Showing papers on "Psychotropic drug published in 1985"

Psychometric characteristics of the Aberrant Behavior Checklist.

Abstract: Information was presented on the psychometric characteristics of the Aberrant Behavior Checklist. The internal consistency and test-retest reliability of the Checklist appeared to be very good. Interrater reliability tended to vary across raters and subscales and ranged from mediocre to good but was generally in the moderate range and acceptable for research purposes. Validity was assessed by comparing Checklist scores for residents presenting with attributes thought to reflect varying degrees of social adaptation. Validity was also evaluated by comparing Aberrant Behavior Checklist scores with ratings on adaptive behavior scales and with objective observations of behavior. In general, validity was established for most Aberrant Behavior Checklist subscales. Preliminary data from drug investigations suggested that the Checklist may provide a useful adjunct for the assessment of psychotropic drug effects.

An International Overview

Abstract: During the almost 25 years since the introduction of LibriumR, the first benzodiazepine, benzodiazepines have become among the most widely used pharmaceutical substances in the history of medicine. These compounds have been of interest to me since they were first discovered, and I was responsible for some of the early clinical studies with LibriumR (Marks 1960a, 1960b). There is now a large number of benzodiazepines and some are antagonists rather than agonists to specific benzodiazepine receptors in the central nervous system (Braestrup & Squires, 1977; Moehler & Okada, 1977).

Minaprine, a new drug with antidepressant properties.

Abstract: Minaprine is a new psychotropic drug which has recently proved to be effective in the treatment of various depressive states. In rodents, minaprine exhibits an atypical spectrum of antidepressant and dopaminomimetic activities. Thus in mice minaprine antagonizes the effects of reserpine, decreases immobility time in the behavioural despair test and potentiates the effects of 5-HTP; in rats it antagonizes muricidal behaviour (blocked by PCPA or raphectomy). However, minaprine does not affect yohimbine lethality and does not induce anticholinergic effects in mice. Minaprine also activates central dopaminergic transmission. Thus at low doses the drug antagonizes neuroleptic-induced catalepsy and induces stereotypies in rats. These stereotypies are blocked by neuroleptics. In addition, minaprine (like apomorphine) induces contralateral turning in mice with a unilateral lesion of the striatum, whereas d-amphetamine induces ipsilateral rotations. Unlike classical dopaminomimetic drugs, minaprine does not stimulate locomotor activity in rats. The mechanisms by which minaprine exerts its effects are still unclear, since in vitro minaprine does not affect monoamine uptake or release and does not interact with monoamine receptors. In vivo, minaprine (acute doses) increases 5-HT, decreases 5-HIAA levels in various brain areas and weakly and reversibly inhibits type A MAO; subacute treatments lead to a decrease in the number of 5-HT1 and 5-HT2 receptors. In addition, in the striatum the drug decreases HVA and DOPAC, and increases 3-MT levels, without affecting DA levels. Minaprine also weakly displaces (3H)-spiperone from striatal D2 receptors and increases striatal ACh levels. Finally, minaprine fails to affect brain NA or MHPG levels in acute doses and does not modify beta receptor density in subacute treatment. Thus minaprine appears to be a chemically and pharmacologically original antidepressant drug which activates both 5-HT- and DA-mediated transmission but which is devoid of NAergic and anticholinergic effects. This latter statement is confirmed by the good cardiovascular tolerance of minaprine in dog, monkey and humans, and by the lack of "tricyclic-like" anticholinergic side-effects in man.

Evaluation of signal detection theory on the effects of psychotropic drugs on critical flicker-fusion frequency in normal subjects.

Abstract: Critical flicker-fusion frequency (CFF) has often been applied to psychotropic drug evaluation as a measure of cortical arousal. There are several variables that must be considered for proper conclusions to be obtained from CFF experimental data. Psychological variables such as subject response bias are especially difficult to control. We studied the effects of single oral doses of 10 mg diazepam and 10 mg amphetamine sulfate on CFF values obtained by a block up-down spatial forced-choice method on 13 healthy volunteers (seven males and six females). Signal detection theory was also used to obtain the non-parametric value P(A) as a measure of sensory function and B as a measure of the psychological function of response bias. As a group, amphetamine increased CFF (Hz) and P(A) and diazepam decreased CFF (Hz) and P(A), with the most significant effects observed at 2 and 3 h after drug administration. B scores showed more individual variation with a trend towards a low score, or a tendency to report more flicker responses after diazepam. Separated by sex, the males had a higher percentage of subjects that demonstrated a reduction of CFF after diazepam, while the females had a higher percentage that demonstrated an increase in CFF after amphetamine. The results suggest that CFF changes following diazepam and amphetamine are mostly changes in sensory function and not changes in response bias. It is possible to apply detection theory to flicker-fusion studies and the accounting of bias by controlling, measuring or eliminating it is essential in interpretation of CFF data.

