DOCSLIB.ORG

Methotrimeprazine-Induced Corneal Deposits and Cataract Revealed by Urine Drug Profiling Test

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Methotrimeprazine-Induced Corneal Deposits and Cataract Revealed by Urine Drug Profiling Test CASE REPORT Ophthalmology DOI: 10.3346/jkms.2010.25.11.1688 • J Korean Med Sci 2010; 25: 1688-1691 Methotrimeprazine-induced Corneal Deposits and Cataract Revealed by Urine Drug Profiling Test Seong Taeck Kim1, Jae Woong Koh1, Two schizophrenic patients who had been taking medication for a long period presented Joon Mo Kim2, Won Young Kim3, with visual disturbance of 6-month duration. Slit-lamp examination revealed fine, discrete, and Gwang Ju Choi1 and brownish deposits on the posterior cornea. In addition, bilateral star-shaped anterior subcapsular lens opacities, which were dense, dust-like granular deposits, were noted. Department of Ophthalmology1, Chosun University College of Medicine, Gwangju; Department of Although we strongly suspected that the patient might have taken one of the drugs of the Ophthalmology2, Kangbuk Samsung Hospital, phenothiazine family, we were unable to obtain a history of medications other than Sungkyunkwan University School of Medicine, haloperidol and risperidone, which were taken for 3 yr. We performed a drug profiling test 3 Seoul; Department of Emergency Medicine , Asan using urine samples and detected methotrimeprazine. The patient underwent surgery for Medical Center, Ulsan University College of Medicine, Seoul, Korea anterior subcapsular lens opacities. Visual acuity improved in both eyes, but the corneal deposits remained. We report an unusual case of methotrimeprazine-induced corneal Received: 2 November 2009 deposits and cataract in a patient with psychosis, identified by using the urine drug Accepted: 2 February 2010 profiling test. Address for Correspondence: Jae-Woong Koh, M.D. Key Words: Methotrimeprazine; Cornea Deposits; Cataract Department of Ophthalmology, Chosun University College of Medicine, 588 Seoseok-dong, Dong-gu, Gwangju 501-140, Korea Tel: +82.62-220-3190, Fax: +82.62-225-9839 E-mail: [email protected] INTRODUCTION CASE REPORTS Phenothiazine was introduced in 1953 and was widely used in Case 1 psychiatry in the 1960s for the chronic treatment of schizophre- A 48-yr-old man, who had been taking medication for schizo- nia. By the 1970s, there was a 30% reduction in the hospitaliza- phrenia, presented with visual disturbance of 6-month dura- tion of schizophrenics, which was attributed to the introduction tion (June 22, 2006). In a span of 10 yr, he had been hospitalized of phenothiazines, especially chlorpromazine. However, despite several times for psychiatric treatment and had been under its extremely effective antipsychotic properties and a low inci- outpatient observation. Slit-lamp examination revealed fine, dence of extrapyramidal symptoms, the use of phenothiazines discrete, and brownish deposits on the posterior cornea (Fig. 1A, has significantly declined over the last decade owing to its ocu- B). In addition, bilateral star-shaped anterior subcapsular lens lar complications. opacities, which were dense, dust-like granular deposits, were Phenothiazine ocular toxicity affecting the cornea, conjunc- noted (Fig. 1C, D). Best-corrected visual acuity was 20/40 in the tiva, and lens was first described by Greiner and Berry in 1964 right eye and 20/50 in the left eye. Other ocular findings were (1). Since then, numerous authors have described ocular mani- normal. According to the information provided by his family festations of long-term phenothiazine therapy. It is hypothe- doctor, the patient had received 3 mg of haloperidol (thioxan- sized that phenothiazines denature proteins when exposed to thene family) and 6 mg of risperidone (molindone