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)

A questionnaire regarding medication preferences for major categories of psychiatric disorders was sent to 1,059 psychiatric drug investigators in 53 countries. 264 questionnaires were returned, of which 165 were appropriate for this survey. A total of 87 different psychotropic drugs were selected. Chlorpromazine was the medication most frequently cited in the treatment of schizophrenia. Amitriptyline and imipramine together accounted for the vast majority of medication chosen for all varieties of depression. In the treatment of mania, chlorpromazine was chosen by almost one-third of our sample, lithium by only one-fifth. Chlordiazepoxide and diazepam were equally preferred in the treatment of alcoholism. Most psychiatrists preferred not to use any psychotropic medications consistently in treating patients with organic brain syndromes. The implications of this study are discussed and compared uith similar studies in more limited geographical regions and in children.
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PMID:Use of psychotropics in the world. 62 3

The authors administered 6 g of L-dopa to 8 schizophrenic patients and 750 mg of chlorpromazine to 7 schizophrenic patients. Chlorpromazine showed only a modest advantage over L-dopa and only on some Brief Psychiatric Rating Scale factor scores, and at maximum dosage the thought disturbance factor score in the L-dopa-treated group was not worse than at baseline. The results suggest that L-dopa is associated more with toxic than with schizophreniform symptoms and that there is adaptation to its effects. The authors discuss implications of these findings for the dopamine hypothesis of schizophrenia.
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PMID:Paradoxical reaction to L-dopa in schizophrenic patients. 70 30

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

A case is presented of Torsade de Pointes (TDP) with T wave alternans in a 31-year-old female receiving a moderate dose of chlorpromazine. She was treated in an another hospital for schizophrenia with chlorpromazine (100 mg daily) for several years and admitted to Fujisawa city hospital for numerous episodes of syncope. The electrocardiogram immediately after admission revealed a marked QTc prolongation to 0.81 seconds, T wave alternation without any obvious change in morphology of the QRS complex, and recurrent ventricular tachycardia called TDP. The T wave alternans and TDP were easily abolished by intravenous administration of a bolus of 50 mg lidocaine infusion. The QT interval however, remained prolonged. Physical examination, including cardiac examination, was normal. Serum potassium was 3.6/mEq. Chlorpromazine was discontinued immediately after admission and no further episodes of TDP were seen after the first day. After the QT interval returned to almost normal, chlorpromazine (50 mg daily) was re-administered. Two days after the re-administration, the electrocardiogram revealed marked QT interval prolongation with prominent T waves. Psychotropic drugs, such as chlorpromazine, prolong the QT interval and cause TDP. Chlorpromazine appears to have been responsible for TDP and the T wave alternans in this case. TDP caused by a moderate dose of chlorpromazine has not been previously reported. Lone T wave alternans unaccompanied by changes in the QRS complex is a rare phenomenon and the mechanism underlying T wave alternans remains unknown.
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PMID:[Torsade de Pointes with T wave alternans in a patient receiving moderate dose of chlorpromazine: report of a case]. 221 93

Chlorpromazine has been reported to interfere with the action of alloantibodies directed against HLA-A1. We attempted to replicate this finding using peripheral blood lymphocytes from 3 healthy donors in a complement-mediated lymphocytotoxicity assay. We were unable to find evidence of interference between chlorpromazine and the anti-HLA sera tested. Possible reasons for the difference between our finding and the previous report, as well as the implications for schizophrenia, are discussed.
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PMID:Failure to find interference between anti-HLA antibodies and chlorpromazine. 232 24

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

Neuroleptic dosing practices during inpatient treatment of schizophrenia were examined for 1490 admission episodes during 1973 through to 1982 in two wards of a university hospital. Chlorpromazine-equivalent dose levels (CPZE) declined 50% between 1974 and 1980. As expected, length of treatment and choice of drug were both strongly related to CPZE. The general drop in CPZE is not explained by shorter treatment and changing choice of drug, however. Oral fluphenazine, haloperidol, and depot fluphenazine are used to higher maximum levels than chlorpromazine and other neuroleptics, when maximum dose is reached after one week or longer. The results illustrate that by seeking an appropriate statistical model, aggregate trends in dosing practices can be described while avoiding several of the shortcomings of earlier surveys of hospital practice.
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PMID:Neuroleptic dose: a statistical model for analyzing historical trends. 289 Jul 63

The authors surveyed pharmacotherapy in a group of hospitalized 18 to 35-year-old young adult patients (N = 286) with a DSM-III diagnosis of schizophrenia. Drug use comparisons were made between patients with a 180 day or less hospitalization (short-stay, N = 226) and those with a 366+ day hospitalization (long-stay, N = 60). Psychotropic drug usage during the initial 180 and most-recent 180 days of treatment of the long-stay group was compared with the total episode of the short-stay group. Antiepileptic, antidepressant, lithium and anxiolytic/sedative/hypnotic agents, were used in significantly more of the long-stay than short-stay patients. This increase was not observed between the two groups for the initial 180 days of the long-stay group but was observed during the most recent 180 days of treatment. Antipsychotic mean daily doses and patterns of use in the two length of stay groups were similar. Chlorpromazine (CPZ) dosage was significantly increased in long-stay patients compared with short-stay patients (P less than .05).
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PMID:Pharmacotherapy of the hospitalized young adult schizophrenic patient. 290 Jul 11

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

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


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