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 21,692 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Much of the current confusion concerning marijuana has been caused by a lack of definition of terms. Variations in drug effect that are related to the type and potency of cannabis preparation and route of administration need clarification. When domestic strength marijuana is smoked recreationally, the subjective effects include relaxation, mild euphoria and increased sensory awareness. The objective effects include tachycardia, reddening of the conjunctivae and a distorted sense of time. Undesirable effects such as panic reactions, amotivational behavior, and acute toxic psychosis occur infrequently and are reversible with proper therapy. Other effects which have been attributed to marijuana are unsubstantiated. The recent upsurge in use of marijuana involves persons of a different type than those who used it heretofore and has greatly increased the number of people familiar with the drug. The disparity between what many people know empirically and the information disseminated through official media has lessened the credibility of physicians with many of our younger citizens. When young people recognize misinformation about marijuana, they are no longer listening when the facts are presented about more dangerous drugs, and the abuse of these drugs must be our main concern. To be considered is the potential hazard to adolescent users who may concomitantly be exposed to a subculture of experimentation with stronger drugs at a time when the opinion of a peer group is a strong factor in their behavior.
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PMID:Marijuana: a realistic approach. 555 11

The symptoms include, by ascending order of severity: nightmares and insomnia, nausea and vomiting, muscular weakness or tremor, postural hypotension, hyperthermia, muscle twitching, convulsions, confusional state or psychosis. Prominent features are the late onset of these symptoms, several days after treatment has been discontinued, and the sometimes difficult diagnosis, since patients are usually unaware of their dependence on these drugs. Reinstituting benzodiazepine treatment, then withdrawing it progressively are the best curative measures. Prevention is easy if treatment is gradually rather than abruptly withdrawn in all patients who receive the compound in high dosage for more than one month.
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PMID:[Benzodiazepine physical dependence. 6 cases (author's transl)]. 610 22

The benzodiazepines are the most effective, safest, and most widely used antianxiety drugs. As a class of drugs, there are few major differences between the various benzodiazepine derivatives. The main distinguishing features are different plasma half-lives and the presence or absence of pharmacologically active metabolites. Plasma half-lives vary considerably, from 2 to 3 hours to more than 100 hours. All benzodiazepines are equally effective in the short term management of anxiety and insomnia, and their classification into 'anxiolytics' and 'hypnotics' is not justified. There are numerous other indications for benzodiazepine use, such as muscle spasm in osteoarthritic conditions, and acute alcohol withdrawal, but the benzodiazepines have no antidepressive or analgesic effects. While there is no good evidence for their long term efficacy in the treatment of anxiety and insomnia, the benzodiazepines are more effective and safer than their main predecessors, the barbiturates. Some of the benzodiazepines, particularly those with long plasma half-lives which are commonly used as hypnotics, have a prolonged duration of action and cause marked 'hang-over' effects. Alcohol enhances the effects of these drugs, and thus can also increase their side effects. Adversely effects such as oversedation, tremor, ataxia and confusion are much more common in elderly patients. Ever since the benzodiazepines were first marketed 20 years ago their use has increased rapidly, and it is now estimated that between 12 and 16% of the adult population in developed countries use tranquillisers at some time each year. However, their overall use has probably diminished somewhat in the last few years. Although their indications are very common, it is possible that some of this extensive usage may be the result of dependence. Until recently, published reports of such dependence were comparatively few. However, withdrawal symptoms have now been demonstrated in a substantial proportion of patients on long term, normal dose benzodiazepine treatment. The abstinence syndrome usually lasts for 8 to 10 days, and is characterised by insomnia, anxiety, loss of appetite and bodyweight, tremor, perspiration, and a host of perceptual disturbances. More serious developments such as epileptic fits and psychosis are probably infrequent during withdrawal from therapeutic doses. The overall incidence of benzodiazepine dependence remains unknown.
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PMID:Rational use of anxiolytic/sedative drugs. 613 9

A case of rhabdomyolysis is described, with onset following three intramuscular injections of loxapine and one injection of benztropine over a 7-hour period. The possible additive effects of intramuscular drug administration and psychotic episode-associated increased muscle membrane permeability are discussed. Because of the risk of acute renal failure following rhabdomyolysis, monitoring of creatine phosphokinase levels and urine tests for myoglobin are recommended for patients who develop muscular discomfort, nausea, or confusion while receiving frequent intramuscular injections of neuroleptics.
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PMID:Rhabdomyolysis complicating rapid intramuscular neuroleptization. 614 Nov 90

Amphetamine induces a behavioral syndrome in mammals that includes a variety of repetitive behaviors. An integral component of this syndrome in humans is the presence of a thought disturbance not unlike that manifest in idiopathic paranoid schizophrenia. The consistent pattern of behavioral changes produced by amphetamine across species, when considered in light of the psychosis it elicits in humans, has suggested to many that these drug-induced changes in animals may provide a model of the endogenous psychosis in humans. Amphetamine-induced changes in open-field behavior in the rat have been the most widely studied in attempts to formulate a model for investigating the neurobiological mechanisms underlying amphetamine psychosis and paranoid schizophrenia in humans and for testing the therapeutic efficacy of new antipsychotic drugs. The procedures used to assess the behavioral response to amphetamine, however, typically include rating scales or automated recordings that by their very nature ignore those components of the behavioral response that may be most critical for developing a viable animal model of the naturally occurring psychosis. Further, open-field behavior is often recorded during arbitrarily selected intervals without consideration for the multiphasic nature of the entire amphetamine response. We discuss how incomplete descriptive analyses of the amphetamine behavioral response in rats has led to confusion in the literature and describe behavioral research that is paradigmatic of the work we believe is most likely to eventuate in significant progress in the field.
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PMID:Critical issues in assessing the behavioral effects of amphetamine. 614 35

