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Biomedical subjects

A Villeneuve

Publications and source records attributed to A Villeneuve.

18 recordsLinked to original sources
PubMed1992

[Duration of antidepressive treatments].

In spite of the considerable amount of research undertaken in the field of biological psychiatry, there is currently no reliable guide allowing us to predict with accuracy the response of a patient to an antidepressant treatment. Moreover, owing to the heterogeneity of the spectrum of affective disorders, to the importance of eliminating the various factors involved in an apparent resistance to an antidepressant therapy, it seems aleatory, particularly for an individual patient, to foresee precisely the length of an antidepressant treatment, except may be in unipolar disorders. The quality of the physician-patient therapeutic relationship should never be neglected. The recent hypotheses pertaining to the etiopathogenesis of affective disorders, the advent of new psychotropic agents such as the specific serotonin uptake inhibitors, or other agents not acting through this mechanism and the MAOI, type A, as well as the utilization of corticosuppressor drugs, may pave the way to new therapeutic avenues that could, in the future, modify the prognosis and the duration of the treatment of the depressive affective disorders.

Antidepressive Agents, Tricyclic↗
PubMed1992

[Mediastinal parathyroid adenomas on a 5th ectopic gland. 2 case reports].

Mediastinal parathyroid adenoma located on the 5th ectopic gland is rare. We report here two new cases diagnosed by scintigraphy. In one case the adenoma was found to be located in the mediastinum prior to cervicotomy. The modern imaging methods capable of locating parathyroid adenomas are evaluated.

Adenoma↗
PubMed1990

Levodopa up-regulates platelet alpha 2-adrenoceptors.

Treatment of dogs for 21 days with oral levodopa (100 mg b.i.d.) plus benserazide (25 mg b.i.d.) induced a significant increase in the number of platelet alpha 2-adrenoceptors labelled by [3H] yohimbine with no change in Kd. The rise was maximal at the end of the treatment and remained significant during the month following the cessation of treatment. Plasma catecholamine levels did not vary. Competition experiments showed a low affinity of both dopamine and levodopa for platelet alpha 2-adrenoceptors. These results suggest that levodopa treatment regulates alpha 2-adrenoceptor number in dog platelets.

Animals↗
PubMed1990

[Functional coronary insufficiency in pheochromocytoma. Contribution of isotopic tests. A case report].

A 67 year old woman with a right adrenal pheochromocytoma was admitted to hospital with decompensated diabetes. She developed clinical signs of myocardial infarction. Complementary investigations showed this to be an adrenergic cardiomyopathy. The radionuclide and angiographic investigations confirmed the ischemic origin of the lesions and the functional nature of the coronary insufficiency in this case of pheochromocytoma.

Adrenal Gland Neoplasms↗
PubMed1979

The utilization of hypnotics in chronic schizophrenics: some critical remarks.

Of 23 hospitalized chronic schizophrenic patients, all under neuroleptic medication, hypnotics taken previously for a long time could be totally withdrawn in 16 cases, and in 7 cases, the dosage was diminished by 30%, without any sleep impairment. The gradual reduction of hypnotics was accompanied by a shift of neuroleptic dosage to the evening and bedtime, with reduction of the morning and midday dose, without change of the total daily dose. A significant improvement in the psychic state was observed in 16 patients after withdrawal of the hypnotic; 7 patients showed a slight improvement after reduction of the hypnotic. Monthly or bimonthly reassessment of insomnia in the hospitalized population of chronic schizophrenics is indispensable to avoid the deleterious effects and abuse of hypnotic drugs.

Adult↗
PubMed1979

[Modern aspects of mood disorders].

