Antipsychotic treatment and sexual functioning in first-time neuroleptic-treated schizophrenic patients

The present study examined sexual functioning among first-time treated schizophrenia patients at the time that they initiated antipsychotic treatment, and again 3 and 6 months later. These first-time treated patients comprise a subgroup of 570 schizophrenia patients who were part of a cohort of 7,655 patients enrolled in the Intercontinental Schizophrenia Outpatient-Health Outcomes observational study (IC-SOHO). As part of a brief clinical assessment conducted at entry to the study, and after 3 and 6 months of antipsychotic medication, patients were asked to rate their sexual functioning, and the investigator was asked to rate the extent to which the patient had neuroleptic-related loss of libido and sexual dysfunction. After being treated, patients treated with olanzapine showed the lowest prevalence of neuroleptic-induced sexual difficulties. At 3 months, there were significant differences between the treatment groups on neuroleptic-related loss of libido, neuroleptic-related sexual dysfunction and change in patient-rated sexual dysfunction. At 6 months, the difference between the groups on neuroleptic-related loss of libido was statistically significant. There were no significant differences between males and females. Many recent onset patients appear to suffer from problems of sexual functioning. Olanzapine may offer an advantage in this area.     

Effects of fenfluramine on sleep-wakefulness in cats

Five cats were prepared with chronically implanted electrodes for recording sleep-wakefulness patterns. Four of these animals received fenfluramine at each of three dose levels and data was recorded for the following 12 hours. Percent of time in paradoxical sleep was significantly reduced by 2.5 and 7.5 mg/kg, but not by 0.5 mg/kg, of fenfluramine. The higher doses also increased slow-wave sleep and, at 7.5 mg/kg (an anorexigenic dose), total sleep time was significantly increased. Under similar conditions amphetamine, at an anorexigenic dose of 1 mg/kg, significantly suppressed both paradoxical sleep and slow-wave sleep in three cats.Rebound of paradoxical sleep after suppression induced by 2.5 mg/kg of fenfluramine was not seen in either of two cats studied when sleep patterns were recorded for 48 hours. After 7.5 mg/kg of the drug, however, rebound was seen on days 3 and 4 after suppression of paradoxical sleep which lasted for over 26 hours. In two animals, daily administration of 2.5 mg/kg of fenfluramine for 16 consecutive days, followed by saline administration for three days, indicated that tolerance was developing to the suppression of paradoxical sleep produced by the drug.     

Effects of controlled-release formulations of atypical antipsychotics on functioning and quality of life of schizophrenic individuals

INTRODUCTION: Controlled-release formulations of atypical antipsychotics have recently been introduced into clinical practice. Clinical studies have indicated that these new therapies induce meaningful improvements in the functioning and quality of life of schizophrenic individuals. AREAS COVERED: The present analysis makes an attempt to address the clinical relevance of these studies and their contribution to the understanding of the mechanisms of action of these new drugs. A Medline search was done using the keywords 'antipsychotic', 'plasma level', 'quality of life' and 'functioning'. EXPERT OPINION: After reviewing the literature, it seems that symptom control and side effects may play a role in modulating the functioning and quality of life of schizophrenic individuals treated with controlled-release formulations of atypical antipsychotics. The analysis also highlights that these new drugs may possess peculiarities and similarities in regulating patient functioning. However, the low number of clinical analyses that have focused on these aspects of antipsychotic therapy limits the interpretation of the results. Additional comparative clinical trials are needed to evaluate how the pharmacokinetic/pharmacodynamic properties of antipsychotic drugs may modulate the functioning and quality of life of schizophrenic individuals, as well as to establish whether new clinical benefits may come from the use of these drugs in schizophrenia therapy.     

Effects of controlled-release formulations of atypical antipsychotics on functioning and quality of life of schizophrenic individuals

Introduction: Controlled-release formulations of atypical antipsychotics have recently been introduced into clinical practice. Clinical studies have indicated that these new therapies induce meaningful improvements in the functioning and quality of life of schizophrenic individuals.