family) per light; the proteins then become opacified and are deposited in day for 3 yr. Although we strongly suspected that the patient the lens, corneal stroma, and conjunctiva (2, 3). These ocular might have taken one of the drugs of the phenothiazine family, changes persist even after discontinuation of the drug. we were unable to obtain a history of medications other than There have been several case reports of chlorpromazine-in- those mentioned above. We performed the Remedi HS drug duced corneal deposits and cataracts; however, methotrime- profiling test (Bio-Rad Co., Hercules, CA, USA) by using urine prazine-induced corneal deposits and cataracts are unusual samples and detected methotrimeprazine. Analyzing the medi- and rare. Herein, we report the first cases, to our knowledge, of cal history, we found that the patient had taken methotrimepra- methotrimeprazine-induced corneal deposits and cataract. zine habitually by using prescriptions from a different doctor © 2010 The Korean Academy of Medical Sciences. pISSN 1011-8934 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. eISSN 1598-6357 Kim ST, et al. • Methotrimeprazine-induced Corneal Deposits and Cataract A B C D Fig. 1. Slit lamp photographs (Case 1). It showed fine, discrete, and brownish deposits on the posterior cornea. A( ) right eye, (B) left eye. It showed characteristic star-shaped deposits in the anterior sub-capsular area. (C) right eye, (D) left eye. for about 3 yr, whenever he suffered from any anxiety or discom- terior subcapsular lens opacities, which were dense, dust-like fort. Methotrimeprazine-induced corneal deposits and cataract granular deposits, were noted (Fig. 2C, D). Visual acuity was were diagnosed on the basis of the clinical and laboratory find- 20/50 in both eyes. Other ocular findings were normal. The -pa ings. It was then decided that the patient should undergo sur- tient was treated with 9 mg of haloperidol (thioxanthene fami- gery for the anterior subcapsular lens opacities, and he subse- ly), 300 mg of valproic acid, 1 mg of benztropine, 50 mg of tra- quently underwent phacoemulsification with posterior cham- zodone, and 2.5 mg of diazepam. After diazepam was discon- ber foldable intraocular lens implantation in both eyes. Topical tinued, she was given 15 mg of haloperidol, 400 mg of valproic antibiotics and steroids were used for 4 weeks, with tapering of acid, 1 mg of benztropine, and 1 mg of risperidone (molindone the steroids. Three years after the operation, visual acuity had family), accordingly. At that time, we strongly suspected that improved to 20/20 in both eyes, but the corneal deposits re- the patient was taking a drug from the phenothiazine family, mained. but we could not find any evidence of such use. However, we did detect methotrimeprazine in her body by using the Remedi Case 2 HS drug profiling system (Bio-Rad Co., Hercules, CA, USA). In another case, a 28-yr-old woman, also being treated for men- Analyzing the medical history, we discovered that the patient tal retardation, hysteria, and nervous ticks, had been experienc- habitually took methotrimeprazine over a period of 4 yr by ob- ing visual disturbance for over a period of 4 months (Jan 12, 2009). taining prescriptions from various doctors, on suffering from Previously, she had been hospitalized and received outpatient any anxiety or discomfort. Furthermore, on the basis of clinical care for these psychiatric illnesses for 4 yr. Slit-lamp examina- and laboratory results, methotrimeprazine-induced corneal tion revealed fine, discrete, and brownish deposits on the pos- deposits and cataract were detected. terior cornea (Fig. 2A, B). In addition, bilateral star-shaped an- DOI: 10.3346/jkms.2010.25.11.1688 http://jkms.org 1689 Kim ST, et al. • Methotrimeprazine-induced Corneal