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

Three patients, aged 23-33 years, with the diagnosis of schizophrenia, developed symptoms of tardive dyskinesia while receiving neuroleptic treatment, mostly with haloperidol. Existential problems and emotional upset seemed contributory. Diazepam was found effective in controlling dyskinesia. Its therapeutic effect seemed not to be related to sedation. Some implications of the reported observations are mentioned.
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PMID:Diazepam in the treatment of tardive dyskinesia. Preliminary observations. 101 Jul 10

Rapid tranquillisation--giving a psychotropic to control behavioural disturbances--is common in medical practice, yet few surveys describe its use in psychiatric populations. Over five months, 102 incidents, involving 60 patients, were retrospectively surveyed. Patients most often involved were young white men. The commonest diagnosis was affective disorder (manic phase) (39%) followed by schizophrenia (33%). Fifteen patients were involved in 57% of the incidents. The majority of incidents involved injury to people or damage to property. The most frequently used drugs were diazepam and haloperidol, alone or in combination. Droperidol, chlorpromazine, sodium amytal and paraldehyde were rarely used. Diazepam alone or in combination with haloperidol delivered intravenously was most rapidly effective and was associated with greatest staff satisfaction. Serious side-effects were rare.
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PMID:Rapid tranquillisation. A survey of emergency prescribing in a general psychiatric hospital. 139 53

Previous electrophysiological studies have demonstrated that non-dopaminergic (non-DA) neurons within the substantia nigra pars reticulata (SNR) are extremely sensitive to the inhibitory effects of GABA and GABA-mimetic drugs, including benzodiazepines, whereas dopaminergic (DA) neurons in the substantia nigra pars compacta (SNC) are less sensitive to these compounds and may be influenced indirectly by SNR neurons. The interactions between A10 DA and non-DA neurons within the adjacent ventral tegmental area (VTA) are not as well characterized. In the present experiments, single unit recording and microiontophoretic techniques were used to determine the effects of benzodiazepines on DA and non-DA neurons in the VTA of chloral hydrate anesthetized rats. Diazepam, administered intravenously (i.v.), potently inhibited non-DA, SNR-like cells within the VTA. The effects of diazepam on A10 DA cells were more variable than those observed on non-DA, SNR-like cells in this region, but 77% of such cells showed moderate to marked excitation. Both of these effects were reversed by the benzodiazepine antagonist Ro 15-1788; on many cells, this agent produced marked rebound effects beyond the original basal firing rates. However, when administered alone, Ro 15-1788 exerted no effect on either cell population. Microiontophoretic administration of the benzodiazepines chlordiazepoxide and flurazepam resulted in marked inhibition of non-DA SNR-like cells, but produced either mild inhibition or no effect on A10 DA cells; excitation of DA cells was never observed even though the same neuron was excited by i.v. diazepam. These findings suggest that benzodiazepines act directly upon non-DA, SNR-like cells in the VTA to produce inhibition of activity and a disinhibition of A10 DA cells. This relationship makes it unlikely that benzodiazepines would enhance feedback inhibition of DA cells following neuroleptic administration. In fact, when administered following haloperidol, i.v. diazepam failed to reverse haloperidol-induced increases of A10 DA cell firing; if anything, diazepam further depolarized the cell. If antipsychotic drugs produce their clinical effects, in part, by inducing depolarization inactivation of DA cells, then benzodiazepines might be a useful adjunctive therapy in the treatment of schizophrenia.
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PMID:Inhibition of non-dopamine cells in the ventral tegmental area by benzodiazepines: relationship to A10 dopamine cell activity. 289 84

