Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Plasma prolactin concentration (pPRL), plasma homovanillic acid concentration (pHVA), and symptomatology were measured in 24 male subjects with schizophrenia during maintenance haloperidol treatment. Fourteen subjects subsequently underwent 50 percent dose decreases under placebo-controlled, double-blind conditions. At baseline, a significant inverse correlation was found between pPRL and both tardive dyskinesia (TD) and "thinking disorder"; pPRL was directly correlated with negative symptoms. No such relationship was found with pHVA. In the patients who underwent a dose decrease, no relationship was found between baseline pPRL or pHVA and any clinical variable after the decrease. These data do not support the use of baseline pPRL or pHVA as markers of central dopamine function subsequent to a neuroleptic dose decrease.
 ...
PMID:Plasma prolactin and homovanillic acid as markers for psychopathology and abnormal movements after neuroleptic dose decrease. 160 34

Obstetric histories of 54 schizophrenic patients and 114 siblings were obtained from their mothers and scored using the Obstetric Complications Scale. There were no statistically significant difference in the proportion of schizophrenic patients (35%) and siblings (29%) who had at least one definite obstetric complication. There was no evidence that schizophrenic patients with a history of obstetric complications were less likely to have a first-degree relative with a history of psychiatric illness leading to in-patient care. Schizophrenic patients with a history of obstetric complications were more likely to have drug-induced Parkinsonism. There was a trend for tardive dyskinesia to be more common in those schizophrenic patients with no obstetric complications but a family history of schizophrenia.
 ...
PMID:The Nithsdale schizophrenia surveys. X: Obstetric complications, family history and abnormal movements. 161 63

The authors review recent research findings on the drug treatment of schizophrenia. A number of studies emphasize that neuroleptic medications are severely limited by neurological side effects that include acute extrapyramidal syndromes and tardive dyskinesia. Studies comparing neuroleptic doses in both acute and maintenance therapy have encouraged clinicians to evaluate methods for treating patients with the lowest effective dose. Other studies, but not all, indicate that plasma level measurement may be helpful in decision making about drug dosage. The management of schizophrenic patients with illnesses that are refractory to conventional neuroleptics is also discussed. Clozapine, an atypical neuroleptic, may be more effective than other available neuroleptics for severely ill, treatment refractory patients or patients who are unable to tolerate the neurological side effects of typical neuroleptics.
 ...
PMID:Drug treatment of schizophrenia. Overview of recent research. 167 83

The epidemiology, etiology, diagnosis, and treatment of schizophrenia are reviewed. In the United States, at least 1 in every 100 persons is afflicted with schizophrenia. The theory that schizophrenia is a biochemical disorder has gained wide acceptance, although none of the etiological theories are conclusive. Criteria contained in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, are most commonly used to diagnose schizophrenia. Accuracy in diagnosing schizophrenia is critical because the treatments and prognoses for different types of psychoses can vary considerably. Treatment primarily involves the use of antipsychotic drugs, which are thought to act by blocking central dopamine receptors. The classical antipsychotics are the phenothiazines; of these, the prototype is chlorpromazine. Other classes of antipsychotics are the thioxanthenes, butyrophenones, dihydroindolones, dibenzoxazepines, diphenylbutylpiperidines, and dibenzodiazepines. Selecting an appropriate agent involves consideration of adverse effects, dosage forms, and the agent's ability to relieve target symptoms. Adverse effects of these agents include sedation, extrapyramidal effects, and anticholinergic effects. Tardive dyskinesia is a serious, irreversible condition associated with long-term antipsychotic therapy. Clozapine, a newer atypical antipsychotic, has been shown to be more effective than chlorpromazine and haloperidol and seems to cause few neurological adverse effects. Treatment of schizophrenia has not changed much since the advent of antipsychotic drug use nearly 30 years ago. Newer atypical antipsychotics show promise in improving target symptoms while causing fewer adverse effects.
 ...
PMID:Epidemiology, etiology, diagnosis, and treatment of schizophrenia. 167 28

Clozapine is a neuroleptic agent whose structure consists of a dibenzodiazepine derivative with a piperazinyl side chain. It has been classified as an atypical neuroleptic drug due to its unique neuropharmacologic profile. Clozapine has a weak binding affinity for dopamine D-1 and D-2 receptors by its slightly greater preference for D-1 receptors, as noted with a D-1:D-2 receptor binding ratio of 1.3. Other neuroreceptors are involved, as the drug has potent binding affinity for serotonin receptors 5-HT1A and 5-HT2. Clozapine also has antihistaminic, anticholinergic, and alpha-adrenergic antagonistic properties. Electrophysiologic studies show that it differs from other typical neuroleptics in that its actions appear to be specific for the cortical-limbic dopamine A-10 tract. In animal paradigms, in contrast to typical neuroleptics, clozapine did not produce catalepsy and had only transient effects in antagonizing other dopamine agonists. The drug is rapidly absorbed orally with a bioavailability of 0.27. After a single oral dose the elimination half-life was approximately 8-10 hours, but with several doses it increased to 14.1 hours. The agent is extensively metabolized by hepatic microsomal enzymes that forms the N-desmethyl and N-oxide metabolites. It is an effective neuroleptic that has been studied in short-term and long-term clinical trials, and multicenter trials. Clozapine was superior to chlorpromazine in the treatment of refractory schizophrenia that failed to respond to previous neuroleptic therapy. Reports of extrapyramidal side effects are minimal, and no case reports of tardive dyskinesia have been published. Indeed, clozapine has been used to treat tardive dyskinesia and other movement disorders. Agranulocytosis is the major adverse effect and its prevalence appears to differ among various ethnic groups. Other adverse effects that have been reported include hypersalivation, orthostatic hypotension, and constipation. Clozapine can lower the seizure threshold in a dose-dependent manner. The drug represents a significant advancement in the treatment of mental illness.
 ...
PMID:Clozapine. 167 65

