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

Movement abnormalities in neuroleptic-treated, psychiatric patients are classified as (a) initial syndromes, including dystonia, parkinsonism, and hyperkinetic abnormalities such as initial dyskinesia (ID) and akathisia, all of which are related to the neuroleptic dose and can be considered as overdose phenomena; (b) tardive syndromes, mainly the classic tardive dyskinesia (TD) syndrome, more seldom tardive akathisia and tardive dystonia, which may all develop or aggravate after withdrawal of neuroleptic treatment; and (c) age-related, spontaneous dyskinesia, akathisia, and dystonia, and schizophrenia-related, hyperkinetic, often stereotyped, movements and restlessness. ID and TD can occur simultaneously, and may depend, at least partially, on identical mechanisms. The pathophysiology of TD is still not clear, and the traditional dopamine (DA) hypersensitivity model seems inadequate. Animal experiments suggest that blockade of some DA receptors in the brain (e.g., in ventromedian striatum) may counteract hyperkinesia and produce parkinsonism, while a concomitant blockade of other similar receptors in other brain regions (e.g., in anterodorsal striatum) may aggravate movements. This offers an explanation for the concomitant occurrence of parkinsonism and hyperkinetic movement abnormalities (ID and akathisia) relatively early in a neuroleptic treatment, and may also contribute to the understanding of the pathophysiology of TD. It is concluded that pathophysiologically TD is a heterogeneous syndrome depending on a subtle balance between several neurotransmitters in the brain, including DA receptor blockade and hypersensitivity of DA and GABA receptors.
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PMID:Pathophysiological mechanisms underlying tardive dyskinesia. 286 Jun 66

Extrapyramidal symptoms cause much misery, often go undiagnosed, and can interfere with treatment and rehabilitation. Akinesia is a behavioral state of diminished motoric and psychic spontaneity that is difficult to distinguish from the negative symptoms of schizophrenia. The most useful clinical correlates of akinesia are a subjective sense of sedation and excessive sleeping. Akinesia interferes with social adjustment and may manifest as "postpsychotic depression." The subjective restlessness of akathisia is usually accompanied by telltale foot movements: rocking from foot to foot while standing or walking on the spot. Akathisia is strongly associated with depression and dysphoric responses to neuroleptics and has even been linked to suicidal and homicidal behavior in extreme cases.
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PMID:Behavioral toxicity of antipsychotic drugs. 288 52

Neuroleptic drugs are a common treatment for acute mania. Although lithium alone may be effective, for those patients with moderate or severe agitation neuroleptics appear to be superior. Low-potency and high-potency neuroleptics are equally effective in mania, as in schizophrenia. Patients with affective disorders, however, may be highly susceptible to the pseudoparkinsonian or extrapyramidal side effects that can occur with neuroleptics. Moderate doses of neuroleptics can be effective in most patients and can reduce the likelihood of serious side effects. Many bipolar patients have manic relapses despite adequate serum lithium levels, and many of those patients are subsequently maintained on a regimen of neuroleptic drugs in addition to lithium. Using the lowest possible dose of the neuroleptic may decrease the high, long-term risk of tardive dyskinesia. More clinical research is needed to determine the most appropriate use of neuroleptic drugs in bipolar disorder.
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PMID:The role of neuroleptics in manic-depressive illness. 290 42

In present-day African psychiatry, there is a sharp differentiation between serious mental illness, which requires medically orientated treatment and chemotherapy, and the more superficial disturbances of personality for which psychological, sociological and educational measures are indicated. With the severe shortage of Western psychiatrists who are prepared to undertake this work, it is providential that black traditional healers address themselves to the latter group of mental abnormalities with a measure of success comparable to psychotherapy in First-World practice. In the back wards of a mental hospital (run on First-World lines) and in outpatient clinics in periurban Durban townships, one meets a large number of patients with severe and chronic disease. All those conditions (mental retardation, organic brain syndromes, schizophrenia and affective disorders) with positive symptomatology (excitement, restlessness and aggression) are found to respond to neuroleptic drugs. Possible reasons why patients with negative symptoms (emotional withdrawal, poverty of ideas and speech), especially in schizophrenia, do not react, are discussed, and administrative and socio-economic implications are reviewed.
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PMID:Severe invalidism--the dominant feature of Third-World psychiatry in southern Africa. 335 19

In this sample of eighty consecutive admissions to the Centre-Neuro-Psycho-Pathologique (CNPP) of Kinshasa, 81% were given a DSM-III diagnosis. This demonstrates that the DSM-III is a useful tool for psychiatric research in developing sub-saharan Africa. Schizophrenia, schizophreniform psychoses, and affective disorders appeared in their familiar forms. Zairois patients tended to present with complaints of insomnia, agitation and pressured speech. The most striking observations were the relative paucity of depressed mood, self-reproach, and suicidal ideation in patients with major depression. Four cases of acute transient psychosis were noted.
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PMID:Tertiary care psychiatry in Zaire: DSM-III in the developing world. 338

Symptom frequency and severity were compared in two sequential clinically referred samples of 95 children and 92 adolescents, aged 6 to 18 years, all medically healthy, assessed with the Schedule for Affective Disorders and Schizophrenia for School Age Children, Present Episode, who met unmodified Research Diagnostic Criteria for major depressive disorder (MDD). There were no significant differences between the two groups in the majority of depressive symptoms. However, prepubertal children had greater depressed appearance, somatic complaints, psychomotor agitation, separation anxiety, phobias, and hallucinations, whereas adolescents had greater anhedonia, hopelessness, hypersomnia, weight change, use of alcohol and illicit drugs, and lethality of suicide attempt, but not severity of suicidal ideation or intent. Adolescents with a duration of the depressive episode of two years or greater had significantly higher rates of suicidal ideation and intent, lethality, and number of suicide attempts than youngsters with depressive episodes of shorter duration. A principal components factor analysis of psychiatric symptoms was carried out in all 296 youngsters evaluated during the same period who met DSM-III criteria for any Axis I diagnosis. The majority had an affective disorder. Factors were quite similar for both adolescents and children and included an "endogenous" and an "anxious" factor, as in many studies of adult depression. In addition, three other factors were found: negative cognitions, appetite and weight changes, and a conduct factor. Suicidal ideation was a component of both the negative cognitions factor and the conduct factor.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The clinical picture of major depression in children and adolescents. 366 42

