Chronic Guanethidine Treatment of Female Rats Including Effects on the Fetus

Total Page:16

File Type:pdf, Size:1020Kb

Chronic Guanethidine Treatment of Female Rats Including Effects on the Fetus Chronic guanethidine treatment of female rats including effects on the fetus Barbara K. Evans and G. Burnstock Department ofZoology, University ofMelbourne, Parkville, Victoria, 3052, Australia Summary. Adult virgin female rats were injected daily with low doses (5 or 10 mg/kg) or a high dose (30 mg/kg) of guanethidine for 12 or 8 weeks respectively. 'Short' and 'long' noradrenergic neurones were unaffected by low doses. This contrasts markedly to earlier findings in male rats in which long-term damage of 'short' noradrenergic neurones occurred, and indicates a basic difference between 'short' noradrenergic neurones in male and female rats. Widespread degeneration of both types of neurones followed treatment with high doses and little reinnervation was observed 8 weeks after cessation of treatment. Fertility, pregnancy and litter size were apparently unaffected. Some teratogenic effects were observed in the offspring of female rats treated with guanethidine (10 or 25 mg/kg/day) before and throughout pregnancy. However, these effects had largely disappeared by the time the offspring were 10 weeks old. Since noradrenergic neurones of newborn rats are particularly sensitive to damage by guanethidine it would appear that either very little guanethidine crosses the placental barrier or that noradrenergic neurones are not susceptible during prenatal development to the cytotoxic effects of guanethidine. Introduction Particular interest has been shown in 'short' noradrenergic neurones (Owman & Sjöstrand, 1965; Sjöstrand, 1965) since they apparently share a number of properties, apart from the length of their aeon, which differ considerably from those of ordinary 'long' noradrenergic neurones (see Owman, Sjöberg & Sjöstrand, 1974). For example, they are more resistant to damage by 6- hydroxydopamine (Malmfors & Sachs, 1968), depletion of noradrenaline stores after reserpine (Sjöstrand & Swedin, 1968) or a-methyl-p-tyrosine (Swedin, 1970) and inhibition of development by anti-nerve growth factor (Hamberger, Levi-Montalcini, Norberg & Sjöqvist, 1965). On the basis of such results it has been suggested that 'short' noradrenergic neurones constitute a distinct neuronal type. However, most of these studies were carried out using male animals and the 'short' noradrenergic neurones which innervate the male, and part of the female internal genitaUa have been shown to differ. Whereas oestrogen and progesterone markedly influence the noradrenaline content of female 'short' noradrenergic neurones (Sjöberg, 1968a, b; Falck, Owman, Rosengren & Sjöberg, 1969a, b), they have no effect on the noradrenaline content of male 'short' noradrenergic neurones (Owman, Sjöberg, Sjöstrand & Swedin, 1970). In male rats and mice the 'short' noradrenergic innervation has been shown to be considerably more sensitive to damage by chronic guanethidine treatment than 'long' noradrenergic neurones (Gannon, Iwayama, Burnstock, Gerkens & Mashford, 1971; Evans, Gannon, Heath & Burnstock, 1972; Evans, Iwayama & Burnstock, 1973; Evans, Heath & Burnstock, 1979a). The purpose of this study was to investigate the effects of chronic treatment * Present address: Department of Anatomy and Embryology, University College London, Gower Street, London WC1E6BT, England. Downloaded from Bioscientifica.com at 10/03/2021 08:17:59PM via free access with low and high doses of guanethidine, a drug used widely in the treatment of hypertension, on the peripheral noradrenergic neurones of the female rat and particularly to see whether the 'short' noradrenergic neurones are affected earlier or with lower doses. The possibihty of damage to fetal noradrenergic neurones as a result of maternally administered guanethidine was also investigated. Materials and Methods Thirty-five (35) adult virgin female rats were injected with guanethidine sulphate (Ismelin: CIBA) at low doses (5 or 10 mg/kg/day) for 12 weeks or a high dose (30 mg/kg/body weight/day) for 8 weeks. The rats were küled by bleeding under light ether anaesthesia at selected intervals during treatment and up to 8 weeks following cessation of treatment. A second group of age-matched untreated female rats served as controls and in all cases control tissue was processed together