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Biomedical subjects

M Schmauss

Publications and source records attributed to M Schmauss.

At least 19 recordsLinked to original sources
PubMed2006

[The work of medical doctors on psychiatric wards: an analysis of everyday activities].

In Germany, the economic situation of psychiatric hospitals has markedly changed during the last years. Whilst the number of patients has steadily increased, many clinics considerably reduced the number of therapeutic staff due to an increasing lack of financial support. The German psychiatry personnel regulations act defines the number of therapeutic staff required for an adequate psychiatric treatment, but the requirements of this regulations act nowadays are widely missed in most of the German psychiatric hospitals. This severely affects the therapeutic work on psychiatric wards. This study analyses tasks and activities of medical doctors on psychiatric wards and compares the hours spent with various types of activities with the amount of time that should be spent according to the personnel regulations act. Results show that doctors spend much more time with documentation and administrative work than originally intended by the personnel regulations act. They compensate this mainly by a reduction of time spent in direct contact with the patients. In this context, the number of psychotherapy sessions as well as sessions with the patients' relatives has been considerably reduced, whereas the time spent for emergency intervention and basic treatment still corresponds to the calculations according to the personnel regulations act. All in all, the results show that a reduction of therapeutic staff in psychiatric hospitals directly leads to a change in treatment settings with a focus on less individual treatment options.

Documentation↗
PubMed2006

[Polypharmacy in the treatment of schizophrenia].

Current standards for the pharmacological treatment of schizophrenia favour antipsychotic monotherapy. Most atypical antipsychotics developed in recent years meet the statutory requirement of being at least as effective as Haloperidol. Nevertheless, pharmacoepidemiological data show an increase in polypharmacy. The importance of the studies is underlined by the fact that 40 - 50 % of schizophrenic inpatients and up to 90 % schizophrenic outpatients receive antipsychotic combination therapies. Treatment resistance, reduction of dose-related side effects caused by antipsychotic monotherapy or the effect on concomitant symptoms of schizophrenia, such as comorbid depression, might justify combination therapy or augmentation strategies. Apart from the high costs, polypharmacy is associated with reduced patient compliance and an increased risk of undesired pharmacological effects. Since polypharmacy is increasingly common further educational measures in psychopharmacology should be getting more attention. Due to the very small number of controlled studies that exist at present this report will focus on case reports of the most frequent as well as some of the lesser prescribed combination therapies. Finally, conclusions will be discussed in relation to therapy recommendations.

Antidepressive Agents↗
PubMed2005

[Dysthymia].

Explore the source record for details and available documents.

Antidepressive Agents↗
PubMed2000

[Valproic acid in prophylaxis of bipolar disorder. A case of valproate-induced encephalopathy].

A 28-year-old patient with a 5-year history of bipolar disorder developed signs of encephalopathy 2 weeks after the addition of valproic acid to his treatment regimen of doxepine, risperidone, and biperidene. The clinical signs were drowsiness, ataxic gait, asterixis, and a generalized epileptic seizure. Discontinuation of valproic acid gradually resulted in complete remission of these symptoms. Valproate encephalopathy has been described mainly in patients receiving anticonvulsant polytherapy. This complication might become more prevalent in psychiatric pharmacotherapy due to the increasing use of valproic acid.

Adult↗
PubMed1996

[Combination therapies in antidepressive drug refractory depression--an overview].

Despite the availability of a wide range of effective antidepressant drugs, nearly 30% of depressed patients fail to respond to antidepressant treatment. Various pharmacological strategies have been developed to treat such refractory depression, of which augmentation therapies are one of the most important. This article reviews both benefits and risks of all known augmentation therapies. Among these treatment strategies the efficacy of lithium augmentation is very well documented by a large number of controlled studies - lithium augmentation can therefore be recommended in depression refractory to antidepressant treatment. The efficacy of triiodothyronine (T3) augmentation and the combination of different antidepressants - like a TCA-MAOI combination - is described in a large number of case reports and uncontrolled studies; the number of placebo controlled double blind studies, confirming the efficacy of these treatment strategies, is however relatively small. T3 augmentation and combined antidepressant treatment may therefore be considered in the treatment of refractory depression; in contrast to lithium augmentation these combination therapies are however only second-line strategies. Other augmentation therapies (TCA + stimulants, TCA + reserpine, TCA + yohimbine, TCA + fenfluramine, SSRI + buspirone) are very interesting clinical research strategies, but don't have too much importance in clinical practice at the moment.

Antidepressive Agents↗
PubMed1995

[Perspectives on the therapy of neuropsychiatric diseases with adenosinergic substances].

The function of the neuromodulator, adenosine, has been thoroughly examined during the last two decades. Adenosine inhibits the release of several neurotransmitters and endogenous adenosine is supposed to have sedative and anticonvulsive properties. Lately, it has been discussed whether neuropsychiatric disorders could be treated with adenosynergic drugs. In patients with anxiety disorder a first clinical trial with the reuptake inhibitor dipyridamole was not successful. Disorders of the basal ganglia and schizophrenia might be positively influenced by newly developed A2-receptor ligands. A1-receptor agonists might prove to be neuroprotective; they also could be of importance in the treatment of epilepsy. Selective A1-receptor antagonists might be used in the treatment of depressive disorders and of neurodegenerative disorders such as Alzheimer's disease. The adenosine receptor antagonist, caffeine, is widely used in the treatment of migraine; more selective antagonists would provide a more powerful treatment.

Adenosine↗