Psychiatric disorders are common in medical inpatient and outpatient populations. As a result, internists commonly are the first to see psychiatric emergencies. As with all medical problems, a good history, including a collateral history from relatives and friends, physical and mental status examination, and appropriate laboratory tests help establish a preliminary diagnosis and treatment plan. Patients with suicidal ideation usually have multiple stressors in the environment and/or a psychiatric disorder (i.e., a major affective disorder, dysthymic disorder, anxiety or panic disorder, psychotic disorder, alcohol or drug abuse, a personality disorder, and/or an adjustment disorder). Of all patients who commit suicide, 70% have a major depressive disorder, schizophrenia, psychotic organic mental disorder, alcoholism, drug abuse, and borderline personality disorder. Patients who are at great risk have minimal supports, a history of previous suicide attempts, a plan with high lethality, hopelessness, psychosis, paranoia, and/or command self-destructive hallucinations. Treatment is directed toward placing the patient in a protected environment and providing psychotropic medication and/or psychotherapy for the underlying psychiatric problem. Other psychiatric emergencies include psychotic and violent patients. Psychotic disorders fall into two categories etiologically: those that have an identifiable organic factor causing the psychosis and those that have an underlying psychiatric disorder. Initially, it is essential to rule out organic pathology that is life-threatening or could cause irreversible brain damage. After such organic causes are ruled out, neuroleptic medication is indicated. If the patient is not agitated or combative, he or she may be placed on oral divided doses of neuroleptics in the antipsychotic range. Patients who are agitated or psychotic need rapid tranquilization with an intramuscular neuroleptic every half hour to 1 hour until the agitation and combativeness are under control. Haloperidol (Haldol) is the safest neuroleptic. Chlorpromazine (Thorazine), perphenazine (Trilafon), and, in the elderly, thiothixene (Navane) can also be useful if haloperidol (Haldol) is not effective and more sedation is needed; these drugs, however, produce more side effects. Violent patients need to be physically restrained and then given antipsychotic medication or, in the case of drug abuse or alcohol withdrawal, the appropriate drug management.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Psychiatric emergencies. 373 71

The authors report the results of an open clinical trial with Cis(Z)-Clopenthixol (Cisordinol), the isolated Cis-isomer of the Clopenthixol racemate (Sordinol). The drug was applied to 18 patients with severe forms of manic or schizophrenic disease, diagnosed according to ICD 9. The compound was applied intravenously or orally, daily doses ranging from 10-160 mg. For the duration of the study (6 weeks) the patients were repeatedly rated with the CGI, BPRS or IMPS (abbreviated version), and several hematological and enzyme patterns, cardiac, renal function and electrolytes were monitored, as was the FFA. Due to the relatively small number of patients in relatively heterogeneous diagnostic composition, a number of items rated failed to reach statistical significance. The CGI showed a good therapeutic effect with a minimal incidence or severity of side effects. BPRS and IMPS documented an impressive decline in formal thought-disorders, agitation, logorrhea and tenseness. The sedative effects of the drug were slight and of short duration, anti-Parkinson medication was necessary in more than 50% of the patients studied. The results of the study show a good efficacy of the drug in manic and schizophrenic disorders, Cisordinol being well tolerated intravenously. The range of doses administered is approximately 50% of the dose-range of the parent-drug (Sordinol).
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PMID:Findings with cis-Z-clopenthixol in the treatment of acute mania and schizophrenia. 379 70

Thirty-seven adult patients meeting the Utah criteria for attention deficit disorder, residual type, were entered into a double-blind crossover trial of methylphenidate and placebo. A moderate-to-marked therapeutic response occurred in 21 (57%) of the patients while receiving methylphenidate and in four (11%) while receiving placebo, a highly significant difference statistically and clinically. The responding patients showed significant improvement in the following areas: attentional difficulty, motor overactivity, affective lability, and impulsivity. The diagnosis of attention deficit disorder, residual type, should be considered in patients with prominent complaints of impulsivity, restlessness, emotional lability, and hot temper who do not suffer from schizophrenia or major mood disorder and do not have symptoms of schizotypal or borderline personality disorders.
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PMID:A controlled study of methylphenidate in the treatment of attention deficit disorder, residual type, in adults. 388 60

The short term activity of neuroleptics allows the possibility to distinguish between: 1 - their instictive-affective effects which can, according to the case, either diminish agitation, vigilance, aggressivity, anxiety and mood, or the disinhibitors in case of anti-autistic action; 2 - their effects reducing hallucinations and delusions. After 6 months, and more, in the case of schizophrenia or other psychotic evolution, the preventive effect on psychotic relapses appears as unquestionable to many psychiatrists even though there do exist discrepancies in controlled studies. A regularly administrated treatment reveals the possibility of a favorable evolution with a restitution of social and hedonic capacities. Indeed, although the patients behave in a neurotic or psychopathic way, there is no indication that they are to shift from their psychotic structure. We think it necessary to find new trends in the biological treatment of psychosis when unpredictable neurological or endocrinal side-effects occur, or when too numerous patients to remain neuroleptic-resistant.
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PMID:[Psychological effects of neuroleptics (author's transl)]. 611 92


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