RESUMEN
Hypothermia as an adverse reaction of antipsychotic drug use represents a potentially life-threatening complication. However, the mechanisms by which antipsychotic drugs alter thermoregulatory processes in the human body are far from being fully understood. Here we present a case series of 5 patients developing severe hypothermia after administration of olanzapine and benperidol. Controlled by a network of neural structures, body temperature is physiologically regulated in far more narrow boundaries than are other vital functions, and its homeostasis is critical for survival. The preoptic region in the ventral hypothalamus is assumed to act as a coordinating center that is endowed with thermosensory units that constantly compare actual body temperature with target values and initiate regulatory and compensatory mechanisms in case of mismatch. Hypothermia risk seems to increase in the first days after initiation of antipsychotic drug therapy or increases in the daily dose. Schizophrenic patients bear a higher risk than nonschizophrenic patients treated with antipsychotic drugs (such as patients with dementia or depression). Antipsychotic drugs with strong 5-HT2 antagonism seem to be more frequently associated with hypothermia. These cases demonstrate the clinical relevance of hypothermia as an adverse reaction to antipsychotic treatment and the importance of careful monitoring of body temperature.
Asunto(s)
Antipsicóticos/efectos adversos , Hipotermia/inducido químicamente , Esquizofrenia/tratamiento farmacológico , Adulto , Anciano , Antipsicóticos/administración & dosificación , Antipsicóticos/uso terapéutico , Benperidol/efectos adversos , Benperidol/uso terapéutico , Benzodiazepinas/efectos adversos , Benzodiazepinas/uso terapéutico , Regulación de la Temperatura Corporal/efectos de los fármacos , Regulación de la Temperatura Corporal/fisiología , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Hipotermia/fisiopatología , Masculino , Persona de Mediana Edad , Olanzapina , Factores de Riesgo , Antagonistas del Receptor de Serotonina 5-HT2/efectos adversos , Antagonistas del Receptor de Serotonina 5-HT2/uso terapéutico , Índice de Severidad de la EnfermedadRESUMEN
Preclinical Safety Pharmacology (PSP) attempts to anticipate adverse drug reactions (ADRs) during early phases of drug discovery by testing compounds in simple, in vitro binding assays (that is, preclinical profiling). The selection of PSP targets is based largely on circumstantial evidence of their contribution to known clinical ADRs, inferred from findings in clinical trials, animal experiments, and molecular studies going back more than forty years. In this work we explore PSP chemical space and its relevance for the prediction of adverse drug reactions. Firstly, in silico (computational) Bayesian models for 70 PSP-related targets were built, which are able to detect 93% of the ligands binding at IC(50) < or = 10 microM at an overall correct classification rate of about 94%. Secondly, employing the World Drug Index (WDI), a model for adverse drug reactions was built directly based on normalized side-effect annotations in the WDI, which does not require any underlying functional knowledge. This is, to our knowledge, the first attempt to predict adverse drug reactions across hundreds of categories from chemical structure alone. On average 90% of the adverse drug reactions observed with known, clinically used compounds were detected, an overall correct classification rate of 92%. Drugs withdrawn from the market (Rapacuronium, Suprofen) were tested in the model and their predicted ADRs align well with known ADRs. The analysis was repeated for acetylsalicylic acid and Benperidol which are still on the market. Importantly, features of the models are interpretable and back-projectable to chemical structure, raising the possibility of rationally engineering out adverse effects. By combining PSP and ADR models new hypotheses linking targets and adverse effects can be proposed and examples for the opioid mu and the muscarinic M2 receptors, as well as for cyclooxygenase-1 are presented. It is hoped that the generation of predictive models for adverse drug reactions is able to help support early SAR to accelerate drug discovery and decrease late stage attrition in drug discovery projects. In addition, models such as the ones presented here can be used for compound profiling in all development stages.
