The comparison of the effects of multi and single doses of buspirone, chlordiazepoxide and hydroxyzine on psychomotor function and EEG

This study compares the effects of buspirone (5 mg), chlordiazepoxide (5 mg), hydroxyzine (10 mg) and placebo on psychomotor function and EEG, when taken thrice daily for a period of two weeks, with those after a single dose administration. Nine healthy volunteers participated in the study. The battery of psychomotor tests included peak velocity of saccadic eye movements (SEM), a Sternberg memory scanning and choice reaction time test (SMS-CRT) and critical flicker fusion frequency (CFFF). The peak velocity of saccadic eye movements was significantly impaired by the single dose of hydroxyzine (P = 0.03) in comparison to the multidose results. A similar comparison regarding buspirone only approached significance (P = 0.07). The SMS-CRT and CFFF did not reveal any difference between the multi and single dose regimens. Spectral analysis of the EEG did not distinguish between the multi and single dosage schedules regarding the respective drugs in the low doses administered.     

Turbidimetric carbamazepine immunoassay on the ADVIA 1650 and 2400 analyzers is free from interference of antihistamine drugs hydroxyzine and cetirizine

A recent report indicates that hydroxyzine and its active metabolite cetirizine interfere with the particle-enhanced turbidimetric inhibition immunoassay (PENTINA) carbamazepine assay. We studied potential interference of hydroxyzine and cetirizine with the turbidimetric carbamazepine immunoassay on ADVIA 1650 and ADVIA 2400 (Bayer Diagnostics, Tarrytown, NY) analyzers. Aliquots of drug-free serum pools were supplemented with various concentrations of hydroxyzine and cetirizine representing therapeutic, moderate toxic, as well as very toxic concentrations. These samples were assayed by the turbidimetric carbamazepine immunoassay on two analyzers. To study the interference in presence of the analyte, aliquots of a serum pool prepared from patients receiving carbamazepine were further supplemented with various amounts of hydroxyzine and or cetirizine and apparent carbamazepine concentrations were measured again in order to compare with the value of original pool. No apparent carbamazepine concentration was observed when aliquots of drug-free serum were supplemented with hydroxyzine or cetirizine. Moreover, in the carbamazepine pool, the original carbamazepine concentration compared well when aliquots of this serum pool were further supplemented with hydroxyzine or cetirizine. We conclude that the turbidimetric carbamazepine immunoassay is free from interference of hydroxyzine and cetirizine.     

Cognitive and psychomotor effects of risperidone in schizophrenia and schizoaffective disorder

OBJECTIVE: The aim of this review was to discuss data from double-blind, randomized controlled trials (RCTs) that have investigated the effects of oral and long-acting injectable risperidone on cognitive and psychomotor functioning in patients with schizophrenia or schizoaffective disorder. METHODS: PubMed/MEDLINE and the Institute of Scientific Information Web of Science database were searched for relevant English-language double-blind RCTs published between March 2000 and July 2008, using the terms schizophrenia, schizoaffective disorder, cognition, risperidone, psychomotor, processing speed, attention, vigilance, working memory, verbal learning, visual learning, reasoning, problem solving, social cognition, MATRICS, and long-acting. Relevant studies included patients with schizophrenia or schizoaffective disorder. Cognitive domains were delineated at the Consensus Conferences of the National Institute of Mental Health-Measurement And Treatment Research to Improve Cognition in Schizophrenia (NIMH-MATRICS). The tests employed to assess each domain and psychomotor functioning, and the within-group and between-group comparisons of risperidone with haloperidol and other atypical antipsychotics, are presented. The results of individual tests were included when they were individually presented and interpretable for either drug; outcomes that were presented as cluster scores or factor structures were excluded. RESULTS: A total of 12 articles were included in this review. Results suggested that the use of oral risperidone appeared to be associated with within-group improvements on the cognitive domains of processing speed, attention/vigilance, verbal and visual learning and memory, and reasoning and problem solving in patients with schizophrenia or schizoaffective disorder. Risperidone and haloperidol seemed to generate similar beneficial effects (on the domains of processing speed, attention/vigilance, [verbal and nonverbal] working memory, and visual learning and memory, as well as psychomotor functioning), although the results for verbal fluency, verbal learning and memory, and reasoning and problem solving were not unanimous, and no comparative data on social cognition were available. Similar cognitive effects were found with risperidone, olanzapine, and quetiapine on the domains of verbal working memory and reasoning and problem solving, as well as verbal fluency. More research is needed on the domains in which study results were contradictory. For olanzapine versus risperidone, these were verbal and visual learning and memory and psychomotor functioning. No comparative data for olanzapine and risperidone were available for the social cognition domain. For quetiapine versus risperidone, the domains in which no unanimity was found were processing speed, attention/vigilance, nonverbal working memory, and verbal learning and memory. The limited available reports on risperidone versus clozapine suggest that: risperidone was associated with improved, and clozapine with worsened, performance on the nonverbal working memory domain; risperidone improved and clozapine did not improve reasoning and problem-solving performance; clozapine improved, and risperidone did not improve, social cognition performance. Use of long-acting injectable risperidone seemed to be associated with improved performance in the domains of attention/vigilance, verbal learning and memory, and reasoning and problem solving, as well as psychomotor functioning. The results for the nonverbal working memory domain were indeterminate, and no clear improvement was seen in the social cognition domain. The domains of processing speed, verbal working memory, and visual learning and memory, as well as verbal fluency, were not assessed. CONCLUSIONS: The results of this review of within-group comparisons of oral risperidone suggest that the agent appeared to be associated with improved functioning in the cognitive domains of processing speed, attention/vigilance, verbal and visual learning and memory, and reasoning and problem solving in patients with schizophrenia or schizoaffective disorder. Long-acting injectable risperidone seemed to be associated with improved functioning in the domains of attention/vigilance, verbal learning and memory, and reasoning and problem solving, as well as psychomotor functioning, in patients with schizophrenia or schizoaffective disorder.     

