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Biomedical subjects

C G Goetz

Publications and source records attributed to C G Goetz.

At least 253 records · Page 14Linked to original sources
PubMed1981

The effect of bromocriptine (BCT) on the on-off phenomenon.

Twenty-three patients with idiopathic Parkinson disease with classic "on-off" phenomena were studied prospectively during treatment with bromocriptine (BCT). Patients were evaluated for an average of 6 to 12 months and received an average of 56.5 mg of BCT. Nine patients (39%) showed improvement in terms of "on-off". When evaluated retrospectively, it appeared that the only difference between the responders and non-responders was a younger mean age (57.1 to 63.2).

Bromocriptine↗
PubMed1981

Drug-induced extrapyramidal disorders - a neuropsychiatric interface.

In psychiatric literature, the term extrapyramidal syndrome has traditionally encompassed a wide variety of drug-induced movement disorders. Recently, it has become increasingly clear that the natural history, pathophysiology, and pharmacology of individual movement disorders are distinct, making this unifying term obsolete and, in fact, a source of confusion. The topic of drug-induced movement disorders is reviewed, and a classification system based on anatomy, pharmacology, and therapeutic considerations is discussed.

Antipsychotic Agents↗
PubMed1981

Weekly drug holiday in Parkinson disease.

Patients with Parkinson disease and drug-related side effects entered an open-trial study in which they stopped all dopaminergic medications for 2 consecutive days each week. Nine of 17 patients could tolerate the cessation of dopaminergic medication, and all of them showed improvement of side effects during the drug holiday and often throughout the week. Patients who could not tolerate withdrawal of medication were identified within 3 weeks by increased tremor or bradykinesia. This at-home drug holiday offers a potential therapy applicable to large numbers of parkinsonian outpatients who suffer progressive drug-related side effects.

Adult↗
PubMed1981

Complications of chronic levodopa therapy: long-term efficacy of drug holiday.

Chronic use of levodopa may be complicated by dyskinesias, on-off effect, or hallucinosis. Transient levodopa withdrawal (drug holiday) may increase motor responsiveness and decrease levodopa-induced side effects, and the improved state may persist for as long as 9 months. After 1 year, parkinsonian signs approached pre-holiday levels, and two of the patients required a second drug holiday; side effects began to reappear 9 to 12 months after the holiday. Four of six patients with psychiatric complications remained free of hallucinations for the entire year.

Aged↗
PubMed1980

Tardive dyskinesia: review and update.

Tardive dyskinesia is an extrapyramidal syndrome associated with the chronic administration of major neuroleptic agents. The pathogenesis of the disorder appears to relate to chronic striatal dopaminergic receptor site blockade; the pathophysiology of tardive dyskinesia appears to relate to the resultant denervation hypersensitivity. Agents that deplete the brain of dopamine are the mainstay of therapy for tardive dyskinesia. Cholinergic agents that potentially modulate the balance between dopamine and acetycholine in the striatum offer possible additional therapeutic options. Clearly, resumption of neuroleptic therapy is treatment with the presumed pathogenic agent and is to be avoided whenever possible.

Adult↗
PubMed1979

Huntington's disease: current concepts of therapy.

Huntington's disease (Huntington's chorea), a degenerative disorder of the central nervous system, is inherited in an autosomal dominant pattern. Since there is no cure for this genetic disorder, therapy has been focused on pharmacologic manipulation of the involved neurotransmitter systems. In Huntington's disease, there is a functional predominance of striatal dopaminergic activity over antagonist cholinergic and possibly GABA-minergic systems. Many dopaminergic antagonists and cholinergic and GABA-minergic agonists are currently used in treatment. Supportive psychiatric care for affected persons and their families is an important therapeutic adjunct in the management of Huntington's disease. The eventual therapy will depend upon accurate identification of the primary genetic defect.

Acetylcholine↗
PubMed1979

Amphetamine-induced hypersensitivity in guinea pigs.

Chronic administration of d-amphetamine to young guinea pigs results in an increased behavioral response to this drug. After 6 months of daily amphetamine exposure, animals demonstrated behavioral hypersensitivity and developed full amphetamine-induced stereotyped behavior with decreased latency. The data suggest that chronic agonism with amphetamine can produce dopaminergic hypersensitivity, a behavior that contrasts with the development of drug tolerance to other pharmacologic agents. The mechanism of this induced hypersensitivity was studied by comparing brain amphetamine levels after acute and chronic amphetamine treatment. The two groups of guinea pigs showed no significant difference in amphetamine levels or drug distribution. These results suggest that altered amphetamine metabolism cannot account for the hypersensitivity seen after amphetamine exposure. Guinea pigs chronically pretreated with d-amphetamine were hypersensitive to another dopaminergic agonist whose metabolic pathway is distinct from that of amphetamine. These results have therapeutic implications in the management of clinical conditions related to chronic agonist-induced hypersensitivity.

Amphetamine↗
PubMed1978

Lergotrile in the treatment of parkinsonism.

Lergotrile mesylate, a direct-acting dopamine agonist, was administered for up to 10 months to 25 patients with Parkinson disease. Of six patients not receiving levodopa concurrently, five showed definite improvement in parkinsonian signs and symptoms. These results are the first clear indication that lergotrile is efficacious, independently of any interaction with levodopa, in the treatment of Parkinson disease. The drug was also effective in relieving some complications of long-term levodopa therapy. Lergotrile was more effective in alleviating on-off problems than in reversing loss of levodopa efficacy. Side effects of lergotrile included exacerbation of hallucinations, dyskinesias, hypotension, and alterations in liver function tests.

Acetonitriles↗