Asunto(s)
Simulación por Computador , Sistemas de Liberación de Medicamentos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Modelos Químicos , Modelos Moleculares , Preparaciones Farmacéuticas/química , Antipsicóticos/efectos adversos , Antipsicóticos/química , Antipsicóticos/farmacología , Antipsicóticos/uso terapéutico , Arritmias Cardíacas/inducido químicamente , Benperidol/efectos adversos , Benperidol/química , Benperidol/farmacología , Benperidol/uso terapéutico , Bases de Datos Factuales , Diseño de Fármacos , Evaluación Preclínica de Medicamentos , Ligandos , Valor Predictivo de las PruebasRESUMEN
BACKGROUND: Benperidol is a relatively old antipsychotic drug that has been marketed since 1966. It has been used in Germany for 30 years, but is also available in Belgium, Greece, Italy, the Netherlands and the UK. Benperidol is a butyrophenone antipsychotic, with the highest neuroleptic potency in terms of D2 receptor blockade. Those taking it are therefore reputed to be at high risk of extrapyramidal side effects, but benperidol's unusual profile may render it valuable to subgroups of people with schizophrenia. OBJECTIVES: To examine the clinical effects and safety of benperidol for those with schizophrenia and schizophrenia-like psychoses. SEARCH STRATEGY: We searched the Cochrane Schizophrenia Group's register (November 2004) for this update. SELECTION CRITERIA: We included all randomised controlled trials that compared benperidol with other treatments for people with schizophrenia, or schizophrenia-like psychoses. DATA COLLECTION AND ANALYSIS: We reliably selected studies, quality rated them and extracted data. We independently extracted data but excluded data if loss to follow up was greater than 50%. For dichotomous data, we estimated relative risks (RR), with the 95% confidence intervals (CI). Where possible, we calculated the number needed to treat/harm statistic (NNT/H) and used intention-to-treat analysis. MAIN RESULTS: The update yielded no further studies for inclusion in the review. We identified only one unpublished poorly randomised controlled trial (N=40, duration 30 days, comparison perphenazine). Although benperidol was inferior to perphenazine (1 RCT, N=40, global state no better or worse RR 8.0 CI 2.1 to 30, NNH 1.4 CI 1 to 2) poor reporting suggests that an overestimate of effect is likely. It was not possible to report other outcomes. AUTHORS' CONCLUSIONS: Currently, there are insufficient data from randomised trials to assess the clinical effects of benperidol. This compound merits further research interest.
Asunto(s)
Antipsicóticos/uso terapéutico , Benperidol/uso terapéutico , Esquizofrenia/tratamiento farmacológico , Humanos , Ensayos Clínicos Controlados Aleatorios como AsuntoAsunto(s)
Benperidol/uso terapéutico , Dihidroxifenilalanina/análogos & derivados , Discinesia Inducida por Medicamentos/prevención & control , Receptores de Dopamina D2/efectos de los fármacos , Adulto , Ganglios Basales/diagnóstico por imagen , Ganglios Basales/efectos de los fármacos , Ganglios Basales/fisiopatología , Benperidol/sangre , Benperidol/farmacología , Radioisótopos de Carbono , Clozapina/sangre , Clozapina/farmacología , Clozapina/uso terapéutico , Discinesia Inducida por Medicamentos/fisiopatología , Radioisótopos de Flúor , Humanos , Masculino , Racloprida/farmacocinética , Receptores de Dopamina D2/metabolismo , Esquizofrenia/tratamiento farmacológico , Tomografía Computarizada de Emisión/métodos , Resultado del Tratamiento , UltrasonografíaRESUMEN
BACKGROUND: Benperidol is a relatively old antipsychotic drug, marketed since 1966, used in Germany for 30 years, but also available in Belgium, Greece, Italy, the Netherlands and the UK. Benperidol is a butyrophenone antipsychotic, with the highest neuroleptic potency in terms of D2 receptor blockade. Those taking it are, therefore, reputed to be at high risk of extrapyramidal side effects, but benperidol's unusual profile may render it of value to subgroups of people with schizophrenia. OBJECTIVES: To examine the clinical effects and safety of benperidol for those with schizophrenia and schizophrenia-like psychoses. SEARCH STRATEGY: The reviewers searched the Cochrane Schizophrenia Group's register (January 2001) which includes relevant randomised controlled trials from the bibliographic databases Biological Abstracts, CINAHL, The Cochrane