Self-reported use of psychotropic drugs and alcohol abuse in South-Verona

Abstract: The data for this cross-sectional survey were obtained from a stratified probability sample of 510 residents in South-Verona during the period May-June 1980. The two-week prevalence of psychotropic drug consumption was found to be 13%. The prevalence was higher in women (18%) than in men (9%). The most commonly consumed category of psychotropic drugs were the benzodiazepines, which accounted for 70% of all the psychotropic drugs consumed by women and 85% of those consumed by men. Using a logistic analysis, a strong association between drug consumption and minor psychiatric morbidity, as indicated by the GHQ scores, was found for both sexes, a finding not significantly different from that found in the West London study by Murray et al. (1981). Alcohol abuse in men was less prevalent in the youngest age-group. Thirty-three (19%) of the male GHQ low scorers were alcohol abusers, compared with 12 (40%) of the high scorers. No significant association was found between psychotropic drug consumption and alcohol abuse in men.

Psychiatric aspects of violence in Northern Ireland

Abstract: This article reviews a number of studies which have examined the possible impact of political violence on psychiatric morbidity in Northern Ireland. A brief introduction outlining the way in which the violence has varied spatially, quantitatively and qualitatively since 1969 also draws attention to other possible stressors in Northern Irish society. This is followed by a detailed review of studies which have analysed either admission and referral rates, suicide and attempted suicide rates, trends in psychotropic drug prescribing or data from community-based studies. The criticism is made that several of the early studies did not pay enough attention to important sociodemographic factors and therefore are open to interpretations other than those originally proposed. Nevertheless some agreement does emerge suggesting that it is unlikely that the political violence caused any marked increase in serious psychiatric illnesses but rather stimulated an increase in normal anxiety, particularly among the more vulnerable and especially those with a previous history. Further recent research has begun to suggest that denial of the seriousness of the violence may be one of the mechanisms being used to enable people in Northern Ireland to cope with this continuing problem.

Generalized Phospholipidosis Induced by an Amphiphilic Cationic Psychotropic Drug

Abstract: Numerous amphiphilic cationic drugs cause generalized phospholipidosis in animals; one of these drugs is the Sandoz compound 200-125, a psychotropic agent. During a 6-month toxicity study in Charles River CD rats, a dramatic increase in foamy macrophages was seen in the lungs. A follow-up experiment was done to study the pathologic basis of these changes including a reversibility phase. Generalized phospholipidosis was induced after 4 weeks of 500 mg/kg/day of 200-125 by gavage. Characteristic pulmonary lesions consisted of extensive accumulations of large pale foamy macrophages as well as granular eosinophilic extracellular material. Lipid analyses of lungs showed marked increases in phospholipids (144%) and cholesterol esters (110%) in rats treated with 200-125. Drug metabolism studies employing 14C-labeled 200-125 showed an affinity for the drug to concentrate in the lungs and lymphoreticular system (spleen, lymph nodes) as well as in the adrenals, liver, and kidney. Reversibility of the phospholipidosis was nearly complete 4 weeks after drug withdrawal. The tissue changes were characterized by transmission and scanning electron microscopy. The potential pulmonary toxicity in humans with the amphiphiles is discussed.

Changes in psychological diagnosis and prescription in a practice employing a counsellor.

Abstract: This study investigated the effect on consultation rates and psychotropic drug prescribing of employing a counsellor in a general practice. No major change was detected in the number of prescriptions for psychotropic drugs or the consultation rates during the years that counselling was available. An increase in the number of psychotropic drug prescriptions in the year after counselling was accounted for by a very small number of patients. Three years after counselling more than three-quarters of the patients who had been counselled were receiving no medical attention for psychiatric problems. This may either reflect the effect of counselling over a longer period or the natural history of the problems.

Hyperpyrexia following psychotropic drug overdose.

Abstract: Summary A case of overdose of tricyclic antidepressants associated with severe pyrexia is reported in a patient taking monoamine oxidase inhibitors, and its management described. The similarities to and differences from the malignant hyperpyrexia syndrome are discussed.