Deposits and Cataract A B C D Fig. 2. Slit lamp photographs (Case 2). It showed fine, discrete, and brownish deposits on the posterior cornea. A( ) right eye, (B) left eye. It showed characteristic star-shaped deposits in the anterior sub-capsular area. (C) right eye, (D) left eye. DISCUSSION veloped in the center of anterior capsular lens. Especially, many studies were conducted on the correlation between phenothi- Phenothiazines, such as chlorpromazine or methotrimepra- azine and lens opacity. McCarty et al. (6) reported that ratio of zine, have been widely used for the treatment of mental diseas- anterior capsular opacity in cataract patients who did not receive es after being introduced to the psychiatric clinics in 1953, and phenothiazine medications was 0.2%, while the ratio was 26% many studies have been conducted on the side effects of over- for schizophrenia patients who received phenothiazine medi- dose and their complications (2-4). Methotrimeprazine is used cation. Ruigomez et al. (7) conducted a study on the incidence for the treatment of psychosis, particularly in schizophrenia and rate of cataract of schizophrenia patients and control group sub- manic phases of bipolar disorder. It should never be used in the jects. Although the incidence rate of cataract was higher in the treatment of agitated depressions because this drug increases control group than in the schizophrenic patients, the incidence agitation through the side effect of akathisia. Methotrimeprazine rate of cataract in patients under long-term medication of over is also used in lower doses for the treatment of nausea. Long- 300 mg chlorpromazine (phenothiazine family) daily was 8.8 term medication of phenothiazine accumulates 50 times higher times that of the control group. Rather than reporting schizo- blood concentration in the ocular tissue in comparison to that phrenia as a risk factor of cataract, the authors reported that of other tissues of the body (5). In 1964, Greiner and Berry (1) long-term medication of phenothiazine increases the risk of first described their findings on 70 patients who received long- cataract. It is believed that the clinical changes in the conjuncti- term medication of chlorpromazine (phenothiazine family), va, cornea, and lens observed in patients who received a specif- reporting that brown granular pigmentation occurred in the pa- ic dosage of drugs belonging to the phenothiazine family could renchyma of the cornea and a central star-shaped opacity de- be attributed to an increase in the number of melanin cells as- 1690 http://jkms.org DOI: 10.3346/jkms.2010.25.11.1688 Kim ST, et al.
Load more

Recommended publications
  • Characterization of Schizophrenia Adverse Drug Interactions Through a Network Approach and Drug Classification Jingchun Sun University of Nashville
    Virginia Commonwealth University VCU Scholars Compass Psychiatry Publications Dept. of Psychiatry 2013 Characterization of Schizophrenia Adverse Drug Interactions through a Network Approach and Drug Classification Jingchun Sun University of Nashville Min Zhao Vanderbilt University School of Medicine Ayman H. Fanous Virginia Commonwealth University Zhongming Zhao Virginia Commonwealth University Follow this and additional works at: http://scholarscompass.vcu.edu/psych_pubs Copyright © 2013 Jingchun Sun et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Downloaded from http://scholarscompass.vcu.edu/psych_pubs/10 This Article is brought to you for free and open access by the Dept. of Psychiatry at VCU Scholars Compass. It has been accepted for inclusion in Psychiatry Publications by an authorized administrator of VCU Scholars Compass. For more information, please contact [email protected]. Hindawi Publishing Corporation BioMed Research International Volume 2013, Article ID 458989, 10 pages http://dx.doi.org/10.1155/2013/458989 Research Article Characterization of Schizophrenia Adverse Drug Interactions through a Network Approach and Drug Classification Jingchun Sun,1,2 Min Zhao,1 Ayman H. Fanous,3,4 and Zhongming Zhao1,2,5,6 1 Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, TN 37203, USA 2 Center for Quantitative Sciences, Vanderbilt
