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

It is evident that couvade syndrome exists in the industrialized culture. However, there are questions about the occurrence of couvade given the large range of reported incidence. Clinton found no difference in the occurrence of symptoms between expectant fathers and nonexpectant men throughout the three trimesters of pregnancy. Differences were noted, however, in the types and perceived seriousness of symptoms between these men, with expectant fathers reporting more colds, unintentional weight gain, insomnia, and restlessness. Significant differences in health deviation were reported by the new fathers during the immediate postpartum period. These new fathers experienced fatigue, emotional and cognitive disturbances, and headaches. Strickland's work did not provide comparative estimates of the incidence of couvade syndrome. The focus of this study was to explore the nature of pregnancy-related symptoms among expectant fathers. These expectant fathers reported key symptoms during the second trimester of pregnancy with increasing occurrence during the last trimester of pregnancy. Expectant fathers most likely to experience couvade were anxious, black, working class men experiencing an unplanned pregnancy. Anxiety, suppression of hostility, and identification with the pregnant partner were explored as predictors of the occurrence of couvade syndrome. Anxiety is likely to occur in expectant fathers because of financial concerns and changes in relationships and roles. Feelings of protectiveness toward the partner and fetus/infant also can be anxiety producing for the expectant father. The developmental tasks described by Duvall and Penticuff were predicated on the transitional nature of becoming a parent. Each task depicts the inherent change in both structure and function of the male's family role which is influenced by society and the family unit. May proposed that expectant fathers have unique styles that predict the degree of involvement with the partner and the pregnancy. Phases of father involvement, described by May, and the father's laboring for relevance, described by Jordan, are conceptually consistent with the developmental tasks identified by Duvall. Each phase or subprocess is sequential, marked by intrapersonal and interpersonal characteristics. Movement through these tasks, phases, or subprocesses is dependent upon accepting the reality of the pregnancy, cultural norms, and society's expectations of fathers. Herzog identified degrees of involvement among fathers whose partners delivered prematurely. In this retrospective inquiry, fathers with a high degree of involvement were more likely to experience symptoms of couvade syndrome than were fathers who were less involved. All fathers in the study, regardless of the involvement, reported being fearful of the unknown outcome and experiencing grief over the preterm delivery.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Expectant fathers' response to pregnancy: review of literature and implications for research in high-risk pregnancy. 239 46

Benzodiazepines are among the most widely-prescribed medications in the world. Although tolerance is unlikely, abuse is widespread. Prescription abuse is especially common, with medication being taken for longer periods than intended, or at the wrong dosage, or for purposes not intended by the physician. Prolonged use, even at therapeutic levels, can produce a definite "benzodiazepine withdrawal syndrome" with disturbing symptoms such as insomnia, twitching, and restlessness, leading to prolongation of the already inappropriate usage. Suggestions for reducing this abuse are discussed.
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PMID:Benzodiazepine prescription abuse and the benzodiazepine withdrawal syndrome. 256 80

This work discusses the papers of the third symposium on psychiatry held in Basle. Herzka interprets substance abuse from a historical and cultural point of view as an escape from external tensions into an internal fight with the drug. The increase of tolerance of the many controversies and discrepancies in our culture could help to prevent drug abuse. The doctor is also in a clash between different cultures and social systems, where most values have become relative. In this situation the doctor will be tempted to only take some of the aspects of the bio-psychosociological model of psychiatric illnesses into account and to become highly specialized as to evade the conflict himself. The development of new benzodiazepines is progressing and the isolation of partial effect components, such as pure antianxiety and antiaggressive effects, is an important goal which has been partly reached. Benzodiazepines today belong to the most important medication for insomnia, restlessness, tension, anxiety present in different functional disorders, which not only concern psychiatry but medicine in general. A lot of patients need longterm treatment with benzodiazepines. This fact is contrary to the common recommendation to avoid benzodiazepine dependence. The one year prevalence of dependence is estimated to be, according to Ladewig, 0.1% of the population, which is, with regard to frequency and toxicity, compared to other substances, socially and medically relatively low. The therapeutic benefit is worth the risk of dependence. The prophylaxis for the reduction of drug dependence in the population is effective.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Perspectives of the 3d Basel Psychiatry Rounds]. 257 Apr 55

