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At least 19 recordsLinked to original sources

Effects of desloratadine, diphenhydramine, and placebo on driving performance and psychomotor performance measurements.

INTRODUCTION: First-generation antihistamines taken for relief of allergic rhinitis are sedating and pose potential risks for those driving a car or operating machinery. Desloratadine is a potent, selective, histamine H(1)-receptor antagonist that does not easily cross the blood-brain barrier. It is nonsedating at therapeutic doses and should not affect driving or psychomotor performance. OBJECTIVE: This study compared the acute effects of desloratadine with diphenhydramine (active control) and placebo on the performance of healthy subjects evaluated with standard over-the-road driving tests (primary objective). The subjects' performances were also evaluated (secondary objective) with the use of conventional performance tests. METHODS: Eighteen men and women received a single dose of desloratadine 5 mg, diphenhydramine 50 mg, or placebo during each period of this randomized, double-blind, three-way, crossover study. Two hours post-dosing, subjects operated a specially instrumented vehicle in a 90-min test designed to measure their ability (1) to maintain constant speed and lateral position while following another vehicle at a constant distance and (2) to respond to brake signals. Additionally, a full battery of performance tests was administered. RESULTS: No significant differences were noted between desloratadine and placebo in standard deviation of lateral position (SDLP), whereas diphenhydramine treatment significantly increased SDLP ( P< 0.001 for both comparisons). Brake reaction time was significantly faster following treatment with desloratadine than diphenhydramine (473.72 ms vs 541.22 ms; P< 0.001) or placebo (512.06 ms; P=0.033). No differences were seen among treatments in deviation of speed or distance to the lead car. The majority of performance tests showed no significant differences among groups. CONCLUSION: Desloratadine at a therapeutic dose does not impair driving performance.

Adult↗

Psychomotor performance in chronic insomniacs during 14-day use of flurazepam and midazolam.

Four skills performance (psychomotor) tasks, including simple and choice reaction time, divided attention, and vigilance, were given to 99 chronic insomniacs to determine whether the use of midazolam 15 mg, or of flurazepam 15 or 30 mg, compared with placebo would produce next-day impairment throughout a 14-day treatment period. Tests were administered during 2 baseline days and on treatment days 1 and 2 (early interval), 7 (middle interval) and 13 and 14 (late interval). Compared with placebo, performance on all four tasks was impaired by flurazepam 30 mg. The deficits associated with flurazepam 15 mg were roughly half the magnitude of those produced by flurazepam 30 mg, but these changes did not reach statistical significance for single response measures at single time intervals. Midazolam showed no consistent pattern of performance effects; however, for divided attention tracking error, there was a significant decrement. The placebo group showed flat performance curves or improved performance as a result of learning (practice effect).

Adult↗

Choice reaction time. A method of measuring postoperative psychomotor performance decrements.

Postoperative psychomotor performance changes were measured in three groups of thirteen subjects using a portable serial four-choice reaction time apparatus. Anaesthesia consisted of either thiopentone, nitrous oxide and halothane (thiopentone subjects) or methohexitone and fentanyl/nitrous oxide and incremental methohexitone (methohexitone subjects). Tests were performed on the day before operation and after 2, 4, 6, 8 and approximately 24 hours recovery on both groups of patients and at approximately the same times on nonoperated control patients. Control subjects' mean four-choice reaction time decreased steadily with practice such that the difference between first and last tests was statistically significant. Mean four-choice reaction times of thiopentone and methohexitone subjects increased from 515 to 550 ms and 552 to 600 ms respectively after 2 hours recovery. Subsequently four-choice reaction times decreased in both groups although methohexitone subjects were still significantly slower than controls after 6 hours. Thiopentone subjects were slower than controls at 2, 4 and 8 hours recovery. There was no difference between the three groups of subjects after 24 hours recovery.

Abortion, Induced↗

Effect of antihypertensive treatment on psychomotor performance in the elderly.

