Biomedical subjects

S C Schulz

Publications and source records attributed to S C Schulz.

93 records · Page 6Linked to original sources

PubMedDate not supplied

Clozapine and risperidone: refining and extending their use.

The recent advent of atypical antipsychotic medications has provided new clinical options and set higher expectations for the treatment of schizophrenia and other psychoses. Two such drugs, clozapine and risperidone, are currently employed in the United States. Researchers continue to fine-tune treatment with these agents and to seek possible new uses for them. For clozapine, refinements in use (optimal duration of trial, optimal dose, use of drug plasma level to optimize efficacy) are described, along with side effects and the specificity (or lack thereof) of the drug's action upon primary negative symptoms. Also discussed is use of clozapine in new subgroups of patients--for example, those with first-episode schizophrenia, polydipsia syndrome, or a dual diagnosis. For risperidone, use in patients with first-episode schizophrenia, affective disorders, autism, and other disorders in described. Cost-benefit considerations are presented for both drugs. The psychosocial needs of patients taking these medications and the potential for synergy between novel antipsychotics and modern psychosocial therapies are also discussed.

Clozapine↗

PubMedDate not supplied

First-episode psychosis: a clinical approach.

BACKGROUND: Psychotic illnesses, such as schizophrenia and bipolar illness, are relatively common and clearly devastating diseases. Most scientific literature focuses on research and care of patients suffering from psychotic illnesses in the middle age-group; subsequently, the first episode or early stages of psychotic illnesses have been relatively ignored, especially the issues of early diagnosis and intervention. The purpose of this article is to highlight issues of first-episode schizophrenia for the family physician and to discuss (1) diagnosis, (2) neuropsychiatry research, (3) new medications, and (4) family issues. METHODS: To approach the issues of first-episode schizophrenia, we describe a case of a young woman who suffered her first episode of psychosis. Relevant literature related to the early stages of psychosis, including new pharmacologic treatments, is addressed. RESULTS: This report of our patient, a 19-year-old woman, illustrates the problems of a long prodromal phase of her illness, the use of medications that might have worsened her condition, and the successful use of new antipsychotic medications. Her family's issues as the patient went through this phase of her illness and recovery are reviewed. CONCLUSIONS: Patients at the outset of a psychotic illness are frequently first seen by a family physician. Familiarity with current diagnostic criteria and effectiveness of new treatments can lead to improved detection and overall outcome.

Adolescent↗

PubMedDate not supplied

The use of beta-adrenergic blocking agents in anxiety disorders and schizophrenia.

In the 1960s, several studies reported that propranolol and other beta-blocking drugs appeared especially useful in patients with physical symptoms of anxiety. However, subsequent reports produced conflicting findings, and at this time the efficacy of propranolol in anxiety disorders is not clearly established. Propranolol's utility in anxiety states may be entirely restricted to those anxiety patients whose physical symptoms have not adequately responded to benzodiazepine therapy. This places the beta-blockers among the least useful drugs in treating anxiety disorders. A major problem in assessing propranolol's antianxiety properties has been a virtual lack of well-designed studies addressing the issue; the studies reviewed here contained a surprising number of study design problems. Several guidelines regarding study design are included to assist the reader in evaluating studies of antianxiety agents. High dose (e.g., 2,000 mg) propranolol may have a role as an alternative to traditional antipsychotic therapy in neuroleptic-resistant patients. During the last decade a number of studies have demonstrated symptomatic improvement in schizophrenic patients using propranolol alone or combined with neuroleptics. However, four recent double-blind reports have failed to replicate this finding. Future research should focus on possible identification of propranolol-responsive patients and their characteristics. The use of propranolol and other beta-blockers in schizophrenia should remain in the research or medical center setting.

Adrenergic beta-Antagonists↗