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Biomedical subjects

A Ross-Chouinard

Publications and source records attributed to A Ross-Chouinard.

14 recordsLinked to original sources
PubMed1993

Thiamine and folate treatment of chronic epileptic patients: a controlled study with the Wechsler IQ scale.

Seventy-two epileptic patients receiving phenytoin (PHT) alone or in combination with phenobarbital for more than 4 years were divided into four groups, the first taking two placebo tablets per day; the second folate (5 mg/day) and placebo; the third placebo and thiamine (50 mg/day); and the fourth both vitamins. The clinical trial lasted 6 months. At baseline assessment, 31% of the patients had subnormal blood thiamine levels and 30% had low folate. The vitamin deficiencies were independent phenomena. It was found that thiamine improved neuropsychological functions in both verbal and non-verbal IQ testing. In particular, higher scores were recorded on the block design, digit symbol, similarities and digit span subtests. Folate treatment was ineffective. These results indicate that, in epileptics chronically treated with PHT, thiamine improves neuropsychological functions, such as visuo-spatial analysis, visuo-motor speed and verbal abstracting ability.

Adult↗
PubMed1990

Articulatory impairment associated with tardive dyskinesia.

The speech of two patients with tardive dyskinesia was studied, and one neuroleptic-treated patient having no signs of overt tardive dyskinesia served as control. A structured interview, including reading, repetition of sentences, and spontaneous conversation, was performed. A phonetic transcription and analysis of abnormal phonemes was done by a linguist under blind conditions. Both patients with tardive dyskinesia had abnormal phonemes whereas the control patient had none. These differences could not be explained by age, direct neuroleptic effect, or neuroleptic exposure time. The abnormal phonemes were all consonants. The authors conclude that tardive dyskinesia may cause articulatory communication problems.

Adult↗
PubMed1988

A 5-year prospective longitudinal study of tardive dyskinesia: factors predicting appearance of new cases.

In a 5-year longitudinal study in a cohort of 169 schizophrenic outpatients treated with neuroleptics, we found a twofold increase (from 22% to 44%) in prevalence of tardive dyskinesia (TD) meeting the Schooler and Kane research diagnostic criteria. If we include cases of TD that were considered definite but did not meet the research criteria, the prevalence increased from 31% to 58%. In the cohort of 131 patients who did not present with the disorder in 1975, we found parkinsonism and increase in parkinsonism to be the best predictors of subsequent development of the disorder. Poor schizophrenic prognosis and long treatment duration also appeared to be risk factors. Another finding was the importance of changes in neuroleptic and antiparkinsonian dosage in both covering and uncovering TD.

Adult↗
PubMed1987

Midazolam: kinetics and effects on memory, sensorium, and haemodynamics.

This study aimed not only to compare the pharmacokinetics of oral and intravenous doses of the new water-soluble benzodiazepine, midazolam, but also to study the effects on haemodynamics, sensorium, and memory performance. Eight normal human volunteers each received a single 15 mg dose of midazolam base orally and intravenously in randomized sequence 2 weeks apart. Serial venous samples were obtained for 12 h after dosing. Vital signs, sensorium testing and memory testing using word lists were also performed. Computerized non-linear least squares curve-fitting of the two-compartment open model to the oral and intravenous data simultaneously yielded the following estimates: V1, 0.33 1 kg-1, VdSS, 1.08 1 kg-1, t1/2,lambda, 0.10 h, t1/2,Z, 1.89 h, ka 1.17 h-1 and bioavailability, 49%. The intravenous dose decreased the systolic pressure 22 mm Hg during the first half-hour and the oral dose had 50% less effect. Most subjects became drowsy halfway through the infusion and were only rousable to voice by its end. The sensorium was clear by 2-3 h. After oral dosing the peak sensorium effects of ataxia-dysarthria were seen at 30 min and had cleared by 2 h. Memory testing showed that memory acquisition was markedly impaired for at least 90 min after the intravenous dose and slight recovery was apparent at this time after the oral dose. Memory performance was proportionately more impaired than the sensorium score. We conclude that: midazolam kinetics are characterized by rapid absorption, but incomplete bioavailability and rapid elimination, midazolam intravenously may lower blood pressure significantly, and the level of consciousness correlates poorly with the degree of memory impairment.

Absorption↗
PubMed1984

Withdrawal symptoms after long-term treatment with low-potency neuroleptics.

Twenty-six chronic schizophrenic outpatients receiving low-potency anticholinergic neuroleptics were switched over periods of up to 2 years to an equivalent dose of high-potency neuroleptics. Of these patients, 85% experienced withdrawal symptoms, mainly insomnia, anxiety, and tensional restlessness. Complete withdrawal of low-potency medication was achieved during the study period in 9 patients only. The mean duration of treatment with low-potency neuroleptics was 15 years and the mean dose was 147 mg chlorpromazine equivalents/day. It is suggested that new symptoms associated with withdrawal of low-potency neuroleptics may lead to overcompliance by patients and difficulty in achieving the minimum therapeutic dosage. Thus, low-potency neuroleptics would not appear suitable for the long-term treatment of most schizophrenic patients.

Adult↗
PubMed1983

Piracetam in elderly psychiatric patients with mild diffuse cerebral impairment.

In a 12-week double-blind study, piracetam at two dose levels (2.4 and 4.8 g/day) was compared to placebo in the treatment of 60 elderly psychiatric patients with mild diffuse cerebral impairment, but no signs of focal brain lesion. The psychiatric illness, schizophrenia or affective disorder, of patients selected was in remission at the time of the study. Monthly evaluations by the nurse revealed that piracetam improved overall functioning, particularly alertness, socialization, and cooperation, relative to the control group. Patients treated with 2.4 g/day piracetam also showed significant improvement in scores for the full IQ and the memory quotient on the Wechsler Adult Intelligence and Memory Scales; greater response was seen in those with lower initial scores. Piracetam at 4.8 g/day had a more rapid onset of action on behavioral variables than 2.4 g/day, but its therapeutic effect tended to diminish at 12 weeks, possibly as the result of overstimulation. Piracetam did not appear to interfere with concomitant psychotropic maintenance medication or affect the psychiatric illness itself.

Aged↗
PubMed1979

Factors related to tardive dyskinesia.

The authors found a 31% incidence of tardive dyskinesia among 261 schizophrenic outpatients treated with neuroleptics. Multiple linear logistic regression analysis revealed a higher incidence of tardive dyskinesia among elderly patients, those with longer records of hospitalization, those for whom neuroleptic medication had little therapeutic effect, and those treated with fluphenazine. Patients manifesting tardive dyskinesia tended to have fewer parkinsonian symptoms than those without the disorder, especially when tremors and akathisia were excluded from consideration. Multiple linear regression analysis indicated that brain-damaged patients and male patients were more susceptible to severe forms of the disorder, even though these factors were not implicated in its initial appearance.

Adult↗
PubMed1979

Ethopropazine and benztropine in neuroleptic-induced parkinsonism.

In a 12-week controlled study ethopropazine was compared to benztropine in the treatment of parkinsonism induced by fluphenazine enanthate in 60 schizophrenic outpatients. Ethopropazine and benztropine were found to be equally effective in controlling parkinsonian symptoms and were as efficacious as procyclidine, their previous antiparkinsonian drug. However, benztropine treated patients had a significant increase in tardive dyskinesia compared to their condition during procyclindine treatment, and significantly more anxiety and depression than ethopropazine treated patients. This suggests that benztropine is not the anticholinergic drug of choice in the treatment of neuroleptic-induced parkinsonian symptoms, because of its more toxic central and peripheral atropinic effect.

Adult↗