Medication and programming in controlling the behavior of mentally retarded individuals in community settings.

Abstract: Behavioral outcomes of a behavioral-chemical intervention procedure on stereotypic and non-compliant behavior were evaluated. One group (n = 22) of community-based mentally retarded clients was initially on psychotropic medication (major tranquilizers). Their dosage was either increased, decreased, or kept the same following behavioral intervention. A second group (n = 19) was placed on psychotropic medication following behavioral intervention. A nonequivalent between-groups design was employed that permitted 36 outcome combinations involving Conditions X Subject X Group. The effects of behavioral intervention, the validity of drug-intervention decision rules, drug-intervention effects, and the validity of the behavioral-chemical intervention model were evaluated. Results indicated that the behavioral-chemical intervention produced expected and desirable behavioral change as well as reduced levels of psychotropic drug usage.

Experience with drugs and driving in queensland, australia

Abstract: The effect of any one psychoactive drug on an individual is a function of its interaction with that individual; for this reason, the effect upon one person may not be the same as on another person. When two or more drugs are given at the same time, their effect may be one of antagonism, synergism or potentiation. The effects of a psychotropic drug (ataxia, incoordination, altered level of consciousness or awareness, disturbances of vision and increased reaction time) must surely impair the skills required for safe driving. Many prescribed drugs acting principally on the central nervous system are capable of impairing driving performance: analgesics, anti-depressants, anti-convulsants, sedatives, hypnotics, narcotics and tranquillizers. Other prescribed drugs: anti-histamines, hypotensive agents, hypoglycaemic substances may produce undesirable side effects which impair driving performance. In Queensland if breath analysis indicated a BAC too low to account for a driver's behaviour, a doctor is called to examine the driver, and samples of blood and urine are forwarded to a central laboratory. If the blood concentration of a drug equals or exceeds the accepted therapeutic level of the particular substance, the driver is considered to be "under the influence" of the drug. The most dangerous period is during the initial stage of taking a prescribed drug. Psychotropic drugs taken in prescribed dosage may initially produce drowsiness, ataxia, impaired judgement and increased reaction time. After a period of time, tolerance to the drug develops, with marked reduction in unwanted side effects. The most common drugs include morphine, pethidine, methadone, methaqualone, benzodiazepines, and barbiturates. The common purpose for such abuse is to get "high" -a stage of unreality characterized by euphoria and/or hallucinations, either visual or auditory or both. Intoxication by any of these drugs produces severe impairment of driving skills. An exaggerated pharmacological effect commonly occurs when alcohol is taken at the same time as another psychoactive drug. Benzodiazepines are the prescribed drug most commonly involved in instances of driving impairment, both alone and in combination with alcohol. Some drugs commonly associated with impaired driving performance are: mandrax, methadone and diazepam. The extent of the contribution of drivers impaired by drugs and drug-alcohol interaction to traffic accidents has not yet been defined. It will not be defined until all countries enact effective legislation to enable such drivers to be identified. The use of alcohol and psychotropic drugs in Australia has been increasing steadily over the past few years, and continues to increase. It is impossible to obtain accurate figures on the consumption of psychotropic drugs in Australia. (Shortened Author Abstract/TRRL)

Determination of Pharmacokinetics and Pharmacodynamics of Amisulpride by Pharmaco-EEG and Psychometry

Abstract: The quantitative pharmaco-EEG has been proven to be a valuable method to classify psychotropic drugs as well as to determine the time- and dose-efficacy relations at the target organ - the human brain (Fink, 1969; Saletu, 1976; Saletu, 1982). Investigating typical and atypical antidepressants, we found that at least 2 types of pharmaco-EEG profiles may be differentiated: 1) a thymeretic, desipramine-like profile suggesting activating properties; and 2) a thymaleptic imipramine - and amitriptyline-like profile showing also sedative qualities (Saletu, 1982). In recent years we have also seen that psychometric techniques mediate additional objective and quantitative information about the pharmacodynamics of psychotropic drugs at still another level — the behavioral one (Grunberger and Saletu, 1980).

