogenic amines. The development of methods to measure histamine metabolism (Hough et al., 1981) offers an opportunity to evaluate further the functions of histamine in brain. Methods to study brain histamine receptors provide additional means of assessing the roles of histamine in brain. A description of these receptors, some of their associated effects, and their response to psychotropic drugs is presented in this review.

Melatonin increases oestrogen receptor binding activity of human breast cancer cells

Abstract: Breast cancer is frequently a hormone-dependent tumour, and several studies have suggested that the pineal gland hormone melatonin may influence the growth and development of this malignancy. Subcutaneous injections of melatonin have been shown to inhibit, and pinealectomy to enhance, the development of dimethyl benz(a)anthracene (DMBA)-induced mammary tumours in rats. Use of the psychotropic drug thorazine, which increases plasma melatonin levels, has been associated with a decreased incidence of breast cancer in psychiatric patients. Calcification of the pineal gland has been correlated with an increased incidence of breast cancer in women. While the mechanism by which melatonin influences these tumours is unknown, both human breast cancer and DMBA-induced tumours contain oestrogen receptors (ER) and respond to changes in the oestrogen milieu. We therefore wondered whether melatonin might be altering ER binding activity of these tumours. We report here that in vitro incubation of MCF-7 human breast cancer cells with melatonin in physiological conditions increased the cytoplasmic and nuclear ER activity of these cells within 40 min, giving no change in the equilibrium dissociation constant (Kd) of the receptor. This induction was blocked by cycloheximide, and thus requires continuous protein synthesis. The modulation of ER binding activity of breast cancer by another endogenous hormone may be important for understanding the behaviour and treatment of this disease, and may provide insight into the factors regulating the synthesis and metabolism of steroid hormone receptors.

Hyponatremia due to psychotropic drugs.

Abstract: The syndrome of hyponatremia in psychiatric patients is described, and cases associated with psychotropic drug treatment are reviewed. The causative role of the drug should be documented by rechallenge or a water loading test. In some instances it is possible to continue psychotropic treatment by restricting fluids or administering demeclocycline.

The path to prescription: sex differences in psychotropic drug prescribing for general practice patients.

Abstract: The excess prescribing of mood-modifying drugs to women has been observed for some time, but the explanation for the sex difference has resisted analysis. In this paper, we develop five distinct hypotheses which summarise several of the most popular explanations and subject them to empirical test using data collected independently from doctors and patients in 1301 general practice consultations. The survey was conducted in Sydney, Australia in 1976, and includes information on psychiatric morbidity, presenting complaint, diagnosis, and prescription. Cross-tabular and regression analyses suggest that higher rates of consulting by women and perhaps a higher incidence of female morbidity account for much of the prescribing differential. That is, the main sources of the sex difference in prescribing appear to lieoutside the consultation rather than arising from doctor/patient interaction. The one exception to this is that doctors tend to “underdiagnose” psychiatric disturbance in males.

Current attitudes about the benzodiazepines: trial by media.

Abstract: Trial by media can never take the place of careful scientific evaluation of a psychotropic drug. The two methods are antithetical. Scientific inquiry depends on careful examination of data. The media cannot present information in detail. It titilates, dramatizes and pulls facts out of context. It is unfortunate, but it is so.

An absolute must in clinico-pharmacological research: pharmaco-electroencephalography, its possibilities and limitations.

Abstract: During drug development effects on blood cells, metabolism or function of heart and circulation are routinely examined. In case there is evidence of influence on such systems, examinations in clinical pharmacology are done. For the organ central nervous system the same rules should be followed, independently whether a substance is primarily a psychotropic drug or developed for other indications. Besides pharmacopsychological procedures pharmacoelectroencephalography is the most sensitive method to describe drug induced changes on brain function of humans. In event related research (e.g. evoked potentials) it is easier to form hypotheses for the mechanism of reaction after stimulation. About the validity of spontaneous cortical activity, like scalp recorded EEG we have little knowledge. However, a single signal of the spontaneous activity is analyzed into several components, each of which can be influenced differently by various drugs. Important areas of pharmacoelectroencephalography are: 1) Determination of CNS effects on a functional level; judgement whether a pharmacon has a potential for influencing CNS function in comparison to placebo. 2) Characterization of CNS-effects; determination of vigilance changes and classification of the profile in comparison to the EEG-effects of standards. 3) Determination of dose/efficacy and time/efficacy relations; description of kinetic data based on an effect-parameter, in contrast to blood levels; comparison of different galenic formulations; determination of onset and duration of effects; etc. 4) Determination of sleep-wake rhythms; measurement of influence on sleep/waking behaviour in the sleep laboratory or under vigilance controlled conditions during daytime.(ABSTRACT TRUNCATED AT 250 WORDS)

Measuring the side-effects of psychoactive drugs: a pharmacodynamic profile of alprazolam

Abstract: An assessment has been made of the actions of the psychotropic drug alprazolam and of its possible interaction with alcohol, using a variety of psycho(pharmaco-)logical test systems designed to examine sensory, motor and other central nervous system functions in addition to giving subjects impressions of drug actions and side-effects. The merits and validity of these tests will be discussed and the simplicity of assessing psychomotor function for investigating drug-alcohol interactions is illustrated.