Balancing the demonstrated effectiveness of antipsychotic medication for long-term maintenance treatment of schizophrenia with the risk of developing tardive dyskinesia (TD) has led to attempts to reduce dosage. Research using two methods is reviewed in this article; continuous low dose and intermittent or targeted medication. Both methods require monitoring of patients and treating decompensations with medication. Studies reviewed in this article indicate that these strategies are feasible for many patients, but are associated with higher risk of relapse than maintaining an established moderate dose. For low dose, relapse rates are higher if treatment continues for a second year, if dosage is very low, or if patients are not stable. However, low dose administration also leads to reduce adverse effects (including TD in at least one study) and improved subjective well being. Targeted medication leads to reduction of administered dose and side effects but to no clear benefit in terms of TD or social functioning. No studies reported to date have compared these strategies directly. Ongoing and future research will do this and identify those patients for whom these strategies can be implemented without increased relapse risk.
 ...
PMID:Maintenance medication for schizophrenia: strategies for dose reduction. 167 54

On the basis of the association of negative schizophrenia with parkinsonism and early age of onset, we predicted that the latter two would covary, as reflecting a similar pathological process. To test this prediction, we studied in 40 neuroleptic-treated female schizophrenic patients with drug-induced movement disorders the association of age at onset with drug-induced parkinsonism and, for comparison, also with persistent tardive dyskinesia (TD) and acute drug-induced dystonia. We found that onset of schizophrenia during adolescence, significantly predicted the presence of parkinsonism but, by contrast, was unrelated to TD and acute drug-induced dystonia. Our findings suggest a specific association between early age at onset of schizophrenia and parkinsonism, implying that the former may be a risk factor for parkinsonism. The significance of these findings to the pathophysiology of negative schizophrenia and parkinsonism are discussed.
 ...
PMID:Drug-induced parkinsonism: relationship to age at onset of schizophrenia. 168 Jul 77

The literature on the pharmacologic treatment of schizophrenia and schizoaffective disorders is reviewed (116 references). All clinically active antipsychotic drugs share the ability to block postsynaptic dopamine receptors in the central nervous system. Their potencies vary, chlorpromazine and thioridazine being the least potent and fluphenazine and haloperidol the most potent. The adverse effects of the neuroleptics include acute dystonia, parkinsonian symptoms (extrapyramidal symptoms), akathisia, tardive dyskinesia, and tardive dystonia. When used at equipotent doses, all classic neuroleptics now available are equally effective in the treatment of schizophrenia. Choice of drug is based on adverse effects and patient response. The neuroleptics are effective in most acute exacerbations of schizophrenia and for the prevention or mitigation of relapse. Their effects are more pronounced on the positive symptoms of schizophrenia, such as hallucinations, delusions, disordered thinking, and paranoia, than on the negative symptoms, such as deficits in social interaction, emotional expression, and motivation. Strategies for acute and maintenance treatment and for the management of treatment-resistant patients are reviewed. The pharmacology and clinical use of the newer atypical neuroleptics, particularly clozapine, and their adverse effects are discussed.
 ...
PMID:Pharmacologic treatment of schizophrenia. 168 69

Longitudinal evaluation of psychiatric patients often yields information that cross-sectional study does not. We previously examined 31 older (age greater than 55) chronic schizophrenics for prevalence of extrapyramidal side effects, severity of psychiatric symptoms, and ventricular brain ratio (VBR). We reexamined 22 of these patients after 2-4 years. Tardive dyskinesia (TD) and drug-induced parkinsonism (DIP) were common (mean prevalences were 52% and 62%, respectively) and often occurred together (38%). The overall prevalences of the disorders did not change significantly with time, although there was some individual fluctuation in diagnosis. Severity of TD was constant, but severity of DIP decreased, probably because neuroleptic doses were significantly decreased. Magnitude of DIP was positively correlated with VBR and severity of negative symptoms of schizophrenia. The correlation of DIP and negative symptoms occurred primarily because of the similarity between masked facies and blunted affect. VBR did not change over the follow-up period. Negative symptoms of schizophrenia were prevalent, moderately severe, and quite stable over time in this cohort. Positive symptoms were less severe but highly variable between examinations.
 ...
PMID:Three-year follow-up of older schizophrenics: extrapyramidal syndromes, psychiatric symptoms, and ventricular brain ratio. 168 18

During long-term treatment of schizophrenia with antipsychotic medication, side effects such as weight gain and tardive dyskinesia may develop, while other extrapyramidal side effects may continue. A large multicenter, double-blind, comparative trial of haloperidol decanoate and fluphenazine decanoate has been completed, in which 181 patients took part. The study lasted for 1 year and patients were assessed using the Krawiecka scale, the Montgomery-Asberg scales for schizophrenia and depression, the Simpson-Angus scale for parkinsonism, the AIMS for tardive dyskinesia, and a scale for akathisia. Patients were also weighed at each assessment. The results provide further evidence about the occurrence of weight changes, extrapyramidal side effects, and depression during long-term treatment and about the relative benefits of the two treatments.
 ...
PMID:Side effects during long-term treatment with depot antipsychotic medication. 175 40


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>