Showing papers on "Psychotropic drug published in 2001"

Psychiatric disorders associated with Cushing's syndrome. Epidemiology, pathophysiology and treatment.

Abstract: Cushing’s syndrome is caused by a chronic excess of glucocorticoids. A number of psychiatric and psychological disturbances may be associated with the condition, regardless of its aetiology. Major depression is the most common co-morbid disorder. Other psychopathological aspects of Cushing’s syndrome in adults include mania, anxiety disorders and cognitive dysfunction. The presence of depression connotes a severe clinical presentation and, in patients with hypothalamic-pituitary forms of Cushing’s syndrome, is prognostically useful. Inhibitors of corticosteroid production (e.g. ketoconazole, metyrapone, aminoglutethimide), rather than antidepressant drugs, are generally successful in relieving depressive symptoms, as well as other disabling symptoms. These drugs can be used to control symptoms prior to surgical treatment of Cushing’s syndrome. Long-standing hypercortisolism may cause some degree of irreversible pathological damage and induce highly individualised affective responses based on each patient’s psychological assets and liabilities. As a result, upon normalisation of cortisol levels, treatment may still be required, and should encompass both psychotherapeutic strategies (particularly cognitive-behavioural therapies that have been found to be effective in affective disorders) and psychotropic drug treatment [antidepressants such as tricyclic agents and selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors]. In patients with severe anxiety, benzodiazepines (e.g. clonazepam in small doses) may also be helpful.

Psychotropic Drug Directory: The Professionals' Pocket Handbook and Aide Memoire

Abstract: Aimed at practising clinicians, this psychiatric drug reference is designed as a companion to the British National Formulary. Arranged in a problem-orientated form, it includes over 3000 references for rapid identification of key papers for further research.

Intracellular distribution of psychotropic drugs in the grey and white matter of the brain: the role of lysosomal trapping

Abstract: 1. Since the brain is not a homogenous organ (i.e. the phospholipid pattern and density of lysosomes may vary in its different regions), in the present study we examined the uptake of psychotropic drugs by vertically cut slices of whole brain, grey (cerebral cortex) and white (corpus callosum, internal capsule) matter of the brain and by neuronal and astroglial cell cultures. 2. Moreover, we assessed the contribution of lysosomal trapping to total drug uptake (total uptake=lysosomal trapping+phospholipid binding) by tissue slices or cells conducting experiments in the presence and absence of 'lysosomal inhibitors', i.e., the lysosomotropic compound ammonium chloride (20 mM) or the Na(+)/H(+)-ionophore monensin (10 microM), which elevated the internal pH of lysosomes. The initial concentration of psychotropic drug in the incubation medium was 5 microM. 3. Both total uptake and lysosomal trapping of the antidepressants investigated (imipramine, amitriptyline, fluoxetine, sertraline) and neuroleptics (promazine, perazine, thioridazine) were higher in the grey matter and neurones than in the white matter and astrocytes, respectively. Lysosomal trapping of the psychotropics occurred mainly in neurones where thioridazine sertraline and perazine showed the highest degree of lysosomotropism. 4. Distribution interactions between antidepressants and neuroleptics took place in neurones via mutual inhibition of lysosomal trapping of drugs. 5. A differential number of neuronal and glial cells in the brain may mask the lysosomal trapping and the distribution interactions of less potent lysosomotropic drugs in vertically cut brain slices. 6. A reduction (via a distribution interaction) in the concentration of psychotropics in lysosomes (depot), which leads to an increase in their level in membranes and tissue fluids, may intensify the pharmacological action of the combined drugs.