Library, EMBASE, MEDLINE, PsycLIT, LILACS, PSYNDEX, Sociological Abstracts and Sociofile. We also searched the references of all included studies and contacted pharmaceutical companies and authors of included studies in order to identify further trials. SELECTION CRITERIA: Randomised controlled trials that compared benperidol with other treatments for people with schizophrenia and/or schizophrenia-like psychoses. DATA COLLECTION AND ANALYSIS: Citations and, where possible, abstracts were independently inspected by two reviewers and papers were ordered, re-inspected and quality assessed. We independently extracted data but excluded data if loss to follow up was greater than 50%. For homogeneous dichotomous data, we calculated the relative risk (RR), the 95% confidence interval (CI) and, where appropriate, the number needed to treat/harm (NNT/H), on an intention-to-treat basis. MAIN RESULTS: We identified only one unpublished poorly randomised controlled trial (N=40, duration 30 days, comparison perphenazine). Although benperidol was inferior to perphenazine (1 RCT, N=40, global state no better or worse RR 8.0 CI 2.1 to 30, NNH 1.4 CI 1 to 2) poor reporting suggests that an overestimate of effect is likely. It was not possible to report other outcomes. REVIEWER'S CONCLUSIONS: Currently, there are insufficient data from randomised trials to assess the clinical effects of benperidol. This interesting compound merits further research.
Asunto(s)
Antipsicóticos/uso terapéutico , Benperidol/uso terapéutico , Esquizofrenia/tratamiento farmacológico , Humanos , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
Animal and post mortem studies indicate that neuroleptic therapy may induce D2-dopamine receptor upregulation in the basal ganglia. To address this phenomenon in a clinical study, we investigated the D2-dopamine receptor binding in 15 DSM-III-R schizophrenics in the drug-naive state and three days after completion of a standardized neuroleptic therapy (benperidol 12-16 mg/d for 25 days) using single photon emission computed tomography (SPECT). SPECT scans were obtained 2 h after intravenous injection of 185 MBq 123I-IBZM. For analysis, basal ganglia to frontal cortex (BG/FC) ratios were calculated and the patient sample was subgrouped into patients with a favourable versus a poor treatment response. Neuroleptic treatment led to decreased BG/FC ratios in patients with a favourable response, but increased ratios in the poor responders (df = 1, F = 4.1, p = 0.06). Changes of BG/FC ratios were significantly correlated with extrapyramidal side effects, but not with neurological soft signs (NSS). Our findings indicate that neuroleptic therapy induces D2-dopamine receptor upregulation in a subgroup of patients characterized by poor treatment response and pronounced extrapyramidal side effects.
Asunto(s)
Antipsicóticos/farmacología , Antipsicóticos/uso terapéutico , Receptores de Dopamina D2/biosíntesis , Esquizofrenia/tratamiento farmacológico , Regulación hacia Arriba/efectos de los fármacos , Enfermedades de los Ganglios Basales/inducido químicamente , Benperidol/farmacología , Benperidol/uso terapéutico , Humanos , Escalas de Valoración Psiquiátrica , Receptores de Dopamina D2/efectos de los fármacos , Esquizofrenia/diagnóstico por imagen , Esquizofrenia/metabolismo , Tomografía Computarizada de Emisión de Fotón ÚnicoRESUMEN
In this study, we investigated experimentally the effects of different activation procedures on both motor and psychic symptoms in of 11 in-patients with acute neuroleptic-induced akathisia using the Hillside and Barnes akathisia rating scales and videotape rating technique. Motor activation was achieved by finger tapping. Cognitive activation tasks consisted of sequences of mental calculations which were designed either to be easy to perform or to produce stress due to a given time limit or to more difficult calculation operations, respectively. Motor as well as psychic symptoms of akathisia decreased during both motor and simple cognitive activation without stress. By contrast, stress-producing calculation tasks led to an increase in motor and psychic symptoms immediately following the task performance. These possibly specific effects of activation procedures on symptoms might be useful in differentiating acute neuroleptic-induced akathisia from other neuroleptic-induced and extrapyramidal movement disorders.
