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Biomedical subjects

R Schilkrut

Publications and source records attributed to R Schilkrut.

10 recordsLinked to original sources
PubMed1981

[Evaluation of a long-acting neuroleptic: penfluridol. Clinical and psychosocial evolution at a year follow-up].

Twenty schizophrenic patients were treated for a year with long term neuroleptic Penfluridol to test its antipsychotic and re-socializing effect. They underwent a clinical follow up and an evaluation of psychosocial aspects was also performed by a psychiatric social worker. Their social behaviour and reinsertion to work and family were studied by the use of specially designed scales. Clinical improvement and significant changes in all of the studied aspects of social behaviour were observed after a year of treatment. Also a reduction of treatment abandonment and of frequency of relapse through family handling was detected. Finally a number of preliminary observations on family structure and dynamics as well as changes determined on it by the treatment of the psychotic patient are summarized.

Adolescent↗
PubMed1980

[Medication with flunitrazepam in electroconvulsive therapy].

The electroconvulsive therapy (ECT) continues to be of use in the management of patients suffering from affective psychosis and some clinical forms of schizophrenia. The use of premedicated anaesthetic and miorelaxant drugs lessens the possibility of complications, but risks the induction of serious cardiorespiratory accidents. The flunitrazepam is a benzodiazepine with hypnotic, ansiolytic and miorelaxant properties, which has been used as an anaesthetic in major and minor surgery. 241 ECT were essayed on 28 psychotic patients and flunitrazepam induced deep sleep in 94.6% of the applications within 0.5 and 15 minutes after the intravenous injection, the required dose oscillating between 2 and 4 mg. In all the applications a generalized convulsive crisis was induced. No significant pulse variations, arterial pressure, nor respiratory frequency took place. Post ECT agitation appeared in 0.82%. The associated pharmacological therapy (neuroleptics, lithium salts) did not modify the effect of flunitrazepam. Nor did tolerancy to the drug appear.

Adolescent↗
PubMed1978

[Course of psychopathologic and extrapyramidal motor symptoms during long-term treatment of schizophrenic patients with psycholeptic drugs (author's transl)].

65 chronic-schizophrenic outpatients were treated with fluphenazinedecanoate for 24 months. Hallucinations and delusions remitted between week 24 and 36, formal disturbances of thinking occurred in 50% of the patients up to the 24th week, mood disorders and disorders and schizophrenic changes in personality could only gradually be controlled. In the first 3 months of treatment the incidence and intensity of rigor grew up to the critical point after 24 weeks of treatment; by the 60th week of treatment it had completely vanished. Akathisia reached its peak after the first and the 36th week and two different populations could be distinguished. 8% of the patients showed dyskinetic reactions up to the 12th week; 20% of the patients showed hyper- and dyskinesia after 72 weeks of treatment. 30 to 40% of the patients required anticholinergics between the 12th and 48th weeks; after the 84th week this medication was no longer necessary.

Adolescent↗
PubMed1976

Clinical and biochemical parameters during neuroleptic treatment. I. Investigations with haloperidol.

26 patients with a paranoid-hallucinatory syndrome were treated with a fixed daily dose of haloperidol. Psychopathological symptoms and parkinsonism were studied before and during the treatment. HVA and 5-HIAA concentrations in CSF were determined immediately before and after 5 or 15 days of treatment. After 5 days of treatment a slight effect was observed on psychotic symptoms and on the extrapyramidal motor system, as well as an elevation of HVA and 5-HIAA concentrations in CSF. After 15 days of treatment the extrapyramidal and antipsychotic effects were significant, but the rise of HVA was smaller than after 5 days of treatment; 5-HIAA remained unchanged. These different time courses of the neuroleptic effects on psychopathological symptoms, on extrapyramidal system and on monoamine metabolites concentration in CSF could be interpreted as a development of drug tolerance in relation to the biochemical parameters.

Adult↗
PubMed1976

Clinical and biochemical parameters during neuroleptic treatment. II. Antipsychotic effect of haloperidol in patients with chronic organic brain damage.