1. Diazepam in high doses, up to 400 mg per day, was administered to paranoid schizophrenic patients in a double-blind placebo-controlled study. 2. The effects of treatment were assessed by the following: the Brief Psychiatric Rating Scale (BPRS); the Clinical Global Impressions Scale (CGI); the Schizophrenia Subscale of the Present State Examination (SS-PSE); the Simpson-Angus Rating Scale (SARS) for extrapyramidal symptoms; the Nurses' Observation Scale for Inpatient Evaluation (NOSIE); and a 90 item Self-Assessment Questionnaire (SCL-90). 3. Within a few hours to a few days from the onset of diazepam treatment both positive (such as auditory hallucinations and persecutory delusions) and negative (such as emotional withdrawal and blunted affect) schizophrenic symptoms were dramatically eliminated in 5 out of the 6 patients.
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PMID:Diazepam in high doses is effective in schizophrenia. 689 18

The mesocortical dopamine system is thought to play an important role in the etiology of the stress response. Dopamine (DA) has been shown to accumulate in the rat frontal cortex in response to a wide variety of stressors. Diazepam, an anxiolytic benzodiazepine, can reverse the effects of stress on cortical DA. We investigated the effects of acute and chronic diazepam administration on immobilization stress-induced changes of the DA system in the frontal cortex of the rat. In the first study, 2.5 mg/kg diazepam was administered 20 min prior to 40 min of immobilization stress. Acute diazepam significantly reduced basal levels of extracellular DA and antagonized the stress-induced increase in cortical DA when compared to untreated stressed rats. Acute diazepam did not significantly effect extracellular DOPAC. In the second study, an experimental group of rats was given approximately 2 mg/kg/day diazepam in their drinking water for 3 weeks. This treatment significantly reduced anxiety as assessed by a staircase test for anxiety. Chronic diazepam had no effect on basal levels of cortical DA. However, chronic diazepam treatment also attenuated stress-induced increases in extracellular DA when compared to untreated stressed control rats. Chronic diazepam did not affect stress-induced changes in DOPAC but it did antagonize the effects of stress on HVA. Thus, acute and chronic diazepam treatment can antagonize stress-induced activation of the mesocortical DA system. It is proposed that this effect is produced through an enhancement of GABAergic neurotransmission by diazepam. The role of the dopaminergic system during stress, anxiety, and schizophrenia is discussed.
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PMID:The effect of acute and chronic diazepam treatment on stress-induced changes in cortical dopamine in the rat. 858 19

Clinical studies indicate that patients with acute schizophrenia may benefit from benzodiazepine treatment. Therefore we investigated the benzodiazepine receptor distribution and diazepam binding in 20 patients with DSM-III schizophrenia using single photon emission computed tomography (SPECT) with iomazenil as the ligand. In each patient, two SPECT images were obtained: SPECT 1 was obtained 2 h after intravenous injection of 200 MBq I-123-iomazenil. Following SPECT 1, patients received 10 mg diazepam intravenously. Twenty min later, SPECT 2 was started. The highest iomazenil uptake was found in the occipital cortex followed by the frontal and temporal cortices. Baseline iomazenil uptake in the medial frontal cortex was significantly (P < 0.05) correlated with the BPRS total score (r = 0.46). Diazepam injection led to a significant activity decrease in iomazenil binding which was greatest in the frontal regions of interest. With respect to the medial frontal cortex, this effect was significantly (P < 0.05) more pronounced in patients with a remitting than a chronic course of the disorder. These findings suggest that changes of the benzodiazepine receptor system in the frontal cortex may be associated with severity and chronicity of schizophrenia.
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PMID:Benzodiazepine receptor distribution and diazepam binding in schizophrenia: an exploratory study. 910 59