with the guanethidine-treated tissue. The formaldehyde-induced fluorescence method for the histochemical demonstration of tissue monoamines (Falck & Owman, 1965), as described in detaü elsewhere (Evans et al., 1973), was carried out on the following tissues: right atrium, superior cervical ganghon, iris, coeliac ganglion, ovary, oviduct, uterus, vagina, paracervical ganglion, urethra and ureter. Using light-field iUumination it is possible to identify the presence of intact non-fluorescent nerve cell bodies in sympathetic ganglia. The absence of such cells and the continued lack of fluorescence many weeks after cessation of treatment were taken to indicate that degeneration of the noradrenergic neurones had taken place. The validity of this belief has been shown in other studies (Burnstock et al., 1971; Heath et al, 1972; Evans et al., 1979b) using Ught and electron microscopy. Another group of 9 virgin female rats were injected with 25, 10 or 1 mg guanethidine/kg/day for 2 weeks before mating with normal males. The injections were continued without interruption until the end of pregnancy. The male offspring were killed 1, 2 and 10 weeks after birth and tissue from the right atrium, superior cervical gangUon, ileum, vas deferens, epididymis and pelvic plexus was prepared for fluorescence histochemistry. Male offspring were examined since the 'short' noradrenergic neurones supplying the male reproductive tract have been shown to be particularly sensitive to low doses of guanethidine (Gannon et al, 1971; Evans et al, 1972, 1973). One vas deferens from the 10-week-old males was reserved for organ bath experiments where the response to stimulation of intramural nerves and sensitivity to noradrenaline were determined. The conditions and experimental procedure were as described elsewhere (Evans et al, 1973). After weaning, the mothers were killed and selected tissues processed for fluorescence histochemistry. Results Low doses Treatment with low doses (5 or 10 mg/kg/day) of guanethidine caused no change in the fluorescent appearance of the noradrenergic innervation to the right atrium, ureter, iris or of the noradrenergic cell bodies in the superior cervical or coeliac ganglia either during or following treatment. The noradrenergic nerves supplying the female reproductive tract were also unaffected by low doses of guanethidine. Fluorescent nerve fibres were still clearly visible in the ovary (PI. 1, Fig. 2), oviduct (PL 1, Fig 6), uterus (PL 2, Fig. 10) and vagina (PL 2, Fig. 14); the pattern and density of this innervation were comparable to that of control tissue (PL 1, Figs 1 and 5; PL 2, Figs 9 and 13). The general appearance of the paracervical ganglion (PL 3, Fig. 21) and the noradrenergic innervation of the urethra was also normal. Downloaded from Bioscientifica.com at 10/03/2021 08:17:59PM via free access High dose The effect of a high dose (30 mg/kg/day) of guanethidine on the fluorescence of the nora¬ drenergic innervation of the atrium, iris and on the cells of the superior cervical and coeliac (PL 3, Figs 17, 18 and 19) ganglia supported the results of an earner study (Burnstock, Evans, Gannon, Heath & James, 1971) in which similar treatment produced a widespread sympa- thectomy involving the degeneration of over 95% of peripheral noradrenergic neurones in both male and female rats. The reinnervation of these tissues after cessation of treatment was the same as seen in male rats and is described in detail elsewhere (Evans et al, 1979b). The normal paracervical gangUon is a diffuse ganglion in which only a small proportion (between 20 and 30%) of the nerve ceU bodies show weak to moderate fluorescence (PL 3, Fig. 20). The remainder are non-fluorescent presumably cholinergic ceUs (see also Adham & Schenk, 1969; Kanerva, 1972a, b). A large number of small intensely fluorescent cells in groups of various sizes are scattered throughout the ganglion. After 1 week of treatment with the high dose of guanethidine there was a decrease in the number of fluorescent ganglion cells and after 4 weeks only occasional fluorescent cell bodies were seen. Some perivascular fibres were still present. After treatment for 8 weeks no fluorescent nerve cell bodies or fibres were seen in the ganglion (PL 3, Fig. 21). Non-fluorescent gangUon cells were still evident and a few of these appeared vacuolated. There was very little increase in autofluorescent material in the ganglion. The