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Query: UMLS:C0917801 (insomnia)
 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The relationship between forced insomnia and acute transitory exogenous psychosis named "railway paranoid" is under discussion. According to the author's data, forced insomnia precedes that psychosis in all the cases; it lasts from 2 to 5 days, being consequent on a tiresome journey. A permanent and direct relationship can be elucidated between the duration of insomnia and the depth of paranoid. Psychosis is eliminated after a deep sleep and subsequent asthenia. In experimental sleep deprivation described by some authors, the general regularities were established between psychosis in question and the status of disturbed consciousness. The conclusion is made that forced insomnia causes railway paranoid. It is of importance to stress that all attempts to discover some other psychogenic factor which would explain the exogenous structure of the given psychosis have so far ended in failure.
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PMID:["Railway" paranoid disorder and forced insomnia]. 165 19

A total of 60 patients with systemic lupus erythematosus (SLE) were under observation; 36 of them had clinical symptoms of the CNS affection and 25 persons included into the control group exhibited no psychic disorders during the clinical examination. Besides, routine clinico-laboratory examinations accepted in rheumatology, the patients were subjected to cranial computer tomography (CT), electroencephalography, examination of cerebral hemodynamics with a radionuclide partechnetate 99mC as well as to psychological testing. Neuropsychic disorders developed during the first four years after the onset of the disease and are grouped in the following way: neurological, border-line, neuropsychic, affective, psychotic, intellectual-mnestic. Moderate affection of the CNS in SLE is characterized by a complex of subjective and objective symptoms: headache, deterioration of memory, insomnia, vertigo, irritability, depressed mood, assymetry of the face innervation, coordinatory disorders. Diffuse widening of the subarchnoidal space, diffuse cerebral changes, interhemispheric assymetry of the venous and arterial phases of cerebral circulation: the most peculiar symptoms of the CNS affection in SLE according to CT and EEG and radionuclide studies of cerebral hemodynamics. Focal changes in the CNS were observed in 50% of the patients with neuropsychic disorders.
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PMID:[Diagnosis of lesions of the central nervous system in patients with systemic lupus erythematosus]. 166 90

A total of 100 new patients was investigated who consulted the Department of Psychiatry of Tosei General Hospital concerning insomnia as a chief complaint. The average age of the subjects was 52, with an age range of 13-88, and a male female ratio of 1:22. According to the DSM-III-R classification, primary sleep disorder was most frequent (39%), followed by affective disorders (34%), organic mental disorders (9%), anxiety disorders (6%), psychoactive substance use disorders (4%), psychotic disorders not elsewhere classified (4%), and others. Various psychosocial stressors were observed in 40% of the subjects, and concurrent major physical disorders in 44% of the subjects. Based on the results, the role of consultation-liaison psychiatry in treatment of sleep disorders and primary care was discussed.
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PMID:Clinical study of insomnia, a common disorder in primary care: from a viewpoint of consultation-liaison psychiatry. 181 73

Ever since the introduction of the alkaloid ephedrine as an anti-asthmatic, the CNS stimulatory effects of this sympathomimetic have been a problem in therapy. Indeed, the use of ephedrine is not only limited by its cardiovascular effects, but also by the occurrence of insomnia, restlessness and anxiety. Exceptionally, ephedrine may even induce toxic psychosis, and the possibility of this side effect has recently received renewed attention. Besides ephedrine, the ephedra plant contains some norpseudoephedrine. This substance is also called cathine, because it is a major alkaloid of Catha edulis or khat, a plant that is widely used as a stimulant in certain countries of East Africa and of the Arab Peninsula. The effects of khat have been explained formerly by those of cathine; some time ago, however, the labile alkaloid cathinone was discovered in khat. This substance is the keto-analog of cathine; it is therefore more lipophilic and penetrates easily to its sites of action in the central nervous system. Indeed, cathinone has been found to be a highly potent CNS stimulant and it is now known to be the main psychoactive constituent of khat; the results of various in vitro and in vivo studies indicate that cathinone must be considered a natural amphetamine. In confirmation of this view, it has recently been demonstrated that cathinone has in humans marked euphorigenic and psychostimulant effects. As the case may be, these findings may lead, together with epidemiological data, to a reconsideration of the use of khat as a stimulant and social drug.
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PMID:The pharmacology of psychoactive alkaloids from ephedra and catha. 188 Nov 58