Treating Mental Illness and Behavior Disorders in Children and Adults with Mental Retardation

Abstract: Preface. Part I: Introduction. Epidemiology, etiology, and presentation of mental illness and behavior disorders in persons with mental retardation. Part II: Treatment Methods. Psychotherapeutic methods. Psychopharmacological approach. Behavioral therapies: individualizing interventions through treatment formulation. Cognitive and social learning treatments. Working with families and caregivers of people with severe mental retardation. Part III: Psychotherapeutic Interventions. Psychoanalytic therapies. A rational-emotive group treatment approach with dually diagnosed adults. Pre-therapy: a treatment method for people with mental retardation who are also psychotic. Systemic therapy. Part IV: Treatment of Mental Illness. Treatment of schizophrenia. Treatment of mood disorders in mentally retarded persons. Treatment of anxiety disorders in persons with mental retardation. Treatment of epilepsy and associated disorders. Mood and affect as determinants of psychotropic drug therapy response in mentally retarded persons with organic mental syndromes. Part V: Treatment of Behavior Disorders. Pharmacotherapy in aggressive and auto-aggressive behavior. Strategic behavioral interventions in aggression. Self-injurious behaviors: multimodal contextual approach to treatment. Group therapy for mentally retarded sex offenders. Treatment and care of mentally retarded offenders. A pedagogical approach to behavioral problems. Part VI: Treatment Methods With Children. Psychodynamically oriented psychotherapy in mentally retarded children. Developmental-dynamic relationship therapy: an approach to more severely mentally retarded children. Pharmacotherapy in mentally retarded children. Management of pervasive developmental disorders. Part VII: Mental Health Services for the Mentally Retarded and Staff Training. Service provision and staff training: an overview. Psychiatric treatment in community care. A model for inpatient services for persons with mental retardation and mental illness. Part VIII: Integrative Treatment. Treatment: an integrative approach. Index.

Risk Society - Reconsidered in a drug context

Abstract: This article attempts to test Ulrich Beck's theoretical concept of risks as presented in his work Risk Society . It questions whether the risks of modern drugs can be explained and understood through the theoretical framework of a Risk Society. Based on a case study of the psychotropic drug fluoxetine, better known as Prozac ®, we show how risks associated with modern drugs are induced by socially constructed technological artefacts and are capable of producing risk on an objective as well as non-objective global level. Here, risks are invisible to individuals and sometimes to social perception as a consequence of their non-objective nature. The transformation of side-effects from a traditional individual level (physical and psychological) to a collective level (economic, societal and ethical) illustrates the new dynamics of risk associated with modern drugs. We conclude that the risks of modern drugs fall within Beck's definition of risks of modernity, and that risk of drugs is expanding beyond control m...

Interindividual variability in human drug metabolism

Abstract: Genetic Factors That Cause Variability in Human Drug Metabolism. Interethnic Differences in Drug Disposition and Effects. Developing and Ageing as Sources of Variability in Drug Metabolism. Genetic and Environmental Factors Causing Variability in Psychotropic Drug Response. Interindividual Variability in the Metabolism of Cardiovascular Drugs. Interindividual Variability in the Metabolism of Antiepileptic Drugs and its Clinical Implications. Variability in the Metabolism of Levodopa and its Clinical Implications. Interindividual Variability in the Disposition of Anti-HIV Drugs. Predictive Modeling of in vivo Drug Interaction From in vitro Data: From Theory to a Computer-based Workbench and Experimental Validation. Interindividual Variation of P450 Enzymes in vitro and it's Causes. Interindividual Variability of Arylamine N-acetyltransferases. Interindividual Variation of UDP-glucuronosyl Transferases and Drug Glucuronidation. Interindividual Variability of Methyltransferases. Interindividual Variability of Sulpho Transferases. Interindividual Variability of Glutathione Transferase Expression

Obesity and medical illnesses in psychiatric patients admitted to a long-term psychiatric facility.

Abstract: Obesity and associated medical conditions may have an impact on morbidity and even mortality in patients with psychiatric disorders. The authors present the results of a survey of the prevalence of obesity and selected medical conditions among 420 consecutively admitted psychiatric inpatients at a long-stay facility and compare these data with those reported in the literature. Female psychiatric subjects had considerably higher rates of being either overweight or obese (69%) as compared to women in the general U.S. population (51%). Male psychiatric subjects did not differ significantly from their counterparts in the general population in being overweight or obese (nearly 55%). The majority of psychiatric subjects with essential hypertension, diabetes mellitus, dyslipidemias, cardiovascular disease, or sleep apnea were either overweight or obese (72%–87%). In this cross-sectional study, no associations could be deduced between psychotropic drug classes and specific medical conditions. No specific psychiatric diagnostic category was associated with a significantly greater prevalence of any specific medical condition, except that subjects with schizoaffective disorder appeared to have a higher prevalence of type II diabetes mellitus (11.6%). Subjects with predominant substance or alcohol abuse or dependence disorders had a lower prevalence of obesity and associated medical conditions. Obesity—either independently or additively along with a sedentary lifestyle, unhealthy dietary habits, and nicotine dependence—may have a serious impact on coexisting medical comorbidity in psychiatric patients. Judicious monitoring for obesity and rapid pharmacological and nonpharmacological intervention, where appropriate, by concerned clinicians may improve several coexisting medical conditions in psychiatric patients and thereby improve patients' overall quality of life.

