About 5-10% of European white population has a genetically determinant defect of the CYP2D6, one of the enzymes of cytochrome P-450. This defect leads to the impaired metabolism of many drugs including various psychopharmacological agents. The measurement of the hydroxylation of debrisoquine is a laboratory test which allows to identify such an individual. Patients who show an impaired hydroxylation of debrisoquine usually demonstrate severe side effects and poor outcome of psychopharmacotherapy. This depends on whether the administered drug is metabolized the same way as debrisoquine, i.e. in the presence of CYP2D6. The diagnosis of the phenotype of debrisoquine hydroxylation before treatment may allow to select the group of poor metabolizers. This diagnosis can help to identify the appropriate treatment for those patients, i.e. the selection of either a drug which is not metabolized in the presence of CYP2D6 or an alternative form of therapy.

Biotransformation↗

PubMedDate not supplied

[A case report of cyclic psychosis].

Cycloid psychoses have a special position in psychiatric classification. Usually they are listed among atypical psychoses, located between the group of schizophrenias and affective psychoses. Nevertheless, there are indications for nosological differentiation of cycloid psychoses from other psychotic conditions. The case of cycloid psychosis of a 38 year old woman with two severe psychotic episodes of mixed, paranoid and affective symptomatology is described. Among the characteristic features of psychotic episodes were acute onset, severe but short course of the episodes and the lack of residual/defect symptoms at outcome. On the basis of this case the differential diagnosis of cycloid psychoses is discussed.

Adult↗

PubMedDate not supplied

[The evaluation of subjective quality of life in patients with schizophrenia or depression].

Subjective evaluation of the quality of life was studied in 53 schizophrenics (hospitalized, from the day-hospital, and from the rehabilitation unit) and in 12 depressed patients before and after pharmacological treatment or rehabilitation. The self-evaluation questionnaire SF-36 was used. The subjective quality of life of depressive patients at baseline was low in comparison to the schizophrenics. The best improvement of subjective quality of life after the treatment was found in hospitalized schizophrenic patients. Evaluation of the quality of life both before and after treatment/rehabilitation did not correlate with doctors' estimation of the severity of their illness. Depressive patients expressed more negative opinion regarding their physical condition and social activity than did the schizophrenics. The positive opinion on patients' health status correlated positively with good evaluation of patients' physical condition and good performance at home or work.

Adult↗

PubMedDate not supplied

[Depression in schizophrenia. Comments on possibilities to use fluoxetine].

Depressive symptoms are frequently diagnosed in patients with schizophrenia. The coexistence of mood disorders and criteria of schizophrenia may result in the diagnosis of schizoaffective disorders. Depressive symptoms can also be recognized after the acute phase of schizophrenia or after neuroleptic treatment which results in the diagnosis of postpsychotic or postneuroleptic depression. Sometimes, depressive symptoms can be misinterpreted; it happens because depressive symptoms can resemble negative symptoms of schizophrenia or neuroleptic side effects. The principles of therapeutic approach to depressive symptoms in schizophrenia have been discussed. Taking into consideration the hypothetical role of the serotoninergic system in the genesis of schizophrenia, special attention has been paid to the drugs selectively acting on this system. The results of the use of fluoxetine as co-treatment with neuroleptics, published by various authors have been presented.

Antidepressive Agents↗

PubMedDate not supplied

[Chronic mental illness: quality of life].

The article summarizes briefly the most important directions of research in the quality of life (QOL) of schizophrenic patients. Results gained by cited authors seem to confirm that the QOL of these patients is lower in comparison with normal population. Researchers look for factors that would be able to rise the subjective QOL of this population. It seems that the most influential factors are: rehabilitation programs, work, active way of spending free time and suitable pharmacological treatment. It is also very important that patients included in community care program and those who live in group houses for patients have the highest QOL. We present also first results of our work that mostly confirm other data and a questionnaire designed for investigation of the quality of life in chronically ill patients.

Adolescent↗

PubMedDate not supplied

[Pneumoencephalography in psychiatric forensic expertise].

Explore the source record for details and available documents.

Adolescent↗

PubMedDate not supplied

[A test for using meta-analysis to evaluate antidepressive effects of fluoxetine].