appearance of the ganglion showed little change 8 weeks after cessation of treatment. Only isolated fluorescent gangUon cells were seen and, apart from a partial return of perivascular innervation within the ganglion, very few fluorescent fibres were seen. Non-fluorescent nerve cell bodies and small intensely fluorescent cells in the ganglion appeared normal throughout treatment and recovery. The fluorescent innervation to the reproductive organs and urethra had decreased greatly after treatment for 1 week. A few fibres were seen in the isthmus of the oviduct (PL 1, Fig. 7) and in the vagina (PL 2, Fig. 15) but virtually no fibres were seen in the uterus (PL 2, Fig. 11), uterotubal junction or ovary. Occasional perivascular fibres were visible throughout the reproductive tract. No fluorescent fibres were present in these organs after treatment for 4 or 8 weeks (PL 1, Fig. 3). The very small noradrenergic
Recommended publications
  • Management of Major Depressive Disorder Clinical Practice Guidelines May 2014
    Federal Bureau of Prisons Management of Major Depressive Disorder Clinical Practice Guidelines May 2014 Table of Contents 1. Purpose ............................................................................................................................................. 1 2. Introduction ...................................................................................................................................... 1 Natural History ................................................................................................................................. 2 Special Considerations ...................................................................................................................... 2 3. Screening ........................................................................................................................................... 3 Screening Questions .......................................................................................................................... 3 Further Screening Methods................................................................................................................ 4 4. Diagnosis ........................................................................................................................................... 4 Depression: Three Levels of Severity ............................................................................................... 4 Clinical Interview and Documentation of Risk Assessment...............................................................
    [Show full text]
  • Data Sheet SURMONTIL Trimipramine (As Maleate) 25 Mg Tablets and 50 Mg Capsules
    Data Sheet SURMONTIL trimipramine (as maleate) 25 mg tablets and 50 mg capsules Presentation SURMONTIL tablets are compression coated, white or cream, circular, biconvex, containing the equivalent of 25mg trimipramine (as maleate) with a diameter of about 8.0mm. The face is indented with the name and strength, reverse plain. SURMONTIL capsules are opaque white with opaque green cap, printed SU50, each containing the equivalent of 50mg trimipramine (as maleate). Uses Actions SURMONTIL has a potent anti-depressant action similar to that of other tricyclic anti-depressants. The mechanism of action is not fully understood but it is thought to be via inhibition of neuronal re- uptake of noradrenalin, thereby increasing availability. SURMONTIL also possesses a pronounced sedative action. Pharmacokinetics SURMONTIL is readily absorbed after oral administration, reaching a mean peak plasma level after 3 hours. High first pass hepatic clearance results in a mean bioavailability of about 41% of the oral dose, and trimipramine is extensively protein bound in plasma. Elimination half-life is 24 hours. Metabolism is in the liver to its major metabolite, desmethyltrimipramine, which is excreted mainly in the urine. Indications SURMONTIL is indicated in the treatment of depressive illness, especially where sleep disturbance, anxiety or agitation is a presenting symptom. Sleep disturbance is controlled within 24 hours and true anti-depressant action follows within 7-10 days. Dosage and Administration Adults Mild/Moderate Depression in General Practice: The recommended dosage is 50-75 mg orally given two hours before bedtime, the larger dose (75 mg) being preferable for those patients with more marked sleep disturbance.
