Treatment of drug-resistant chronic schizophrenics with an association of neuroleptics and the calcium antagonist nimodipine

1992 ◽  
Vol 7 (4) ◽  
pp. 177-182 ◽  
Author(s):  
F Brambilla ◽  
GL Gessa ◽  
A Sciascia ◽  
A Latina ◽  
M Maggioni ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Rating Scale ◽  
Psychiatric Symptomatology ◽  
Brief Psychiatric Rating Scale ◽  
Chronic Schizophrenics ◽  
Daily Dose ◽  
Effect Of Therapy ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
Plasma Mhpg

SummaryNimodipine was administered at the daily dose of 90 mg po, for 30 days, to ten chronic undifferentiated schizophrenics, eight men and two women, aged 31-35 years, maintained on previously longlasting neuroleptic treatments. In five patients, a placebo period of 15 days preceded the administration of the drug. Monitoring of psychiatric symptomatology by the Brief Psychiatric Rating Scale (BPRS) revealed significant nimodipine-induced improvement. However, the Andreasen Rating Scale for Positive Symptoms (SAPS) showed favourable effects only in the five patients who had not received placebo, while in the others both SAPS and the Andreasen Rating Scale for Negative Symptoms (SANS) showed no significant effect of therapy. The Tardive Dyskinesia Scale revealed no improvements of neurological symptoms after either placebo or drug treatment. Measurement of plasma MHPG concentrations revealed no significant changes induced by either placebo or nimodipine, while HVA plasma levels showed a trend toward decrease, and prolactin a trend toward increase, after nimodipine.

Effects of Neuroleptic Reduction in Schizophrenic Outpatients Receiving High Doses

1994 ◽  
Vol 39 (4) ◽  
pp. 223-229 ◽  
Author(s):  
Gérard Leblanc ◽  
Hugues Cormier ◽  
Marie-Andrée Gagné ◽  
Sylvie Vaillancourt
Keyword(s):  
Negative Symptoms ◽  
Rating Scale ◽  
High Dose ◽  
Clinical Effects ◽  
Relative Paucity ◽  
Brief Psychiatric Rating Scale ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
High Doses ◽  
Schizophrenic Outpatients

This paper presents an open study which evaluated the clinical effects of a partial and progressive reduction in neuroleptic medication in 32 outpatients suffering from schizophrenia who were receiving high doses (equivalent of ≥ 18 mg of oral haloperidol per day; EHL). After an observation period of twelve weeks, each subject's dose of neuroleptics was reduced by 50% at the rate of 10% every four weeks. Patients were receiving a mean of 62 mg per day EHL at the beginning of the study and 30 mg per day EHL at the completion of the study. After the reduction, the following was observed: 1. a significant but modest change in psychopathology: a decrease in negative symptoms and in the total score on Brief Psychiatric Rating Scale; and 2. a significant increase in tardive dyskinesia symptoms. Six subjects relapsed but five of them recovered without increasing their reduced medication. Results of this study are discussed in the context of trying to find a minimal maintenance dose in the treatment of schizophrenia. The relative paucity of change despite a large reduction in medication argues for réévaluation of dosage in patients on high or very high doses of neuroleptics. The results suggest that many patients taking high doses could be maintained on significantly lower doses of neuroleptics. With gradual reduction of medication it would seem that many patients who are receiving a high dose of neuroleptic can achieve a lower dose than their current maintenance level.

Combined clozapine-lithium treatment for schizophrenia and schizoaffective disorder

1998 ◽  
Vol 13 (2) ◽  
pp. 104-106 ◽  
Author(s):  
M Moldavsky ◽  
D Stein ◽  
R Benatov ◽  
P Sirota ◽  
A Elizur ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Schizoaffective Disorder ◽  
Negative Symptoms ◽  
Rating Scale ◽  
Lithium Treatment ◽  
Brief Psychiatric Rating Scale ◽  
Psychiatric Rating ◽  
Clinically Significant ◽  
Psychiatric Rating Scale ◽  
Positive And Negative Symptoms

SummaryThree adolescent and two adult patients suffering from chronic excited psychoses (either schizophrenia or schizoaffective disorder) resistant to traditional neuroleptics and clozapine were treated with combined clozapine-lithium. Improvement was assessed with the Positive and Negative Symptoms Scale, the Brief Psychiatric Rating Scale and the Clinical Global Impressions, administered before and during combined clozapine-lithium treatment. All patients demonstrated a significant improvement with this combination. There was no occurrence of agranulocytosis, neuroleptic malignant syndrome or other clinically significant adverse effects.

scholarly journals Alysis Reliability Study: Rearranging Phenomenology into Etiology in Mental Disorders

2022 ◽  
Author(s):  
Abraham Peled
Keyword(s):  
Mental Disorders ◽  
Negative Symptoms ◽  
Rating Scale ◽  
Psychiatric Patients ◽  
Depression And Anxiety ◽  
Guiding Principle ◽  
Brief Psychiatric Rating Scale ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
Positive And Negative Symptoms

