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

Two hundred and forty-two patients with acute schizophrenia were enrolled in a double-blind, comparative, dose-finding study of a novel antipsychotic, remoxipride. Remoxipride was evaluated in a low (30 to 90 mg), medium (120 to 240 mg) and a high (300 to 600 mg) dose range and compared with a haloperidol (15 to 45 mg), which was administered to a similar group of patients. The results support the antipsychotic effect of remoxipride, with maximum efficacy occurring at daily doses between 120 mg and 600 mg. Side-effects were more frequent at doses of remoxipride over 300 mg. In all groups, remoxipride caused consistently fewer extrapyramidal side-effects than haloperidol. The antipsychotic effect of remoxipride may be derived from specific blockade of dopamine D2 receptors in the mesolimbic tract. The findings also suggest that remoxipride may have a therapeutic effect on negative symptoms of schizophrenia.
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PMID:A dose-finding study with remoxipride in the acute treatment of schizophrenic patients. 145 Jan 86

Seventy-two patients fulfilling the DSM-III criteria for schizophrenia and schizophreniform psychosis were admitted to a multicentre, double-blind controlled study to evaluate the efficacy and safety of remoxipride in comparison to haloperidol. The mean daily dose of remoxipride at the end of treatment was 353 mg and of haloperidol, 11 mg. Patients were assessed each week on the Brief Psychiatric Rating Scale (BPRS), the Clinical Global Impression (CGI) and the symptoms checklist. No significant differences in efficacy were found between the two treatments. The median total BPRS score in the remoxipride group was 25 at start of active treatment and 17 at the last valid rating (n = 31). For the haloperidol group the corresponding figures were 24 and 15 (n = 29). According to the CGI, 40% of remoxipride patients and 50% of haloperidol patients were much or very much improved. Treatment-emergent extrapyramidal symptoms, such as akathisia and rigidity, occurred significantly more frequently, and were more severe during treatment with haloperidol than with remoxipride (p = 0.012 and 0.024, respectively). Haloperidol-treated patients reported significantly more drowsiness and increased sleep during treatment (p = 0.026 and 0.012, respectively). No statistically significant differences were seen in endocrine or autonomic symptoms. Remoxipride seemed to be as effective as haloperidol, had a lower frequency of side effects, and was used safely in the dose range 150-600 mg/day.
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PMID:A double blind comparative multicentre study of remoxipride and haloperidol in schizophrenia. 197 67

The efficacy and safety of remoxipride in the treatment of schizophrenia were compared with those of haloperidol in a multicentre double-blind 6-week study which was randomized with a parallel group design and was preceded by a washout period. Eighty-nine consecutively admitted men and women meeting the Research Diagnostic Criteria for schizophrenia in an acute phase of the illness were treated with remoxipride 75-300 mg twice daily or haloperidol 5-20 mg twice daily. The efficacy assessments were the Brief Psychiatric Rating Scale, Krawiecka Rating Scale, and Clinical Global Impression. Both antipsychotic drugs produced clinical improvement with no significant differences between the efficacy of the two drugs. There were relatively few side effects. There were significantly fewer extrapyramidal symptoms and instances of blurred vision with remoxipride and less constipation with haloperidol. The results indicate that remoxipride is as effective an antipsychotic as haloperidol. Remoxipride has an advantage over haloperidol in respect to extrapyramidal side effects.
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PMID:Remoxipride and haloperidol in the acute phase of schizophrenia: a double-blind comparison. 197 70

A total of 186 patients who met the DSM-III criteria for schizophrenia were admitted to a double-blind randomized multicentre trial in which the efficacy and safety of remoxipride at two dose levels was compared with those of haloperidol. Over a period of six weeks the patients received remoxipride 100-300 mg/day (n = 60), remoxipride 200-600 mg/day (n = 61), or haloperidol 10-30 mg/day (n = 64). There was no significant difference between the three treated groups with regard to the Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression (CGI) scores obtained. Remoxipride, at both dosage ranges used, thus had comparable therapeutic efficacy to that of haloperidol. In contrast, extrapyramidal symptoms occurred significantly more frequently in the group treated with haloperidol. Laboratory tests and cardiovascular investigations showed no specific drug effect in any of the treated patients. Remoxipride is thus effective in acute treatment of schizophrenia at both dosage levels and has an advantage over haloperidol in neurological acceptability.
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PMID:A double-blind multicentre comparison of remoxipride, at two dose levels, and haloperidol. 197 97