Areas covered: The present analysis makes an attempt to address the clinical relevance of these studies and their contribution to the understanding of the mechanisms of action of these new drugs. A Medline search was done using the keywords ‘antipsychotic', ‘plasma level', ‘quality of life' and ‘functioning'.

Expert opinion: After reviewing the literature, it seems that symptom control and side effects may play a role in modulating the functioning and quality of life of schizophrenic individuals treated with controlled-release formulations of atypical antipsychotics. The analysis also highlights that these new drugs may possess peculiarities and similarities in regulating patient functioning. However, the low number of clinical analyses that have focused on these aspects of antipsychotic therapy limits the interpretation of the results. Additional comparative clinical trials are needed to evaluate how the pharmacokinetic/pharmacodynamic properties of antipsychotic drugs may modulate the functioning and quality of life of schizophrenic individuals, as well as to establish whether new clinical benefits may come from the use of these drugs in schizophrenia therapy.     

Effects of cocaine and fenfluramine on progressive-ratio performance

Pigeons obtained food on a progressive-ratio schedule that required 8 additional responses for each successive reinforcement. The number of responses in the final completed ratio of the session was defined as the breaking point. When cocaine was administered (IM, 5 min presession), the breaking point increased and then decreased as a function of increasing doses (0.3-10 mg/kg). In contrast, across the same range of doses of fenfluramine, the breaking point only decreased. At doses of each drug that decreased the breaking point, the high running rate of responding was interrupted by pauses. At doses of cocaine that increased the breaking point, the running rate was also disrupted, but the disruption was characterized by lower, irregular rates rather than pausing. The increases in breaking point observed at 3 mg/kg of cocaine were no longer seen when fenfluramine was administered at the same time.     

Effects of fenfluramine on the adrenergic system

The influence of fenfluramine on sympathetic transmission has been examined in various intact and isolated preparations. Fenfluramine both facilitated and inhibited the responses elicited by the sympathetic stimulation according to the dose administered and the preparation used. Fenfluramine, to a lesser extent than amphetamine, antagonized, in some preparations, the neuron blocking action of guanethidine. Fenfluramine did not antagonize the sympathomimetic effects elicited by amphetamine in the isolated atria and the isolated vas deferens unless very high concentrations of both drugs were used.     

Effects of demeclocycline on psychiatric polydipsia in schizophrenic patients]

Excess intake of water by schizophrenic patients is referred to as psychiatric polydipsia. This symptom causes incontinence, vomiting and hyponatremia, and may sometimes lead to death. We have no effective therapeutic methods other than administrating sodium chloride solution and diuretics, or restricting the intake itself. A case was reported stating that demeclocycline, used in case where there is the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), was effective for the treatment of psychiatric polydipsia. We administered demeclocycline to 8 schizophrenic patients with psychiatric polydipsia, and noticed improvement in incontinence, vomiting and hyponatremia. There was also a decrease of polydipsic behavior. Demeclocycline inhibits the antidiuretic effect of vasopressin on the distal renal tubule. Considering the function of demeclocycline and the relevance of vasopressin to the central nervous system, it has been suggested that demeclocycline has effects on the central nerve through vasopressin or cyclic AMP.     

Effects of fenfluramine on hepatic intermediary metabolism

Effects of fenfluramine on hepatic intermediary metabolism have been studied using the isolated hepatocyte system.Fenfluramine inhibits the formation of glucose from lactate plus pyruvate and from alanine as well as the production of ketone bodies from added oleate. The latter observation suggests that inhibition of gluconeogenesis may result from a decrease in the level of mitochondrial acetyl-CoA.Fatty acid synthesis by hepatocytes is slightly stimulated by fenfluramine, perhaps as a consequence of the increase in cystosolic reducing equivalents, observed as an increase in the ratio of lactate/pyruvate.     