Diazepam: Kinetic profiles in various brain areas, plasma and erythrocytes after chronic administration in the rat

Abstract: The regional distribution of diazepam (DZP) was established in eleven discrete brain areas in the rat afteri.m. chronic treatment (15 days; 5 mg/kg/day). In addition, the kinetic profiles of this drug were investigated in plasma, eryhtrocytes, and three CNS regions (nucleus caudatus, hippocampus, and cerebellum) upon which the pharmacokinetic study was focused. The modifications occuring in plasma-protein binding and erythrocytes binding were reported. In the CNS, the DZP was rapidly distributed; its concentrations and its kinetic profiles were not uniform in the different brain areas studied. The highest amount of DZP was noted in the hypothalamus, while nucleus caudatus and colliculi also presented important DZP levels. Concerning the kinetic parameters after chronic administration, an increase in the elimination half-life time value in central and peripheral compartments, as compared to values reported after acute administration, was observed. The study of cerebral DZP levels as compared with those in the erythrocytes or in plasma suggests a linear correlation in the three CNS areas investigated. These experimental results demonstrate the interest of such studies for psychotropic drug monitoring.

Implementation of a psychotropic drug review service in a mental retardation facility.

Abstract: A redesigned psychotropic drug review service was needed for our 650-bed intermediate care facility for the mentally retarded (ICF/MR). A committee consisting of a client's rights monitor, pharmacist, and psychologist prepared the necessary policy and procedure as well as data collection sheets. Meetings are now conducted in a semiformal fashion, with each discipline contributing in tis area of expertise. Since the inception of the restructured psychotropic drug review service, psychotropic medication dosages (neuroleptic agents only) have decreased at a projected annual rate of 17% and there have been no significant withdrawal reactions. This dosage decrease has saved the institution approximately $2800 to $3200 in medication costs after a 10-month period.

Long-term Psychotropic Drug Prescribing for General Practice Patients

Abstract: Although 11.3% of patients of an academic general practice unit were prescribed one of the four commonest psychotropic drugs in 1978, only 1.6% received six or more prescriptions. During the following three years further prescriptions for the same drug were issued in 61% of the patient years for which information was available. Most of the frequent recipients were elderly women. Further research is needed into the natural history of conditions for which psychotropic drugs are prescribed in general practice.

On the Value of CNS, ANS and Behavioral Measures in Early Clinical Psychopharmacology

Abstract: The ever increasing number of newly developed potentially psychoactive compounds since 1952 resulted in a need for screening methods in early clinical pharmacology. The quantitative analysis of the human scalp-recorded EEG in combination with certain statistical procedures (called “quantitative pharmaco-EEG”) along with psychometric methods has been proven to mediate valuable objective and quantitative information about the effect of psychotropic drugs on their target organ— the human brain — and on human behavior (Fink, 1969, Saletu, 1976; Grunberger and Saletu, 1980). It seems possible to predict 1) if; 2) how; 3) in which dosage; 4) at which time a new compound will act, which will be shown by an example of a recently performed pharmaco-EEG and psychometric study with temazepam—a relatively new benzodiazepine with the advantage of a short half life and lack of active metabolites.

Psychotropic drug-related suicides.

Abstract: This study examined the 92 suicides investigated by the Medical Examiner's Office in Rhode Island between 1975 and 1982, in which either tranquilizers or antidepressant drugs were present in the body fluids or tissues of the deceased. We found that traumatic suicides were more prevalent among the tranquilizer victims and that tranquilizers were combined more often with alcohol and other drugs. While the antidepressants were obtained by prescription more often than the tranquilizers, the latter were prescribed by a wider variety of doctors. More antidepressant than tranquilizer suicide victims had a history of psychiatric hospitalization and had previously attempted suicide or spoken of it prior to their death. Our findings also seem to indicate that the antidepressant victims took more time and effort in both contemplating and planning their suicides.

Pharmacoendocrinology and Its Clinical Relevance

Abstract: Studies of effects of a variety of psychotropic drugs on pituitary hormone secretion are based on the theory that such drugs affect the functions of aminergic neurons, which in turn can influence the effects of the pituitary hormones. The three following sections include primarily our own results on first, the effect of psychotropic drugs on pituitary hormone secretion, second, the effect of receptor blockers on the changes in pituitary hormone secretion due to psychotropic drugs and third, the GH stimulating properties of DMI in depressive patients.