Continuation and maintenance electroconvulsive therapy (ECT-C & ECT-M) has been used to control schizophrenic patients for more than 50 years. In spite of this, there has been no prospective study made of this treatment. Most of the information comprises naturalistic studies or case reports. As a result many unanswered questions concerning ECT-C & ECT-M remain, including its therapeutic efficacy. This pilot study was prospectively completed on 16 schizophrenic patients, suffering acute exacerbations in order to determine the merits of ECT-C. After acute treatment using only ECT, 12 patients were identified as ECT responders and enrolled in this study. No neuroleptic drugs were used. Diazepam was the only medication prescribed to control agitation on prn basis. The duration of the study was 6 months. Bilateral ECT was used throughout the study, after the acute treatment. Global Assessment of Functioning (GAF), Brief Psychiatric Rating Scale (BPRS) and the Thai Mental State Exam (TMSE) were used to measure the outcome. A total of 8 patients completed the study and 4 dropped out. There were no relapses and all measurements progressed satisfactorily. There were no serious side effects, in particular no cognitive impairment. This study supports the therapeutic efficacy of ECT-C in schizophrenia.
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PMID:Continuation electroconvulsive therapy in schizophrenia: a pilot study. 917 75

We examined the anxiolytic potential of perospirone, a novel serotonin-2 and dopamine-2 antagonist (SDA)-type antipsychotic agent, and compared its effects with those of the standard anxiolytic diazepam and the conventional antipsychotic haloperidol by using conditioned defensive burying (CDB) and social interaction (SI) tests in rats. The tests were conducted 1 h after oral administration of the drug. Diazepam inhibited CDB specifically directed toward a probe previously associated with brief electric shock and increased the time spent in SI by pairs of naive rats in a brightly illuminated novel environment. Perospirone mimicked the effects of diazepam by dose dependently suppressing CDB and facilitating SI. In contrast, haloperidol failed to inhibit CDB or increase SI. These results suggested that, unlike the conventional antipsychotic haloperidol, perospirone exerts anxiolytic-like effects in animal models with different motivational and emotional states. A braoder efficacy of perospirone for the treatment of anxiety and related symptoms in schizophrenia is discussed.
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PMID:Anxiolytic-like effects of perospirone, a novel serotonin-2 and dopamine-2 antagonist (SDA)-type antipsychotic agent. 970 Sep 71

A sample of 44 patients with a neurological disorder and a DSM-IV diagnosis of Psychosis due to a General Medical Condition were followed on average for 4 years and their response to treatment and clinical course noted. Outcome was more benign than in schizophrenia, with most patients having a brief duration of psychosis and good response to small doses of neuroleptics. One-fourth of patients suffered a single, brief psychotic episode with return to full premorbid function. None required maintenance neuroleptic treatment. The outcome and descriptive profile of the disorder also differed from late-onset schizophrenia. Thus, Psychosis due to a General Medical (Neurological) Condition does appear to have predictive validity. However, no temporal association was found between the neurological illness and psychosis. Possible reasons for this are discussed.
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PMID:A longitudinal study of psychosis due to a general medical (neurological) condition: establishing predictive and construct validity. 981 91

Patients with schizophrenia have Wisconsin Card Sorting Test (WCST) deficits, which are commonly interpreted as reflecting frontal cortex-based executive dysfunction. One means of assessing the refractoriness of frontal-executive impairment is to utilize a training or modification strategy to improve WCST performance. In this study, 73 patients with schizophrenia were assigned to 1 of 2 groups. Group 1 received the standard WCST instructions for 64 cards (Condition 1). For the second 64-card deck, the patients were asked to verbalize the reason that they placed the card where they did after each sort (Condition 2). Group 2 received this modified instruction 1st (Condition 1) and then the standard instructions for the second deck (Condition 2). A group of normal comparison participants was also tested using standard instructions alone. Group 2 committed significantly fewer perseverative responses than did Group 1. Furthermore, there was no significant difference between Group 2 (Condition 1) and the normal participants. Group 1's performance improved when patients were exposed to the modified instructions (Condition 2). Additionally, poor premorbid factors and disorganized symptoms were associated with decreased benefit from the modified instructions across both groups. Cumulatively, these data suggest that a simple instruction may enhance executive function and impact WCST performance in patients with schizophrenia.
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PMID:Self-monitoring enhances Wisconsin Card Sorting Test performance in patients with schizophrenia: performance is improved by simply asking patients to verbalize their sorting strategy. 1131 Oct 35


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