    [Show full text]
  • Supplementary Table S1: Search Strategy for Ovid MEDLINE Electronic Database Search
    Supplementary Table S1: Search strategy for Ovid MEDLINE electronic database search Database(s): Ovid MEDLINE: Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid MEDLINE® Daily and Ovid MEDLINE® 1946-Present Search Strategy: # Searches 1 exp "schizophrenia spectrum and other psychotic disorders"/ (psychotic disorder* or schizo* or psychosis or psychotic* or first episode or antipsychotic naive or 2 untreated or unmedicated).tw,kf. 3 Antipsychotic Agents/ or (antipsychotic* or neuroleptic*).tw,kf. 4 Chlorpromazine.mp. or Chlorpromazine/ 5 Chlorprothixene.mp. or Chlorprothixene/ 6 Droperidol.mp. or Droperidol/ 7 Flupentixol.mp. or Flupenthixol/ 8 Fluphenazine.mp. or Fluphenazine/ 9 Haloperidol.mp. or Haloperidol/ 10 (Levomepromazine or Methotrimeprazine).mp. or Methotrimeprazine/ 11 Loxapine.mp. or Loxapine/ 12 Mesoridazine.mp. or Mesoridazine/ 13 Molindone.mp. or Molindone/ 14 Periciazine.mp. 15 Pimozide.mp. or Pimozide/ 16 Prochlorperazine.mp. or Prochlorperazine/ 17 Promazine.mp. or Promazine/ 18 Thioproperazine.mp. 19 Thioridazine.mp. or Thioridazine/ 20 Thiothixene.mp. or Thiothixene/ 21 Trifluoperazine.mp. or Trifluoperazine/ 22 (Zuclopenthixol or Clopenthixol).mp. or Clopenthixol/ 23 (antipsychotic* adj5 (typical or first generation)).tw,kf. 24 (amisulpride or solian).mp. 25 ARIPIPRAZOLE/ or (aripiprazol or aripiprazole or abilify or OPC 14597).mp. 26 (asenapine or saphris or sycrest).mp. 27 (blonanserin or lonasen).mp. 28 Brexpiprazole.mp. 29 CLOZAPINE/ or (cloazpine or clozaril or leponex).mp. 30 (iloperidone or fanapt or fanapta).mp. 31 Lurasidone Hydrochloride/ or (lurasidone or latuda or sm 13496).mp. 32 (melperone or buronil).mp. 33 (olanzapine or zyprexa).mp. 34 Paliperidone Palmitate/ or (paliperidone or invega or r 76477).mp. 35 (perospirone or lullan).mp.
    [Show full text]
  • The Effects of Antipsychotic Treatment on Metabolic Function: a Systematic Review and Network Meta-Analysis
    The effects of antipsychotic treatment on metabolic function: a systematic review and network meta-analysis Toby Pillinger, Robert McCutcheon, Luke Vano, Katherine Beck, Guy Hindley, Atheeshaan Arumuham, Yuya Mizuno, Sridhar Natesan, Orestis Efthimiou, Andrea Cipriani, Oliver Howes ****PROTOCOL**** Review questions 1. What is the magnitude of metabolic dysregulation (defined as alterations in fasting glucose, total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, and triglyceride levels) and alterations in body weight and body mass index associated with short-term (‘acute’) antipsychotic treatment in individuals with schizophrenia? 2. Does baseline physiology (e.g. body weight) and demographics (e.g. age) of patients predict magnitude of antipsychotic-associated metabolic dysregulation? 3. Are alterations in metabolic parameters over time associated with alterations in degree of psychopathology? 1 Searches We plan to search EMBASE, PsycINFO, and MEDLINE from inception using the following terms: 1 (Acepromazine or Acetophenazine or Amisulpride or Aripiprazole or Asenapine or Benperidol or Blonanserin or Bromperidol or Butaperazine or Carpipramine or Chlorproethazine or Chlorpromazine or Chlorprothixene or Clocapramine or Clopenthixol or Clopentixol or Clothiapine or Clotiapine or Clozapine or Cyamemazine or Cyamepromazine or Dixyrazine or Droperidol or Fluanisone or Flupehenazine or Flupenthixol or Flupentixol or Fluphenazine or Fluspirilen or Fluspirilene or Haloperidol or Iloperidone