The psychomotor effects of control of hypertension were studied in a parallel group comparison of 25 elderly hypertensives (aged 61-79 years; SBP = 192 (range 162-212) mmHg; DBP = 112 (range 98-124) mmHg) shown to have psychomotor impairment when not on antihypertensive treatment. Single blind treatment was commenced with placebo or a diuretic: atenolol, nifedipine or captopril (5 x n = 5). A range of tests using an automated psychomotor test battery showed a significant improvement compared with placebo in tests of attention and psychomotor speed in subjects rendered normotensive (n = 18) after treatment for one week (SDST + 3.8, P < 0.001; CAT + 1.2, P < 0.03; PWAT + 1.9, P < 0.004; INSP -49.5 ms, P < 0.001). Subgroup analysis suggested greater improvement in psychomotor performance with captopril, but this was equivocal because of the small sample size in each group. Hence, the psychomotor effects of treatment with nifedipine and captopril were compared in a further 13 hypertensives (aged 62-76 years; SBP = 178 (range 169-193) mmHg; DBP = 106 (range 97-117) mmHg) in a double-blind crossover study. With both drugs, control of hypertension was associated with a significant and comparable improvement in several psychomotor performance measures. The results suggest that impaired psychomotor performance due to hypertension improves with antihypertensive treatment. The improvement appears to be related to control of hypertension rather than to the direct CNS effects of antihypertensive drugs.

Aged↗

Effect of hypoxia on psychomotor performance during graded exercise.

We evaluated the combined effects of reduced O2 (12%) and graded ergometer exercise (10, 70, and 140 W) on the performance of a psychomotor task. Six men participated in two test sessions each. Each session began with the baseline data (air) and finished with exposure data (12% or 21%, random, unidentified). The gas mixtures were air (control condition) and 12% O2-balance N2 (12% O2 condition). The psychomotor task score was degraded during the 140 W work rate of the 12% O2 condition (p less than 0.05). Reductions of the SaO2 (p less than 0.05) at each work rate proved that hypoxia existed during exercise in the 12% O2 condition. The arterial blood gases indicated that respiratory alkalosis was mixed with metabolic acidosis during the hypoxic exercise. The results differ from previously reported findings of an arousal effect of exercise on psychomotor performance and the decrement of task performance at work rates less than or equal to 50 W. We conclude that hypoxia degraded the performance of the psychomotor task during graded exercise.

Adult↗

Effects of terfenadine on psychomotor performance. An overview.

Sedation and impairment of psychomotor performance are well known adverse effects of the traditional antihistamines. These effects appear to be caused by different mechanisms, but both may have potentially dangerous consequences. while several of the newer antihistamines, such as terfenadine, have overcome the problem of sedation, it is also important to establish their propensity to cause psychomotor impairment. Many single- and multiple-dose studies (mostly in healthy volunteers) have compared the effects of terfenadine on psychomotor performance with those of placebo, as well as traditional and other nonsedating antihistamines. Over half of the studies employed divided-attention tasks that are considered relevant to everyday activities, such as driving. Like several other nonsedating antihistamines, single doses of terfenadine of up to 120 mg did not impair driving performance and generally had no significant effects on other psychomotor tests compared with placebo. In most of the multiple-dose studies, terfenadine 60 mg twice daily was administered for up to 5 days. Again, the effects of terfenadine on psychomotor performance differed little from those of placebo. Thus, the available evidence suggests that the problem of impaired psychomotor performance associated with the older, traditional antihistamines does not apply to terfenadine.

Clinical Trials as Topic↗

Effect of pain on human psychomotor performance.

The effect of pain on human psychomotor performance was measured in seven healthy volunteers after an intramuscular injection of vitamin B or saline using a controlled cross-over method. Vitamin B, causing moderate to severe pain, or painless saline was injected into the buttock at a time when the subjects' performance was impaired after an intravenous injection of diazepam (0.3 mg/kg). The subjects' psychomotor performance was tested before and 2, 3, and 4 h after diazepam (before, 15 min, and 1 h 15 min after the vitamin B and saline injections). The effects of the vitamin B injection on the subjects' divided attention, reaction or co-ordination skills or their ability to discriminate the fusion of flickering light did not differ from the corresponding effects of the saline injection. The results suggest that pain as such does not have any major influence on human psychomotor performance.

Adult↗

Psychomotor performance after desflurane anesthesia: a comparison with isoflurane.

