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I Reznik

Publications and source records attributed to I Reznik.

At least 19 recordsLinked to original sources
PubMed2004

Clozapine in the treatment of obsessive-compulsive symptoms in schizophrenia patients: a case series study.

INTRODUCTION: Obsessive-compulsive (OC) symptoms have been observed in a substantial proportion of schizophrenic patients. There are some reports describing the appearance de novo or reemergence of preexisting OC symptoms under clozapine (CLZ) therapy. However, there are also reports describing a positive effect of CLZ therapy in OC schizophrenic patients. It seems that comorbid OC symptoms are common among CLZ-treated refractory schizophrenic patients and are likely to be an integral part of their illness. The complex nature of the treatment response in this group of schizophrenic patients is as yet unclear. The effects of CLZ on OC symptoms may vary, with evidence of improvement in some and worsening among others. METHODS: The present case series study describes our experience with CLZ as a sole agent (n = 10) or in combination with serotonin reuptake inhibitors (n = 5), in schizophrenic patients with prominent OC symptomatology. RESULTS: Systematic analysis of clinical features of our patients, as well as findings in the literature to date, led us to suggest some factors that may predict response to CLZ treatment in treatment-resistant schizophrenic patients with prominent OC symptoms: 1) schizophrenic patients who began to exhibit OC symptoms within the course of the psychotic process need and might to be successfully treated with CLZ alone; 2) when OC symptomatology preceded the development of schizophrenic process, CLZ monotherapy is inefficient and may even worsen OC symptoms; therefore, it should be treated concomitantly with specific anti-obsessive agents; 3) in both groups there is a definite dose-related pro-obsessive influence of CLZ when it is given in high doses. DISCUSSION: Further controlled investigations in a larger cohort of OC schizophrenic patients are needed to substantiate our hypothesis. OCD:Obsessive-compulsive disorder OCS:Obsessive-compulsive symptoms SRI:Serotonin reuptake inhibitors

Adult↗
PubMed2000

Obsessive and compulsive symptoms in schizophrenia: a randomized controlled trial with fluvoxamine and neuroleptics.

Obsessive-compulsive-related disorders are frequently comorbid with schizophrenia. The existence of obsessive and compulsive symptoms in patients with schizophrenia represents one of the most severe types of psychotic disorders and may predict a poor prognosis in most cases. Previous pilot studies and case reports have shown that the condition of some patients with schizophrenia did not exacerbate and even improved when serotonin reuptake inhibitors (SSRIs) were added to their standard neuroleptic regimen. The aim of this study was to evaluate the efficacy of a combination treatment of an SSRI (fluvoxamine) and standard neuroleptics for the treatment of obsessive-compulsive (OC) symptomatology in patients with schizophrenia compared with administration of neuroleptics only. Thirty inpatients who met DSM-IV criteria for schizophrenia and also had prominent OC symptoms were randomly divided into two groups. Fourteen patients were treated with conventional neuroleptics and fluvoxamine in doses of 100 to 200 mg/day for 8 weeks. Sixteen patients comprised a control group and received only their previous therapeutic neuroleptic therapy. The patients were assessed using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Positive and Negative Syndrome Scale (PANSS), and the Clinical Global Impression Scale (CGI) at baseline and endpoint. Side effects were assessed weekly. The data were analyzed using an analysis of variance. A considerable reduction in PANSS (34.3%) and Y-BOCS (29.4%) scores was noted, and CGI scores decreased moderately in both groups. None of the patients showed an acute exacerbation at the end of the study. Side effects were mild and easily tolerated in most patients. This open, randomized, controlled study reveals that coadministration of fluvoxamine, an SSRI, and neuroleptics in patients with schizophrenia and OC symptoms was associated with specific improvements of these symptoms. Thus, the use of an SSRI in treating a patient with schizophrenia and OC symptomatology may be warranted and safe. Other implications of the findings, including general safety of the combined pharmacotherapy and the use of new antipsychotic medications, are also discussed.

Adult↗
PubMed1999

Sildenafil citrate (Viagra) treatment of sexual dysfunction in a schizophrenic patient.

A high frequency of sexual dysfunction occurs in treated and untreated patients with schizophrenia. Unfortunately, no effective therapy for this problem is currently available. We present a case of a 26-year-old patient with paranoid schizophrenia, who suffered from lack of desire and erection, and was successfully treated with sildenafil citrate (Viagra). This case illustrates the complex character of sexual dysfunction in male schizophrenia patients.

Adult↗
PubMed1999

An acute ischaemic event associated with the use of venlafaxine: a case report and proposed pathophysiological mechanisms.

Venlafaxine, a structurally novel antidepressant, belongs to a new generation of antidepressants--the serotonin/noradrenaline reuptake inhibitors. In clinical trials, venlafaxine was found safe and effective in most patients. However, significant changes in vital signs (hyper- and hypotension) and cardiac conduction abnormalities were observed in a few patients, notably in elderly patients. We present a case of an elderly woman with a pre-existing history of ischaemic heart disease, who was treated with venlafaxine, and developed acute myocardial ischaemia within the first week of treatment. This is the first report of a possible association between an acute cardiovascular event and venlafaxine. The association of venlafaxine treatment with ischaemic events could be explained by its unique pharmacological and haemodynamic properties.

Aged↗
PubMed1996

[Seroquel in a resistant schizophrenic with negative and positive symptoms].

