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

The authors report of experimental tests in which the blood plasma from patients with the progressive paralysis, involution-psychosis and basic nuclear-schizophrenia was transferred on to embryonic human and rat brain tissue in tissue culture. The blood plasma from schizophrenics brought about the strongest changes in comparison with the other illnesses, which were again weakened when the patients were treated with Aminazin. The effects on embryonic human brain tissue were considerably more pronounced than in the culture of brain tissue from newborn rats.
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PMID:[Action of blood plasma of schizophrenics treated with psychotropic agents on the human embryonal brain tissue in tissue culture]. 82 43

Cerebrospinal fluid (CSF) levels of an opioid receptor-active, chromatographically separated endorphin fraction (Fraction I) were measured in 45 schizophrenic patients and 18 healthy volunteers. Significantly increased levels of Fraction I differentiated the patient group from controls, with no difference being found between newly admitted untreated and chronic previously neuroleptic-treated subjects. Fraction I levels did not correlate with age, weight, height, duration of illness, total time hospitalized, or age when symptoms first appeared. No differences were found between patients with or without a family history of schizophrenia. Fraction I levels were negatively correlated with "hallucinations" and "indecision" on the Comprehensive Psychopathological Rating Scale. Increased levels of Fraction I were associated with low levels of the dopamine metabolite homovanillic acid in drug-free schizophrenics. This relationship was not present after neuroleptic treatment or in healthy controls. No relationship was found between Fraction I and the serotonin metabolite 5-hydroxyindoleacetic acid. Neuroleptic treatment did not significantly change Fraction I levels; when only patients above the control range were considered, however, a significant decrease was observed. The data support our previous hypothesis of an increased opioid activity in schizophrenia and further indicate a concomitant dysfunction of brain endorphin and dopamine activity in schizophrenic patients.
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PMID:CSF levels of receptor-active endorphins in schizophrenic patients: correlations with symptomatology and monoamine metabolites. 243 27

Events that occur early in the course of neuroleptic drug therapy in schizophrenia and which may be useful in predicting clinical outcome were investigated. Early subjective response and symptom change at twenty-four and forty-eight hours following initiation of drug therapy with either CPZ or haloperidol were the only variables that significantly related to therapeutic outcome. These preliminary results replicate and confirm previous results and provide a tool which can be included with other available approaches in developing a battery for prediction of drug response.
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PMID:Early treatment events and prediction of response to neuroleptics in schizophrenia. 286 92

The following are key factors to consider in assessing a patient for long-term neuroleptics: 1. Who--accurate diagnosis of schizophrenia is of primary concern. There are no good prognostic indicators other than a history of repeated relapses and positive responses to neuroleptics. 2. When and for how long--should always be considered for the patient who has had more than two acute episodes. The first year post-acute episode back in the community is extremely critical. Consider maintaining patient on tapering dosage of medication for at least four to five years. 3. What benefits--symptoms of acute psychosis respond, those of chronic defect state do not. Medication also can act as buffer against stress. 4. Dosages--standard range is the equivalent of 300-800 mg. of Thorazine for most patients. Dose range for depot administration of Prolixin decanoate is 25-62.5 mg. 2-4 week intervals. Differences within this range may not be important. Data about very low doses (one-tenth standard dose) and megadoses (4-5 times standard dose) are inconsistent. 5. Risks--extrapyramidal symptoms, tardive dyskinesia, and akinetic depression are the most prevalent risks. Extrapyramidal symptoms can often be controlled effectively with dosage reduction. However, anticholinergic drugs are the treatment of choice during acute phases, and for the first 3-5 months post-acute phase. Tardive dyskinesia rarely occurs after a few weeks or months, but occurs most commonly beginning after two years of drug treatment. The usual form is persistent, but transient forms also occur. The earliest signs are reversible in some patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Maintenance medication for chronic schizophrenics: risk/benefit assessment. 290 33

The use of a structured diagnostic interview (The Schedule for Affective Disorders and Schizophrenia) with 58 consecutively admitted general adult psychiatric patients revealed that 62.1% of them abused alcohol and 58.6% had a substance use disorder. The drug abusers did not differ significantly from the nonabusers on mean psychoticism (Brief Psychiatric Rating Scale) scores. However, they received higher doses of antipsychotic agents (mean daily dose 1022 mg CPZ EQ (SD = 614) vs 609 mg CPZ EQ (SD = 481); z = 2.58, p < .01) to achieve stabilization. The clinical implications of this finding are discussed.
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PMID:Relationship between concurrent substance abuse in psychiatric patients and neuroleptic dosage. 763 11

In contrast to the well known chlorpromazine-induced cholestatic hepatitis, we report the case of a schizophrenic patient who presents a cytolytic hepatitis, without any prior hepatic disease. Mr G. was first hospitalized for depressive symptomatology. A pseudo-nevrotic schizophrenia was diagnosed. Pretherapeutic clinical and biological data were normal. A treatment with chlorpromazine 400 mg/day was given. At day 8, the patient was still anxious and began to be agitated. An increase to 500 mg/day of chlorpromazine posology and an addition of haloperidol 200 mg/day was implemented. At day 10, the following clinical symptoms appeared: 38.6 degrees C fever; headache; myalgia; epigastralgia and hypocondrium pain. Biological hepatitis disturbances (ALAT, 984 U/L; ASAT, 414 U/L) and hypereosinophilia with normal white cell count were found. Clinical and biological investigations were normal. Blood-culture, A, B, C hepatitis, HIV and CMV serologies were negative. Neuroleptic treatment was discontinued. Evolution to normality of the disturbances and biological data suggested a cytolytic hepatitis. Mr G... remained treated with flupentixol without side-effects. Phenothiazine-induced cholestatis is frequent, mild, and recovers spontaneously. The biological mechanism is supposed to be immunologic. Prevalence of biological hepatic disturbances is 10 to 20% with chlorpromazine in long-term treatment. More often, symptomatology is the same; jaundice, pruritus, abdominal pain, fever. Although pharmacological data suggest for a cytotoxic activity of phenothiazines, cytolytic hepatitis is poorly described. Maximum range of transaminase blood level reported in previous studies is about 400 U/l. This level is not clearly correlated with hepatic cell lysis. Few cases of hepatic necrosis have been reported. In all cases, preexistent hepatic injuries were observed. Chlorpromazine-induced cytolytic hepatitis is uncommon and cholestatic hepatitis mild. Biological hepatic parameters investigations remain necessary during neuroleptic treatment.
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PMID:[Cytolytic hepatitis during treatment with phenothiazines: apropos of a case]. 903 96