Recovery and psychomotor performance were studied in 80 ASA physical status I-III adult patients undergoing outpatient surgery. Patients were divided into four equal groups: thiopental induction of anesthesia followed by desflurane in nitrous oxide and oxygen (Th-DES-N2O/O2), thiopental induction of anesthesia followed by isoflurane in nitrous oxide and oxygen (Th-ISO-N2O/O2), thiopental induction of anesthesia followed by desflurane in oxygen (Th-DES-O2), and desflurane inhaled induction followed by desflurane in oxygen (DES-DES-O2). Patients were excluded from analysis if they required opioids or antiemetics postoperatively. The use of desflurane was associated with more rapid awakening compared with isoflurane (time to eye opening 9.45 +/- 0.67 min [Th-DES-N2O/O2] and 13.8 +/- 1.59 min [Th-ISO-N2O/O2], P less than 0.05). Psychomotor performance was measured using the choice reaction time and critical flicker fusion threshold. At 30 min after discontinuing anesthesia, five patients in the Th-ISO-N2O/O2 group and one patient in the Th-DES-N2O/O2 group were too sleepy to perform psychomotor tests. In addition, five patients who received Th-DES-O2 and one patient who received the inhaled induction and maintenance of anesthesia with desflurane in oxygen were too sleepy to perform tests at 30 min. Patients receiving Th-DES-N2O/O2 showed less impairment of choice reaction time than those receiving Th-ISO-N2O/O2. Critical flicker fusion threshold, however, showed no difference between groups. The use of thiopental was associated with delayed recovery. Compared with isoflurane, desflurane anesthesia is associated with more rapid initial awakening and less impairment of choice reaction time.

Adult↗

Psychomotor performance in elderly hypertensive patients.

The psychomotor performance of 25 elderly patients with mild to moderate hypertension (aged 62-78 years, SBP = 162-212 mmHg; DBP = 98-124 mmHg) was compared with 25 age-matched controls (SBP = 110-160 mmHg; DBP = 64-92 mmHg). The hypertensive subjects did not have evidence of target-organ damage and were on no antihypertensive treatment at the time of assessment. Performance on a range of tests: symbol/digit substitution test (SDST) (34.3 vs. 39.5, P < 0.01), continuous attention test (CAT) (33 vs. 36.2, P < 0.01), choice reaction time (CRT) (270 ms vs. 320 ms, P < 0.01), paired word association test (PWAT) (4.1 vs. 7.0, P < 0.001) and inspection time threshold (INSP) (158 ms vs. 52 ms, P < 0.001), showed significant impairment in the hypertensive group compared with controls. These differences did not correlate with the duration of hypertension or degree of BP elevation. The impairment in hypertensive subjects was stable over a four week period. These results suggest the occurrence of a functional and possibly reversible impairment of psychomotor performance in elderly hypertensive patients which may have implications for antihypertensive treatment.

Aged↗

Assessment of changes in psychomotor performance of elderly subjects.

1. The repeatability of a computerised psychomotor test battery on a day-to-day and week-to-week basis was assessed by determining its test-retest reliability and variations in group-means and intraindividual psychomotor performance scores of elderly people. 2. Psychomotor performance was assessed in 50 well-screened elderly subjects (21 males, 29 females; mean age 70.4 +/- 5.0 (s.d.) years) on 5 consecutive days and over 4 weeks in standardised test conditions. 3. The psychomotor test battery consisted of computerised versions of symbol digit substitution test (SDST), continuous attention test (CAT), choice reaction time (CRT), critical flicker fusion test (CFFT), cognitive flexibility test (FLEX), paired word association test (PWAT) and inspection time (INSP). 4. Main outcome measures were test-retest reliability, group variability and intraindividual variability. 5. There was no significant variation in group-means for all components of the test battery over 5 days or 4 weeks on two way analysis of variance. The intraindividual coefficient of variation was low for SDST, CRT, CFFT, FLEX, PWAT and INSP during the period of assessment. Test retest reliability was greater than 0.8 for SDST, CAT, CRT and PWAT. 6. Tests in the Automated Psychomotor Test Battery are reliable and repeatable measures of psychomotor performance on a day-to-day and week-to-week basis.

Aged↗

Lack of psychotomimetic or impairing effects on psychomotor performance of acamprosate.

The possible effects on psychomotor performance, concentration, attention, and mood of acamprosate (calciumacetylhomotaurinate) were assessed using a randomized, double-blind, cross-over, placebo-controlled design involving 12 healthy male volunteers. Acamprosate 2 g daily per os or placebo was administered for seven days and separated by washout intervals of at least 21 days. Objective tests evaluated psychomotor functions (simple reaction time measurement, binary choice reaction test, computerized visual searching task, sustained attention test). Mood was assessed using the Beck Depression Inventory and the Beschwerde-Liste to assess subjective physical impairment. Additionally, a visual 3-D illusion paradigm was applied to measure the psychotomimetic effect. A dose of acamprosate of 2 g/day for seven days was free of any significant effects on mood, concentration, attention, psychomotor performance and did not produce any subjective sedation, excitation or psychotomimetic effects.

Acamprosate↗

Median nerve electrophysiologic parameters and psychomotor performance in carpal tunnel syndrome.