    [Show full text]
  • Effects of Sympathetic Inhibition on Receptive, Proceptive, and Rejection Behaviors in the Female Rat
    Physiology & Behavior, Vol. 59, No. 3, pp. 537-542, 1996 Copyright © 1996 Elsevier Science Inc. Printed in the USA. All rights reserved 0031-9384/96 $15.00 + .00 ELSEVIER 0031-9384(95)02102-2 Effects of Sympathetic Inhibition on Receptive, Proceptive, and Rejection Behaviors in the Female Rat CINDY M. MESTON, 1 INGRID V. MOE AND BORIS B. GORZALKA Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, British Columbia, Canada V6T 1Z4 Received 27 September 1994 MESTON, C. M., I. V. MOE AND B. B. GORZALKA. Effects of sympathetic inhibition on receptive, proceptive, and rejection behaviors in the female rat. PHYSIOL BEHAV 59(3) 537-542, 1996.--The present investigation was designed to examine the effects of sympathetic nervous system (SNS) inhibition on sexual behavior in ovariec- tomized, steroid-treated female rats. Clonidine, an alpha2-adrenergic agonist, guanethidine, a postganglionic noradren- ergic blocker, and naphazoline, an alpha2-adrenoreceptor agonist were used to inhibit SNS activity. Intraperitoneal injections of eit:aer 33/zg/ml or 66/xg/ml clonidine significantly decreased receptive (lordosis) and proceptive (ear wiggles) behaviors and significantly increased rejection behaviors (vocalization, kicking, boxing). Either 25 mg/ml or 50 mg/ml guanethidine significantly decreased receptive and proceptive behavior and had no significant effect on rejection behav!iors. Naphazoline significantly inhibited lordosis behavior at either 5 mg/ml or 10 mg/ml doses, significantly inhibited proceptive behavior at 5 mg/ml, and had no significant effect on rejection behaviors. These findings supporc the hypothesis that SNS inhibition decreases sexual activity in the female rat. Lordosis Proceptive behavior Rejection behavior Clonidine Guanethidine Naphazoline Alpha-adrenergic INTRODUCTION as 2 /xg/animal also inhibits lordosis behavior (1).
    [Show full text]
  • (Mibg) Scintigraphy: Procedure Guidelines for Tumour Imaging
    Eur J Nucl Med Mol Imaging (2010) 37:2436–2446 DOI 10.1007/s00259-010-1545-7 GUIDELINES 131I/123I-Metaiodobenzylguanidine (mIBG) scintigraphy: procedure guidelines for tumour imaging Emilio Bombardieri & Francesco Giammarile & Cumali Aktolun & Richard P. Baum & Angelika Bischof Delaloye & Lorenzo Maffioli & Roy Moncayo & Luc Mortelmans & Giovanna Pepe & Sven N. Reske & Maria R. Castellani & Arturo Chiti Published online: 20 July 2010 # EANM 2010 Abstract The aim of this document is to provide general existing procedures for neuroendocrine tumours. The information about mIBG scintigraphy in cancer patients. guidelines should therefore not be taken as exclusive of The guidelines describe the mIBG scintigraphy protocol other nuclear medicine modalities that can be used to obtain currently used in clinical routine, but do not include all comparable results. It is important to remember that the The European Association has written and approved guidelines to promote the use of nuclear medicine procedures with high quality. These general recommendations cannot be applied to all patients in all practice settings. The guidelines should not be deemed inclusive of all proper procedures and exclusive of other procedures reasonably directed to obtaining the same results. The spectrum of patients seen in a specialized practice setting may be different than the spectrum usually seen in a more general setting. The appropriateness of a procedure will depend in part on the prevalence of disease in the patient population. In addition, resources available for patient care may vary greatly from one European country or one medical facility to another. For these reasons, guidelines cannot be rigidly applied. These guidelines summarize the views of the Oncology Committee of the EANM and reflect recommendations for which the EANM cannot be held responsible.