Remoxipride is a novel substituted benzamide derivative with specific dopamine-(D2)-receptor blocking properties and selective action on brain mesolimbic functions. Ten inpatients with a DSM-III diagnosis of schizophrenia were treated with the drug in a 6-week open-label study. After 1 week placebo washout, the patients were given stepwise increased doses from 20 to 100 mg t.i.d. Most patients showed a clinically significant improvement; the mean scores in the Brief Psychiatric Rating Scale decreased from 25.8 at baseline to 11.3 at endpoint. Few adverse events were recorded and the rated extrapyramidal symptoms were lower at endpoint than at baseline. No abnormalities in clinical chemistry, haematology, cardiovascular assessments or EEG recordings were seen.
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PMID:An open study of remoxipride, a benzamide derivative, in schizophrenia. 286 58

Since the beginning of the neuroleptics in 1952, French psychiatrists have proposed a classification of neuroleptics, taking into account the pharmacological and therapeutic differences between these drugs. They distinguished 3 different clinical effects of neuroleptics: sedative effects, effects on the positive symptoms of schizophrenia and effects on the negative symptoms. The effect of some neuroleptics on negative symptoms is recognized by the international community, which considers clozapine to be effective. In France, in most cases, the indication of clozapine is still refractory paranoid schizophrenia. The effect of this atypical neuroleptic on other types of schizophrenic patient is not well known. Remoxipride appears to be as effective in treating psychotic symptoms and to have fewer side effects than haloperidol. Remoxipride is effective for both positive and negative symptoms. Loxapine has been prescribed in France since 1980. Its pharmacological profile is close to that of clozapine: it has dopamine (D2), histamine (H1), serotonin (5-HT2) and adrenergic (alpha 1)-blocking activities. Its best indication seems to be paranoid schizophrenia, although some data suggest bipolar action. The bipolar action of some new neuroleptics is illustrated by amisulpride, a substitute benzamide derivative. The originality of this molecule lies in its two opposite actions at two distinct doses. Doses of 600-1200 mg/day are effective against positive symptoms; 50-150 mg/day improves negative symptoms. This latter effect could be mediated by activation of the dopamine system.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:New antipsychotics in schizophrenia: the French experience. 791 51

Remoxipride is a selective dopamine D2 antagonist with virtually no activity on other transmitter receptors. It antagonizes dopamine agonists within a wide dose range in animals when it does not cause sedation or akinesia. Clinical studies with remoxipride have demonstrated antipsychotic efficacy apparently equal to classical neuroleptics in short- and long-term treatment of schizophrenia. Remoxipride has a low extrapyramidal syndrome (EPS) profile, and it is generally well tolerated. In clinical practice remoxipride has been reported to differ from classical neuroleptics with regard to subjective side effects. On switching to remoxipride, patients report improvement in cognitive, conative, affective and emotional functions. In many cases the reports are supported by family members and/or caregivers. Although anecdotal, such reports are in line with the low EPS profile of remoxipride and its weak sedative properties. It may indicate that remoxipride does not elicit the neuroleptic-induced deficit syndrome, commonly experienced with classical neuroleptics, or that remoxipride improves the deficit syndrome (or primary negative symptoms) of schizophrenia. These and other hypotheses need to be confirmed by formal clinical studies.
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PMID:Overcoming the neuroleptic-induced deficit syndrome: clinical observations with remoxipride. 791 53