The effects of psychomotor performance of fluvoxamine versus mianserin in depressed patients in general practice.

This study examined the psychomotor and antidepressant effects of fluvoxamine in a depressed, GP patient population, compared to those of mianserin. It was a single centre, double-blind, six-week study, preceded by a one-week pre-treatment placebo washout, in 59 patients suffering from major depressive episode (DSM III) and scoring over 24 on MADRS. The starting dose was 100 mg fluvoxamine or 60 mg mianserin daily for one week, rising to 300 mg fluvoxamine or 180 mg mianserin. Both treatment groups showed significant improvement over time with no differences between drugs in terms of efficacy. Fluvoxamine and mianserin were both shown to be effective in the treatment of depressive illness. Some psychomotor impairment in the first few days and weight gain over a longer period could affect compliance with mianserin. Fluvoxamine does not reduce psychomotor performance or cause weight gain.     

Analytical performance evaluation of ADVIA Chemistry Carbamazepine_2 assay: minimal cross‐reactivity with carbamazepine 10, 11‐epoxide and none with hydroxyzine or cetirizine

Carbamazepine is an anticonvulsant requiring routine therapeutic drug monitoring. Recently, Siemens Healthcare Diagnostic Division released a new carbamazepine assay: ADVIA Chemistry Carbamazepine_2 (Carbamazepine_2) for application on ADVIA analyzers. We evaluated the analytical performance of this assay as well as its potential cross‐reactivities with carbamazepine 10, 11‐epoxide, hydroxyzine, and cetirizine. The within‐run and between‐run precisions of the Carbamzepine‐2 assay were <6% and limit of detection was 0.5 µg/ml using ADVIA 1800 analyzer. The assay was linear up to a carbamazepine concentration of 20.0 µg/ml. The new method compared well with a widely used carbamazepine EMIT 2000 assay on the Hitachi 917 analyzer. Using 75 patients' specimens (where carbamazepine concentrations varied from 0.5 to 21.7 µg/ml) and carbamazepine EMIT 2000 as the reference method (x‐axis), we observed the following regression equation: y=1.04 x+0.32 (r=0.99). The new carbazepine_2 method was not affected by a hemoglobin concentration of 1,000 mg/dl, conjugated or unconjugated bilirubin concentration of 60 mg/dl, and triglyceride concentration of 1,000 mg/dl. In addition, this assay showed no cross‐reactivity with hydroxyzine or cetirizine and demonstrated minimal cross‐reactivity with carbamazepine 10, 11‐epoxide. We conclude that the ADVIA Chemistry carbamazepine_2 assay has adequate precision and accuracy for routine therapeutic drug monitoring of carbamazepine in clinical laboratories. J. Clin. Lab. Anal. 24:278–282, 2010. © 2010 Wiley‐Liss, Inc.     