    [Show full text]
  • Drug and Medication Classification Schedule
    KENTUCKY HORSE RACING COMMISSION UNIFORM DRUG, MEDICATION, AND SUBSTANCE CLASSIFICATION SCHEDULE KHRC 8-020-1 (11/2018) Class A drugs, medications, and substances are those (1) that have the highest potential to influence performance in the equine athlete, regardless of their approval by the United States Food and Drug Administration, or (2) that lack approval by the United States Food and Drug Administration but have pharmacologic effects similar to certain Class B drugs, medications, or substances that are approved by the United States Food and Drug Administration. Acecarbromal Bolasterone Cimaterol Divalproex Fluanisone Acetophenazine Boldione Citalopram Dixyrazine Fludiazepam Adinazolam Brimondine Cllibucaine Donepezil Flunitrazepam Alcuronium Bromazepam Clobazam Dopamine Fluopromazine Alfentanil Bromfenac Clocapramine Doxacurium Fluoresone Almotriptan Bromisovalum Clomethiazole Doxapram Fluoxetine Alphaprodine Bromocriptine Clomipramine Doxazosin Flupenthixol Alpidem Bromperidol Clonazepam Doxefazepam Flupirtine Alprazolam Brotizolam Clorazepate Doxepin Flurazepam Alprenolol Bufexamac Clormecaine Droperidol Fluspirilene Althesin Bupivacaine Clostebol Duloxetine Flutoprazepam Aminorex Buprenorphine Clothiapine Eletriptan Fluvoxamine Amisulpride Buspirone Clotiazepam Enalapril Formebolone Amitriptyline Bupropion Cloxazolam Enciprazine Fosinopril Amobarbital Butabartital Clozapine Endorphins Furzabol Amoxapine Butacaine Cobratoxin Enkephalins Galantamine Amperozide Butalbital Cocaine Ephedrine Gallamine Amphetamine Butanilicaine Codeine
    [Show full text]
  • Clomipramine 25 Mg Capsules, Hard
    Package leaflet: Information for the patient Other medicines and Clomipramine Tell your doctor if you are taking, have recently Clomipramine 10 mg Capsules, Hard taken or might take any other medicines. Clomipramine 25 mg Capsules, Hard Some medicines may increase the side effects of Clomipramine 50 mg Capsules, Hard Clomipramine and may sometimes cause very clomipramine hydrochloride serious reactions. Do not take any other medicines whilst taking Clomipramine without first talking to Read all of this leaflet carefully before you your doctor, especially: start taking this medicine because it contains - medicines for depression, particularly MAOIs (see important information for you. section “Do not take” above) e.g. tranylcypromine, - Keep this leaflet. You may need to read it again. phenelzine, moclobemide; SSRIs e.g. fluoxetine (or - If you have any further questions, ask your have taken within the last 3 weeks), fluvoxamine, doctor or pharmacist. paroxetine, sertraline; SNaRIs e.g. venlafaxine; - This medicine has been prescribed for you only. tricyclic and tetracyclic antidepressants e.g. Do not pass it on to others. It may harm them, amitriptyline, dothiepin, maprotiline even if their signs of illness are the same as yours. - diuretics, also known as ‘water tablets’, e.g. - If you get any side effects, talk to your doctor bendroflumethiazide, furosemide or pharmacist. This includes any possible side - anaesthetics, used for the temporary loss of effects not listed in this leaflet. See section 4. bodily sensation - antihistamines e.g. terfenadine What is in this leaflet - medicines for other mental health conditions 1. What Clomipramine is and what it is used for. such as schizophrenia or manic depression 2.
    [Show full text]
  • Doxepin Hydrochloride Oral Solution Or Any Who Does Not Have a Patent Iridectomy
    Suicidality and Antidepressant Drugs Angle-Closure Glaucoma Allergic Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in The pupillary dilation that occurs following use of many antidepressant drugs including doxepin Skin rash, edema, photosensitization, and pruritus have occasionally occurred. children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and hydrochloride oral solution may trigger an angle closure attack in a patient with anatomically narrow angles Hematologic other psychiatric disorders. Anyone considering the use of doxepin hydrochloride oral solution or any who does not have a patent iridectomy. Eosinophilia has been reported in a few patients. There have been occasional reports of bone marrow other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Usage in geriatrics depression manifesting as agranulocytosis, leukopenia, thrombocytopenia, and purpura. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared The use of doxepin on a once-a-day dosage regimen in geriatric patients should be adjusted carefully based Gastrointestinal to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to on the patient’s condition (see PRECAUTIONS, Geriatric Use). Nausea, vomiting, indigestion, taste disturbances, diarrhea, anorexia, and aphthous stomatitis have been placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves Usage in pregnancy reported (see Anticholinergic Effects). associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant Reproduction studies have been performed in rats, rabbits, monkeys and dogs and there was no evidence of therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, Endocrine harm to the animal fetus.