Clozapine is a great advance in the treatment of schizophrenia. It should be tried in any neuroleptic-resistant schizophrenic as well as some who are neuroleptic intolerant. If progress is made in controlling its agranulocytosis, clozapine could be the drug of choice for all types of schizophrenia and perhaps other conditions as well for which neuroleptic drugs are employed, e.g., mania resistant to mood stabilizers. Its advantage with regard to lower risk of tardive dyskinesia indicates that potent antipsychotic activity and liability to cause tardive dyskinesia can be dissociated. This must be the object of future antipsychotic drug development. Risperidone could be the next clozapine but at the time of this writing, there is too little data to pass judgment on this. Its low EPS profile and apparent effects on negative symptoms at lower doses are promising. Remoxipride may be useful because of its low EPS profile. How much better tolerated it is than currently available drugs, especially thioridazine, is not clear. Many other novel agents are being tested. Clinicians will be challenged to follow this emerging field closely and identify the most promising new agents that may be indicated for specific stages of, or subtypes of, schizophrenia.
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PMID:New drugs for the treatment of schizophrenia. 810 73

506 patients with schizophrenia, diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (DSM-III) criteria, were included in a long term treatment programme with remoxipride, a selective dopamine (D2)-receptor antagonist. This overview includes pooled data from all patients who have been treated long term with remoxipride in clinical trials, focusing on patients treated for more than 6 months (n = 283). Remoxipride was administered in daily doses of 75 to 600mg. The assessment tools were Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI), Simpson and Angus scale, Abnormal Involuntary Movements Scale (AIMS) for abnormal involuntary movements, adverse events/symptoms using a 26-item checklist, clinical chemistry, and haematology and cardiovascular investigations. The majority of patients had a long duration of illness (median 11 years). 67% of patients (340/506) withdrew from treatment before 12 months and 44% (223/506) stopped treatment before 6 months. The median BPRS total score decreased during the first 3 months from 23 to 12, and this level of improvement was maintained throughout the 12-month period. Treatment-emergent adverse events reported by more than 5% of the patients were insomnia, tiredness, drowsiness and tremor in the group treated for 6 to 12 months. No symptoms, including checklist extrapyramidal symptoms (EPS), were reported by more than 5% of patients treated for 12 months. Low frequencies of EPS according to the Simpson and Angus scale were seen in patients treated for more than 6 months (n = 147). A small but statistically significant reduction of the mean total AIMS score from baseline to last rating was observed. There were infrequent changes in heart rate, resting diastolic blood pressure and electrocardiogram (ECG). Clinical chemistry and haematology data showed no evidence of clinically significant changes over time during the 12 months of treatment. Among 506 patients, 7 suicides and 7 suicide attempts occurred during the study period. Other serious adverse events were abnormal liver function test (2 cases), gastrointestinal, urinary retention, status epilepticus (psychotic polydipsia), granulocytopenia (1 each) and myocardial infarction (5 cases). Remoxipride is of potential value as a drug which is both effective and well tolerated in the long term management of patients with schizophrenia.
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PMID:Tolerability of remoxipride in the long term treatment of schizophrenia. An overview. 832 49

Schizophrenic patients are deficient in various neurologic measures reflecting information processing. One such measure in prepulse inhibition (PPI) of acoustic startle, in which schizophrenics display less inhibition than normal subjects. PPI is also diminished in rats treated with psychotomimetic drugs such as amphetamine and phencyclidine. PPI has been suggested as a model relevant for studying the pathophysiology of schizophrenia. We studied the effect of a variety of antipsychotics and putative antipsychotics and some key reference compounds on the acoustic startle response (ASR) and PPI. Some, but not all, antipsychotics tested (mainly selective dopamine D2 antagonists) enhanced PPI. Remoxipride and clozapine, both of which are antipsychotics, and the very potent and highly selective D2 antagonist, NCQ-298, did not. It is concluded that enhanced PPI in otherwise untreated rats does not reflect antipsychotic efficacy. We further noted that the effect on PPI was independent of the effect on ASR.
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PMID:Prepulse inhibition of acoustic startle, a measure of sensorimotor gating: effects of antipsychotics and other agents in rats. 858


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