Mood disorders, particularly depression, now represent a major world health problem which will most likely continue increasing. From a clinical standpoint, the synthesis of new antidepressant agents of various chemical structures and the advent of the thymoregulators (lithium salts) has allowed a more flexible, better individualized, therapeutic approach to the affective disorders. However, the widespread use by general practitioners of the antidepressants, alone or in combination with other psychotropic drugs, often with mitigated success, brings to psychiatric consultation patients whose symptomatology has become less characteristics, is more difficult to identify rapidly, requiring thus greater diagnositc refinement. Moreover, greater attention is currently given to depressive affects that can occur during organic illnesses or at various periods of life, particularly at senescence. Besides sustained concerns concerning suicide, the attitude of man confronted with his death arouses great interest and a depressive phase constitutes one of the steps towards this ending. Finally, during the last two decades, some psychoanalysts have reexamined the psychodynamic concepts of mood disorders, whereas from behavioral and cognitive theories new techniques of treatment of depression have emerged. In brief, if no revolution has occurred, there has been evolution. Mood disorders and their approach have known modifications and some concepts pertinent to this are considered here from various angles, particularly from the clinical (association with organic illnesses, with respect to death), therapeutic (psychopharmacological, behavioral and cognitive therapies), sociological (including suicide) and psychoanalytic viewpoints.

Antidepressive Agents, Tricyclic↗
PubMed1978

Deanol, lithium and placebo in the treatment of tardive dyskinesia. A double-blind crossover study.

A double-blind crossover study on the effects of deanol and lithium carbonate was conducted on a sample of 29 chronic schizophrenic patients with tardive dyskinesia. In addition to his usual treatment with different neuroleptics, each patient received during an 8-week period either deanol, lithium carbonate or placebo. A 4-week wash-out period was inserted between each of the 8-week periods of experimental treatment of the tardive dyskinesia. The administration of either deanol, lithium carbonate or placebo added to the neuroleptic treatment did not produce a statistically significant improvement of tardive dyskinesia in our patient population as a whole. Favorable and unfavorable responses are discussed.

Adult↗
PubMed1978

Pharmacokinetic interaction between amitriptyline and neuroleptics.

The influence of amitriptyline on the plasma level of various neuroleptics was studied in 25 chronic schizophrenic patients. The study lasted 20 weeks. Patients were kept first 4 weeks on their former neuroleptic medication, with amitriptyline added for 12 subsequent weeks, and withdrawn during the last 4 weeks when only the neuroleptic medication was continued unchanged. The plasma level of neuroleptics was assayed by gas-liquid chromatography, once weekly throughout the study. The amitriptyline plasma level was also evaluated once weekly during the 12 weeks of its administration. The mean neuroleptic plasma values for each 4-week period were pooled together in three groups: aliphatic, piperdine and piperazine phenothiazine derivatives. Amitriptyline provoked some increase of the plasma level of all phenothiazine derivatives. This augmentation was significant only transitorily, however. The putative mechanisms of this neuroleptic tricyclic antidepressant interaction are discussed.

Adult↗
PubMed1978

Therapeutic trials in tardive dyskinesia.

The search for a treatment of tardive dyskinesia has generally been guided by the putative biochemical mechanisms underlying the extrapyramidal disorders, but no markedly effective treatment has yet been found. The currently postulated mechanism in tardive dyskinesia involves namely an imbalance between the central dopamine-acetylcholine systems whose balance may also be influenced by neuroendocrine factors. The agents reported having some clinical efficacy in the management of this neurological complication act on these systems. The clinical investigation for the treatment of tardive dyskinesia is laborious and raises several problems that could account for the unpredictability and the discrepancies in results. These problems can be divided into three broad categories: patient variables, experimental treatment variables and methodological variables. These variables are discussed and some suggestions made.

Acetylcholine↗
PubMed1977

Influence of the antiparkinsonian drugs on the plasma level of neuroleptics.