Asunto(s)
Acatisia Inducida por Medicamentos/diagnóstico , Antipsicóticos/efectos adversos , Nivel de Alerta , Destreza Motora , Solución de Problemas , Esquizofrenia/tratamiento farmacológico , Adulto , Antipsicóticos/uso terapéutico , Nivel de Alerta/efectos de los fármacos , Atención/efectos de los fármacos , Benperidol/efectos adversos , Benperidol/uso terapéutico , Diagnóstico Diferencial , Femenino , Flupentixol/efectos adversos , Flupentixol/uso terapéutico , Haloperidol/efectos adversos , Haloperidol/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Destreza Motora/efectos de los fármacos , Examen Neurológico/efectos de los fármacos , Solución de Problemas/efectos de los fármacosRESUMEN
Recent studies have described a left lateralized striatal asymmetry of D2 dopamine receptors in male patients with schizophrenia. To replicate this finding and to explore its potential functional consequences, we investigated the D2 dopamine receptor system in 23 drug-naive patients with schizophrenia using single photon emission computed tomography (SPECT). Patients were examined in the drug-naive state and 72 h after completing a standardized neuroleptic treatment with benperidol (12-16 mg/day) for 25 days. Each SPECT examination comprised two scans: the first scan was taken 2 h after intravenous injection of 185 MBq [123I]iodobenzamide. After completion of the first scan, patients received benperidol (8 mg) intravenously. The second scan was started 20 min later. For analysis, basal ganglia to frontal cortex ratios were calculated. Fifteen of the 23 patients originally recruited completed the study on day 28. When compared to female patients, male patients showed a left lateralized asymmetry of striatal D2 dopamine receptor binding in the drug-naive state with an almost significant (P = 0.07) sex x hemisphere interaction. In the male patients, benperidol challenge led to a reversal of asymmetry patterns. These findings support previous reports of a left lateralized striatal D2 receptor binding in drug-naive male patients with schizophrenia and suggest that this asymmetry may affect the binding of conventional neuroleptics such as benperidol at the D2 dopamine receptor.
Asunto(s)
Benzamidas , Cuerpo Estriado/diagnóstico por imagen , Antagonistas de Dopamina , Pirrolidinas , Receptores de Dopamina D2/fisiología , Esquizofrenia/diagnóstico por imagen , Tomografía Computarizada de Emisión de Fotón Único , Adolescente , Adulto , Benperidol/efectos adversos , Benperidol/uso terapéutico , Mapeo Encefálico , Cuerpo Estriado/efectos de los fármacos , Dominancia Cerebral/efectos de los fármacos , Dominancia Cerebral/fisiología , Femenino , Lóbulo Frontal/diagnóstico por imagen , Lóbulo Frontal/efectos de los fármacos , Humanos , Masculino , Persona de Mediana Edad , Receptores de Dopamina D2/efectos de los fármacos , Esquizofrenia/tratamiento farmacológico , Factores SexualesRESUMEN
[123I]Iodobenzamide (IBZM) is an iodine-labeled dopamine receptor ligand and can be used to visualize brain D2 receptors in humans with single photon emission computerized tomography (SPECT). The ratio of striatal IBZM uptake to uptake in frontal cortex (ST/FC ratio) represents a semiquantitative measure of D2 receptor binding in the striatum. Our study sample included six patients treated with haloperidol (3.0-8.0 mg/day orally; one patient with an average of 0.9 mg/day intramuscularly), five patients with benperidol (9.0-15.0 mg/day orally) and nine patients treated