Single oral doses of 10 to 160 mg centpropazine, a new antidepressant (synthesized by CDRI, Lucknow, India) were administered to groups of 4-5 male volunteers, each dose being interspersed with placebo in a double blind, non-crossover study by random distribution. The drug was well tolerated. Drowsiness, heaviness, weakness and/or headache were reported only at doses of 120 mg and above. No adverse effect was noted in various laboratory tests, ECG or vital parameters. In a multiple dose study, volunteers received 40 or 80 mg centpropazine daily for 4 wk. Mild restlessness and insomnia were observed in some subjects receiving 80 mg dose. In this study also no effect was observed in various laboratory tests, ECG or vital parameters.
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PMID:Clinical pharmacological studies on centpropazine--a new antidepressant compound. 262 4

The majority of patients receiving cisplatin at a dose of 120 mg/m2 experience delayed nausea and vomiting occurring between 24 and 120 hours after chemotherapy administration. Ninety-one patients who were receiving cisplatin (120 mg/m2) as initial chemotherapy were entered into this double-blind trial. All patients received intravenous (IV) metoclopramide, dexamethasone, and lorazepam for the control of acute emesis during the period from 0 to 24 hours after cisplatin. Patients were then randomized to one of three treatment regimens: placebo; oral dexamethasone, 8 mg twice daily for two days, then 4 mg twice daily for two days; or the combination of oral metoclopramide, 0.5 mg/kg four times daily for four days, plus oral dexamethasone administered as above. Forty-eight percent of individuals who received the two-drug combination of metoclopramide plus dexamethasone experienced delayed vomiting as opposed to 65% who were administered dexamethasone alone and 89% who received placebo (P = .006). Scores assessing the severity of delayed nausea and vomiting were consistently worse in individuals receiving placebo. The incidences of sleepiness, restlessness, heartburn, hiccoughs, loose bowel movements, insomnia, and acute dystonic reactions did not differ significantly among the three regimens and were mild and self-limited. The two-drug combination of oral metoclopramide plus dexamethasone is well tolerated, safe, and more effective than dexamethasone alone or placebo in controlling delayed vomiting following cisplatin.
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PMID:Controlling delayed vomiting: double-blind, randomized trial comparing placebo, dexamethasone alone, and metoclopramide plus dexamethasone in patients receiving cisplatin. 264 36

Hexamethylene bisacetamide (HMBA), a potent differentiating agent, was administered to patients with refractory malignant tumors. Thirteen patients received 30 evaluable courses. HMBA was given by continuous i.v. infusion for 5 days. Therapy was repeated every 28 days, if patients had recovered from toxicity. The starting dose was 24 g/m2/day. Because our previous trial had shown wide interpatient variability in HMBA pharmacokinetics and excess toxicity at HMBA plasma concentrations greater than 2 mM (HMBA doses between 24 and 33.6 g/m2/day), we attempted to individualize each patient's dose based on a dosing scheme using an adaptive (feedback) control algorithm, which assumed linear clearance for HMBA. In all courses, a plasma sample was assayed daily and infusion rates were adjusted to achieve an HMBA plasma concentration of 1.5-2.0 mM (300-400 mg/liter). The patients included 12 men and 1 woman with a median age of 56 years (range, 34-76) and median Karnofsky performance status of 90% (range, 60-100). All patients had received prior chemotherapy and 9 patients had also received radiation therapy. The linear adaptive control algorithm was reasonably precise, with a mean absolute error of 0.28 (SE 0.04) mM. However, adjustments in infusion rate systematically overshot the desired change in steady state concentration, probably due to nonlinear clearance of HMBA. For levels within 24 h of a change in infusion rate, this resulted in significant bias, with a mean error of 0.24 (SE 0.09) mM. The mean absolute error was 0.40 (SE 0.06) mM. A second adaptive control algorithm, using a pharmacokinetic model with parallel first-order (renal) clearance and Michaelis-Menten (nonrenal) clearance and using Bayesian parameter estimation with a priori estimates based on our previous phase I trial, proved to be much more precise than the linear method and was unbiased when applied retrospectively to the same observations, with a mean error (within 24 h of a change in infusion rate) of 0.02 (SE 0.06) mM and a mean absolute error of 0.22 (SE 0.03) mM. Toxicity was reversible in all cases. Neurotoxicity, consisting of hallucinations, agitation, somnolence, or confusion, was seen in 2 patients. Four patients complained of insomnia or anxiety. Mild asymptomatic acidosis was seen in 3 patients. Other toxicity included grade 1-2 nausea and vomiting (10 patients), grade 2 diarrhea (2 patients), grade 3 thrombocytopenia (3 patients), grade 1-3 leukopenia (3 patients), and oral herpes simplex infection (4 patients). Mild reversible renal insufficiency (measured by creatinine clearance) was seen in 8 patients.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Phase I trial using adaptive control dosing of hexamethylene bisacetamide (NSC 95580). 272 Jun 96