Psychomotor performance (PMP) involving a repeated, rapid pinch and release task was correlated with median nerve electrophysiologic parameters for control subjects (16 hands) and subjects with carpal tunnel syndrome (CTS) (14 hands). The psychomotor task was used because of its functional resemblance to many work related activities. A strain gauge dynamometer was repeatedly pinched to a predetermined force level using the index finger and thumb and then released as rapidly as possible, while measuring the actual isometric force exerted. Discrete visual and auditory feedback was provided. Median and ulnar nerve motor latencies and amplitudes, as well as median antidromic sensory latencies and amplitudes, and transcarpal latencies and amplitudes were obtained. CTS subjects had longer median motor and sensory latencies and were weaker than controls, however median motor and sensory amplitudes were not statistically different. A strong relationship was observed between electrophysiologic variables and PMP, which could not be accounted for by age differences alone. It is unclear whether the measured differences in PMP are related to sensory or motor deficits.

Adult↗

Effects of haloperidol and atypical neuroleptics on psychomotor performance and driving ability in schizophrenic patients. Results from an experimental study.

The influence of antipsychotic treatment on the neuropsychological and psychomotor performance of schizophrenic patients is still a subject of investigation. The present study was designed to evaluate the effects of atypical neuroleptics in comparison with a conventional dopamine antagonist neuroleptic (haloperidol) on several dimensions of psychomotor performance (visual perception, attention, reaction time, and sensorimotor performance) considered to be of relevance in evaluating driving fitness. Psychomotor performance was assessed by means of the ART 90, a computerized Act and React Test which is generally used in diagnosis of psychomotor performance. The 49 participating patients were examined at discharge following psychopathological stabilisation; 20 received haloperidol, 29 received an atypical neuroleptic. Our findings demonstrate a remarkably reduced psychomotor performance in the haloperidol-treated group of schizophrenic patients compared with patients treated with atypical neuroleptics. Only 1 (5%) subject passed all subtests without major failures and could be regarded as competent to drive. Among patients with atypical neuroleptics, 7 patients (24%) passed all test parameters without major failures.

Adult↗

Effects of haloperidol and risperidone on psychomotor performance relevant to driving ability in schizophrenic patients compared to healthy controls.

The effects of antipsychotic treatment on the psychomotor performance and driving ability of schizophrenic patients is subject of investigation. The present study was designed to evaluate the effects of an atypical neuroleptic (risperidone) in comparison to a conventional dopamine antagonist neuroleptic (haloperidol) on several dimensions of psychomotor performance (visual perception, attention, reaction time, and sensorimotor performance) considered to be of relevance in evaluating driving fitness. Psychomotor performance was assessed by means of the ART 90 (act-and-react test), a computerized test battery which is frequently used in diagnosis of psychomotor performance. The 40 participating patients were examined at discharge following psychopathological stabilisation; 20 received haloperidol medication, 20 received the atypical neuroleptic risperidone. Nineteen healthy individuals were studied as a control group. Our findings indicate a remarkably reduced psychomotor performance in both groups of schizophrenic patients compared to healthy controls. We did find a significant but low correlation between age and some items of the RST3 and between age and the tracking performance on the PVT. The younger patients showed a better test performance than older patients. The BPRS-score was significantly correlated with only two items of the RST3. However, patients under treatment with risperidone showed significantly better results compared to patients treated with haloperidol. Only one (5%) subject passed all subtests without major failures and could be regarded as competent to drive. Among patients with risperidone, seven patients (35%) passed all test parameters without major failures. Clinical implications of these findings are discussed.

Adult↗

Effects of a three-month active rehabilitation program on psychomotor performance of lower limbs in subjects with low back pain: a controlled study with a nine-month follow-up.

Proper psychomotor performance is needed in work and in activities of daily living, but among subjects with low back pain this area has been studied little. The present purpose was to evaluate the effect and permanence of a 3-mo. physical exercise program on the psychomotor performance of lower limbs in subjects with low back pain. The associations between psychomotor performance and intensity of low back pain and subjective disability were also evaluated. 90 subjects with nonspecific, subacute low back pain were assigned to one of the three groups: one given three months intensive training, one home exercise, or the control group. Four measurement sessions were made during the 1-yr. study. Psychomotor speed of lower limbs was analyzed with Choice Reaction Time, Movement Time, and Total Response Time. Flight Time of a vertical static jump was also measured. Muscle strength was assessed with conventional methods from trunk, lower limbs, and hand. Intensity of Current Back Pain was analyzed with the Borg scale. Subjective disability was evaluated with the Oswestry Index. Analysis showed that muscle strength and back pain intensity had associations with psychomotor performance but subjective disability or physical activity did not affect it noticeably. There were no changes in Choice Reaction Time, but Total Response Time and Movement Time decreased and Flight Time increased for all subjects. In the first postintervention measurement the home exercise group had significantly lower Movement Time than the intensively trained group. Back Pain Intensity decreased in both exercise groups for those subjects whose psychomotor performance values were below the mean value for the sample.

