Search PubMed⌕ Search

Biomedical subjects

W Poser

Publications and source records attributed to W Poser.

At least 55 records · Page 3Linked to original sources

[Benzodiazepine dependence: addiction potential of the benzodiazepines is greater than previously assumed (author's transl)].

The position of benzodiazepine dependence among addiction diseases was studied retrospectively by analysing the case reports of in-patients at the Psychiatric Clinic, Göttingen. Addicts constitute the largest group of patients in this clinic, a situation probably true in general of psychiatric hospitals in the Federal Republic of Germany. Isolated alcoholism is the most frequent addiction, followed by combined alcohol-drug dependence and pure drug dependence. At present, benzodiazepines are the most commonly used addictive drugs. Although most of benzodiazepine dependents have changed to it from another drug, primary benzodiazepine dependence is increasing. Among the benzodiazepines, lorazepam seems to have a particularly high addiction potential. On withdrawal of benzodiazepines, symptoms were less marked than after stopping a combination of benzodiazepines and alcohol, and (or) barbiturates; they generally developed with some time delay.

Alcoholism↗

[Drug monitoring in psychiatry (author's transl)].

The Study Group for Drug Surveillance in Psychiatry (AMUP) has been working since July 1978 as a task force group of the "Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie" (AGNP). A protocol was designed for the initiation of drug monitoring in psychiatric hospitals. With support of the Bundesgesundheitsamt, Berlin, the first part of this project was started as a practicability study in the psychiatric hospitals of the Universities of Berlin, Göttingen, and Munich and in the municipal hospital of Schleswig. The study includes 7650 in-patients. It is based on the following methods: intensive drug monitoring, organized spontaneous monitoring of adverse drug reactions and registration of drug applications. This drug monitoring system in psychiatry will be expanded to other psychiatric hospitals, and eventually to out-patient clinics as well as private practices within the next two years.

Costs and Cost Analysis↗

Imparied glucose tolerance in long-term lithium-treated patients.

The oral glucose tolerance test (oGTT) was performed twice in patients under long-term lithium treatment. Blood glucose and plasma insulin were determined. The oGTT results were evaluated by three criteria (Köbberling-Creutzfeldt, WHO, and Epidemiological Study Group of the European Diabetes Association) and were compared to two representative reference studies from normal populations. The frequency of impaired glucose tolerance in the patients was three times higher than expected on the basis of the studies on normal populations. The variability of the oGTT curves between the first and second tests as well as the steepness of the time-course of the 'insulinogenic index' suggested mild disturbances of carbohydrate metabolism (mild diabetes) in some of the patients. It is considered unlikely that the impairment of glucose tolerance in the patients was a direct pharmacological effect of lithium salts. The possible role of age, sex, manic-depressive disease, additional medication, and particularly obesity in the effects of long-term lithium treatment on glucose tolerance is discussed. The authors suggest that the oGTT should be carried out periodically in long-term, lithium-treated patients over the age of 40 years in order to detect abnormalities in their carbohydrate metabolism.

Blood Glucose↗

Clinical features of the spinal form of multiple sclerosis.

Out of a data pool of 1271 patients with Multiple Sclerosis (MS) a total of 109 cases are selected having a sole spinal symptomatology throughout the course of the disease. This group differs in three particular features from the non-spinal forms of MS: In this group there is a higher percentage of females, the age at onset of the disease is higher, and the course of the disease is more often chronic progressive from the beginning. After the mean duration of 11 years, the spinal and the non-spinal cases show the same grade of disability. The ability to work is slightly better for spinal cases; office workers are able to keep their jobs longer after the onset to the disease than patients with any other occupation. The spinal form of MS is discussed in respect to its relationship to the classical form of MS and as a differential diagnosis to other spinal processes.

Adult↗

[Effect of long-term treatment with neuroleptics or lithium salts on carbohydrate metabolism].

Long-term treatments with neuroleptic drugs or lithium salts are well established and, with regard to side-effects, possess a common denominator: both treatments may increase the body weight, and may influence in different, even contrary ways the carbohydrate metabolism. In this study the oral glucose tolerance test (oGTT) including the determination of immunologically measurable insulin (IMI) has been performed in 49 lithium-treated out-patients, and in 125 inpatients under neuroleptic long-term treatment. The test was repeated within six months in the lithium-group. 3 different evaluation criteria were used. Among the patients with neuroleptic treatment there were 25 to 36% with a pathological glucose tolerance curve; the expected frequency would have been approx. 8%. 55% of the patients had overweight, which positively correlated to the occurrence of pathological glucose tolerance. 24.5 to 30.6% of cases with pathological oGT were found in the lithium-group. 69% of the patients had overweight; age and overweight positively correlated with pathological oGT. According to the very conservative criterion of the European Study Group (EDESG), the still increased frequency of pathological oGT curves in the second investigation, compared to epidemiological data, just failed statistical significance. The results suggest that also under long-term lithium treatment an increased lability of carbohydrate metabolism, be it due to the drug or the manic-depressive disease, must be discussed as a potential risk for the patient.

Adult↗

Inhibition of insulin and glucagon release from the perfused rat pancreas by cyproheptadine (Periactinol, Nuran).

The tricyclic compound cyproheptadine (Periactinol, Nuran) inhibited glucose-induced insulin release from the perfused rat pancreas. Tolbutamide-stimulated insulin release was significantly reduced in the presence and completely suppressed in the absence of a substimulatory glucose concentration (5 mM). Arginine produced a slow rise of insulin release, which was completely abolished by cyproheptadine. Furthermore the biphasic glucagon release due to the stimulus was inhibited. Oxidation of 14C-glucose in isolated islets was unaltered in the presence of cyproheptadine, and pyruvate added to the perfusion medium failed to reverse the inhibitory effect on glucose induced insulin release, indicating that impaired glucose metabolism is not responsible for the inhibition. In addition, the inhibition remained unchanged when phentolamine was present, suggesting that the effect is not mediated by inhibitory adrenergic alpha receptors. Theophylline, in contrast, partly overcame the inhibition. When the calcium concentration of the medium was enhanced, the inhibitory effect of cyproheptadine was still visible, although the relative inhibition had become smaller. The results suggest that cyproheptadine blocks insulin release by affecting a fundamental step of the stimulus-secretion coupling common to peptide hormones. A participation of a calcium-antagonizing effect in the inhibition is discussed.

Animals↗

[Significance of the chronic abuse of bromoureide containing hypnotics. Simple chemical methods for its detection (author's transl)].

The abuse of bromoureide (= bromocarbamide) containing sedatives gains increasing clinical relevance. Up to 50% of acute intoxications nowadays are caused by suicidal ingestion of bromocarbamides. The symptoms of the chronic intoxications are due to ionised bromide split off from the organic molecule and slowly accumulating in the organism. Due to the extremely long biological half-life of the bromide ion the chronic ingestion of bromocarbamides can be demonstrated easily and for long periods by determining the concentration of free, i.e. ionised bromide in serum or saliva. Simple and rapid methods suitable for screening purposes are discussed and the results of routine determinations of serum bromide in a psychiatric-neurological department are presented.

Bromates↗