    [Show full text]
  • Imipramine Hydrochloride Tablets USP 10 Mg, 25 Mg, and 50 Mg
    IMIPRAMINE HYDROCHLORIDE - imipramine hydrochloride tablet, film coated Excellium Pharmaceutical, Inc Rx only Prescribing Information Suicidality and Antidepressant Drugs Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of Imipramine Hydrochloride or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Imipramine Hydrochloride is not approved for use in pediatric patients (see WARNINGS: Clinical Worsening and Suicide Risk, PRECAUTIONS: Information for Patients, and PRECAUTIONS: Pediatric Use). DESCRIPTION Imipramine Hydrochloride Tablets USP is supplied in tablet form for oral administration. Imipramine Hydrochloride USP, the original tricyclic antidepressant, is a member of the dibenzazepine group of compounds. It is designated 5-3-(Dimethylamino) propyl-10, 11-dihydro-5H dibenz [‘b, f]-azepine monohydrochloride. Its structural formula is: C19H24N2 • HCI MW = 316.88 Imipramine Hydrochloride USP is a white to off-white, odorless, or practically odorless crystalline powder.
    [Show full text]
  • Norepinephrine Transporters Have Channel Modesof Conduction
    Proc. Natl. Acad. Sci. USA Vol. 93, pp. 8671-8676, August 1996 Neurobiology Norepinephrine transporters have channel modes of conduction AURELIO GALLI, RANDY D. BLAKELY, AND Louis J. DEFELICE* Department of Pharmacology, Vanderbilt University School of Medicine, Nashville TN 37232-6600 Communicated by Ronald H. Kaback University of California, Los Angeles, CA, April 25, 1996 (received for review October 17, 1995) ABSTRACT Neurotransmitter transporters couple to ex- concentrations and that they require millimolar concentrations isting ion gradients to achieve reuptake of transmitter into of Na and Cl to function. Furthermore, NETs have a specific presynaptic terminals. For coupled cotransport, substrates requirement for Na such that even similar ions, like Li, cannot and ions cross the membrane in fixed stoichiometry. This is substitute for Na. Nevertheless, NETs recognize and transport in contrast to ion channels, which carry an arbitrary number structurally similar substrates including epinephrine, dopa- of ions depending on the channel open time. Members of the mine, amphetamines, and guanethidine (GU). Radioligand ry-aminobutyric acid transporter gene family presumably uptake studies on resealed membrane vesicles from NET- function with fixed stoichiometry in which a set number of containing cells indicate that NETs function through the ions cotransport with one transmitter molecule. Here we stoichiometric transport of NE, Na, and Cl, whereby Na and Cl report channel-like events from a presumably fixed stoichi- move down their electrochemical gradients to concentrate NE. ometry [norepinephrine (NE)+, Na+, and Cl-], human NE The predicted stoichiometry of one NE', one Na+, and one (hNET) in the y-aminobutyric acid transporter gene family. Cl- indicates the net transfer of one positive charge per These events are stimulated by NE and by guanethidine, an transport cycle.
    [Show full text]
  • Anafranil (Clomipramine Hydrochloride) Tablets 1 Name of the Medicine 2 Qualitative and Quant
    AUSTRALIAN PRODUCT INFORMATION – ANAFRANIL (CLOMIPRAMINE HYDROCHLORIDE) TABLETS 1 NAME OF THE MEDICINE Clomipramine hydrochloride 2 QUALITATIVE AND QUANTITATIVE COMPOSITION Each tablet contains 25 mg clomipramine hydrochloride. Lactose and sucrose Anafranil tablets contain lactose and sucrose. Patients with rare hereditary problems of galactose intolerance, fructose intolerance, severe lactase deficiency, sucrase-isomaltase insufficiency or glucose-galactose malabsorption should not take Anafranil tablets. For the full list of excipients, see Section 6.1 List of excipients. 3 PHARMACEUTICAL FORM Tablet 4 CLINICAL PARTICULARS 4.1 THERAPEUTIC INDICATIONS • Major depression. • Obsessive-compulsive disorders and phobias in adults. • Cataplexy associated with narcolepsy. 4.2 DOSE AND METHOD OF ADMINISTRATION General The dosage should be determined individually and adapted to the patient's condition. Doses should be kept as low as possible and increased cautiously. Note that the plasma concentrations of the drug and active metabolite do not stabilise for 7 to 14 days after commencing treatment and after a dosage change. During treatment, the efficacy and tolerability of Anafranil must be judged by keeping the patients under close surveillance. Depression, obsessive-compulsive disorders and phobias: Start treatment with one tablet of 25 mg 2 or 3 times daily. Raise the daily dosage stepwise, e.g. 25 mg every few days, (depending on how the medication is tolerated) to 4 to 6 tablets of 25 mg. Once a distinct improvement has set in, adjust the daily dosage to a maintenance level averaging 2 to 4 tablets of 25 mg. 1 Cataplexy accompanying narcolepsy: Anafranil should be given orally in a daily dose of 25 to 75 mg.