1. The authors review the literature describing acute symptomatology produced by the gradual or abrupt withdrawal of heterocyclic antidepressants, monoamine oxidase inhibitors (MAOI) and neuroleptics. 2. Withdrawal of heterocyclic antidepressants and antipsychotic agents causes similar symptomatology. Symptoms produced by the discontinuation of these drugs include nausea, emesis, anorexia, diarrhea, rhinorrhea, diaphoresis, myalgias, paresthesias, anxiety, agitation, restlessness, and insomnia. 3. Psychotic relapse is often presaged by anxiety, agitation, restlessness, and insomnia. Prodromal symptoms are distinguished from the effects of neuroleptic withdrawal by a temporal relationship of the latter to reductions in the dosage or discontinuation of antipsychotic agents. 4. Withdrawal of MAOIs can result in severe anxiety, agitation, pressured speech, sleeplessness or drowsiness, hallucinations, delirium, and paranoid psychosis. 5. MAOI withdrawal phenomena resemble the symptoms produced by the discontinuation of chronically administered psychostimulants. 6. The capacity of MAOIs to exert amphetamine-like effects presynaptically and the propensity of somatic treatments for depression to subsensitize presynaptic receptors regulating the release of catecholamines provide a basis for the development of psychotic symptoms upon the withdrawal of MAOI. Evidence for this hypothesis is reviewed.
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PMID:Heterocyclic antidepressant, monoamine oxidase inhibitor and neuroleptic withdrawal phenomena. 196 71

Carisoprodol (Somadril) was gradually withdrawn for a fortnight in nine male prisoners who had been taking daily doses of from 700 to 2,100 mg for at least nine months. The patients were assessed clinically during the withdrawal period, with special attention to the occurrence of abstinence symptoms. Most of the patients reported mental distress, such as anxiety, insomnia and irritability. Cranial and muscular pain and vegetative symptoms were also frequently reported. Most of these symptoms were transient, and no seizures or psychotic reactions occurred. Our information from drug addicts indicates that carisoprodol can be misused as a narcotic. The occurrence of abstinence symptoms during withdrawal supports this supposition. We propose a more gradual reduction of the doses when terminating medication with carisoprodol in general practice.
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PMID:[Dependence on carisoprodol (Somadril)? A prospective withdrawal study among prisoners]. 199 78

In a double-blind randomized trial, we evaluated the efficacy and safety of three oral dosage regimens of fleroxacin, a new fluoroquinolone, once daily in 62 patients for the treatment of complicated urinary tract infections. The regimens compared were 200 mg for 10 days (n = 20), 400 mg for 10 days (n = 21), and 600 mg for 10 days (n = 21). Forty-five patients were evaluable for efficacy. A clinical cure was reached in 78% of the patients. Overall, a favorable bacteriological response (negative culture or reinfection at 4 to 6 weeks) was obtained in 36 of 45 (80%) patients. No significant difference could be found among the three dosage groups. During therapy, one Klebsiella ozaenae strain became resistant and one Pseudomonas aeruginosa strain became less susceptible to fleroxacin. In 13 patients, therapy had to be discontinued due to major adverse events (oliguria [n = 1], psychosis [n = 1], photosensitivity [n = 1], insomnia [n = 1], and nausea [n = 9]). Minor side effects were seen in 13 other patients. Increased dosage correlated significantly (P less than 0.01) with total number of adverse events.
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PMID:Double-blind, dose-range-finding study of fleroxacin (RO 23-6240; AM-833) for treatment of complicated urinary tract infections. 211 Apr 37

