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Psychotropic drug
About: Psychotropic drug is a research topic. Over the lifetime, 2309 publications have been published within this topic receiving 54070 citations.
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TL;DR: The results indicated that both EGb and, to a lesser degree, tacrine induced pharmacological effects, as established by QPEEG measurements, in the CNS similar to those previously established in healthy, young subjects.
Abstract: In 1994, a standardized dry extract of Ginkgo biloba leaves (SeGb), has been approved by German health authorities for the treatment of primary degenerative dementia and vascular dementia. More than 24 different brands of Ginkgo biloba extract are sold in the United States. Tacrine, also known as tetrahydroaminoacrine (THA), and donepezil are currently the only drugs approved in the United States for the treatment of Alzheimer's disease. Previous studies demonstrated that SeGb and tacrine induce significant pharmacological effects on the brains of young, healthy human males, as determined by bioelectrical activity measurements obtained using the quantitative pharmaco-electroencephalogram (QPEEG) method. The type of central nervous system (CNS) effects we have seen on computer-analyzed EEGs (CEEGs) after administration of tacrine or EGb suggests both are "cognitive activators" which are, as a class of products, characterized by a (prepost) relative increase of 7.5 to 13 Hz ("alpha") and decrease of 1.3 to 7.5 Hz ("delta" and "theta") activity. To determine whether EGb or tacrine had noticeable pharmacological effects on elderly subjects diagnosed with possible or probable Alzheimer's, the present open, uncontrolled trial was conducted. Data from 18 subjects (11 males, 7 females) at an average age of 67.4 years with light to moderate dementia (Mini Mental mean score = 23.7, ranges: 15-29 [Geriatric Depression Scale mean scores = 3.7; range: 3.2-5.4]) were analyzed for this presentation. Each subject was randomly administered a single oral "Test-Dose" of either 40 mg of tacrine or 240 mg of EGb2 in two separate sessions within 3- to 7-day intervals. Before drug administration and at 1- and 3-hour intervals after drug administration, CEEGs were recorded for a minimum of 10 minutes. The CEEGs were analyzed using Period Analysis programs we developed for QPEEG. The results indicated that both EGb and, to a lesser degree, tacrine induced pharmacological effects, as established by QPEEG measurements, in the CNS similar to those previously established in healthy, young subjects. The type of CNS effects produced by EGb (as established by HZI's CEEG psychotropic drug database) in elderly dementia patients were similar to those induced by tacrine responders as well as those seen after the administration of other "cognitive activators" (pramiracetam, vinpocetine, BMY-21502, suloctidil, and lisuride) and anti-dementia drugs approved in the United States or Europe (tacrine, donepezil, nimodipine, piracetam, and oxiracetam) from our database. The results also showed that 240 mg of EGb has typical cognitive activator CEEG profiles (responders) in more subjects (8 of 18) than 40 mg tacrine (3 of 18 subjects). Because of the small sample size, we could not test the hypothesis that subjects who showed cognitive activator-type pharmacological response to the first Test-Dose of EGb or tacrine also exhibit more therapeutic effects (compared to nonresponders) when drugs are administered chronically.
69 citations
TL;DR: The dextromethorphan pharmacogenetic test can be used for clinical purposes, but to avoid artefacts it should be done after a washout period, especially after treatment with thioridazine; testing with mephenytoin is less likely to be influenced by thIORidazine or amitriptyline.
Abstract: The metabolism of most tricyclic antidepressants and some phenothiazine neuroleptics is under the genetic control of hepatic cytochrome P-450IID6, which also regulates the metabolism of dextromethorphan. This study investigated the effect of treatment with amitriptyline or thioridazine on testing for genetically regulated efficiency of the metabolism of dextromethorphan and mephenytoin. One group of 33 patients was treated with 150 mg amitriptyline a day (the AMI group); 25 other patients received a daily dose of thioridazine, either 200 mg (200-THD group; n = 7) or 400 mg (400-THD group; n = 18). Before and after 10 days of this treatment, all patients were tested with 25 mg dextromethorphan and 100 mg mephenytoin to determine their pharmacogenetic status with respect to their hepatic drug oxidizing systems (cytochrome P-450IID6 and P-450 MP). Two patients were poor metabolizers (PMs) of dextromethorphan and three of mephenytoin. Treatment with either psychotropic drug was without significant effect on the metabolism of mephenytoin, but both amitriptyline and thioridazine increased significantly the metabolic ratio of dextromethorphan/dextrorphan. Thioridazine had the effect of changing the pharmacogenetic status of 15 efficient metabolizers of dextromethorphan to poor metabolizers; amitriptyline did not have such an effect. There was no significant correlation between day-11 plasma levels of thioridazine, mesoridazine, or sulforidazine and the metabolism of dextromethorphan, but there was a correlation between the metabolism of dextromethorphan and plasma levels of amitriptyline and nortriptyline. Amitriptyline (p less than 0.05), but not thioridazine, decreases the ratio of conjugated/total dextrorphan in urine.(ABSTRACT TRUNCATED AT 250 WORDS)
68 citations
TL;DR: Thermodynamic analysis revealed that binding of CPZ to hemoglobin was exothermic, whereas binding to myoglobin was endothermic with a high entropic contribution, suggesting that CPZ binding toMyoglobin is hydrophobic in nature.
68 citations
01 Jan 1985
TL;DR: 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.
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).
68 citations
TL;DR: The relationship between reports of falling down and the administration of sedative/hypnotics or other psychotropic drugs was examined during a 1-year period in a 1,000-bed teaching hospital as discussed by the authors.
Abstract: The relationship between reports of falling down and the administration of sedative/hypnotics or other psychotropic drugs was examined during a 1-year period in a 1,000-bed teaching hospital. It was found that patients who fell were approximately 2.7 times as likely to have received a psychotropic drug compared to control subjects matched for age, gender, and medical service. Orally administered benzodiazepines that were significantly associated with falls included temazepam, alprazolam, diazepam, and lorazepam, but not triazolam, chlordiazepoxide, or chlorazepate. When viewed as the frequency of falls per dose dispensed by the pharmacy, the highest rates were with lorazepam (0.0012 falls/dose) and alprazolam (0.0010 falls/dose), whereas the lowest rate was for diazepam (0.00052 falls/dose). Falls with antidepressants were comparable to the higher rates with benzodiazepines; frequencies for nortriptyline and sertraline were 0.0021 and 0.0012 falls/dose, respectively. Patients receiving two or three psychotropic drugs concomitantly were 3.7 and 9.5 times, respectively, more likely to fall compared to control subjects. Patients under 21 years old who fell were also significantly more likely to have received a psychotropic medication compared to control subjects. Although these data are associational and do not necessarily imply causality, prudence indicates that the risk of falls be considered in making benefit/risk decisions about prescribing sedative/hypnotics.
68 citations