Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We used a new D2 dopamine agonist, mesulergine (8-alpha-amino-ergoline, CU 32-085), to treat 20 patients (12 men and 8 women), mean age 62.6 (SEM = 1.7) and mean duration of illness 5.9 (SEM = 1.0) years. Wearing-off effect was the principal indication for new therapy in 15 patients, and the others had inadequate response to levodopa. All continued on levodopa therapy, and 10 patients were studied in a double-blind controlled test. The mean motor disability decreased from 2.8 (SEM = 0.12) to 1.6 (SEM = 0.18) with mesulergine (p less than 0.0001) and increased to 1.9 (SEM = 0.20) with placebo (p less than 0.001). Tremor improved most, followed by rigidity, bradykinesia, gait, and postural instability. Side effects included dyskinesia, light-headedness, hallucinations, nausea, vomiting, drowsiness, and ankle edema, but, in general, mesulergine was tolerated well.
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PMID:Placebo-controlled study of mesulergine in Parkinson's disease. 388 92

A sequential sample of 101 patients hospitalized for ethanol withdrawal and requiring sedation for evolving withdrawal syndromes was assigned randomly according to a double-blind protocol to treatment with either alprazolam or chlordiazepoxide administered orally. The data from one patient were unevaluable due to acute bleeding, leaving a sample of 100 (50 in each condition). At discharge, three independent ratings of diaphoresis, tremor, hallucinations, nausea/vomiting, and overall severity of withdrawal were obtained, and the occurrence of delirium tremens and grand mal seizures was noted. Patients also completed the Beck Depression Inventory, and their disposition following discharge was recorded. There were no statistically significant differences between the two treatment groups on any of the dependent variables studied. It was concluded that the choice between alprazolam and chlordiazepoxide for managing ethanol withdrawal should be based on criteria other than efficacy of control. Potential antidepressant effects and drug kinetics were suggested as the basis for rational decision-making.
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PMID:Double-blind trial of alprazolam and chlordiazepoxide in the management of the acute ethanol withdrawal syndrome. 388 64

A patient is described who developed unilateral seizures whilst being treated with recombinant interferon for hairy cell leukemia. Special features included the relatively low dose of interferon, the focal aspect of the epilepsy and the high resistance to anticonvulsants. Oligoclonal banding of cerebrospinal fluid proteins may have resulted from polyclonal activation of bone marrow plasma cells during interferon treatment. Disturbances of consciousness, dysphasia, visual hallucinations, upper motor neuron deficit, tremor, dizziness, numbness, myalgia and headache, all of them neurological complications of interferon treatment, are discussed.
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PMID:Unilateral seizures in a patient with hairy cell leukemia treated with interferon. 393 49

In 15 patients (8 men, 7 women), aged 44-81 years, with idiopathic parkinsonism, the effects of mesulergine (CU 32-085) were observed for up to 3 years. Of these patients, four had been without previous levodopa treatment, five had been on levodopa/decarboxylase inhibitor for 6.4 years and six patients had been on levodopa/decarboxylase inhibitor and bromocriptine for a period of 7.5 years. Mesulergine proved to be effective in all three groups of patients and for each main symptom of the disease. Rigidity and tremor showed a better response than akinesia. A decline in efficacy could be observed after 18 months of treatment. By increasing the levodopa dosage, the worsening of the symptomatology could be reduced again and after 3 years patients were slightly better off than before the introduction of mesulergine. Fine motor performance showed a longer-lasting improvement than walking, which was affected by an increase of freezing. Mesulergine was not fully sufficient when given in monotherapy and the levodopa saving effect was only temporary. Parallel with the decline in the therapeutic response as assessed by the rating scales, there was a worsening in the on/off symptomatology. The on/off symptoms, evaluated by patients themselves, had shown very small or no improvement at the beginning of mesulergine administration, contrasting with the findings reflected in the assessment scales. The most frequent side-effects were hallucinations and dyskinesias. Orthostatic hypotension did not prove a problem. Dyskinesias were not seen during monotherapy with mesulergine in de novo patients.
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PMID:Three-year observation of mesulergine (CU 32-085) in advanced and newly treated parkinsonism. 399 71

One hundred and eighty-one patients with treated Parkinson's disease completed a self-administered questionnaire on symptoms, and their responses were compared with those of 263 control subjects randomly selected from a general practice population. Nine symptoms were reported by the patients with more than a fivefold excess when compared with the controls. These included jerking of the limbs, shaking of the hands, excessive salivation, poor mental concentration, grimacing, being frozen or rooted to the spot, and hallucinations. Compared with the general control population, the patients did not have an excess of stomach or limb pain, indigestion, headache, or any decrease of interest in sex. This observational survey, unlike a randomised controlled trial, could not ensure that the different treatment groups were comparable in important respects. However, certain associations were apparent; for example, patients receiving both a decarboxylase inhibitor and levodopa tended to report fewer attacks of being frozen to the spot, fewer problems with salivation, and a reduced frequency of defaecation. Patients receiving anticholinergic drugs reported an excess of dry mouth, faintness, and dyskinesia, and fewer hot flushes.
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PMID:The symptoms of patients treated for Parkinson's disease. 400 65