A patient with a disseminated malignancy received 3 mg of synthetic beta-endorphin administered intrathecally by lumbar puncture. A marked behavioral syndrome characterized by confusion, hypomanic/manic behavior, and psychosis followed drug administration and persisted for more than 2 days.
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PMID:Behavioral change in a cancer patient following intrathecal beta-endorphin administration. 619 91

Phencyclidine (PCP) is a major drug of abuse as well as a 'drug of choice' among substance abusers in the U. S. A. Unfortunately, PCP use may result in the development of psychotic behavior. PCP-induced psychosis is characterized by confusion, excitation, aggression, paranoia, hallucinations and delusions of grandeur and may evoke violent or suicidal behavior. Therefore, many patients suffering from PCP-induced psychosis have been diagnosed initially as schizophrenic. However, PCP-related research has not kept pace with the rise in abuse and PCP-induced psychosis. The neurochemical effects of PCP are not well defined at present, but both behavioral and biochemical studies suggest that it may interact with dopaminergic, cholinergic, noradrenergic, serotonergic, GABAergic and enkephalinergic systems. In addition, the specific reversible, saturable, high affinity 3H-PCP binding site is discovered recently in rat brain. On the other hand, there is now a large body of evidence to suggest that opiate receptors may be subdivided into mu, sigma, kappa and delta receptors. On the basis of behavioral and binding studies, it is proposed that the sigma receptor and the PCP binding site are one and the same. This receptor interacts with PCP and psychotomimetic opioids to produce their psychotomimetic effects. In connection with this receptor, a trial to isolate an endogenous ligand produces psychotomimetic effects, "angeldustin" is progressing. This review has served to illustrate the paucity of information currently available on the central effects of PCP. However, our current notions of the mechanisms of action of PCP are very complicate. Such a review inevitably raises more question than it answers but it is hoped that these may stimulate further investigation in this field.
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PMID:[Phencyclidine, a drug which induces psychosis: its neuropharmacological actions]. 639 56

The adverse psychic effects of antiepileptics embrace all categories of psychiatric symptomatology, including disturbances of consciousness (delirium, confusion), psychotic state (schizophrenia-like psychosis, affective disorder), neurotic state, behavior and character disorder. Antiepileptic intoxication can take the form of a psychotic episode. The lowered level of consciousness due to a high blood level of antiepileptics is expressed as inhibitory symptoms such as a lack of initiative, psychomotor slowing, lowering mood, stuporous state and the like. Another group of manifestation of a high blood level of antiepileptics, by contrast, consists of salient positive symptoms such as irritability, hyperkinetic syndrome, hysterical symptoms, aggravation of character change, delirium and confusion. An elevated blood level of antiepileptics by itself is not sufficient to give rise to a psychiatric symptom, which is rather prone to occur in the presence of some trouble or problems (defect in intelligence or personality, fragility of brain function, organic brain damage, psychogenic factors) in the patient.
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PMID:Antiepileptic drugs and psychiatric disorders: mechanism involved in manifestation of psychic symptoms of high blood level of antiepileptics. 642 78

Because psychiatric symptoms are frequently the earliest signs of CNS pathology, the author outlines the structural brain diseases that may underlie several psychiatric syndromes and describes the computerized axial tomographic (CAT) scan findings associated with those diseases. On the basis of an awareness of these conditions and a cost-benefit analysis, the following indications for CAT scanning of psychiatric patients are proposed: 1) confusion and/or dementia of unknown cause, 2) first episode of a psychosis of unknown etiology, 3) movement disorder of unknown etiology, 4) anorexia nervosa, 5) prolonged catatonia, and 6) first episode of major affective disorder or personality change after age 50.
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PMID:Brain disease and psychiatric illness: when should a psychiatrist order a CAT scan? 643 55

Catatonia, which until 1874 was called atonic melancholia, has remained a relative mystery despite many advances in the understanding of schizophrenia. Its typical symptoms are certainly distinctive: a motionless stupor, bizarre posturing, waxen flexibility, religious delusions, stereotyped movements, negativism, loss of will, confusion, and recurrent frenzy (Kahlbaum 1874). The processes which motivate this particular derailment of self and body have been sought in various organic etiologies, with little success. Arieti (1974) proposes several reasons for the paucity of case studies of the treatment of catatonic schizophrenia. First, catatonic schizophrenia has been declining in occurrence. Second, the symptoms themselves, such as mutism and excitement, make verbal therapy extremely difficult. Finally, catatonics often have no memory of their psychotic experiences. Psychotherapists have therefore had to rely on highly personal intuitions of their patients' crisis-in-being. Despite therapists' attention to nonverbal behavior, mutism and stupor are particularly effective hindrances to communication in psychotherapy. Psychotherapy is often not begun until the patient's symptoms ameliorate through chemotherapy and milieu support. The centrality of the verbal medium of communication in psychotherapy suggests that other approaches, using nonverbal media, may be indicated in the study of catatonia. This paper describes a treatment of a catatonic schizophrenic man which utilized movement and drama therapy. These methods were successful in evoking representations of the patient's inner life.
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PMID:Representation of the internal world in catatonic schizophrenia. 651 81


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