An LD50 model for predicting psychotropic drug toxicity using biopartitioning micellar chromatography.

Abstract: The LD50 determination is the main way to measure the acute toxicity of all types of substances. At the present time, however, there is increasing opposition to the use of living animals in research and testing activities from animal rights groups as well as some scientists. Nevertheless, the need to have a tool for estimating the potential toxicity of new compounds for human consumption has encouraged the development of alternative methods. Under adequate conditions, the partitioning in micellar liquid chromatography can describe the drug biopartitioning. We have named this chromatographic system biopartitioning micellar chromatography (BMC). In this paper, an LD50 QRAR model developed for psychotropic drugs from their retention data in BMC, is described. The model's ability to predict new psychotropic drug toxicity is statistically proved.

Integration of Olanzapine Determinations in a HPLC-Diode Array Detection System for Routine Psychotropic Drug Monitoring

Abstract: Olanzapine is an atypical antipsychotic drug now considered as a first-line agent to treat schizophrenia and psychotic mood disorders (1). Plasma concentrations indicative of a clinical response are known to be >9 μg/L (2). Knowledge of plasma concentrations, to check compliance or drug-drug interactions, is also necessary in treatment of schizophrenia (3). Moreover, olanzapine toxicity may appear at blood concentrations that are considerably lower than those observed in antidepressant-related deaths (4). Numerous publications have described the usefulness of a HPLC silica column and aqueous methanol eluents for the analysis of many basic drugs in plasma (5)(6). The use of this type of column provides more reproducible results, making it possible to obtain a sensitive HPLC-ultraviolet (UV) procedure that is easier to perform and less expensive than electrochemical (7)(8) or mass spectrometric (9) detection. We have adapted this HPLC system for routine therapeutic drug monitoring of psy- chotropic drugs (10)(11)(12). To update this system, it is important to include new antipsychotic drugs, such as olanzapine. The Dionex HPLC system used consisted of a Dionex injector (Model ASI-100), an isocratic pump (Model P-580A), and a photodiode array detector (Model UVD-170S). Chromatograms were processed using …

Effects of combination psychotropic drug treatment on heart rate variability in psychiatric patients

Abstract: The aim of this study was to evaluate the effects of combination psychotropic drug treatment on heart rate variability (HRV), which was mainly controlled by the parasympathetic nervous system. Mean R–R intervals (mRR) and coefficient of variation (CV), an index of HRV, were studied in 22 psychiatric patients and 21 age- and sex-matched healthy controls. Next, in the patient group focusing on both anticholinergic and antidopaminergic properties, combination psychotropic drug daily doses were converted into biperiden milligram equivalents (BPDeq) and chlorpromazine milligram equivalents (CPZeq), respectively. The relationship between mRR and CV and these equivalent dosages was examined. A significant reduction in both mRR (P < 0.05) and CV (P < 0.05) was found in the patient group. In addition, significant negative correlations were observed between the dose of BPDeq and mRR (P < 0.05), and between the dose of BPDeq and CV (P < 0.005). In contrast, no significant correlations were observed between the dose of CPZeq and either parameter. These findings suggest that the effects of combination psychotropic drug treatment on HRV are mainly due to their anticholinergic properties. Therefore, CV is a useful indicator to assess the parasympathetic activity of psychiatric patients under combination psychotropic drug treatment.

[Is cocoa a psychotropic drug? Psychopathologic study of a population of subjects self-identified as chocolate addicts].