    [Show full text]
  • Zine and Some Related Phenothiazines in Reducing the Rigidity of the Decerebrate Cat and in Some Other Central Actions by Elizabeth M
    Br. J. Pharmac. Chemother. (1967), 29, 400-416. A COMPARISON OF THE EFFECTS OF CHLORPROMA- ZINE AND SOME RELATED PHENOTHIAZINES IN REDUCING THE RIGIDITY OF THE DECEREBRATE CAT AND IN SOME OTHER CENTRAL ACTIONS BY ELIZABETH M. KEARY AND D. R. MAXWELL From the Research Laboratories, May & Baker Ltd., Dagenham, Essex (Received March 2, 1967) One of the many interesting properties of chlorpromazine is its ability to reduce skeletal muscle tone in experimental animals (Dasgupta & Werner, 1955; Sheatz, 1955). Henatsch & Ingvar (1956) and Busch, Henatsch & Schulte (1960) have shown that small doses of chlorpromazine abolish the rigidity of the intercollicular decerebrate cat and reduce the discharge of -y-motoneurones. These authors also found that much larger doses of chlorpromazine were required to depress the rigidity of the decerebrate cat prepared by the ischaemic method of Pollock & Davis (1930). It was suggested that chlorpromazine had a selective depressant effect on the y- as opposed to the a-moto- neurones at a supraspinal level. Chlorpromazine has been reputed to be of some value in reducing the muscle tonus in patients with spasticity (Basmajian & Szatmari, 1955). Although the actions of chlorpromazine in reducing skeletal muscle tone and in affecting spinal reflexes have been extensively studied, little is known about the activity of related phenothiazine derivatives in this context. It thus appeared interesting to compare chlorpromazine with some related phenothiazine derivatives for their ability to reduce rigidity of the intercollicular decerebrate cat with the object of seeing to what extent there was correlation between activity in reducing skeletal muscle tone and other pharmacological actions.
    [Show full text]
  • Screening of 300 Drugs in Blood Utilizing Second Generation
    Forensic Screening of 300 Drugs in Blood Utilizing Exactive Plus High-Resolution Accurate Mass Spectrometer and ExactFinder Software Kristine Van Natta, Marta Kozak, Xiang He Forensic Toxicology use Only Drugs analyzed Compound Compound Compound Atazanavir Efavirenz Pyrilamine Chlorpropamide Haloperidol Tolbutamide 1-(3-Chlorophenyl)piperazine Des(2-hydroxyethyl)opipramol Pentazocine Atenolol EMDP Quinidine Chlorprothixene Hydrocodone Tramadol 10-hydroxycarbazepine Desalkylflurazepam Perimetazine Atropine Ephedrine Quinine Cilazapril Hydromorphone Trazodone 5-(p-Methylphenyl)-5-phenylhydantoin Desipramine Phenacetin Benperidol Escitalopram Quinupramine Cinchonine Hydroquinine Triazolam 6-Acetylcodeine Desmethylcitalopram Phenazone Benzoylecgonine Esmolol Ranitidine Cinnarizine Hydroxychloroquine Trifluoperazine Bepridil Estazolam Reserpine 6-Monoacetylmorphine Desmethylcitalopram Phencyclidine Cisapride HydroxyItraconazole Trifluperidol Betaxolol Ethyl Loflazepate Risperidone 7(2,3dihydroxypropyl)Theophylline Desmethylclozapine Phenylbutazone Clenbuterol Hydroxyzine Triflupromazine Bezafibrate Ethylamphetamine Ritonavir 7-Aminoclonazepam Desmethyldoxepin Pholcodine Clobazam Ibogaine Trihexyphenidyl Biperiden Etifoxine Ropivacaine 7-Aminoflunitrazepam Desmethylmirtazapine Pimozide Clofibrate Imatinib Trimeprazine Bisoprolol Etodolac Rufinamide 9-hydroxy-risperidone Desmethylnefopam Pindolol Clomethiazole Imipramine Trimetazidine Bromazepam Felbamate Secobarbital Clomipramine Indalpine Trimethoprim Acepromazine Desmethyltramadol Pipamperone
    [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]
  • Behaviour Management in Dementia Where Do Antipsychotics Fit?