‘Alysis’ )abbreviation of Neuroanalysis(, - is the chosen definition for the rearrangement of psychiatric phenomology to approximate the hypothesized etiology of mental disorders. Currently the relevant scales such as Positive and Negative Symptoms Scale (PANSS) for schizophrenia and the Hamilton scales for depression and anxiety, and Mania Rating Scale have no specific guiding principle in the order of items. ‘Alysis’ is a reorganization of multiple known scales to fit a future brain-related diagnostic approach to mental disorders. Due to the regrouping of items from different scales and reorganizing them according to a brain-related hypothetic order, it is necessary to reassess the reliability of the new ‘Alysis’ rearrangement. In this work the new ‘Alysis’ format is described and then using t-scores analysis, compared to the widely-used Brief Psychiatric Rating Scale (BPRS) scale for mental disorders. It is shown that ‘Alysis’ is reliable thus can be a good diagnostic platform to go ahead and generate personalized testable-predictions about brain-related diagnostics for psychiatric patients.

Cross-sectional similarities and differences between schizophrenia, schizoaffective disorder and mania or mixed mania with mood-incongruent psychotic features

2004 ◽  
Vol 19 (1) ◽  
pp. 8-14 ◽  
Author(s):  
Stefano Pini ◽  
Valeria de Queiroz ◽  
Liliana Dell'Osso ◽  
Marianna Abelli ◽  
Concettina Mastrocinque ◽  
...  
Keyword(s):  
Schizoaffective Disorder ◽  
Negative Symptoms ◽  
Rating Scale ◽  
Cross Sectional ◽  
Brief Psychiatric Rating Scale ◽  
Patient Groups ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
Psychotic Features ◽  
Mood And Cognition

AbstractBackground. – The cross-sectional clinical differentiation of schizophrenia or schizoaffective disorder from mood-incongruent psychotic mania or mixed mania is difficult, since pathognomonic symptoms are lacking in these conditions.Aims of the study. – To compare a series of clinical variables related to mood and cognition in patient groups with DSM-III-R diagnosis of schizophrenia, schizoaffective disorder, mood-incongruent psychotic mania and mood-incongruent psychotic mixed mania.Methods. – One hundred and fifty-one consecutive patients were evaluated in the week prior to discharge by using the structured clinical interview for DSM-III-R-patient edition (SCID-P). Severity of psychopathology was assessed by the 18-item version of the brief psychiatric rating scale (BPRS) and negative symptoms by the scale for assessment of negative symptoms (SANS). Level of insight was assessed with the scale to assess unawareness of mental disorders (SUMD).Results. – There were no differences in rates of specific types of delusions and hallucinations between subjects with schizophrenia, schizoaffective disorder, psychotic mania and psychotic mixed mania. SANS factors scores were significantly higher in patients with schizophrenia than in the bipolar groups. Patients with mixed state scored significantly higher on depression and excitement compared to schizophrenia group and, to a lesser extent, to schizoaffective group. Subjects with schizophrenia showed highest scores on the SUMD indicating that they were much more compromised on the insight dimension than subjects with psychotic mania or mixed mania.Conclusion. – Negative rather than affective symptomatology may be a useful construct to differentiate between schizophrenia or schizoaffective disorders from mood-incongruent psychotic mania or mixed mania.

scholarly journals Chinese herbal medicine for schizophrenia

2007 ◽  
Vol 190 (5) ◽  
pp. 379-384 ◽  
Author(s):  
John Rathbone ◽  
Lan Zhang ◽  
Mingming Zhang ◽  
Jun Xia ◽  
Xiehe Liu ◽  
...  
Keyword(s):  
Herbal Medicine ◽  
Chinese Herbal Medicine ◽  
Negative Symptoms ◽  
Rating Scale ◽  
Medium Term ◽  
Chinese Herbal ◽  
Brief Psychiatric Rating Scale ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
Randomised Controlled

BackgroundChinese herbal medicine has been used to treat millions of people with schizophrenia for thousands of years.AimsTo evaluate Chinese herbal medicine as a treatment for schizophrenia.MethodA systematic review of randomised controlled trials (RCTs).ResultsSeven trials were included. Most studies evaluated Chinese herbal medicine in combination with Western antipsychotic drugs; in these trials results tended to favour combination treatment compared with antipsychotic alone (Clinical Global Impression ‘not improved/worse’ n= 123, RR=0.19, 95% CI 0.1-0.6, NNT=6,95% CI 5–11; n=109, Brief Psychiatric Rating Scale ‘not improved/worse’ RR=0.78,95% CI 0.5-1.2; n=109, Scale for the Assessment of Negative Symptoms ‘not improved/worse’ RR=0.87,95% CI 0.7-1.2; n= 109, Scale for the Assessment of Positive Symptoms ‘not improved/worse’ RR=0.69,95% CI 0.5-1.0, NNT=6 95% CI 4-162). Medium-term study attrition was significantly less for people allocated the herbal/antipsychotic mix (n=897, four RCTs, RR=0.34,95% CI 0.2–0.7, NNT=23,95% CI 18-43).ConclusionsResults suggest that combining Chinese herbal medicine with antipsychotics is beneficial.