The time-course of psychopathological symptoms, of extrapyramidal side effects, and of changes in cerebrospinal fluid (CSF) concentration of homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA) were simultaneously studied during Haloperidol treatment of 14 psychotic patients with chronic organic brain damage. After 15 days of treatment significant antipsychotic effect was found, while Parkinsonism scores in clinical and experimental tests increased only slightly. CSF concentration of HVA increased significantly by 150% compared to the baseline value (p less than 0.05) and 5-HIAA remained unchanged. No correlation was found between the clinical and biochemical variables studied. The comparison of these results with those obtained in patients without brain damage suggests that different psychopathological and extrapyramidal responses to neuroleptics are not strictly associated with specific HVA changes in CSF.

Adult↗
PubMed1976

Clinical and biochemical parameters during neuroleptic treatment. III. Primitive reflexes during neuroleptic treatment.

Palmomental reflex, glabellar reflex and oral responses were studied in the course of a treatment with Haloperidol in 14 psychotic patients with a chronic organic brain damage. An increase of the three responses was found; maximum intensity and frequency of the primitive reflexes were reached during the first 5 days of treatment. There was no correlation found between the intensity of primitive reflexes and changes of psychopathological symptoms, of extrapyramidal scores and of homovanillic acid (=HVA) and 5-hydroxyindoleacetic acid (5=5-HIAA) concentration in cerebrospinal fluid (=CSF). The presence of primitive responses is interpreted as a "decompensation phenomenon" induced by neuroleptics, probably in relation to an effect on the central nervous system (=CNS) dopamine receptors. It is suggested that the appearance of several definite, primitive reflexes during neuroleptic therapy may have some diagnostic and prognostic significance.

Adult↗
PubMed1975

Growth hormone release during sleep and with thermal stimulation in depressed patients.

The pattern of human growth hormone (HGH) release was studied in depressed patients during sleep under EEG control and employing high temperature exposure. The patients were free of drugs and were compared with corresponding control groups. In the sleep study (6 depressed patients), 2 patients showed no definite increase in HGH plasma concentration, and 3 patients showed an increase in HGH only in the second half of the night, independent of slow wave sleep (SWS). But sleep disturbances were present in all 5 patients. A correlation between SWS and HGH release was found in only 1 patient. One nondepressed control, without SWS, showed a delayed HGH response. Exposure to high temperature in normal subjects induced an acute HGH release. 8 of the 13 patients studied had a deficient HGH RESPONSE. All were depressive, with psycho motor retardation and marked vital and neurovegetative disturbances. These findings support the idea that, at least in a high percentage of depressed patients, there is a disturbance of the hypothalamic pituitary function.

Adult↗
PubMedDate not supplied

[Standard and high doses of haloperidol. Clinical, pharmacokinetic and pharmacodynamic aspects].

The investigation was designed to study plasma drug concentration and prolactin response determined by two different doses of haloperidol, a standard one and four-fold higher the other, and to explore the relationships between clinical effects and pharmacokinetic and physiological variables in psychotic patients. 24 psychotic patients received haloperidol during 40 consecutive days. During the first 10 days they received 0,25 mg/kg b.w. During the next 20 days they were given 1 mg/kg b.w. Finally they received 0,25 mg/kg b.w. during the last ten days. The patients were clinically assessed and plasma haloperidol and prolactin concentrations were determined on days 0, 5, 10, 20, 30 and 40. In the range of dose studied, the use of higher than conventional doses of haloperidol results in an increased concentration in the cellular site of action and in a more complete blockade of central dopamine receptors. Prolactin response was positive correlated with serum haloperidol concentration. Clinical remission was not direct correlated, neither with serum neuroleptic concentration nor with prolactin level. Those patients who reached higher levels of plasmatic neuroleptic and prolactin concentrations were more susceptible to develop severe extrapyramidal side-effects. Pharmacokinetic and pharmacodynamic monitoring of neuroleptic treatment could be useful to identify these patients.

Adolescent↗