    Behaviour Management in Dementia Where Do Antipsychotics Fit? October 2011 Reprinted February 2012 Guidelines/Reviews Background Issues What do we know about the benefits and Dementia Behavioural and psychological symptoms of risks of psychotropic meds in BPSD? 2006 CCCDTD3 : http://www.cccdtd.ca/ dementia (BPSD) create a significant caregiver o Evidence for psychotropic use is limited and Tx Mild‐Mod 2008: challenge. Key symptoms include aggression, all classes have limited efficacy and serious http://www.cmaj.ca/content/17 1 agitation, psychosis and mood disorders. adverse event (SAE) concerns. (See Table 3) 9/10/1019.full.pdf+html 5 Tx Severe Alzheimer’s 2008: For an overview see BPSD chart (Page 4). http://www.cmaj.ca/content/17 Table 1: Common BPSD Neuropsychiatric symptoms 2 9/12/1279.full.pdf+html agitation* resistive emotional Where do Antipsychotics (APs) Fit? NICE (UK) 2006: apathy wandering lability AP effectiveness in BPSD is modest & their role http://www.nice.org.uk/nicemedia aggression*, intrusiveness paranoid 11,12,13,14 6 /live/10998/30318/30318.pdf verbal/physical repetitive behaviours is limited due to SAEs. See CATIE-AD Trial Summary. APs, both typical (e.g. haloperidol) & atypical Other Reviews calling out, behaviours psychosis*, o (risperidone , olanzapine & Cognitive Impairment: screaming vocalizations hallucinations Risperdal Zyprexa http://www.rxfacts.org/professi hostility hoarding /delusions quetiapine Seroquel), have been studied in BPSD. onals/CognitiveImpairment.php sexual dis‐ nocturnal o Placebo response rates often ~40%, reflecting inhibition restlessness high rates of spontaneous resolution & the Pt/Caregiver Resources *symptoms with some evidence for benefit of antipsychotics 15 value of psychosocial input in such trials.
    [Show full text]
  • EFFECT of SOME PSYCHOACTIVE AGENTS on PENTOBARBITONE Promethazine, Imipramine A~ ANAESTHESIA in RATS Presented in Table 1
    Volume 17 Number 4 SHORT COMMUNICATION The mean anaesthetic I administration prolonged the time was reduced after ha EFFECT OF SOME PSYCHOACTIVE AGENTS ON PENTOBARBITONE promethazine, imipramine a~ ANAESTHESIA IN RATS presented in Table 1. TABLEI: Influence of RAJE DRA K. RAINA Drugs (mg/kg., i.p.) Department of Pharmacology, Government Medical College, Srinagar Summary: Several psycho-active agents we-re investigated fo'r their influence on pentobarbitone Control (Saline 2 ml/kg) anaesthesia time in rats. It was found that prior administration of haloperido.l, methaqualone Methylcellulose (2%) in ormal s and triflupromazine reduced the duration of anaesthesia. An increase in durati~n was noted Promethazine (l0.0 mg) after diazepam. The probable mechanism has been discussed. Chlorpromazine (5.0 IIIg) Triflupromazine (10.0 mg) Key words: pentobarbitone anaesthesia psychoactive agents Thioproperazine (10.0 mg) Haloperidol (10.0 IIIg) INTRODUCTION Methaqualone (15.0 mg) Diazepam (10.0 mg.) Kato and Chiesara (7) reported that many centrally active agents may produce tolerance to Imipramine (10.0 mg) barbiturates as a result of induction of liver microsomal enzymes involved in drug metabolism Haloperidol and promethazine have also been reported to influence the enzyme activity (6). As there is lack of information concerning the effect of various psycho-active agents on metabolic The results obtained mechanisms, it was thought of interest to study the influence of some of the commonly used after pretreatment with agents on pantobarbitone anaesthetic time and if possible to attempt to correlate the data servations made by Kato ar obtained with the results on enzyme activity reported in the literature.