Knowledge and attitudes of primary health care personnel concerning mental health problems in developing countries.

Abstract: A semi-structured interview for assessing the knowledge and attitude of health workers concerning mental health problems was applied in seven developing country areas within the context of a World Health Organization coordinated collaborative study. The results indicate a lack of basic mental health training associated with a failure to recognize mental health problems, restricted knowledge concerning psychotropic drug therapy, and an inability to visualize practical forms of mental health care which could be introduced at primary care level. The results were used to design appropriate training programs, and the observations will be repeated to assess the effectiveness of training.

Psychotropic drug prescription in Nigeria

Abstract: – – A study of prescribing practice in three psychiatric institutions in Nigeria revealed high frequency of polypharmacy, liberal routine use of antiparkinsonian agents and daily multiple administration of drugs. In the treatment of depression and schizophrenia older and better known oral neuroleptics were preferred to newer ones, but there was apparent tendency for depressives to be under-treated and long-acting depot preparations were seldom administered to schizophrenics. Several aspects of drug use were similar to those observed elsewhere, particularly in the Anglo-American practice – an observation presumed explicable in terms of common psychiatry training background. The need for clinicians to comply with accept-able pharmacokinetic principles of drug treatment is stressed.

Compliance with therapeutic regimens: a follow-up study for patients with affective disorders

Abstract: The purpose of this study was to assess the impact of patient education on patient compliance to psychotropic medication after discharge from the hospital. A sample of 36 patients discharged from an in-patient care facility and receiving an oral form of psychotropic drug were the subjects of this study. All subjects were patients of affective disorders. Subjects were randomly assigned to two groups: a control group; and a directive patient-education group. The subjects were followed up after discharge for a 6-month period. In analyzing the data, results indicated that the difference in percentage of compliance between the two groups was statistically significant. Findings imply that patient education did have an effect on patient compliance to medication. The findings of the study support a technique that can be incorporated in both in-patient and out-patient programmes in psychiatric-mental health nursing. It would increase patient compliance to medication and hence decrease chances of rehospitalization.

A Double-Blind Placebo-Controlled Trial

Abstract: Acupuncture treatment of chronic low back pain was studied in a placebo-controlled double-blind crossover trial completed by 77 patients. The patients had significantly increased depression, neuroticism, and hypochondriasis scores. lnltial pain levels correlated with state-anxiety, depresslon, pain duration, and abnormal illness behavior measures, as well as with the intake of psychotropic but not analgesic medication. Overall reduction in pain score was 26 percent for acupuncture and 22 percent for placebo treatment; the difference was not significant (p >0.6). Analgesic drug intake was reduced to a similar extent in both groups. During the first phase of treatment, patients receiving acupuncture had a greater but not significantly dlfferent reduction in pain rating scores compared with those receiving placebo (t = 0.52; p >0.6). This group showed significantly lower pain scores (p X0.05) in the second phase of the trial while receiving placebo treatment. Overall reduction in individual patient’s pain score was best predicted by initial pain severity (r = 0.43; p

Utilization of psychotropic drugs in Sweden and the other Nordic countries

Abstract: Marked geographical differences have been found in the utilization of important drugs, e.g. antidiabetics, antihypertensives and psychotropics, both within and between several European countries (Bergman et al., 1975, 1979b; Grimsson et al., 1977; Baksaas, 1978). As there are no data available to suggest correspondingly large differences in the disease patterns between these countries, geographical variations are of great potential interest to public health.

Introduction: The Practice of Pharmacotherapy

Abstract: Experimentation with drugs that alter mood, thinking, or perception represents a timeless human enterprise. Although largely aimed at the relief of suffering, the utilization of various pharmacological agents also reflects different cultural, religious, and political ideologies. Frequently, the implementation of effective pharmacological treatments depends more on social issues, economic considerations, and serendipity than on clinical factors. A historical account of both the discovery and introduction of psychoactive drugs in the United States highlights these patterns.

Patterns of use of psychotropic drugs in Spain in an international perspective

Abstract: The increase in the consumption of psychotherapeutic drugs, and particularly of sedatives and hypnotics, has led to increasing concern about the overprescribing and abuse of these drugs by the public. The study of drug consumption, and eventually the identification of particular areas of misuse, soon leads to a search for medical, social or cultural factors which can influence drug utilization. Drug utilization has been defined by the World Health Organization (1977) as ‘the marketing, distribution, prescription and use of drugs in a society, with special emphasis on the resulting medical, social and economic consequences’. Five questions arise when the utilization of sedatives and hypnotics is to be studied: (1) which are the characteristics of the milieu which may have some influence on the consumption of these drugs; (2) which are the characteristics of the supply of these drugs; (3) which are the most consumed drugs; (4) how are these drugs prescribed, dispensed and consumed; and (5) which (if any) are the effects of the consumption of these drugs.