Refractoriness to treatment is a common problem in management of schizophrenics. Conventional pharmacotherapy is usually effective in controlling positive symptoms of the disease, such as delusions and hallucinations. However, they have restricted ability to affect negative symptoms (flat affect, social withdrawal) and to reverse functional disability and behavioral deviance. Furthermore, typical neuroleptics produce adverse effects, such as extrapyramidal symptoms and tardive dyskinesia. A new generation of antipsychotic agents with a low profile of side-effects and good tolerance has recently been developed and actively investigated. Seroquel (ICI 204-636), a dibenzoth azepine derivative, is a novel, putative, potential, atypical neuroleptic; it is a combined dopamine/ serotonin receptor antagonist. We report a 54-year-old man suffering from chronic therapy-resistant schizophrenia, with both positive and negative symptoms, who was successfully treated with Seroquel during 1 year.

Antipsychotic Agents↗
PubMed1996

Eliciting facial affect, motivation, and expectancies in transference: significant-other representations in social relations.

Recent research has demonstrated transference in social perception, defined in terms of memory and schema-triggered evaluation in relation to a new person (S. M. Andersen & A. B. Baum, 1994; S. M. Andersen & S. W. Cole, 1990; S. M. Andersen, N. S. Glassman, S. Chen, & S. W. Cole, 1995). The authors examined schema-triggered facial affect in transference, along with motivations and expectancies. In a nomothetic experimental design, participants encountered stimulus descriptors of a new target person that were derived either from their own idiographic descriptions of a positively toned or a negatively toned significant other or from a yoked control participant's descriptors. Equal numbers of positive and negative target descriptors were presented, regardless of the overall tone of the representation. The results verified the memory effect and schema-triggered evaluation in transference, on the basis of significant-other resemblance in the target person. Of importance, participants' nonverbal expression of facial affect when learning about the target person (i.e., at encoding) reflected the overall tone of their significant-other representation under the condition of significant-other resemblance, providing strong support for schema-triggered affect in transference, through the use of this unobtrusive, nonverbal measure. Parallel effects on interpersonal closeness motivation and expectancies for acceptance/rejection in transference also emerged.

Affect↗
PubMedDate not supplied

Combined electroconvulsive-clozapine therapy.

We reviewed 36 reported psychiatric patients who were treated with a combination of electroconvulsive therapy (ECT) and clozapine. The indication of the ECT-clozapine treatment was resistance to classical antipsychotic agents, clozapine, or ECT alone. Sixty-seven percent of the patients benefited from the combined treatment. In most of the patients, the combined treatment was safe and well tolerated. Adverse reactions occurred in 16.6% of the patients and included prolonged ECT-induced seizures (one case), supraventricular (one case) and sinus tachycardia, and blood pressure elevation. It seems that combined ECT-clozapine treatment is effective and safe. This strategy may be a therapeutic option in treatment-resistant patients.

Adult↗
PubMedDate not supplied

An open study of fluvoxamine augmentation of neuroleptics in schizophrenia with obsessive and compulsive symptoms.

Patients whose schizophrenia is characterized by marked obsessive-compulsive features can be difficult to treat successfully and often require a combination treatment. The aim of this open-label study was to evaluate the efficacy and tolerability of an addition of fluvoxamine--a selective serotonin reuptake inhibitor (SSRI)--to standard neuroleptics in treatment of obsessive-compulsive (OC) symptomatology in patients with schizophrenia. Sixteen patients with schizophrenia were treated with conventional neuroleptics and fluvoxamine in doses of 100-200 mg/d for 8 weeks. The patients were assessed with use of the Brief Psychiatric Rating Scale (BPRS) and the Yale Brown Obsessive-Compulsive Scale (YBOCS) at baseline and endpoint. Results included considerable reduction in BPRS (39.4%) and Y-BOCS (32.9%) scores. None of the patients showed an acute exacerbation during the whole study period. Side effects were clinically insignificant. This open-label trial supports previous suggestions that coadministration of SSRIs and neuroleptics in patients with schizophrenia with OC symptoms is associated with robust improvements of these symptoms. Therefore, the use of SSRIs in patients with schizophrenia with OC symptomatology may be warranted and safe.

Adult↗
PubMedDate not supplied

Myotoxicity and neurotoxicity during clozapine treatment.

Some recent studies have shown that clozapine (CLZ) has myopathic side effects and causes alterations in motor force control. The aim of this study was to evaluate the neurologic and electrophysiologic characteristics of patients with schizophrenia who are undergoing long-term CLZ treatment. Ninety-four patients with schizophrenia treated with CLZ for 18.2 +/- 15.5 months were studied retrospectively and prospectively (40% and 60%, respectively) for serum creatine kinase (CK) levels before and after initiation of CLZ treatment. An electrodiagnostic study was performed on patients with CK elevation above normal limits, complained of general weakness or muscle pains, and/or had abnormal clinically significant findings. In 13 patients (13.8%), abnormal CK levels were found. Six patients complained of some muscular weakness. In two patients, clinical assessment revealed mild general muscular weakness; one revealed decreased tendon reflexes and, in both, CK levels were above 1,750 IU/L. On electrophysiologic examinations performed in the six patients with abnormal neurologic findings, the motor and sensory nerve conduction velocity were within normal range in all but one patient, who exhibited some prolongation of distal latency in the lower limbs. In two patients, the electromyography demonstrated a myopathic pattern. In 2.1% of medically healthy patients with schizophrenia treated with clozapine on a long-term basis, signs of myotoxicity were found. It seems warranted to discontinue CLZ therapy in patients who exhibit abnormal CK levels and myopathic features during treatment. Further studies are needed to provide more objective data on the impact of CLZ treatment on muscle tissue.

Adult↗