喹硫平与舒必利对精神分裂症患者血脂代谢的影响

目的 探讨喹硫平和舒必利对精神分裂症患者血脂代谢影响,并比较男女之间的差异.方法 2006年1月至2009年1月期间入院予喹硫平或舒必利治疗的精神分裂症患者453例,分析喹硫平与舒必利治疗8周前后的空腹血胆固醇(TC)、甘油三酯(TG)浓度变化.结果 ①喹硫平治疗组胆固醇及甘油三酯前后变化不明显,差异均无统计学意义(t=1.45,P=0.13;t=1.58,P=0.10),男女间差异无统计学意义(t=1.03,P=0.28;t=1.34,P=0.16).②舒必利组治疗后胆固醇及甘油三酯明显升高(t=3.01,P=0.006;t=2.42,P=0.017),且女性胆固醇及甘油三酯升高的程度显著大于男性患者(t=2.46,P=0.019,t=2.13,P=0.034).③舒必利对胆固醇及甘油三酯的影响程度均大于喹硫平(t=2.69,P=0.008;t=2.08,P=0.021).结论 喹硫平对精神分裂症患者血脂代谢的影响不大;舒必利使血胆固醇及甘油三酯水平升高,且对女性影响大.舒必利对胆固醇及甘油三酯的影响均大于喹硫平.     

氯氮平和思瑞康对精神分裂症患者血糖代谢的影响

目的探讨服用抗精神病药物氯氮平和思瑞康对糖耐量的影响。方法92例精神分裂症患者随机分为氯氮平组和思瑞康组,各46例,两组患者治疗前和治疗后第4周末、8周末分别检测空腹血糖、餐后1h、2h和3h血糖,并分析糖耐量。结果治疗后4周末和8周末,氯氮平组餐后1h和2h血糖浓度与治疗前比较明显升高[(8.6±1.6)(8.8±1.8)mmol/Lvs.(7.1±1.1)mmol/L,(7.2±1.1)(7.4±1.2)mmol/Lvs.(5.8±0.8)];而思瑞康组无明显变化。治疗后氯氮平组(21.7%,10例)患者糖耐量减低的发生率高于思瑞康组(4.3%,2例),差异有显著性(χ2=6.13,P<0.05)。结论氯氮平对精神分裂症患者餐后血糖有影响,而思瑞康对血糖的影响甚微。     

Effects of nifedipine on psychosis and tardive dyskinesia in schizophrenic patients.

In an open label study, two fixed doses of nifedipine (30 mg and 60 mg daily) were added to the usual antipsychotic drug treatments of 10 patients suffering from chronic schizophrenia. While no patient experienced significant improvements, statistically significant falls in Brief Psychiatric Rating Scales scores were observed. A significant reduction in Abnormal Involuntary Movement Scale scores was observed in those patients with tardive dyskinesia. After the addition of nifedipine, four of the 10 patients showed large increases in plasma neuroleptic activity (radioreceptor assay) that decreased to baseline levels within two weeks. The possibility that this represents competitive inhibition and subsequent induction of the liver metabolism of the antipsychotic drugs is discussed. Adverse effects encountered are also discussed.     

Effects of debrisoquin and haloperidol on plasma homovanillic acid concentration in schizophrenic patients

Plasma levels of the dopamine metabolite homovanillic acid (pHVA) may potentially reflect upon central dopamine activity. This study examines the effects of debrisoquin, haloperidol, and the two drugs combined on pHVA concentrations of schizophrenic patients. Debrisoquin is a drug that suppresses the peripheral formation of homovanillic acid without affecting the central formation. Acute haloperidol administration consistently increased pHVA concentrations in patients pretreated or not pretreated with debrisoquin, suggesting that this increment reflects haloperidol's central and not peripheral effects.     

Effects of fenfluramine on the metabolism of calcium and phosphorus in the rat: fenfluramine effects on Ca and P metabolism.