Extent of drug abuse: an international review with implications for health planners.

Abstract: This review of drug abuse on a global scale summarizes current knowledge regarding the predominant patterns of use and adverse effects of 9 major drug types: opium heroin other opiates cocaine cannabis hallucinogens amphetamines barbiturates and volatile solvents. Cannabis accounts for 62% of all reported abuse worldwide. There are distinctive regional patterns of drug abuse but within regions each country appears to have its own profile in terms of the types of drugs abused their use patterns populations involved and the seriousness with which drug abuse is viewed. The tendency of drug abuse to spread in epidemic fashion the involvement of young people and its association with criminality make this a priority area for national governments. The current system of annual government reports to the UN on the extent of drug abuse is considered to represent the most comprehensive source of current information in this area. The report closes with several recommendations concerning international data on drug abuse. Guidelines are needed to help national planners to develop national estimates on the total number of abusers for the major drug types. Also needed are operational criteria for defining drug dependence and disability. It is noted that the total of 48 million drug abusers worldwide includes 30 million cannabis abusers and 1.6 million coca leaf chewers who are not as likely to contribute to public health and social problems in their communities as the 1.7 million opium and 0.7 million heroin users lumped in the same category. In addition there is a general lack of data on the extent of psychotropic drug abuse and dependence in patient populations. All governments especially those in the African region are urged to report annually statistical data to the UN on number of abusers and drug-related deaths by drug type. When specific drugs are creating public health and social problems this information should be reported to the UN so that action can be taken to strengthen international controls on these substances.

Psychiatric pharmacy in a partial hospital program.

Abstract: Psychiatric pharmacy practice in a partial hospital program (PHP) is described. The program's objectives are: (1) to provide a transitional setting in which to assist persons with psychiatric disorders to reenter the community after hospitalization; (2) to provide more structured and intensive therapy than is available in an outpatient setting; and (3) to diagnose and treat early psychiatric symptoms, providing an alternative to hospitalization. The pharmacist conducts medication history interviews, co-directs a weekly medication group, participates in weekly medication clinic, provides individual consultation, teaches pharmacy students, participates in health care group, and provides inservice education to the staff. Clinical pharmacy services in a psychiatric partial hospital program increase knowledge of psychotropic drug efficacy and side effects in PHP staff, increase learning about these medications in PHP clients, and can result in safer and more effective use of medication.

Behavioural analysis of drug action

Abstract: In order to understand what are the aims and means of behavioural analysis of drug action, a practical example may be useful.

To what extent are inter- and intraregional differences in psychotropic drug use explained by demographic and socioeconomic factors?

Abstract: Geographical comparisons made between psychotropic drug usage levels in different countries (Grimsson et al., 1979) or particular regions (Westerholm, 1979; Elmes et al., 1976a) have not usually taken into consideration the varying proportions of inhabitants that constitute the ‘at risk’ population, or any differences in their living conditions, and without reference to these characteristics of the people receiving drug treatment it is difficult to judge the clinical relevance of any disparities found. Furthermore, since comparable and reliable psychiatric morbidity data are particularly difficult to obtain, regional differences in psychotropic drug prescribing are probably more usefully related to objective demographic and socio-economic measures in the first instance. A Central Mental Health Records Scheme, based on returns from all psychiatric hospitals and units in Northern Ireland, has been in operation since 1960. Although these data are incomplete in some respects, it is hoped to make some comparisons with the drug utilization data in a subsequent study.

Application of HPLC for Analysis of Psychotropic Drugs in Body Fluids

Abstract: Psychopharmaca are a subgroup of medicaments which are characterized by their influence on the psyche. In order to develop their effect they must reach the central nervous system, and it is therefore necessary that they are rather lipophile substances. Due to their high enrichment in the tissue, plasma concentrations are relatively low and difficult to measure. Due to their physico-chemical properties it is impossible to separate psychotropic drugs from other medicaments. Rather the transitions are somewhat fluid as, for instance, to the beta blockers. In this article the following 3 groups are understood as psychotropic drugs: benzodiazepines, antidepressant and neuroleptic drugs.

Clinical evaluation of the cardiac effects of new psychotropic drugs

Abstract: This paper briefly describes some methods for investigating the cardiac effects of psychotropic drugs and describes some studies with the newer antidepressant drugs — nomifensine and zimelidine.

The Use of Psychotropic Drugs during Pregnancy and Nursing

Abstract: Treatment of a pregnant or nursing patient presents unusual challenges to the physician, who must consider not only the usual guidelines for administering drugs but also the special problems of pregnancy and the postpartum period. These include: 1. The significant alterations in maternal physiology during pregnancy and delivery. 2. The vulnerability of the developing fetus. 3. The physiological changes in the neonate. 4. The transfer of various agents to the newborn through milk. 5. The possibility of long-term neuroendocrine or behavioral effects on the developing nervous system.