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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The selective use of different neuroleptics in the treatment of schizophrenia by some psychiatrist according to the greater need for a sedative, antidelusional or activating effect is supported only by some uncontrolled clinical observations. Most extensive controlled studies done until now showed no significant differences among neuroloptics in their therapeutic efficacy. The hypothesis that these drugs have specific and selective actions therfore cannot be accepted. In the single patient it seems more rational to choose the right dosage schedule instead of the "right drug". Though the study of the metabolism of these drugs remains the most interesting approach to the problem of the individualization of the therapy., the results of these studies have until now been disappointing e.g. plasma levels of chlorpromazine correlated weakly with clinical improvement. In clinical practice an important element in the process of choosing is still the incidence of side effects and in fact at the moment "the drug of choice" can only be the drug best tolerated by the patient.
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PMID:The choice of neuroleptics in the treatment of schizophrenia: a critical review. 0 2

The purpose of this note is to point out that conclusions drawn in the title paper about the role of logic in the schizophrenia thought process are not reliable, since they are based on patients medicated with antipsychotic drugs. The substance of this note is drawn from the title paper and related literature. The principal conclusion is that Dr. Ho's deductions about the role of logic in schizophrenia follow only if one confuses psychiatric diagnosis with psychotic behavior.
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PMID:On Ho's "modern logic and schizophrenic thinking". 0 70

Clinical trials with major tranquilizers must take into account the clinical features of patients with schizophrenia and pharmacokinetic and pharmacodynamic properties of the drug. The objectives of the trial must be carefully defined so that appropriate selection criteria for patients, rating instruments and dosage schedules can be selected. It is useful to monitor physiological and biochemical actions of major tranquilizers as well as the clinical effects.
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PMID:Assessment of drugs in schizophrenia. Basic trial design. 0 64

Tardive dyskinesia has been regarded as a long-term complication of neuroleptic administration to patients with the diagnosis of schizophrenia. However, nine of the first fourteen patients evaluated for an investigation of tardive dyskinesia met diagnostic criteria for depression. Neuroleptics produce blockade of post-synaptic dopaminergic receptors. Tardive dyskinesia occurs when neuroleptics are discontinued, and is regarded as a manifestation of super-sensitive post-synaptic dopaminergic receptors. Tardive dyskinesia occurs when neuroleptics are discontinued, and is regarded as a manifestation of super-sensitive post-synaptic dopaminergic receptors. Chronically decreased neurotransmission in the synapse of a patient with depression may contribute to the development of a super-sensitive receptor and could explain the high proportion of patients with depression seen in this sample of patients with tardive dyskinesia.
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PMID:Tardive dyskinesia and depressive illness. 1 Jun 3

Schizophrenia may be associated with increased prostaglandin synthesis in certain parts of the brain. This hypothesis is based on the following findings: (1) Catalepsy, which is the nearest equivalent in animals to human catatonia, develops in cats when prostaglandin E1 is injected into the cerebral ventricles and when during endotoxin or lipid A fever the prostaglandin E2 level in cisternal c.s.f. rises to high levels; however, when fever and prostaglandin level are brought down by non-steroid anti-pyretics which inhibit prostaglandin synthesis, catalepsy disappears as well. (2) Febrile episodes are a genuine syndrome of schizophrenia.
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PMID:Possible association of schizophrenia with a disturbance in prostaglandin metabolism: a physiological hypothesis. 1 19

Cerebrospinal fluid (CSF) cyclic GMP may derive from central cholinergic neurotransmission. Measurement of CSF cyclic GMP may allow evaluation of possible implications of the dopaminergic hyperactivity in schizophrenia proposed by the dopamine hypothesis. The CSF cyclic GMP levels in 27 drug-free schizophrenic patients was measured and compared to that in 9 psychiatrically-healthy individuals. The mean CSF cyclic GMP level of the schizophrenic patients was 23 per cent lower than that of the control group, but this difference did not attain statistical significance. In addition the CSF cyclic GMP levels in a group of 10 schizophrenic patients were compared before and after 2 months of neuroleptic treatment. The mean level of cyclic GMP rose 50 per cent after treatment with phenothiazines (P less than 0.05). These results could indicate some tendency for decreased activity of central cholinergic neurons in schizophrenia as well as a restored dopaminergic-cholinergic balance after neuroleptic treatment.
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PMID:Cyclic GMP in the CSF of patients with schizophrenia before and after neuroleptic treatment. 1 48