The review of clinical antidepressive efficacy of fluoxetine was made on the basis of various authors' reports. The results showed that clinical efficacy of fluoxetine and of classical antidepressive drugs in the treatment of depression was comparable. The meta-analysis revealed effect-size of fluoxetine to be similar to tricyclics. Also the clinical effects of fluoxetine in the treatment of depressive disorders of different severity (mild, moderate, severe) were similar to the effects of classic tricyclic agents. The tolerability of therapeutic doses of fluoxetine in the daily range 20 to 40 mg is comparable while the dosage augmentation to 60 mg per day causes increase in the percentage of patients demonstrating side effects. In comparison with placebo fluoxetine showed significantly better clinical efficacy in the treatment of depression.

Antidepressive Agents, Second-Generation↗

PubMedDate not supplied

[Improvement criteria after neuroleptic treatment and clinical and neuroradiological factors in schizophrenic psychoses. Preliminary studies].

In 40 schizophrenic patients, various criteria of clinical improvement after neuroleptic treatment were compared in order to establish correlations between improvement after treatment and some clinical and MRI parameters. Three ways of evaluation of clinical improvement (CGI scale, PANSS index, percentage of improvement) correlated strongly with one another. Only the distribution of numbers of patients with different clinical improvement evaluated by the use of PANSS index was not statistically significant. Clinical improvement, evaluated with all three methods, significantly correlated with basal PANSS score as well as with the severity of positive symptoms and affective blunting, but not with the severity of schizophrenia negative symptoms. Only clinical improvement with the use of CGI demonstrated significantly better improvement in patients who had good previous response to neuroleptics. This particular method of clinical improvement evaluation, in contrast to other two methods, failed to reveal better response to neuroleptics among patients with no cortical atrophy found in MRI. Among patients with different improvement after treatment, evaluated with the use of all three methods, selected MRI parameters did not show significant differences with the exception of CGI improvement which correlated positively with the intensity of signal in T2-weighted image of gray matter in left medial frontal gyrus.

Adult↗

PubMedDate not supplied

[Selected parameters of magnetic resonance imaging of the brain, clinical picture and recovery after treatment in schizophrenia. Preliminary report].

In forty schizophrenic (or schizophreniform disorder) patients diagnosed according to DSM-IV, the magnetic resonance imaging was performed. The T2 relaxation time was measured in selected brain regions from the dorsolateral prefrontal cortex as well as in amygdala. These results were compared with clinical parameters regarding severity of psychopathology and improvement after neuroleptic treatment. The mean T2 values of grey matter of right inferior frontal gyrus were significantly higher in patients with schizophreniform disorders (those patients were clinically diagnosed as suffering from cycloid psychoses) than in other types of schizophrenia. The T2 values of this region correlated inversely with the severity of negative symptoms before treatment. The T2 values of gray matter of left inferior frontal gyrus correlated positively with the severity of schizophrenic symptoms before treatment. Mean T2 values of left amygdala were significantly higher in patients showing less favorable improvement after neuroleptic treatment in comparison to those who improved better. No correlation was found between the presence of brain atrophy and T2 values in brain regions studied. The results allow to suggest that the measurement of T2 relaxation time might reveal interesting relations between clinical picture and neuroradiologic findings in schizophrenia, however clinical significance of such parameters still requires further elaboration.

Adult↗

PubMedDate not supplied

[Therapeutic effect of zuclopenthixol acetate on positive and negative symptoms in schizophrenia].

Fifty schizophrenic in-patients (DSM-IV) were treated in an open study with zuclopenthixol acetate. Mental status, improvement and side-effects were measured before administration of the drug as well as after the 1st, 2nd and 3rd injection. Positive and negative symptoms were evaluated with the use of PANSS. 60% of patients received three injections. Usually the intervals between injections lasted 48 hours. The improvement after the 3rd injection of zuclopenthixol acetate was found in 80% of patients. All positive symptoms improved after the treatment (p < 0.001), among them excitement (54% reduction vs. baseline), hostility (49%) suspiciousness/persecution (45%). The study revealed that parallel to the decrease of positive symptoms, the severity of negative symptoms also decreased, in particular: difficulty in abstract thinking (28%) and stereotyped thinking (27%) (p < 0.001). Passive/apathetic social withdrawal and lack of spontaneity as well as flow of conversation only slightly improved (p < 0.05). 50% of patients experienced side-effects--usually extrapyramidal reactions.

Adult↗