The relative effects of system parameters on texture in gray-scale ultrasonograms

Texture in B-mode ultrasonography of the abdomen can, in many cases, serve as an important diagnostic tool. Unfortunately, because texture as it is now presented depends on many parameters which are independent of pathology, it is not always a reliable sign. Parameters such as transducer size, center frequency, and bandwidth; B-mode display and storage methods; near and far field wave effects; and the type of intervening tissue all influence the display of texture. We have investigated these parameters of texture through the analysis of computer simulated B-mode ultrasonograms based on in vitro A-line data collected under a variety of circumstances and conditions. A freshly excised bovine pancreas served as the target tissue. Computer generated textured B-mode images, produced with different gray-scale and scan converter storage algorithms, were evaluated by a panel of six radiologists who individually divided sixty images into groups of images with similar texture. These evaluations were mapped into a six feature hyperspace with each axis representing a particular parameter. By applying a variation of the principal components transformation, each parameter could be ranked according to its effect on texture. We found that the type of gray-level preprocessing map had the most effect on texture; intervening tissue and transducer variations had intermediate effects. So long as the target distance did not exceed the focal length of the transducer, the distance between the transducer and the target tissues had the least effect on texture.     

The effects of alprazolam, quazepam and diazepam on saccadic eye movements, parameters of psychomotor function and the EEG

The effects of a single oral dose of alprazolam (1 mg), quazepam (15 mg) and diazepam (10 mg) on the peak saccadic velocity (PSV) of saccadic eye movements (SEM), the Sternberg memory scanning and choice reaction time (SMS-CRT), critical flicker fusion frequency (CFFF), spectral analysis of the EEG and a mood scale were assessed in 9 healthy volunteers in a double-blind, placebo-controlled cross-over study. Alprazolam revealed greater sedative effects than diazepam in the above-mentioned tests. Quazepam had the least sedative effect of the 3 drugs tested, showed a time lag at the onset of its effects and a more prolonged effect on psychomotor impairment than reported previously.     

Comparative effects of ginkgo biloba extracts on psychomotor performances and memory in healthy subjects

The effect on psychomotor and mnesic performances of acute oral dose (600 mg) of 2 Ginkgo biloba extracts were evaluated in twelve healthy female in a dummy placebo-controlled double blind study. Tests were performed comprising: objective measures of vigilance [critical flicker frequency (CFF), choice reaction time (CRT)], memory tasks (pictures and Sternberg scanning tests) and self-rating evaluation (visual analogue scales). Tests session took place before and 1 hour post-dosing. No statistically significant changes from placebo were observed on CFF, CRT or subjective rating of drug effects. No differences between treatment were evidenced on Sternberg scanning test and pictures recognition. Comparing to baseline, free recall score, while decreasing under placebo and Ginkgo, remained the same under Tanakan. As the differences between treatment are localized on one test, it appears important to examine the reproductility in healthy subjects. In order to verify the clinical relevance of these results, they need to be replicated in older healthy volunteers with age-associated memory impairment.     

Comparison of salbutamol and ephedrine in oral bronchodilator combinations with theophylline and hydroxyzine: their effects on asthmatics.

The efficacies of three antiasthamatic bronchodilator combinations were compared using data obtained from sixteen patients. During the trial the patients measured their peak expiratory flow (PEF) every day at 7.00 a.m., 10.00 a.m. and 9.30 pm. Six patients also measured their PEF at 1.30 a.m. The frequency and severity of symptoms and side-effects as well as the auxiliary use of isoprenaline inhalations were also recorded. This double-blind cross-over trial consisted of five four-day periods including three periods with different drug combinations and two placebo periods. By increasing the sympathomimetic activity of the basic oral drug combination of theophylline and hydroxyzine with salbutamol or ephedrine the therapeutic effect of the combination was also increased although not statistically significantly. All combinations tested differed significantly from placebo in their effect. Harmful side-effects increased in proportion to the potency of the sympathomimetic drug used in the combination; they were minimal during treatment with the basic theophylline-hydroxyzine combination. Circadian variation of bronchial obstruction was a constant phenomenon in all asthmatics participating in this trial.