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Biomedical subjects

R J Pary

Publications and source records attributed to R J Pary.

12 recordsLinked to original sources
PubMed1995

Discontinuation of neuroleptics in community-dwelling individuals with mental retardation and mental illness.

Many individuals with mental retardation and mental illness who are on neuroleptics can have the dose reduced or discontinued. A recent study, however, suggests that individuals with psychosis not only may be difficult to discontinue from neuroleptics but also may require an increased neuroleptic dose. The current study is a retrospective chart review. Individuals were followed for 12 months postneuroleptic discontinuation. Individuals with a "psychotic" disorder were significantly more likely to be restarted on neuroleptics at 3 months and 12 months. A logistic regression failed to reveal any psychotic symptoms that predicted resumption on neuroleptics. An absent history of delusions, however, was significantly associated with remaining neuroleptic-free at 3 months.

Activities of Daily Living↗
PubMed1994

Clozapine in three individuals with mild mental retardation and treatment-refractory psychiatric disorders.

Few investigators have focused on the response of individuals with mental retardation to clozapine. In the general population, some people who have responded to no other psychotropic have had a tremendous positive response, including increased positive scores "quality of life" measures. Clozapine, however, can cause fatal side effects. At least six people in the United States have died from agranulocytosis despite weekly blood counts. The use of clozapine in the general population was reviewed, potential difficulties in prescribing it for individuals with mental retardation discussed, and three relevant case histories presented.

Adult↗
PubMed1993

Acute psychiatric hospital admissions of adults and elderly adults with mental retardation.

Records of 247 inpatients with mental retardation or autism discharged from a university hospital during 62 consecutive months were examined with regard to acute inpatient treatment. The main finding was that elderly adults with mental retardation had significantly more medical problems than did adults. There was a trend toward significantly more elderly adults being transferred to a state hospital. An unexpected finding was that the most common diagnosis in both adults and elderly adults was chronic schizophrenia, paranoid type. Limitations of the study and possible explanations of the findings were discussed.

Adolescent↗
PubMed1991

Towards defining adequate lithium trials for individuals with mental retardation and mental illness.

Lithium has been recommended for some psychiatric conditions and/or behavior disturbances in patients with mental retardation. Components of an adequate clinical trial were described here and case studies and double-blind cases reviewed. Based on existing data, there are few guidelines for the use of lithium with this population. Of the various indicators for lithium, the most solid are for aggression, although the type of aggression is not specified: (a) achieve a serum concentration of at least 0.5 mEq/1 to 1.0 mEq/1 unless the patient responds or trial-ending side effects appear and (b) treat for 6 to 8 weeks before concluding that the patient will not respond.

Aggression↗
PubMed1988

Communication difficulty of patients with schizophrenia and physical illness.

Our study was done to determine whether patients with schizophrenia and a coexisting physical disorder could adequately discuss the physical illness with a physician. We defined the minimal standard of adequate communication as the ability to acknowledge and name a physical problem during an index hospitalization. Of the 110 patients studied, 38 had a total of 54 medical illnesses (diabetes mellitus, hyponatremia, thyroid disorder, urinary tract infection, bladder dysfunction, hypertension, anemia, liver disorder, and seizure disorder). After two years of follow-up, 28 of these 38 patients agreed to participate in the second part of the study. Upon interview, 24 patients were unable to name at least one of their physical problems. This study reproduces the previous findings of psychiatric patients' difficulty in communicating about physical illness. It suggests that the communication difficulty is constant and not lessened in the nonacute situation.

Communication↗
PubMed1984

Plasma concentrations and clinical effects after single oral doses of prazepam, clorazepate, and diazepam.

In a double-blind parallel-group pharmacokinetic and pharmacodynamic study, 31 healthy volunteers received single oral doses of prazepam (10 mg), clorazepate (7.5 mg), or diazepam (5 mg). Appearance in plasma of diazepam and of desmethyldiazepam was rapid after administration of diazepam and clorazepate, respectively, with peak plasma concentrations reached within an average of 1 hour. After oral prazepam, however, desmethyldiazepam appeared in blood slowly, with the highest mean concentration at 6 hours postdosage. Clinical self-ratings of fatigue and of "feeling spacey" were significantly different among groups, with changes over baseline being more marked with clorazepate and diazepam than with prazepam. Thus, differences in absorption rate of orally administered benzodiazepines can lead to differences in the intensity of single-dose effects, despite administration of doses that are equivalent in terms of long-term anxiolytic efficacy.

Administration, Oral↗