Dexamethasone suppression test in chronic schizophrenia

1988 ◽  
Vol 3 (3) ◽  
pp. 189-194 ◽  
Author(s):  
S.D. Soni ◽  
A. Mallik ◽  
V. Harris ◽  
J. Shrimanker ◽  
J. McMurray
Keyword(s):  
Negative Symptoms ◽  
Rating Scale ◽  
Chronic Schizophrenia ◽  
Neuroleptic Treatment ◽  
Brief Psychiatric Rating Scale ◽  
Structural Abnormalities ◽  
Psychiatric Rating ◽  
Suppression Test ◽  
Psychiatric Rating Scale ◽  
Anxiety Depression

SummaryDexamethasone suppresson test (DST) was administered to 26 chronic schizophrenic inpatients who were on stable doses of neuroleptics for over 3 months. Clinical assessments were made on the Brief Psychiatric Rating Scale (BPRS), the Manchester Scale (KGV) and the Scale for the Assessment of Negative Symptoms (SANS). Patients’ neuroleptic treatment was then stopped for 4 weeks and the clinical assessements and the DST repeated. Thirty two percent of the patients showed DST non-suppression which was mostly stable over the 4-week period of the study and was unaffected by the neuroleptic treatment. Contrary to some reports in the literature, the clinical rating scores (including those for depression and negative symptoms), in our patients, showed no relationship with the DST status. We suggest that the DST abnormality in chronic schizophrenies may result from two quite different mechanisms: one due to stress assoeiated with transient psychopathology such as agitation, anxiety, depression or psychotic perturbation which is transient, the other resulting from structural abnormalities in the brain and which remains stable over time.

Electrodermal activity and therapeutic response to neuroleptic treatment in chronic schizophrenic in-patients

1982 ◽  
Vol 12 (3) ◽  
pp. 607-613 ◽  
Author(s):  
Sid J. Schneider
Keyword(s):  
Rating Scale ◽  
Electrodermal Activity ◽  
Therapeutic Benefit ◽  
Neuroleptic Treatment ◽  
Brief Psychiatric Rating Scale ◽  
Chronic Schizophrenics ◽  
Skin Conductance Levels ◽  
Psychiatric Rating ◽  
Pre Treatment ◽  
Psychiatric Rating Scale

SYNOPSISElectrodermal measures, psychiatric ratings (Brief Psychiatric Rating Scale, Clinical Global Impressions) and several Wechsler subtest scores were obtained for 26 hospitalized chronic schizophrenics during drug ‘washout’. The psychiatric ratings and Wechsler scores were obtained again after 6 months' treatment with thiothixene or thioridazine. Results revealed that those patients who displayed therapeutic benefit from the neuroleptic treatment displayed greater pre-treatment electrodermal activity and higher skin conductance levels, compared with schizophrenics who did not benefit. No effect for laterality was noted.

Fitness to plead. A prospective study of the inter-relationships between expert opinion, legal criteria and specific symptomatology

2001 ◽  
Vol 31 (1) ◽  
pp. 139-150 ◽  
Author(s):  
D. V. JAMES ◽  
G. DUFFIELD ◽  
R. BLIZARD ◽  
L. W. HAMILTON
Keyword(s):  
Rating Scale ◽  
Psychiatric Symptomatology ◽  
Legal Concept ◽  
Brief Psychiatric Rating Scale ◽  
Psychiatric Rating ◽  
Mentally Impaired ◽  
Psychiatric Rating Scale ◽  
The Uk ◽  
A Prospective Study ◽  
Anxiety Depression

Background. Psychiatrists are asked to give opinions as to fitness to plead, a legal concept. There is a dearth of research into fitness to plead in the UK, with no prospective studies and no studies involving the comparison of fit and unfit subjects. In particular, there have been no investigations into the meaning of ‘unfit to plead’ in terms of psychiatric symptomatology, or as to the relative importance of each legal fitness criterion in psychiatrists' conclusions as to fitness.Method. The study comprised a prospective evaluation of 479 consecutive referrals to psychiatrists at court. Individual legal fitness criteria were examined as predictors of unfitness. Associations of unfitness, and of individual legal fitness criteria, were examined with Brief Psychiatric Rating Scale (BPRS) symptom scores.Results. The two most important of the legal criteria in clinical decisions as to unfitness were whether the person could follow the proceedings of the trial or give adequate instructions to their solicitor. The legal criteria concerning trial were more predictive of unfitness than those concerning plea. Unfitness was significantly associated with the presence of positive psychotic symptomatology, in particular conceptual disorganization and delusional thinking, but not with symptoms of anxiety, depression or withdrawal.Conclusion. Unfitness is most significantly associated with symptoms affecting comprehension and communication. The fitness criteria could be simplified without loss of power. These results, predominantly concerned with mental illness, may not generalize to the mentally impaired.

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