Abstract: The aim of this work was to search for eating disorders, DSM III-R Axis I mental disorders, personality disorders, and addictive behavior, in self-labeled "chocolate addicts". Subjects were recruited through advertisements placed in a university and a hospital. Fifteen subjects were included, 3 men and 12 women aged between 18 and 49. Most of them were not overweight, although 7 thought they had a weight problem. They consumed an average of 50 g per day of pure cacao and, for 13 subjects, this consumption was lasting since childhood or adolescence. The psychological effects of chocolate, as indicated by the subjects, consisted in feelings of increased energy or increased concentration ability, and in an anxiolytic effect during stress. Seven subjects described minor withdrawal symptoms. None of the subjects reached the thresholds for eating disorders on the EAT and BULIT scales. The structured interview (MINI) identified an important ratio of subjects with a history of major depressive episode (13/15), and one woman was currently experiencing a major depressive episode. Four people suffered, or had suffered from anxiety disorders. Although only one subject satisfied all criteria for a personality disorder on the DIP-Q, seven displayed some pathological personality features. The self-labeled "chocoholics" do not seem to suffer from eating disorders, but may represent a population of psychologically vulnerable and depression--or anxiety--prone people. They seem to use chocolate as a light psychotropic drug able to relieve some of their distress. The amount of cacao consumed, although very chronically, remains moderate, and they rarely display other addictive behaviors.

Lessons learned from trends in psychotropic drug expenditures in a canadian province.

Abstract: Although prescription drug prices are lower in Canada than in the United States, trends indicate that there has nevertheless been a steep increase in expenditures on psychotropic drugs. Between 1992 and 1998, such expenditures increased by 216 percent; 61 percent of these expenditures were on antidepressants, 33 percent on antipsychotics, and less than 7 percent on anxiolytics. Most of the increase in costs in Canada is attributable to a greater use of newer agents and the higher prices of these agents. These trends are a reminder not only that the use of newer, more expensive psychotherapeutic agents has become a widely embraced part of care but also that lower drug prices do not necessarily insulate a health care system from rising expenditures. The authors' findings prompt the questions of whether the use of these newer agents meets practice guidelines and whether there are ways to control the increases in drug expenditures while ensuring high-quality care.

Cardiac drug and psychotropic drug interactions: significance and recommendations.

Abstract: Understanding cardiac drug interactions with concurrent psychotropic prescriptions is essential for the practicing cardiologist, primary care physician, and psychiatrist. There has been an explosion in the use of new drugs in both psychiatry and cardiology without widespread knowledge of their potential interactions. The increasing tendency toward polypharmacy, the use of psychotropic medications by cardiologists and primary care physicians caring for cardiac patients, and the growth of the aging population present major challenges for the practitioner. Finally, there is a need to have models and paradigms for predicting potential drug interactions-the cytochrome P450 schema. This article describes a method to identify, understand, and codify the interactions between psychotropic and cardiac drugs, a systematic approach for updating this key database, and specific cardiac-psychotropic drug interactions. Specifically, this paper 1) details the interactions, 2) addresses the level of their clinical significance, 3) describes the potential mechanism(s) of the interactions, and 4) offers recommendations to the clinician (Appendix). Because the majority of the original clinical trials, either for cardiac medications or for psychotropic drugs, did not include studies comparing these two drug domains contemporaneously, their interactions often become known only with their combined use in the clinical arena, using the patient as "guinea pig" and through subsequent reporting.

Mental health, stress correlates and psychotropic drug use or non-use among aged caregivers to elders with dementia.

Abstract: The goal of the study was to compare caregivers who used psychotropic drugs with caregivers who were non-users in order to pinpoint differences in coping styles between the two groups. We performed a secondary analysis of a study on the stress and psychological well-being of persons caring for relatives with dementia. We compared elderly caregivers, as either psychotropic drug users (n = 61) or non-users (n = 133), over various psychosocial characteristics relating to the care-giving context. Results reveal that users, as compared to non-users were: (a) more disturbed (appraised a greater stress) by the relative's dysfunctional behaviours, after controlling for the frequency of the behaviours; and (b) experienced more conflict during interpersonal interactions, although their appraisal of self-satisfaction with formal and informal support to their care-giving activities did not differ significantly. Strikingly, users combined and called on a greater number of problem-focused and emotion-reducing coping strategies than did non-users. They more frequently used affective regulation and information seeking coping styles. Stress-related measures (especially stress appraisal and conflict) contributed more to the variation in mental distress of users than of non-users. Results provide a theoretical and empirical rationale for therapeutic interventions such as the cognitive behavioural approach.