with clozapine (200.0-600.0 mg/day orally). Typical neuroleptics (TNs) and atypical neuroleptics (ANs) were significantly different in their ST/FC ratios. The ST/FC ratios indicated that patients treated with benperidol exhibited the lowest ST/FC ratios, with increasingly higher ratios in patients on haloperidol or clozapine. We found a curvilinear relationship between the ST/FC ratios and the dose/kg body wt. of TNs and ANs on the basis of a dose-normalization according to Ki-values of the neuroleptic at D2 receptors and a weaker, but also curvilinear relationship between ST/FC ratios and normalized dosages according to clinically defined chlorpromazine equivalents. The specific uptake of IBZM did not correlate with the plasma levels of the TN haloperidol at the present dose range (0-12.4 ng/ml). For clozapine, a meaningful negative correlation between plasma levels and ST/FC ratio could be established. There was a negative continuous correlation between uptake of IBZM and extrapyramidal side effects, which is different from the threshold-based relationship between extrapyramidal side effects and IBZM uptake reported previously.
Asunto(s)
Antipsicóticos/uso terapéutico , Benzamidas , Trastorno Bipolar/tratamiento farmacológico , Encéfalo/efectos de los fármacos , Trastorno Depresivo Mayor/tratamiento farmacológico , Antagonistas de Dopamina , Pirrolidinas , Esquizofrenia Paranoide/tratamiento farmacológico , Tomografía Computarizada de Emisión de Fotón Único , Adulto , Anciano , Antipsicóticos/efectos adversos , Antipsicóticos/clasificación , Enfermedades de los Ganglios Basales/inducido químicamente , Enfermedades de los Ganglios Basales/diagnóstico por imagen , Benperidol/efectos adversos , Benperidol/uso terapéutico , Trastorno Bipolar/diagnóstico por imagen , Encéfalo/diagnóstico por imagen , Clozapina/efectos adversos , Clozapina/uso terapéutico , Cuerpo Estriado/diagnóstico por imagen , Cuerpo Estriado/efectos de los fármacos , Trastorno Depresivo Mayor/diagnóstico por imagen , Relación Dosis-Respuesta a Droga , Femenino , Lóbulo Frontal/diagnóstico por imagen , Lóbulo Frontal/efectos de los fármacos , Haloperidol/efectos adversos , Haloperidol/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Examen Neurológico/efectos de los fármacos , Escalas de Valoración Psiquiátrica , Receptores de Dopamina D2/efectos de los fármacos , Esquizofrenia Paranoide/diagnóstico por imagenRESUMEN
With the tracer [123I]iodobenzamide ([123I]-IBZM), it is possible to image dopamine receptor occupancy with single-photon emission-computed tomography (SPECT). We report follow-up examinations with IBZM-SPECT in neuroleptic malignant syndrome (NMS) to display D2-receptor availability in the acute phase and during the course of remission. A 27-year-old man was admitted with severe akinesia, rigor, tachycardia, fever, and elevated creatine phosphokinase level (CK) after neuroleptic medication. NMS was diagnosed, and treatment was started with dantrolene, amantadine, and dopamine agonists. IBZM-SPECT examination was performed on days 6, 34, 90, 107, 131, and 201. In the acute state of NMS, there was no binding of IBZM to D2-receptors. SPECT reached almost normal values on day 131, but clinical examination still showed a mild parkinsonian syndrome. With SPECT, the D2-receptor occupancy in NMS could be successfully shown in correlation with extrapyramidal signs. IBZM-SPECT may therefore serve to monitor D2-receptor occupancy in patients at risk for NMS.