1. This study presents the results of the preliminary screening of vigabatrin as add-on therapy in an open, non-controlled multicentre study in children with refractory epilepsy. 2. There were 135 children, with an age range of 2 months-12 years. Main seizure type was partial in 42%, generalized in 29%, Lennox-Gastaut syndrome in 19% and West syndrome in 10%. 3. Vigabatrin was added onto current antiepileptic treatment in an initially recommended dose of 40-80 mg kg-1 day-1. However, the doses were frequently increased when tolerance allowed it, and the final mean dose used was 87 mg kg-1 day-1 (27-600). 4. A 75% to 100% reduction in seizure frequency was observed in 25% of patients (11 patients became seizure free) and 50 to 75% decrease in a further 13%. Efficacy was better in partial seizures, with good to excellent results in 49% of patients. The use of high doses, above 100 mg kg-1 day, was not associated with greater efficacy in this preliminary study. 5. No side effects were reported in 79% of patients. Agitation and insomnia were observed in 8.8% and somnolence in 6%. Other adverse events included ataxia (2.2%), nausea (2.2%) and increased appetite (1%). A moderate and transient decrease in haemoglobin was reported in six patients from the same centre; these patients were all receiving very high doses of vigabatrin (250 to 600 mg kg-1 day-1). 6. Vigabatrin thus appears to be a safe antiepileptic drug that may be effective in the treatment of severe epilepsy in children.
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PMID:Vigabatrin in the treatment of epilepsy in children. 275 1

Treatment services in Pakistan have been swamped by the recent appearance and rapid growth of heroin abuse, and there is an urgent need to initiate and strengthen effective responses. This paper presents the results of an exercise in national monitoring of heroin detoxification services in Pakistan. The study also offers the first systematic description of the withdrawal response of heroin addicts dependent upon doses greatly in excess of those reported in developed countries. The trial was conducted at four major treatment centres and looks at three of the most widely used detoxification procedures in Pakistan (symptomatic treatment only, opium reduction plus symptomatic treatment and clonidine). Data are presented on 118 addicts receiving inpatient detoxification from heroin. The results indicate that all three detoxification methods reduced peak levels of withdrawal symptoms to acceptable levels, and that all produced a return to baseline levels of symptomatology within 10 days or less. The three most persistent symptoms were aches and pains, restlessness and insomnia. Several differences were found between treatments, notably with regard to the number of drugs required to modify the withdrawal response. The implications of these and other results are discussed.
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PMID:The detoxification of high dose heroin addicts in Pakistan. 279 89

The author reviews the literature reporting the untoward effects of withdrawing monoamine oxidase inhibitors (MAOIs). The withdrawal of these agents can result in severe anxiety, agitation, pressured speech, sleeplessness or drowsiness, hallucinations, delirium and paranoid psychosis. MAOI withdrawal phenomena resemble the symptoms produced by the discontinuation of chronically administered psychostimulants. The capacity of MAOI to exert amphetamine-like effects presynaptically, and the propensity of somatic treatments for depression to subsensitize presynaptic receptors regulating the release of catecholamines, can provide a basis for the development of psychotic syndromes upon the withdrawal of MAOIs. Evidence for this hypothesis is reviewed.
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PMID:Monoamine oxidase inhibitor withdrawal phenomena: symptoms and pathophysiology. 284 11

The authors review the literature discribing non-dyskinetic antipsychotic withdrawal phenomena. Withdrawal of these agents can cause nausea, emesis, anorexia, diarrhea, rhinorrhea, diaphoresis, myalgia, paresthesia, anxiety, agitation, restlessness, and insomnia. Psychotic relapse is often presaged by increased anxiety, agitation, restlessness and insomnia, but the temporal relationship of these prodromal symptoms to reduction in the dosage or discontinuation of neuroleptics distinguishes them from the effects of abrupt withdrawal.
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PMID:Antipsychotic withdrawal symptoms: phenomenology and pathophysiology. 289 77


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