    [Show full text]
  • International Pharmaceuticals Group
    PFIZER SINEQUAN® Doxepin 1. NAME OF THE MEDICINAL PRODUCT SINEQUAN® 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Active Ingredient: doxepin hydrochloride (HCl) Capsules containing doxepin HCl equivalent to 10 mg and 25 mg doxepin. 3. PHARMACEUTICAL FORM Capsules. 4. CLINICAL PARTICULARS 4.1 Therapeutic Indications Doxepin is a safe and effective psychotherapeutic agent for the treatment of patients with a wide range of psychoneurotic disorders where anxiety and/or depression are prominent symptoms. Thus, where these prime symptoms are present, the compound has been shown to be of value in patients with anxiety neuroses, with and without somatic symptoms; reactive depression; mixed anxiety depression; and patients with alcoholism with anxiety and/or depression. In addition, doxepin is similarly effective in the treatment of patient suffering from psychotic depression, including endogenous depression, involutional melancholia, senile depression, postpartum depression, and for the treatment of manic-depressive reactions during the depressed phase. Target symptoms that respond to treatment include: anxiety, depression, tension, apprehension, agitation, functional somatic complaints, insomnia, loss of interest, guilt, psychomotor retardation, and hypochondriasis. Doxepin may be used with benefit where symptoms are of short or long duration prior to treatment and in patients with a wide range of intensity of illness. As with other psychotherapeutic agents, the degree of response varies with each patient. In patients exhibiting a beneficial response, this may be seen within a few days of commencing therapy, while others may not respond for two weeks or longer. 4.2 Posology and Method of Administration Page 1 of 8 Oral use For most patients with illness of mild to moderate severity, a starting daily dose of 75 mg is recommended.
    [Show full text]
  • Drug/Substance Trade Name(S)
    A B C D E F G H I J K 1 Drug/Substance Trade Name(s) Drug Class Existing Penalty Class Special Notation T1:Doping/Endangerment Level T2: Mismanagement Level Comments Methylenedioxypyrovalerone is a stimulant of the cathinone class which acts as a 3,4-methylenedioxypyprovaleroneMDPV, “bath salts” norepinephrine-dopamine reuptake inhibitor. It was first developed in the 1960s by a team at 1 A Yes A A 2 Boehringer Ingelheim. No 3 Alfentanil Alfenta Narcotic used to control pain and keep patients asleep during surgery. 1 A Yes A No A Aminoxafen, Aminorex is a weight loss stimulant drug. It was withdrawn from the market after it was found Aminorex Aminoxaphen, Apiquel, to cause pulmonary hypertension. 1 A Yes A A 4 McN-742, Menocil No Amphetamine is a potent central nervous system stimulant that is used in the treatment of Amphetamine Speed, Upper 1 A Yes A A 5 attention deficit hyperactivity disorder, narcolepsy, and obesity. No Anileridine is a synthetic analgesic drug and is a member of the piperidine class of analgesic Anileridine Leritine 1 A Yes A A 6 agents developed by Merck & Co. in the 1950s. No Dopamine promoter used to treat loss of muscle movement control caused by Parkinson's Apomorphine Apokyn, Ixense 1 A Yes A A 7 disease. No Recreational drug with euphoriant and stimulant properties. The effects produced by BZP are comparable to those produced by amphetamine. It is often claimed that BZP was originally Benzylpiperazine BZP 1 A Yes A A synthesized as a potential antihelminthic (anti-parasitic) agent for use in farm animals.
    [Show full text]