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Biomedical subjects

S A Chong

Publications and source records attributed to S A Chong.

54 records · Page 3Linked to original sources
PubMed1998

Use of atypical neuroleptics in a state mental institute.

The authors sought to give a perspective of the local use of two atypical neuroleptics which may represent a new era in the treatment of schizophrenia. The findings from local drug trials and clinical reports are summarised. Both clozapine and risperidone are efficacious in reducing the psychotic symptomatology of schizophrenia as well as inducing less extrapyramidal side-effects. Differences in plasma clozapine levels were found in local Chinese patients when compared to American subjects. Combined use of clozapine and risperidone may give rise to adverse reactions. Both clozapine and risperidone are efficacious and safe in the treatment of schizophrenia.

Antipsychotic Agents↗
PubMed1997

Clinical evaluation and plasma clozapine concentrations in Chinese patients with schizophrenia.

The relationships between clozapine dosages, plasma concentrations, and clinical responses in Chinese schizophrenics were studied. Fourteen treatment-refractory schizophrenic patients were treated with clozapine for 12 weeks. Patients were assessed before and after 6 and 12 weeks of treatment using the Brief Psychiatric Rating Scale (BPRS), the Clinical Global Impression (CGI), and the Simpson-Angus Scale for Extrapyramidal Side Effect. Plasma clozapine concentrations were determined by high-performance liquid chromatography. Ten patients (71.4%) responded after 12 weeks of treatment. Although the mean daily dosage at week 12 (373 +/- 90 mg/day) was lower than that reported in American trials (444 mg/day), the mean plasma clozapine concentration attained (1,078 +/- 385 ng/ml) was higher. This higher concentration may be due to the lower body wight and the preponderance of women among our patients, absence of smoking and alcohol use, and/or ethnic difference between Chinese and non-Chinese. There was wide interindividual variation in the plasma clozapine concentrations. Compared with other studies, the plasma clozapine concentrations and the response rate were higher. Although the sample size was small, the findings are suggestive of pharmacokinetic and pharmacodynamic ethnic differences in Chinese with clozapine therapy.

Adult↗
PubMed1997

Disordered water homeostasis in Asian patients with schizophrenia.

OBJECTIVE: The aim of this study was to determine the prevalence of polydipsia-hyponatremia among patients with schizophrenia in an Asian mental hospital. METHOD: Seven hundred and twenty-eight inpatients with schizophrenia were assessed for polydipsia-hyponatremia using case notes reviews, specific gravity of urine, normalised diurnal weight gain, and serum sodium levels. RESULTS: One hundred and three (13.8%) patients had polydipsia, 30 (4.1%) had polydipsia-hyponatremia and 14 (1.9%) had a history of water intoxication. Eight of the 30 patients were receiving carbamazepine, three were on tricyclic antidepressants and two had diabetes mellitus and were on sulfonylureas. CONCLUSION: The prevalence of water intoxication among polydipsic patients was low compared to Western studies. This could be due to different methods of assessing polyuria, or ethnic differences and/or the prohibition of smoking in our patients. Certain medications might have also contributed to hyponatremia.

Adult↗
PubMed1997

Initial experience with clozapine in Woodbridge Hospital.

OBJECTIVES: This study was performed to evaluate the efficacy and side-effect profile of the atypical neuroleptic clozapine in local Asian patients with treatment-resistant schizophrenia. METHOD: Patients were treated with 12 weeks of clozapine after undergoing a washout of all previous neuroleptics. They were assessed weekly on the Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI) and the Simpson-Angus Scale for Extrapyramidal Side-Effects. RESULTS: Clinical improvement (according to criteria established a priori) at study end point was shown in 78.9% of the patients. There was no statistical difference in the incidence of the extrapyramidal side-effects at starting and end points. The mean daily dosage was 356.6 mg. The most common adverse effect was hypersalivation. CONCLUSION: Clozapine is effective and well tolerated in local patients with treatment-resistant schizophrenia.

Adolescent↗
PubMed1996

Treatment of kleptomania with fluvoxamine.

We report a patient fulfilling DSM-IV criteria for kleptomania who failed to respond to psychotherapy, behavioural therapy and pharmacotherapy with clomipramine, imipramine and lithium. He was successfully treated with the serotonergic agent fluvoxamine.

Adult↗
PubMed1996

Smoking among Chinese patients with schizophrenia.

OBJECTIVES: This study aimed to determine the prevalence of smoking among Chinese with schizophrenia, and to determine if smokers and nonsmokers differ in their age of onset of illness and neuroleptic requirement. METHOD: One hundred and ninety-five patients were assessed by a single rater using the Brief Psychiatric Rating Scale (BPRS) and the Simpson-Angus Scale. Other historical, demographic and treatment variables were recorded from case records and interviews with patients and family members. RESULTS: A higher rate of smoking was found in patients with schizophrenia than in the general population. There was no significant difference between the smokers and non-smokers in their respective neuroleptic dosages and extrapyramidal side-effects but the smokers had a significantly higher BPRS score. CONCLUSIONS: Racial difference is proposed to account for this discrepancy from other Western studies. The contribution of nicotine towards aggravating schizophrenic symptoms is also considered.

Adult↗
PubMed1995

Schizophrenia and kleptomania: a case report--a biological link?

This case of co-morbidity of schizophrenia and kleptomania in a 21-year-old Chinese man is believed to be the first reported. In kleptomania, loss of impulse control seems to be the central disturbance. The neurotransmitter serotonin has been proposed to be important in impulse control. The role of serotonin in schizophrenia is also briefly reviewed and an abnormality in serotonergic neurotransmission is proposed to be a possible link between these two conditions.

Adult↗
PubMed1995

Derealisation following head injury: a case report.

Depersonalisation and derealisation which are often present together, occur in a number of functional and organic conditions. However, their occurrence in the post-concussional syndrome has been previously described in only one case. A case is presented in which derealisation was the only presentation following a minor closed head injury. The possible aetiology is discussed.

Adult↗