One hundred patients, aged between 60 and 92 years, were treated with tiapride for neurological disorders (abnormal movements, buccofacial dyskinesias, dopa therapy complications, ballism, eyelid tics, senile tremor, post-traumatic headache, delirium tremens), psychiatric disorders with more or less marked agitation and of various types (hysteria, depression, mood disturbances, hypochondria, delusions, hallucinations), or for mental deficiency, senile dementia, or arteriopathic dementia. Results were excellent, being satisfactory in 70 p. cent, and even more marked in some groups. Tolerance was very good, with some rare cases of somnolence. The efficacy and safety of tiapride makes it of particular value for treating neuropsychiatric disorders in geriatric patients.
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PMID:[Tiapride in the treatment of neurological and psychiatric disorders in the elderly (author's transl)]. 627 32

The neuropsychiatric manifestations of alcoholism can be amended by neutralizing the somatic effects of alcohol on nervous centers. Tiapride acts electively on the mesolimbic area. Promising results have been obtained with tiapride in the various clinical forms of alcohol intoxication. Sixty patients (40 men and 20 women) were given tiapride for abnormal symptoms due to alcohol. Tolerance was good: no side-effects were recorded, with the exception of extrapyramidal manifestations in one patient. Symptoms due to alcohol abuse were alleviated. Relief of tremor was significant. Tiapride proved helpful in anxiety and depression and caused hallucinations to disappear in 35 cases.
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PMID:[Treatment of alcoholic patients with tiapride]. 629 73

Various indications of benzodiazepines in the treatment of chronic alcoholism are discussed. They are prescribed in the treatment of Delirium Tremens and other acute withdrawal syndromes, often by intramuscular injections or intraveinous infusions. Their efficacy is particularly marked on withdrawal seizures, agitation, more inconstant on confusion, hallucinations and even on tremor symptoms. They more prevent withdrawal symptoms than they reverse severe ethanol withdrawal symptomatology, on humans like on experimental animals. Most authors recommend short prescriptions of BZD in alcoholic patients: the main difficulty is not the problem of the pharmacological interactions between alcohol and BZD, only observed during acute and important ingestions of alcohol and more linked to summation than to potentialisation , but the risk of an abuse and even a psychological and physical dependency to BZD. Such a dependence syndrome would probably develop more frequently in alcoholic patients. One must not overrate its importance; the extended prescription of BZD must not be therefore prohibited when they seem useful in the maintain of alcohol abstinence.
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PMID:[Benzodiazepines in the treatment of alcoholism]. 637 35

The efficacy of chlordiazepoxide and tiapride in the management of acute alcohol withdrawal syndrome was compared in a randomized, parallel-group, double-blind trial. The mean daily dose for both preparations on the first two days was four capsules, i.e., 200 mg for chlordiazepoxide and 400 mg for tiapride. Thereafter the patients were treated according to the relief of symptoms obtained. The treatment periods lasted 3-5 days. Both drugs effectively alleviated alcohol withdrawal symptoms, especially anxiety, fear, hallucinations, insomnia, sweating, tremor, abdominal pain and vertigo. Seventy percent of the patients in the chlordiazepoxide and 42% in the tiapride group considered the drug effective. The difference was statistically significant in favour of chlordiazepoxide (p less than 0.05). Tiapride is an alternative drug in the treatment of this condition, if benzodiazepines are to be avoided.
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PMID:Tiapride and chlordiazepoxide in acute alcohol withdrawal. A controlled clinical trial. 639 14

A total of 26 patients were treated with pergolide mesylate, a semi-synthetic ergot derivative with the property of direct dopamine activity. Of these patients, 18 suffered from late failure of L-dopa, while the remaining 8 had never before been treated with L-dopa. The aim of the trial was to study the activity of pergolide, either by giving it to untreated patients or by reducing as much as possible the L-dopa given in patients with parkinsonism. Adverse effects and failure rate were reduced by slowly increasing the daily dosage, by giving considerable dose flexibility whenever side-effects were manifest, and by the use of relatively low doses (mean of 3.8 mg in the L-dopa-group and 2.9 in the other group). At present, from 26 patients, 13 (50%) still remain in the study for an average treatment period of 16 months (3 weeks to 25 months for the group as a whole). All patients experienced a beneficial effect from pergolide, especially during the first months of treatment, in selfcare, rigidity, gait and automatic movements. Slight or no improvement was seen in tremor, speech and posture. The most frequent side-effects were nausea and vomiting (in the initial phase of the treatment), insomnia and psychotoxic reactions (mostly periods of confusion accompanied by visual hallucinations and paranoid illusions). The study indicated that pergolide mesylate is a useful additive for treatment of parkinsonism, but special attention should be paid to the important psychotoxic adverse effects that may appear, even at a low dose.
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PMID:Pergolide therapy in Parkinson's disease. 648 22


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