Interactions of chlorpromazine with milk proteins.

Abstract: The mode and nature of the binding of chlorpromazine (CPZ), a psychotropic drug, with milk proteins--alpha-lactalbumin (with substantial amounts of alpha-helix, beta-sheet and random coil), alpha-lactoglobulin (a major beta-sheeted protein) and alphas-casein (a random coiled protein) have been studied spectrofluorometrically and spectropolarimetrically. The binding affinity of CPZ for unfolded proteins is comparatively less than that of folded proteins although the number of binding sites is smaller in the latter case, due to the greater extent of binding of CPZ for folded proteins. Thermodynamic analysis reveals that CPZ binds to alpha-lactalbumin and alphas-casein in an endothermic (deltaH degrees is positive) and hydrophobic manner but with beta-lactoglobulin in an exothermic (deltaH degrees is negative) manner. Far UV Circular dichroic studies reveal that CPZ increases the secondary structure of the major beta-sheeted protein, beta-lactoglobulin possibly by increasing the relative contact orders (non-local contacts) within the residues. On the other hand, for proteins possessing random coil, it increases the unfolded state of the protein. CPZ does not affect local contacts in alpha-helix when its interaction is compared with a major alpha-helical protein, myoglobin.

[Body weight changes and psychotropic drug treatment: neuroleptics].

Abstract: Weight gain associated with neuroleptics or antipsychotic treatment is well known by psychiatrists, but is too rarely considered as justifying a specific treatment program. Overweight is a risk factor for somatic disorders and can have a negative influence on self-esteem and self-confidence. This can lead to poor observance, and relapse of psychotic symptoms. Some studies try to describe the weight fluctuations according to the different neuroleptics and taking into account other variables like treatment duration, age or sex. Mechanisms of weight gain are less studied, in spite of evidence that neuroleptics interact with receptors of dopamine, norepinephrine, serotonin, histamine and acetylcholin, all implicated in a way or another, in weight regulation. Antipsychotics, like clozapine and olanzapine, are more concerned with neuroendocrine and neurovegetative interactions, and are responsible for the most severe weight increases. Loxapine and molindone induce weight decreases, and these exceptions are difficult to explain. The paper discusses the clinical and the epidemiological data, and indicates the methodological problems for such studies. Some hypotheses about the pathophysiological aspects of this side effect are made, in regard to growing knowledge about the biological mechanisms of weight regulation. Some solutions for a better consideration and caretaking of patients with such problems or "at risk" treatment are proposed.

Process for preparing optically active aminopentane derivatives

Abstract: A novel practical process for preparing optically active 1-(benzofuran-2-yl)-2-propylaminopentane derivatives useful as drugs, particularly psychotropic drug, antidepressant, antiparkinson drug, or antialzheimer drug. This process comprises using optically active aziridine or amide compounds which can be prepared from optically active amino acids with the chirality maintained and makes it possible to prepare optically active 1-(benzofuran-2-yl)-2-propylaminopentane derivatives or pharmaceutically acceptable salts thereof without a special catalyst, through extremely simple and easy operation, at high purity, with high selectivity, and in high yield.

Screening of Psychotropic Drugs in Human Hair Based on High-Performance Thin-Layer Chromatography and Microliquid Extraction

Abstract: The monitoring of the physiological and functional state of personnel from dangerous industries is very important for the ensuring of ecological security. Usually, this involves testing for the consumption of alcohol and drugs of abuse. During the last several years the use of legal psychotropic drugs has increased and the control over these drugs has became an actual problem. As is well known, the long-term history of drugs present in the body is accessible through hair analysis. This is why the aim of our research is to create a screening procedure based on coupling high-performance thin-layer chromatography with microliquid extraction as a psychotropic drug testing method for hair. Some widely distributed antidepressants, neuroleptics, and sedative drugs are chosen for research. The optimal experimental conditions for all of the consequent steps for the screening detection of the model samples are determined. The visual and densitometric detection limits allow for the employment of the proposed technique for a fast and cost-effective analysis of the drugs of abuse.