Asunto(s)
Antipsicóticos/efectos adversos , Benperidol/efectos adversos , Benzamidas , Antagonistas de Dopamina , Haloperidol/efectos adversos , Radioisótopos de Yodo , Síndrome Neuroléptico Maligno/diagnóstico por imagen , Trastornos Psicóticos/tratamiento farmacológico , Pirrolidinas , Receptores de Dopamina D2/efectos de los fármacos , Tomografía Computarizada de Emisión de Fotón Único , Adulto , Antipsicóticos/uso terapéutico , Ganglios Basales/diagnóstico por imagen , Ganglios Basales/efectos de los fármacos , Benperidol/uso terapéutico , Lóbulo Frontal/diagnóstico por imagen , Lóbulo Frontal/efectos de los fármacos , Haloperidol/uso terapéutico , Humanos , Masculino , Síndrome Neuroléptico Maligno/fisiopatología , Examen Neurológico/efectos de los fármacos , Trastornos Psicóticos/diagnóstico por imagen , Receptores de Dopamina D2/fisiologíaRESUMEN
By the application of 123([123I]IBZM), an iodine-labelled dopamine D2-receptor antagonist, brain D2 receptors in humans can be visualized with single photon emission computed tomography (SPECT). The ratio of IBZM binding to striatal regions versus binding to frontal cortex (ST/FC ratio) provided a semiquantitative measurement of D2 receptor binding in the striatum. This study investigated the relationship between receptor occupancy and plasma prolactin levels in 12 male patients treated with haloperidol, benperidol or clozapine. Prolactin levels were positively correlated with D2 receptor occupancy, reflecting at least in part a comparable dopamine receptor antagonism in different dopaminergic pathways.
Asunto(s)
Benzamidas , Cuerpo Estriado/metabolismo , Antagonistas de Dopamina , Prolactina/sangre , Pirrolidinas , Receptores de Dopamina D2/metabolismo , Esquizofrenia Paranoide/metabolismo , Adulto , Antipsicóticos/uso terapéutico , Benperidol/uso terapéutico , Clozapina/uso terapéutico , Cuerpo Estriado/diagnóstico por imagen , Haloperidol/uso terapéutico , Humanos , Radioisótopos de Yodo , Masculino , Persona de Mediana Edad , Prosencéfalo/diagnóstico por imagen , Prosencéfalo/metabolismo , Esquizofrenia Paranoide/diagnóstico por imagen , Esquizofrenia Paranoide/tratamiento farmacológico , Tomografía Computarizada de Emisión de Fotón ÚnicoRESUMEN
Plasma levels of prolactin (PRL) and the butyrophenone neuroleptic benperidol (BPD) were closely followed 0 to 48 h after acute application of 6 mg BPD as intravenous injection, orally as liquid, and orally as tablets in 12 schizophrenic patients using a partially randomized cross over design. Drug concentrations showed application specific pharmacokinetic behavior with complete elimination within 48 h. All three applications led to a biphasic PRL response with pronounced initial plasma PRL peaks returning to baseline levels within 48 h. The results suggest that after acute neuroleptic challenge BPD plasma levels as low as 2-3 ng/ml can be sufficient for complete depletion of pituitary PRL stores. This initial peak was followed by a PRL plateau about twice above pretreatment values indicating doubling of the PRL synthesis and secretion independent of supraeffective actual BPD concentrations. The PRL plateau persisted as long as BPD concentrations were above those levels which triggered the initial PRL response. As compared with the time of maximum concentrations (tmax) for BPD, the PRL tmax was later after i.v. injection, equal after liquid application, and earlier after tablet administration leading to pronounced application specific differences in shape, direction, and position of resulting hysteresis curves. Plasma levels of homovanillic acid (HVA) were not affected by BPD treatment. The PRL and HVA levels registered after acute doses of BPD indicated that the hormone responses were most likely the result of acute depletion of PRL stores and subsequent stimulation of hormone synthesis whereas it seemed unlikely that dopaminergic activities were relevant.