    [Show full text]
  • ORIGINAL ARTICLE Pharmacotherapy of Schizophrenia: the American Current Status Winston W Shen
    ORIGINAL ARTICLE Pharmacotherapy of Schizophrenia: The American Current Status Winston W Shen Department of Psychiatry and Human Behavior, Saint Louis University School of Medicine, St Louis, MO, USA (Receivedfor publicationon August22, 1994) Abstract. This is a review paper covering the American current status of pharmacotherapy of schizo phrenia. The author lists all available antipsychotic agents on the market in the United States and describes the American prescribing pattern of antipsychotic agents. This includes a brief history of antipsychotic use in America, acute treatment and chronic maintenance with antipsychotic drugs, the recent advent of atypical antipsychotic agents, and management of antipsychotic-induced side-effects. The characteristics of prescribing American antipsychotics in America are described, and they are then compared with Japanese prescribing practices. The author also makes brief remarks about the uncovered issues in antipsychotic pharmacotherapy and about atypical antipsychotic agents in the context of the future pharmaceutical development. (Keio J Med 43 (4): 192-200, December 1994) Key words: antipsychotics, atypical antipsychotics, psychopharmacology, American prescribing pattern, schizophrenia Introduction Available Antipsychotic Agents on the US Market This paper is a brief review which deals with research Table 1 is a list of antipsychotic agents which are findings, clinical issues and strategies in the pharmaco commonly prescribed in the US. The numbers of potency logical treatments for "Schizophrenia and Other Psy equivalent dose in mg listed in Table 1 are from various chotic Disorders" as one of new 15 DSM-IV Axis I sources and are often inconsistent. Promazine and reser diagnostic categories.1 The diagnoses (and their codes) pine are available in America but are omitted from include schizophrenia (395.xx, 5 types), schizophreniform the list due to their inferior antipsychotic effects.
    [Show full text]
  • Special Article: One Resident's Perspective on a Different Style of Psychopharmacological Practice
    Jefferson Journal of Psychiatry Volume 8 Issue 1 Article 4 January 1990 Special Article: One Resident's Perspective on a Different Style of Psychopharmacological Practice Michael Amiel, M.D. North Florida Evaluation / Treatment Center, Gainsville Florida Docteur J.P. Blayac Hospital St. Charles, Montpellier Cedex, France Follow this and additional works at: https://jdc.jefferson.edu/jeffjpsychiatry Part of the Psychiatry Commons Let us know how access to this document benefits ouy Recommended Citation Amiel, M.D., Michael and Blayac, Docteur J.P. (1990) "Special Article: One Resident's Perspective on a Different Style of Psychopharmacological Practice," Jefferson Journal of Psychiatry: Vol. 8 : Iss. 1 , Article 4. DOI: https://doi.org/10.29046/JJP.008.1.001 Available at: https://jdc.jefferson.edu/jeffjpsychiatry/vol8/iss1/4 This Article is brought to you for free and open access by the Jefferson Digital Commons. The Jefferson Digital Commons is a service of Thomas Jefferson University's Center for Teaching and Learning (CTL). The Commons is a showcase for Jefferson books and journals, peer-reviewed scholarly publications, unique historical collections from the University archives, and teaching tools. The Jefferson Digital Commons allows researchers and interested readers anywhere in the world to learn about and keep up to date with Jefferson scholarship. This article has been accepted for inclusion in Jefferson Journal of Psychiatry by an authorized administrator of the Jefferson Digital Commons. For more information, please contact: [email protected]. Special Article: One Resident's Perspective on a Different Style ofPsychopharmacological Practice Michael Arniel, M.D . DocteurJ.P. Blayac This article provides a comparison of psychopharmacological practices in the u.s.and France.
