Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085631 (agitation)
 12,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three cases of acute psychotic illness following sudden withdrawal from high daily doses of benzodiazepines were associated with agitation and confusion. Disorientation was prominent in two of the patients. None of the patients had had previous psychotic episodes. The condition of all patients was reversed dramatically with hypnotic drugs. Gradual withdrawal was successfully accomplished without relapse, with a follow-up of as much as one year. To our knowledge, this is the first such series in the literature.
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PMID:Benzodiazepines and withdrawal psychosis. Report of three cases. 1 58

Depression is both a common and a greatly undertreated illness in the United States today. The focus of this review is a definition of the characteristics of four subtypes of depression which appear to be differentially sensitive to four different classes of medications. The tricyclic antidepressants should be used for patients with unipolar depression and vegetative symptoms. Lithium appears to be most effective for bipolar depressives. The monoamine oxidase (MAO) inhibitors are best used for patients with atypical depression. Antipsychotic medications appear to be useful for depressed patients with psychotic symptoms or agitation. Recent pharmacokinetic and biochemical data, including serum lithium levels, plasma tricyclic levels, and the predictive ability of pretreatment urinary 3-methoxy-4-hydroxyphenylglycol (MHPG) levels are also reviewed.
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PMID:Subtypes of depression--diagnosis and medical management. 1 27

A therapeutic trial has been carried out on 50 patients, most of them being hospitalized, in order to compare the characteristics of a new benzamide, Sultopride, to those of a butyrophenone, Fluanisone, for the treatment of important and chronic agitation states. Clinically, they were essentially psychotic states, with dissociation. From this trial it appeared that sultopride is superior to fluanizone with regard to their sedative effects and that it has specific characteristics: a very powerful antipsychotic action, an increasing efficiency over time, as well as an improvement of incoercible agitation in children. Thus, the present trial has checked out the well-known sedative action of Fluanisone, and has revealed a new major antipsychotic drug, Sultopride, the superiority of which lies on a much wider therapeutic field.
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PMID:[Comparative trials on sultopride and fluanisone]. 2 39

Representative studies which elucidate present treatment principles regarding parenteral administration of neuroleptics for acute psychoses with agitation are reviewed. "Rapid tranquillization" with drugs such as haloperidol generally appears preferable, but controlled comparisons with more conservative types of treatment are lacking. It is suggested that parenteral chlorpromazine should be avoided because of its tendency to provoke severe hypotension, whereas loxapine apparently is a valuable drug if strong sedation is required for behavioural control. Possible advantages of ultra-high-dose therapy need to be proved in controlled trials, and the occurrence of toxic side-effects requires further evaluation. From an ethical and psychological point of view, it is recommended that antiparkinsonian medication should be administered simultaneously with neuroleptics which induce a high incidence of acute dystonia. Several types of acute psychosis with agitation which do not require treatment with a neuroleptic as drug treatment of first choice are briefly mentioned.
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PMID:Parenteral treatment of acute psychotic patients with agitation: a review. 3 May 96

In this double-blind study dihydrotachysterol (DHT) was given orally to eight psychotic patients; in each case marked increases in psychosis and agitation accompanied increases in serum calcium and phosphorus within two weeks after active drug was substituted for placebo. In the three patients whose psychoses exhibited periodic spontaneous exacerbations, the agitated episodes grew more severe. Serum creatine phosphokinase (CPK) increased in all but one patient. By contrast, when three periodically psychotic patients received synthetic salmon calcitonin (SCT), the severity and frequency of agitated episodes decreased while CSF calcium increased in all three. These data support the hypothesis that the observed abrupt increases in serum calcium and phosphorus might cause the opposite CSF calcium shifts, the behavioral agitation and the increases in serum CPK frequently noted during acute psychosis.
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PMID:Calcium: pacesetting the periodic psychoses. 3 47

A report is made on the first results of the treatment with Droperidol of subacute illnesses of the schizophrenic type. Droperidol is a quick-working, very potent neuroleptic which leads to rapid comfort in cases of psychomotor conditions of agitation. The idea is discussed that Droperidol tends to accumulate and, beyond mere sedation, produces an excessive anti-psychotic effect which provides a favourable medium for the further introduction of other neuroleptics.
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PMID:[Intensive neuroleptic treatment in schizophrenias]. 12 58