A combined analysis of data from 11 controlled studies of loxapine versus either chlorpromazine or trifluoperazine in acute schizophrenia (5 studies) and chronic schizophrenia (6 studies) showed statistically significant superiority of loxapine on several items and factors of standardized psychiatric rating scales. Upon review of these findings, it was observed that the rating scale symptoms for which loxapine appeared superior to the reference compounds could, in the main, be considered a broad paranoid "cluster". The data were then reanalyzed to detect possible differences in efficacy of loxapine versus the reference compounds in those patients with a clinical diagnosis of schizophrenia, paranoid type and in those patients of any diagnostic subtype other than paranoid. Results of these analyses demonstrated clear superiority of loxapine in paranoid schizophrenic patients; nonparanoid patients responded at least equally as well to loxapine as to the reference compounds. Findings could not be attributed to inadequate dosages of the references compounds or inequality of treatment groups at baseline.
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PMID:Efficacy of loxapine in the treatment of paranoid schizophrenia. 1 50

A statistically planned double blind cross-over test with the substances 1-[3-(10,11-dihydro-5H-dibenz[b;f]-azepin-5-yl)-propyl]-4-piperidino-piperidine-4-carboxamide dihydrochloride-monohydrate (carpipramine, BAY b 4343 b) and placebo (BAY b 4343 a) was carried out on 30 long-term hospitalized schizophrenic patients. The study was evaluated by means of the kappa2-test and yielded the following results: 1. It could be statistically proved that carpipramine has a positive effect on psycho-pathological disorders in the behaviour of long-term hospitalized schizophrenic patients (kappa2 = 9.224; FG = 1; p greater than 0.05). 2. As regards the favourable influence of carpipramine on "productive" versus "non-productive" form of schizophrenia there were no differences. 3. Side effects or complications of a psychic, autonomic and/or motoric manner could not be seen. The usual laboratory tests showed no deviation from normal.
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PMID:[Double-blind clinical study of carpipramine/placebo (author's transl)]. 1 51

During an uncontrolled trial 46 depressed patients (39 endogenous depressions, 5 schizoaffective psychoses and 2 paranoic schizophrenics with depressive syndromes) were treated for 43 days on the average with 3 X 100 mg 1-[3-(10,11-dihydro-5H-dibenz[b,f]-azepin-5-yl)-propyl]-4-piperidino-piperidine-4-carboxamide-dihydrochloride-monohydrate (carpipramine) daily. The clinical impression of the improvement and the results of the Hamilton-Scale for depressions (19 patients, 24 items) showed a clear antidepressive effect of carpipramine. During a double-blind trial 14 patients were treated with carpipramine and 16 with doxepine for 30 days. Most patients suffered from endogenous depressions with paranoic symptoms or from schizophrenia with depressive syndromes. Statistical analysis of the Hamilton-Scale for depressions and the AMP-System showed the antidepressive and antipsychotic effect of carpipramine. Analysis of covariance showed no significant difference between carpipramine and doxepine. Altogether we treated 60 depressive patients with carpipramine. 26 patients improved very well and 11 moderately, that means 37 patients out of 60 reacted positively to therapy with carpipramine. One endogenous depression and a schizoaffective psychosis changed into a manic phase. A provocation of schizophrenic symptoms was not noticed. Carpipramine was very well tolerated and can be classified as a non-sedative antidepressant with an antipsychotic effect.
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PMID:[Activity profile of carpipramine. Results of an open trial and a double-blind trial versus doxepin]. 1 52

In a multicenter collaborative study, 28 newly readmitted schizophrenic patients, stabilized for one week on short-acting neuroleptic drugs, had their medication abruptly changed to penfluridol given once a week on an outpatient basis. The average dose required for maintenance was approximately 40 mg weekly. Analysis of BPRS evaluations carried out during the 16-week trial revealed a significant linear trend toward further improvement. Social functioning, as measured by the KAS questionnaire in the outpatient period of the trial, also revealed a significant linear trend toward improvement. Significant worsening was not found with any psychometric evaluation. Side effects, when observed, were neither frequent nor severe. Three laboratory and vital sign values showed significant changes: increase in BUN concentrations, decrease in pulse rate, and increase in body weight. The changes in weight and pulse appeared to be within relatively normal ranges, and the increase in BUN concentrations did not appear to be clinically significant. During the first part of a long-term study, penfluridol received a high degree of patient acceptability and is a welcome addition to the maintenance treatment of schizophrenia.
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PMID:Penfluridol, a peroral long-acting neuroleptic, for the maintenance treatment of schizophrenic patients who relapse. 1 77


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