    [Show full text]
  • Electronic Search Strategies
    Appendix 1: electronic search strategies The following search strategy will be applied in PubMed: ("Antipsychotic Agents"[Mesh] OR acepromazine OR acetophenazine OR amisulpride OR aripiprazole OR asenapine OR benperidol OR bromperidol OR butaperazine OR Chlorpromazine OR chlorproethazine OR chlorprothixene OR clopenthixol OR clotiapine OR clozapine OR cyamemazine OR dixyrazine OR droperidol OR fluanisone OR flupentixol OR fluphenazine OR fluspirilene OR haloperidol OR iloperidone OR levomepromazine OR levosulpiride OR loxapine OR lurasidone OR melperone OR mesoridazine OR molindone OR moperone OR mosapramine OR olanzapine OR oxypertine OR paliperidone OR penfluridol OR perazine OR periciazine OR perphenazine OR pimozide OR pipamperone OR pipotiazine OR prochlorperazine OR promazine OR prothipendyl OR quetiapine OR remoxipride OR risperidone OR sertindole OR sulpiride OR sultopride OR tiapride OR thiopropazate OR thioproperazine OR thioridazine OR tiotixene OR trifluoperazine OR trifluperidol OR triflupromazine OR veralipride OR ziprasidone OR zotepine OR zuclopenthixol ) AND ("Randomized Controlled Trial"[ptyp] OR "Controlled Clinical Trial"[ptyp] OR "Multicenter Study"[ptyp] OR "randomized"[tiab] OR "randomised"[tiab] OR "placebo"[tiab] OR "randomly"[tiab] OR "trial"[tiab] OR controlled[ti] OR randomized controlled trials[mh] OR random allocation[mh] OR double-blind method[mh] OR single-blind method[mh] OR "Clinical Trial"[Ptyp] OR "Clinical Trials as Topic"[Mesh]) AND (((Schizo*[tiab] OR Psychosis[tiab] OR psychoses[tiab] OR psychotic[tiab] OR disturbed[tiab] OR paranoid[tiab] OR paranoia[tiab]) AND ((Child*[ti] OR Paediatric[ti] OR Pediatric[ti] OR Juvenile[ti] OR Youth[ti] OR Young[ti] OR Adolesc*[ti] OR Teenage*[ti] OR early*[ti] OR kids[ti] OR infant*[ti] OR toddler*[ti] OR boys[ti] OR girls[ti] OR "Child"[Mesh]) OR "Infant"[Mesh])) OR ("Schizophrenia, Childhood"[Mesh])).
    [Show full text]
  • When GWAS Meets the Connectivity Map: Drug Repositioning for Seven Psychiatric
    bioRxiv preprint doi: https://doi.org/10.1101/096503; this version posted December 23, 2016. The copyright holder for this preprint (which was not certified by peer review) is the author/funder. All rights reserved. No reuse allowed without permission. When GWAS meets the Connectivity Map: drug repositioning for seven psychiatric disorders Hon-Cheong So1,2*, Carlos K.L. Chau1, Wan-To Chiu3, Kin-Sang Ho3, Cho-Pong Lo3, Stephanie Ho-Yue Yim4 and Pak C. Sham5,6,7,8 1School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong 2KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research of Common Diseases, Kunming Zoology Institute of Zoology and The Chinese University of Hong Kong 3Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong 4Univeristy of Exeter Medical School, United Kingdom 5Department of Psychiatry, University of Hong Kong, Pokfulam, Hong Kong 6Centre for Genomic Sciences, University of Hong Kong, Pokfulam, Hong Kong 7State Key Laboratory for Cognitive and Brain Sciences, University of Hong Kong, Pokfulam, Hong Kong 8Centre for Reproduction, Development and Growth, University of Hong Kong, Pokfulam, Hong Kong *Correspondence to: Hon-Cheong So, School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong Email: [email protected] (Submitted to bioRxiv on 23 Dec 2016) 1 bioRxiv preprint doi: https://doi.org/10.1101/096503; this version posted December 23, 2016. The copyright holder for this preprint (which was not certified by peer review) is the author/funder. All rights reserved. No reuse allowed without permission. Abstract Our knowledge of disease genetics has advanced rapidly during the past decade, with the advent of high-throughput genotyping technologies such as genome-wide association studies (GWAS).
    [Show full text]