Daily administration of 2, 5, 10, 15 and 20mg of fenfluramine/kg body weight to adult rats for four weeks resulted in dose dependent decrease in calcium and phosphorus absorption with an inverse correlation of r = -0.94 for calcium and r = -0.93 for phosphorus. Significant (P less than 0.05) increase in the total faecal lipids and moderate decline in plasma calcium levels were also observed in the rats. Adult rats made obese by dietary methods when treated with 10mg and 15 mg of fenfluramine/kg body weight/day for 10 weeks showed a significant reduction (p less than 0.001) in the intestinal absorption of both calcium and phosphorus. The reduction at 15mg/kg drug dose was 10.7 pc for calcium and 9.5 pc for phosphorus. Analyses of the long bones as well as carcasses of the obese rats showed significant decrease (p less than 0.001) in the content of these minerals. Plasma calcium and phosphorus levels were also significantly (p less than 0.001) reduced in the obese-treated rats. However, fenfluramine treatment significantly reduced the plasma calcium but not the phosphorus levels in the non-obese rats. These studies have demonstrated that chronic administration of fenfluramine (greater than or equal to 10mg/kg body weight) to rats, obese or non-obese, impairs calcium and phosphorus metabolism in the body.     

Effects of neuroleptics on electrodermal activity in schizophrenic patients: a review

The effects of neuroleptics on electrodermal activity (EDA) in schizophrenic patients are addressed in a review of research conducted since the publication of an earlier review by Tecce and Cole in 1972. It is concluded that neuroleptics reduce skin conductance level but that effects on other electrodermal parameters are less robust and may be confounded by methodological issues. A discussion of these issues is presented and directions for future research are proposed.     

Childhood problem behavior and neuropsychological functioning in persons at risk for alcoholism

The relationship of childhood hyperkinetic and minimal brain dysfunction (Hk-MBD) to neuropsychological functioning was examined in three groups of young adults. Nonalcoholic offspring of an alcoholic parent (N = 21) and of nonalcoholic parents (N = 21) were examined. A comparison group of similar age alcoholic patients (N = 21) was also studied. Each subject completed a battery of neuropsychological test measures and was administered a checklist on the presence of Hk-MBD symptoms in childhood. Offspring of an alcoholic parent and offspring of nonalcoholic parents could not be distinguished on the basis of their cognitive abilities or their frequency of reported Hk-MBD symptoms in childhood. Alcoholic subjects performed more poorly on measures of verbal and performance intelligence and reported a higher frequency of childhood Hk-MBD symptoms. Further, it was found that the frequency of childhood Hk-MBD symptoms was related to poor performance on certain types of cognitive tasks, regardless of group membership. These findings do not support the suggestion that certain cognitive deficits distinguish persons with a family history for alcoholism. However, poor neuropsychological performance in adulthood, at least on certain types of tasks, appears to be associated with the presence of childhood Hk-MBD.     

护理干预对精神分裂症患者遵医行为的影响

目的探讨护理干预对精神分裂症患者遵医行为的影响。方法选择本院2010年4月～2012年4月精神分裂症患者100例,所有患者随机分为观察组和对照组。两组患者均给予相同抗精神分裂症药物治疗,对照组给予精神科常规护理干预,观察组在常规护理基础上实施综合性护理干预。观察两组患者干预后遵医行为情况。结果观察组中,按照医嘱用药、不滥用药物、不擅自停药、规律作息、避免劳累、定期复诊所占比例分别高于对照组,差异有统计学意义(P<0.05)。结论综合性护理干预能够提高精神分裂症患者的遵医行为,有助于提高临床治疗效果。     

Effects of fenfluramine and para-chloroamphetamine on sexual behavior of male rats

The present studies have evaluated the effects of pharmacologically induced release serotonin on sexual responses of male rats during exposure to a sexually receptive female rat. Following acute administration of fenfluramine or para-chloroamphetamine (PCA), significant dose-related decreases in copulatory rate and copulatory efficiency, and increases in ejaculatory latency were observed. These effects were not observed when the animals were pretreated with LY53857, a 5-HT_1c/2 antagonist. These studies indicate that acute release of serotonin evoked by these releasing agents has inhibitory effects on sexual sexual drive, capacity to achieve erection and threshold for ejaculation, and these effects are mediated by either the 5-HT_1c or 5-HT₂ receptor.