Considerations for Treating the Elderly with Psychotropic Medications

Abstract: Elderly people are at high risk for encountering the type, frequency, and severity of stresses that can lead to psychiatric disturbance. When they seek the assistance of the medical profession for relief of their psychiatric distress they enter still another arena in which they are at higher risk than younger cohorts for adverse experiences. Because old people often suffer multiple ailrtients for which they may be prescribed a number of medications by a number of physicians, the possibility of untoward drug interactions increases accordingly. Deficits in organ function common to old age can affect the ability of the aged body to absorb, distribute, metabolize, and excrete medications with the same efficiency and at the same rate as a younger body. Increased retention may require modification of dosage, frequency, and concomitant medications. Some practical considerations can augment the psychiatrist’s pharmacologic expertise in providing effective treatment to the elderly.

Monoacylglycerophosphatide accumulation and changes in properties of benzodiazepine receptors in brain synaptosomes

Abstract: It has been shown that specific binding of tritium-diazepam with synaptosomal membranes of the rat cerebral cortex is increased as a result of hydrolysis of the phopholipids by phospholipase A/sub 2/ in membranes. It can be tentatively suggested that the effect of phospholipase A/sub 2/ on the properties must be mediated either through the combined action of these compounds or the action of only one of them. Solution of this problem would reveal the possible mechanism of regulation of the properties of receptors for diazepam, an effective psychotropic drug, and this investigation was undertaken for this purpose. Results are presented.

Anti-Anxiety Drugs in Cardiac Disorders

Abstract: Although stress is an inescapable component of life and its adverse effects in some individuals at some times are well appreciated, these effects have never been systematically investigated from a clinical point of view. In particular, the effects of stress on organic illnesses, as for example, cardiovascular disorders, are not fully appreciated.

Psychopharmacology of Suicide: The Background

Abstract: My purpose as introductory speaker is to discuss two background issues which are important to what will come later. These are first the inter-relationships of depression and suicidal phenomena, and the second, the impact of the development of psychotropic drugs on the incidence of suicidal behaviour. I will largely present British data but the same general conclusions apply internationally.

Psychometry in Early Psychopharmacology

Abstract: As psychotropic drugs, by definition, alter psychological functioning, it is important to know the range and the intensity of these effects. Yet psychotropic drugs are classified according to the abnormal psychological function that they affect — antidepressant, antipsychotic, antianxiety, etc. — and this compartmentalization of psychoactive compounds has led to a relative neglect of their other actions. This would not matter if the generality of psychotropic drugs were highly specific therapeutically, that is, if they ameliorated the target symptoms and did very little else. However, as we are all made aware of each day in our clinics, psychotropic agents, by and large, are unselective agents and our patients complain of a wide variety of side effects, both peripheral and central. In addition, drugs are now being sought to affect impaired psychological functioning rather than abnormal (in the qualitative sense) functioning. The best current example is the development of remedies for dementia.

The Pharmacological Management of Mood and Emotion

Abstract: Addressing himself to psychopathology, Klerman refers to mood as the individual’s subjective experience including his perception of his inner emotional state. Emotion includes the individual’s own self-perception as well as the behavioral and psychophysiological concomitant phenomena which can be observed by others. Human emotions are very complex of course. Efforts, such as those of Ekman continue to be made in order to discern basic ubiquitous emotions like happiness, sadness, anger, fear, surprise and disgust. The task is not easy because cognitive factors do influence one’s emotional states and the interpretation one gives to conditions of arousal.

Therapeutic Alternatives in Other Psychosomatic Disorders

Abstract: Psychosomatic disorders other than those of cardiovascular disorders mainly comprise gastrointestinal disorders and others such as asthma, skin disorders, neuromuscular disorders, etc. According to the result of investigation conducted on the first 500 patients who attended the outpatient clinic of the department of psychosomatic medicine, Tokyo University Hospital in 1982, it was found that the four groups of disorders, i.e. anorexia nervosa, writer’s cramp, irritable colon and pain, were observed most frequently excluding cardiovascular psychosomatic disorders, depression and neurosis. Thus, it was demonstrated also by this investigation that the gastrointestinal disorders are in the highest frequency among the non-cardiovascular disorders. The usual types of treatment for these cases include autogenic training, biofeedback, and group therapy, while psychotropic drugs were prescribed in about 40% of these cases. On the other hand, the psychotropic drugs was prescribed at the frequency of 70 to 90% for the cases of irritable colon, headache, muscle pain and abdominal pain. The prescribed psychotropic drugs were mainly minor tranquillizers and antidepressants. Highly frequent use in Japan of the psychotrpic drugs for the gastrointestinal disorders is also shown by the sales volume of ethical drugs and the nosologically grouped prescription ratio of minor tranquillizers in Japan.