The authors researched the demographic characteristics of 233 patients with methamphetamine-associated disorders, and the relation between years of methamphetamine use and symptoms of methamphetamine psychosis. The results were as follows: There were more male users than females. However there were signs that the female users were gradually increasing. Users tended to be older, but users in their 20's and 30's continued to be predominant. Their school careers were usually limited and most of them had left school at a young age. Relations with a particular social group (e.g. organized gangs) has given most of them a chance to use methamphetamine. The symptoms that were seen with high frequency at the first examination were anxiety, fretfulness, auditory hallucination, insomnia, irritability, psychomotor excitement, delusion of persecution, suspicion, delusion of reference, mistake of circumstance, loss of appetite, affective disorder, hypobulia and personality change. With these symptoms, there is a possibility that five years of methamphetamine use is the turning point in terms of the frequency of symptoms occurrence. It was suggested that affective and perceptual disorders depend on the dose of methamphetamine, but abnormalities in thought subject may be deeply influenced by the patient's "feeling of social wrong". Emotional exhilaration and euphoria decreased as the number of years of methamphetamine use increased. These phenomena may be an indication of tolerance. The symptoms that were seen with high frequency at the last examination were hypobulia, affective disorder, personality change, insomnia, anxiety and fretfulness. The symptoms that were highly resistant to treatment were hypobulia, affective disorder, personality change, general malaise, hypochondriasis, insomnia, anxiety and fretfulness. It was suggested that five years of methamphetamine use may be a turning point in the residual rate of symptoms at the last examination after treatment, and also the resistance rate to treatment. Hypobulia and personality change became more evident during treatment.
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PMID:[Relationship between years of methamphetamine use and symptoms of methamphetamine psychosis]. 222 83

The therapeutic efficacy and target symptoms of maprotiline were tested by administering it in addition to conventional neuroleptic treatment for 10 weeks to a total of 32 chronic schizophrenic patients who showed no, or only partial, response to the neuroleptic medication. The final global improvement rating was 68.8% for all patients. Average therapeutic doses administered were 150 mg per day. Changes in psychotic symptoms were assessed by the Brief Psychiatric Rating Scale (BPRS), Psychiatric Evaluating scale (PES), and the Scale for the Assessment of Negative Symptoms (SANS). All mean improvement rates of these rating scales were observed at the 2nd week after the start of treatment, and maprotiline produced a marked amelioration in negative symptoms such as decreased spontaneity, blunted affect, emotional withdrawal, impaired work or recreation, etc. The incidence of side-effects was 37.5%. Constipation was the most frequently occurring side-effect. Neither side-effects nor laboratory test results were serious enough to discontinue the trial, except in the case of one chronic patient who showed acute exacerbation of symptoms due to maprotiline-induced insomnia, elation and hallucination. These results suggest that maprotiline improves the negative symptoms of schizophrenia by a noradrenaline potentiating action not demonstrated by dopaminergic or serotonergic reward systems.
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PMID:Effect of maprotiline combined with conventional neuroleptics against negative symptoms of chronic schizophrenia. 257 Jun 87

A case of psychosis occurring 13 days after 1st trimester abortion in a 17-year old primigravida without family history of mental illness of postpartum psychosis is described. The young woman denied any ambivalence or guilt concerning abortion. The abortion itself involved repeat hospitalization for evacuation of retained products, and a course of antibiotics (metronidazole). The illness was marked by insomnia, anorexia, labile mood, auditory hallucinations, inappropriate speech, flat affect, and withdrawal alternating with disinhibition. She was hospitalized 10 days after onset, and treated with neuroleptics (pimozide 4 mg/day). She improved rapidly, and was discharged, taking medication for a few more weeks. After stopping medication she became pregnant, and delivered without any further psychotic symptoms. It is unlikely that metronidazole caused the illness, although it has been associated with confusion, disorientation and hallucinations, because the symptoms occurred 2 days after discontinuing the drug. On the other hand, the patient's flat affect after recovery suggests she might have had incipient schizophrenia.
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PMID:Psychotic illness following termination of pregnancy. 259 Jul 89


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