A study of sultopride, a new derivative of the substituted anisamides, has shown that this neuroleptic drug reduces markedly and rapidly psychomotor agitation, especially its aggressive component. It also has an action on hallucinations. Its indications, in order of efficacy, are states of acute agitation, psychotic states during the active phase, acute manifestations of alcoholism and behaviour disorders such as expansivity, impulsivity and agressivity. Its tolerance is good considering its strong activity.
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PMID:[Study of the action of sultopride on psychomotor agitation. Apropos of 31 cases]. 18 84

A strategy is presented for biological psychosis research with neuroleptics acting as a point of crystallisation like antidepressants do in biological depression research. The neuroleptics chlorpromazine, haloperidol and oxypertine were studied, and it was found that they influence central catecholamine (CA) metabolism in man. An increased central dopamine (DA) turnover was found to occur in psychotic disorders, mostly in the form of motor agitation. As the first of a planned series of studies, chlorpromazine with presumed ability to reduce both DA-ergic and noradrenaline (NA)-ergic transmission and oxypertine as a more selective blocker of NA-ergic transmission were selected for comparison. The overall therapeutic effect of oxypertine was inferior to that of chlorpromazine, whereas oxypertine proved more effective in cases where loss of initiative was predominant. On the other hand, chlorpromazine exerted a more marked influence on extrapyramidal motor functions than oxypertine. In chronic psychotic disorders with inertia, oxypertine thus seems to be a neuroleptic which is strong enough to prevent exacerbation of delusions and hallucinations while at the same time increasing the level of motivation. These findings were in accordance with our predictions. The comparative study is illustrative of the practical significance of the research approach in this study: The biochemical action profile of a neuroleptic seems to be a more reliable indicator of its clinical action than does its chemical structure.
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PMID:Biochemical research into psychosis. 23 63

The first thioxanthene derivative without the double bind up to now considered mandatory for the antipsychotic effect, teflutixol, was administered in a phase II pilot efficacy trial to acute or subacute psychotic inpatients (mean age 36,1) during at least 5 weeks at a dosage of 3 to 20 mg p.d. once a day. The patients were abruptly switched from a haloperidol baseline therapy, which was administered on an average for 3 weeks at 15 mg p.d. Preliminary results are reported for the first 11 patients on a purely clinical basis. Despite the limitations of a small sample and of a qualitative analysis of data, it is hypothesized that teflutixol is a potent and original neuroleptic drug combining at 6 mg p.d. or less potent antidelusional, hallucinolytic and antiautistic effects. Latency and duration of action approximate 2 days. At 6 mg and above appear side-effects of the desinhibiting type (anxious and/or aggressive mood, withdrawal, flaring up of delusions, insomnia, agitation) and extrapyramidal side-effects of the akathisia type. No adrenolytic, anticholinergic or toxic effects were prominent. The patient followed up for the longest period (6 months on 3 mg p.d.) has not relapsed and has normal liver functions.
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PMID:[Preliminary note on the antiautistic, antidelusional and hallucinolytic effect of teflutixol (author's transl)]. 33 57

A double-blind, randomized, multicentre trial was carried out in 47 psychotic patients to evaluate the efficacy of oral treatment with loxapine compared with perphenazine. In total, 22 patients were included in diagnostic Group I (cases of acute schizophrenia and psychogenic (reactive) psychoses). The average maximum daily dose was 60.0 mg in the loxapine group and 36.8 mg in the perphenazine group. After 3-weeks' treatment, no significant differences were found between the two treatment groups according to the Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI) Scale or side-effect records. Twenty-five patients were included in diagnostic Group II (cases of chronic schizophrenia). The average daily dosage was 81.1 mg in the loxapine group and 90.1 mg in the perphenazine group. After 10 to 12-weeks' treatment, no significant differences between the two treatment groups could be found according to BPRS, CGI scale, Nurses' Observation Scale for In-patient Evaluation (NOSIE) or side-effect records. The diastolic blood pressure (lying and standing) tended to increase slightly in both treatment groups. In conclusion, it was found that loxapine and perphenazine seemed to be equally effective and, based on experience with parenteral loxapine treatment, it is suggested that further investigation of oral loxapine should be carried out in psychotic patients in whom agitation is a feature.
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PMID:Loxapine versus perphenazine in psychotic patients. A double-blind, randomized, multicentre trial. 36 45


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