Adult↗

Psychomotor performance during a 28 day head-down tilt with and without lower body negative pressure.

Several factors may affect psychomotor performance in space: sensory-motor changes, sleep disturbances, psychological modifications induced by the social isolation and confinement. However, psychomotor performance is difficult to assess. A battery of standardized and computerized tests, so-called "Automated Portable Test System" (APTS) was devised to ascertain the cognitive, perceptive and motor abilities and their possible fluctuations according to environmental effects. Antiorthostatic bedrest, often used to simulate weightlessness, (particularly cardiovascular modifications) also constitutes a situation of social confinement and isolation. During two bedrest experiments (with head-down tilt of -6 degrees) of 28 days each, we intended to assess psychomotor performance of 6 males so as to determine whether: on the one hand, it could be altered by remaining in decubitus; on the other, the Lower Body Negative Pressure sessions, designed to prevent orthostatic intolerance back on Earth, could improve the performance. To accomplish this, part of the APTS tests as well as an automated perceptive attention test were performed. No downgrading of psychomotor performance was observed. On the contrary, the tasks were more accurately performed over time. In order to assess the experimental conditions on the acquisition phase, the learning curves were modelled. A beneficial effect of the LBNP sessions on simple tests involving the visual-motor coordination and attention faculties can only be regarded as a mere trend. Methods used in this experiment are also discussed.

Adult↗

Effects of single dose of gamma-hydroxybutyric acid and lorazepam on psychomotor performance and subjective feelings in healthy volunteers.

OBJECTIVE: This study investigated the possible effects of gamma-hydroxybutyric acid (GHB) on human psychomotor performance and subjective feelings important for the safety of skilled performance. METHODS: Twelve healthy volunteers, six males and six females, aged 22-36 years, participated as subjects. Drugs and placebo were administered according to a single-dose, double-blind, balanced, four-way, crossover design. Treatments were separated by a wash-out period of 1 week and consisted of placebo, lorazepam 0.03 mg x kg(-1), GHB 12.5 mg x kg(-1) and GHB 25 mg x kg(-1). Subjects' psychomotor performance was assessed at baseline and at 15, 60, 120 and 180 min after treatment. Mood was assessed using 16 visual analogue scales, before treatment and 120 min later. Psychomotor performance was measured using the following tests: Critical Flicker Fusion. Response Competition Test, Critical Tracking Task, Choice Reaction Time and Visual Vigilance Task. RESULTS: GHB at both doses had no effects on attention, vigilance, alertness, short-term memory or psychomotor co-ordination (delta-placebo, P > 0.05); calmness increased with the lower dose and contentedness decreased significantly at both doses (delta-baseline, P < 0.05); adverse effects were limited to slight subjective feelings of dizziness and dullness, which disappeared 30-60 min after administration of the dose. Lorazepam caused impairment of psychometric functions. CONCLUSION: After single therapeutic doses, GHB does not induce changes in psychomotor performance and therefore the drug does not influence the ability to drive or work. However, repeated reports of the abuse potential of GHB and its usefulness in treating ethyl alcohol addiction indicate that it may play an "agonist-like" role, which means that it should only used under close medical supervision.

Adult↗

Effects of acamprosate on psychomotor performance and driving ability in abstinent alcoholics.

The possible effects of acute and long-term treatment of the antidipsotropic agent acamprosate on psychomotor performance and driving ability were studied in a prospective open clinical trial involving 5 alcoholic patients without any clinical evidence for cognitive impairement. Acamprosate 1995 mg/day was given for 6 months for relapse prevention with all patients being abstinent throughout the study. No side effects were reported during treatment. Psychomotor performance and driving ability were assessed using the ART 90, a standardized and computerized neuropsychological test battery. A number of relevant subtests measuring peripheral vision, split attention, sensomotoric function, reaction time, stress resistance and the capacity to integrate information was used at study entry, 6 weeks and 6 months after onset of treatment. While in two subtests a moderate improvement in psychomotor performance was found, in most subtests no differences compared to baseline could be shown. The results of this pilot study do not indicate any impairment of psychomotor performance by acamprosate.

Acamprosate↗