Search PubMed⌕ Search

Biomedical subjects

C Salzman

Publications and source records attributed to C Salzman.

At least 91 records · Page 5Linked to original sources
PubMed1983

Long v short half-life benzodiazepines in the elderly. Kinetics and clinical effects of diazepam and oxazepam.

Oxazepam and diazepam were compared in healthy elderly volunteers. Absorption of diazepam was faster than oxazepam and onset of clinical effects were more profound. Diazepam accumulation was extensive, washout was slow and active compounds were present two weeks after the last dose. Oxazepam accumulation was significantly less and elimination significantly faster than diazepam. There was no difference between oxazepam and diazepam in sedation or fatigue during the drug treatment, but sedative effects persisted for two weeks after diazepam therapy was discontinued. Sedation rapidly returned to baseline in the oxazepam group. Thus, the differing pharmacokinetic profiles of diazepam and oxazepam have clinical consequences during multiple dosage in the elderly.

Age Factors↗
PubMed1982

Basic principles of psychotropic drug prescription for the elderly.

Elderly patients pose special pharmacological problems. The combination of failing health, an aging body, and multiple drug prescriptions can alter drug effects clinicians would expect to occur in younger patients. Clinicians may also encounter problems of noncompliance of capricious compliance when treating older patients. They should be aware that elderly patients are more susceptible to psychotropic drug toxicity, severe extrapyramidal side-effects from neuroleptics, and anticholinergic side-effects from tricyclic antidepressants. Clinicians should make a complete medical evaluation and determine all of the medications an older patient is taking before they prescribe a psychotropic drug.

Aged↗
PubMed1982

Key concepts in geriatric psychopharmacology. Altered pharmacokinetics and polypharmacy.

Certain general principles should be considered whenever psychotropic drugs are prescribed to elderly patients. 1. The aging body usually responds to psychotropic drugs with a prolonged and heightened effect. 2. Before prescribing a psychotropic drug, it is necessary to determine all other medications an older patient is taking, including medications from other physicians as well as self-prescribed, over-the-counter preparations. 3. A careful assessment of the physical health of the patient must be completed before drug treatment begins. 4. The possibility of psychotropic drug toxicity should be considered in any older patient who is taking a psychotropic drug and who appears restless, agitated, confused, forgetful, or depressed. Doses of psychotropic drug should be reduced or the drug discontinued before adding another drug the the regimen. 5. Psychiatric drugs with simple metabolic pathways, particularly tricyclic antidepressants (secondary amines) and short-acting benzodiazepines, are preferred in elderly patients.

Aged↗
PubMed1981

Psychotropic drug use and polypharmacy in a general hospital.

This paper presents the usage of psychotropic drugs by all general inpatients of a Boston teaching and referral hospital on a randomly chosen weekday. Of all surveyed inpatients, 42.8% were receiving at least one psychotropic medication. Sleep medications were the most frequently prescribed class of psychotropic drugs and flurazepam was the most commonly prescribed of all drugs. Phenothiazine and neuroleptics were given to control agitation, pain, or nausea, rather than psychosis. Antidepressants were prescribed without notated justification in the medical record, and if given for depression, were underdosed. Diazepam was the most frequently prescribed antianxiety drug and was the most frequently prescribed psychotropic drug after flurazepam. Psychotropic drug polypharmacy was common, with the average patient receiving seven different drugs. Remedial approaches to this widespread problem are recommended.

Anti-Anxiety Agents↗
PubMed1980

Psychotropic drug prescriptions for elderly patients in a general hospital.

A survey was made of drug prescriptions written for all medical/surgical patients in a general hospital on a single weekday in 1978. Of these 348 patients, 195 were over the age of 60. In this elderly group, 62 (32 percent) were receiving psychoactive drugs. Flurazepam was the drug most commonly prescribed (in 63 percent of the patients). Diazepam was the most frequently prescribed nonhypnotic psychoactive drug (in 29 percent). Neuroleptic drugs and phenothiazine anti-emetics (in 52 percent) were not prescribed for psychosis but for augmenting analgesia and sedation and for reducing nausea. The average daily doses were about 20 percent of those used to treat psychotic young adults. All antidepressants (in 9.7 percent) had been prescribed before admission. No monoamine oxidase inhibitors were used, and doses of tricyclic antidepressants were half to one-third lower than those used to treat younger depressed adults. Antidepressants, which pose a risk to the elderly patient, were overprescribed and underdosed.

Aged↗
PubMed1980

The use of ECT in the treatment of schizophrenia.

ECT has been replaced by neuroleptics for the treatment of schizophrenia. The production of serious drug-related side effects, particularly tardive dyskinesia, raises the question of the efficacy and toxicity of ECT versus neuroleptics. Most of the studies in the English literature on the use of ECT in the treatment of schizophrenia are unacceptable according to contemporary criteria: the question of ECT versus neuroleptic drugs thus remains unanswered. In the few acceptable published studies, clinical response to ECT was inversely proportional to duration of schizophrenic symptoms. Schizophrenic patients with affective and catatonic symptoms responded best: those with chronic symptoms rarely responded. ECT does not alter the fundamental psychopathology of schizophrenia.

Acute Disease↗
PubMed1978

Depression in the elderly. II. Possible drug etiologies; differential diagnostic criteria.

Drugs for the treatment of various medical or psychiatric disorders may sometimes cause or exacerbate depression in the elderly. Drug interactions due to polypharmacy (a common method of prescribing for aged patients) may also play a role the genesis of depression. The roles of specific drugs and of drug interactions are reviewed. Criteria for the diagnosis of depression in the elderly, as well as differential diagnostic guidelines, are presented and constructive suggestions offered.

Aged↗
PubMed1978

Depression in the elderly. I. Relationship between depression, psychologic defense mechanisms and physical illness.

Diagnosis of depression in the elderly is sometimes difficult owing to the presence of ego defensive mechanisms or somatic symptoms that can disguise the affect. Depression also may precede, or be associated with a variety of medical illnesses which are common among older persons. Specific ego defenses and representative medical illnesses are discussed. The concepts of a depressive equivalent and pseudodementia, which particularly act to disguise the depression, are reviewed in detail.

Adaptation, Psychological↗
PubMed1978

Day hospital treatment of borderline patients: a clinical perspective.

The authors suggest that day hospitalization can provide a useful therapeutic framework for patients with borderline personality organization without creating the ego regression often seen in such patients during 24-hour hospitalization. The lack of room and board facilities and of contact with patients who need 24-hour hospitalization plus the maintenance of contact with the people in the patient's nonhospital life facilitate treatment in this setting.

Adult↗