Asunto(s)
Benperidol/administración & dosificación , Benperidol/sangre , Ácido Homovanílico/sangre , Prolactina/sangre , Esquizofrenia/sangre , Esquizofrenia/tratamiento farmacológico , Administración Oral , Adulto , Benperidol/uso terapéutico , Estudios Cruzados , Femenino , Humanos , Inyecciones Intravenosas , MasculinoRESUMEN
A minority of people with mental retardation have sexual behaviour which is socially unacceptable or which brings them into conflict with the law. Such behaviour may be the result of ignorance about sexual matters, often best managed by counselling or by a behavioural approach. There are a small number of men with mental retardation and aberrant sexual behaviour who benefit from the prescription of an antilibidinal drug. Treatment with an antilibidinal drug alone reduces the intensity of sexual drive but does not alter its direction; concurrent sexual counselling or psychotherapy is often indicated. The various antilibidinal medications available are reviewed, with particular attention to reports which have described the treatment of people with mental retardation. Of the antilibidinals currently used, medroxyprogesterone acetate and cyproterone acetate are those for which there is most evidence of efficacy. Cyproterone acetate is preferable because it has a specific antiandrogenic action and fewer adverse effects. There is a need for controlled studies of antilibidinal drugs, with clearly defined inclusion criteria and adequate measures of both behavioural and attitudinal change.
Asunto(s)
Benperidol/uso terapéutico , Ciproterona/análogos & derivados , Discapacidad Intelectual/psicología , Medroxiprogesterona/análogos & derivados , Delitos Sexuales , Conducta Sexual/efectos de los fármacos , Ciproterona/uso terapéutico , Acetato de Ciproterona , Humanos , Medroxiprogesterona/uso terapéutico , Acetato de MedroxiprogesteronaAsunto(s)
Benperidol/uso terapéutico , Esquizofrenia/tratamiento farmacológico , Benperidol/efectos adversos , Benperidol/sangre , Ensayos Clínicos como Asunto , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Discinesia Inducida por Medicamentos/etiología , Humanos , Prolactina/sangre , Escalas de Valoración Psiquiátrica , Psicología del EsquizofrénicoAsunto(s)
Tranquilizantes/uso terapéutico , Amitriptilina/análogos & derivados , Amitriptilina/uso terapéutico , Benperidol/uso terapéutico , Fenómenos Químicos , Química , Medicina Familiar y Comunitaria , Humanos , Trastornos Mentales/tratamiento farmacológico , Tranquilizantes/efectos adversos , Trimeprazina/uso terapéuticoRESUMEN
Some neuroleptic medicine or hormonal by-products may--partly or fully-as to the dose--inhibit the libido of the patients who ask for it themselves causing in this way a pharmacological castration, a temporary or permanent one, but which is always reversible when the therapy is stopped. These inhibiting treatments, which essentially apply to males, are particularly useful in the case of the hypersexual patients or in the case of second offenders.
Asunto(s)
Libido/efectos de los fármacos , Trastornos Parafílicos/tratamiento farmacológico , Adulto , Benperidol/uso terapéutico , Ciproterona/análogos & derivados , Ciproterona/uso terapéutico , Acetato de Ciproterona , Estrenos/uso terapéutico , Homosexualidad , Humanos , Masculino , Represión Psicológica , Conducta Sexual/efectos de los fármacos , Testosterona/sangreRESUMEN
Improvement of acute psychotic exacerbations under neuroleptic therapy can depend on the time course of the disease itself, on the individual patient or on the specific neuroleptic applied. Previous studies demonstrated that neither the characteristics of the patients nor the disease qualities could predict the outcome of neuroleptic therapy (review by May and Goldberg 1978). In this study the initial improvement after the onset of neuroleptic treatment was tested for its predictive value. In 33 patients treated with constant doses of butyrophenones the decrease of psychotic symptomatology during the first 5 days of treatment not only accounted for the major part of the overall improvement, but was also a relatively reliable predictor for the further course of the therapy.