The One-Day Survey On Psychotropic Drugs Use In 788 Psychotic Inpatients In Beijing Anding Hospital

Abstract: OBJECTIVE: To investigate the one-day data of psychotropics use of 788 psychiatric inpatients in Beijing Anding Hospital. METHODS: The day of Nov. 10, 1999 was collected. The one-day utilization of psychotropic drugs in all inpatients were surveyed and analyzed statistically. RESULTS: The five psychotropic drugs in order were clozapine (30.7%), haloperidol (15.6%), perphenazine (12.3%), risperidone (10.5%), chlorpromazine (10.4%). The five antidepressants in order were amitriptyline (3.7%), paroxetine (2.5%), clomipramine (2.3%), fluoxetine (1.8%), and doxepin (1.5%). CONCLUSION: It shows that most scheme of psychotropic drug treatment tended to be rationalized. The benzodiazepine abuse should be avoided.

4-[3-(4-Chloro­benzyl­idene­amino)-2-oxo­oxazolidin-5-yl­methyl]­morpholin-4-ium chloride monohydrate

Abstract: A series of derivatives of 3-amino-2-oxazolidinone have been prepared. The title derivative, C15H19ClN3O3+·Cl−·H2O, is a potential psychotropic drug. The structure is assembled by strong and weak hydrogen bonds into a three-dimensional infinite framework. In the structure, intramolecular hydrogen bonds link C and O atoms to create a fused three-membered ring system.

4-{3-[(4-Fluoro­benzyl­idene)­amino]-2-oxo-1,3-oxazolidin-5-yl­methyl}morpholine

Abstract: A series of derivatives of 3-amino-2-oxazolidinone have been prepared. The 5-morpholino­methyl-3-(4-chloro­benzyl­idene­amino)-2-ox­azol­idin­one derivative is a potential psychotropic drug. Preliminary clinical data showed that the compound exhibits antidepressive activity in humans. The molecular geometry of the title compound, C15H18FN3O3, is similar to 5-morpholino­methyl-3-(4-chloro­benzyl­idene­amino)-2-ox­azol­idin­one. Two atoms of the title compound are disordered so that two different conformations of the ox­azol­idin­one ring were found; one is a twist and the other is an envelope con­formation. The crystal structure of title compound is formed by weak intermolecular C—H⋯O hydrogen bonds resulting in a two-dimensional infinite hydrogen-bond network.

Prolactinémie et médicaments psychotropes actuels

Abstract: Resume L'hyperprolactinemie est un effet secondaire bien connu des traitements psychotropes. Au cours des dernieres annees de nouvelles molecules therapeutiques sont apparues, et sont maintenant tres largement utilisees en psychiatrie en raison de leurs effets secondaires attenues. Afin d'evaluer le risque hyperprolactinemiant de ces nouveaux psychotropes par rapport aux medicaments conventionnels, nous avons dose la prolactine chez 140 patients traites en monotherapie, antidepressive ou antipsychotique. Soixante-quinze pour cent des patients traites par un neuroleptique et 21 % traites par un antidepresseur presentent une hyperprolactinemie. Seulement 20 % des patients traites par le Leponex ® , neuroleptique recent, ont une prolactinemie elevee. Les inhibiteurs de la recapture de la serotonine, une classe recente d'antidepresseur, engendrent une hyperprolactinemie dans 18 % des cas contre 60 % des cas avec l'Anafranil ® . Les resultats de cette etude, en accord avec les donnees de la litterature, confirment que la frequence et la severite des hyperprolactinemies tendent a diminuer avec les nouvelles generations de psychotropes.

Antipsychotic Drug Prescription in a Serbian Long-Stay Psychiatric Care Facility

Abstract: Objective This study evaluated the current use of antipsychotic drugs in a long-stay psychiatric care facility.