Patients with schizophrenia show impairments of attention and neuropsychological performance, but the extent to which this is attributable to antipsychotic medication remains largely unexplored. We describe here the putative influence of the dose of antipsychotic medication (chlorpromazine equivalents, CPZ), the antipsychotic serum concentration of dopamine (DA) D2-blocking activity and the approximated central dopamine D2-receptor occupancy (DA D2-occupancy), on conditioned blocking (CB) measures of attention and performance on a neuropsychological battery, in 108 patients with schizophrenia (compared with 62 healthy controls). Antipsychotic serum concentration and D2-occupancy were higher in patients with a paranoid versus non-paranoid diagnosis, and in female versus male patients (independent of symptom severity). Controlling for D2-occupancy removed the difference between high CB in paranoid and impaired low CB in non-paranoid patients. Similar partial correlations for antipsychotic drug dose and serum levels of DA D2-blocking activity with performance of the trail-making and picture completion tests (negative) and the block-design task (positive) showed the functional importance of DA-related activity. High estimates of central DA D2-occupancy were related to impaired verbal fluency but were associated with improved recall of stories, especially in paranoid patients. This, the first study of its kind, tentatively imputes a role for DA D2-related activity in left frontal (e.g. CB, verbal fluency) and temporal lobe functions (verbal recall) as well as in some non-verbal abilities mediated more in the right hemisphere in patients with schizophrenia.
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PMID:Neuropsychological and conditioned blocking performance in patients with schizophrenia: assessment of the contribution of neuroleptic dose, serum levels and dopamine D2-receptor occupancy. 1110 86

Tricyclic psychotropic drugs (TDP) are used in the therapy of both schizophrenia and affective disturbances, especially depressive ones. They are a large group of compounds with a broadband spectrum, especially as an antipsychotic and antidepressant drugs. Phenothiazine derivatives distinguish themselves with a structure of triple cycles arrangement, composed of electrons such as a sulphur and nitrogen atoms. Among patients with schizophrenia there are many groups with different psychopathological symptoms, course of disease and neuroleptics drugs response. Affective disturbances occur particularly often in the course of schizophrenia. A higher incidence of depression in the course of schizophrenia has been observed during treatment with neuroleptics, especially in the late phase of treatment, particularly after using strong neuroleptics.
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PMID:[Application of pharmacotherapy with classic neuroleptics: phenothiazine derivatives in schizophrenia]. 1272 74

Antipsychotic medications have been first line treatment for schizophrenia for half a century, yet few studies have assessed outpatient maintenance treatment in large populations. This article describes oral antipsychotic dosing patterns and psychotropic treatments using computerized Medicaid claims data for individuals who were diagnosed with schizophrenia and received treatment on an outpatient basis during 1991. The findings show that the mean daily oral antipsychotic dose was 729 +/- 586 chlorpromazine equivalents (CPZ-EQ) for high-potency agents and 304 +/- 328 CPZ-EQ for low-potency agents. Males, younger individuals, and African-Americans received larger mean daily doses of high-potency agents, ranging from 747 to 800 CPZ-EQ. Antiparkinsonian agents were prescribed for over 90 percent of the outpatient antipsychotic treatment exposure. In summary, young adults, males, and African-Americans were given high-potency antipsychotic medications at outpatient maintenance doses that exceeded the maximum recommended levels, despite well-established evidence that high-dose treatment offers no additional benefit. Likewise, concurrent antiparkinsonian treatment exceeded the 1990 World Health Organization recommendations.
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PMID:Antipsychotic dosing and concurrent psychotropic treatments for Medicaid-insured individuals with schizophrenia. 1279 94

In order to test the hypothesis that acute schizophrenia episodes have a negative impact on cognitive function, 35 consecutive non-abuse schizophrenia outpatients (age < 60) were enrolled in this study. All subjects for whom grades from the 9(th) year of the Swedish school system were available, had to complete a comprehensive computerized neuropsychological test session. Symptoms were rated by PANSS and GAF, previous episodes were tallied, and medication was logged. A premorbid cognitive score was calculated on the basis of school grades and validated by comparison with academic career and current cognitive performance (r = 0.56). Half had college level studies or higher, and the overall school grades for the group were above average. PANSS (sum = 59) and GAF [59] ratings as well as medication (M = 230 CPZ units) suggested a moderate symptom level. Two patients had no neuroleptic drugs, 16 had atypical and 17 had conventional neuroleptics. Vocabulary was intact. On average, patients had lost 1 standard deviation (SD) in most cognitive tests but response time slowing amounted to 3.5 SD. There were no differences in cognition between drug types and no correlation with CPZ dose. The number of previous episodes was positively correlated with reaction time prolongation and negatively correlated with short-term verbal memory, consistent with a previous study suggesting that acute episodes cause specific cognitive reduction.
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PMID:Premorbid IQ and schizophrenia. Increasing cognitive reduction by episodes. 1279 46


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