The interaction between various neuroleptics and antiparkinsonian drugs was analyzed by measuring the neuroleptic plasma level before and after withdrawal of antiparkinsonian drugs. The population completing the study consisted of 32 chronic schizophrenics treated with chlorpromazine (8), levomepromazine (14), thioridazine (6), or haloperidol (4). Twenty-five were also receiving benztropine; 4, trihexyphenidyl; and 3, procyclidine. During the first 4 weeks patients remained on neuroleptics and antiparkinsonians, the latter being withdrawn during the 5th week, and the neuroleptics alone being administered during 16 following weeks. The plasma level of neuroleptics was assayed by gas liquid chromatography, once weekly in the morning at two different times. The analysis of variance showed a significant difference in neuroleptic plasma level when patients took neuroleptics only versus the period they had received neuroleptics and antiparkinsonians. The multiple comparison based on Studentized range Q0-05 revealed a significant progressive increase of neuroleptic plasma level during 12 weeks after withdrawal of antiparkinsonian drugs after which a plateau was reached. The hypothetical mechanisms of action of antiparkinsonians on neuroleptic plasma level are discussed.

Adult↗
PubMed1975

Influence of reserpine on all-night sleep pattern in nonlobotomized and lobotomized chronic schizophrenic patients.

This study was performed on two groups of schizophrenic patients. One group consisted on nine nonlobotomized patients and the other of nine lobotomized ones. The groups were matched for age, sex, duration of illness, clinical symptoms, type and dose of psychopharmacological treatment. The patients of both groups were administered 1 mg of reserpine half an hour before bedtime, for three successive days. Before reserpine administration the mean percentage time of the NREM stage 4 was significantly higher in the lobotomized group. There was no significant difference in the REM parameters. After three days of reserpine administration in the nonlobotomized group, there was no significant difference in the mean percentage of the NREM stage 4, whereas the mean REM percentage significantly increased and REM latency decreased. In the lobotomized group the same procedure, i.e., three days of reserpine administration, provoked a significant decrease in the mean percentage of the NREM stage 4 and no significant changes in the REM parameters. This difference in reserpine action on sleep in the lobotomized group is discussed.

Chronic Disease↗
PubMedDate not supplied

A long-term study of penfluridol in chronic schizophrenia.

Penfluridol, a member of the novel diphenylbutylpiperidine class of antipsychotic drugs, is the first long-acting oral neuroleptic. The population of the present study consisted of 24 chronic schizophrenic patients (14 males, ten females) whose treatment with penfluridol was initiated in our previous open/double-blind trial lasting 32 weeks 1; mean age was 42.2 years and mean duration of illness, 15.4 years. During one additional year in an uncontrolled clinical study, penfluridol in the form of 20-mg capsuent procedures included BPRS, CGI, NOSIE, vital signs, and laboratory measurements. During this long-term treatment with penfluridol, the scores of a cluster of BPRS items that included emotional withdrawal, conceptual disorganization, motor retardation, uncooperativeness, and blunted affect showed a progressively significant improvement. This indicated that the Bleulerian primary symptoms in chronic schizophrenics can be improved by the long-term administration of this long-acting neuropleptic with concomitant betterment of social adaptation and activity. The percentage of failure was very low (four patients) and was marked by instability of psychopathology with periods of excitation. The incidence of extrapyramidal reactions necessitating the administration of an antiparkinsonian drug during the length of trial was 35 per cent. No serious effects nor significant laboratory test changes were observed.

Adult↗
PubMedDate not supplied

[Side-effects of neuroleptics].

Due to their pharmacological activity on various receptors, particularly dopaminergic, cholinergic and adrenergic ones, neuroleptics induce various side effects, central as well as peripheric. These side effects are of various nature: psychic and cognitive, neurologic affecting mostly the extrapyramidal system, neuroendocrinian and metabolic, as well as neurovegetative. Toxic manifestations, hepatic, hematologic and others, have been associated with their use, as well as a malignant syndrome that can be lethal. They also have a potential teratogenic action. Their main side effects are therefore described and discussed as to their physiopathology and treatment. Nevertheless, in spite of their various side effects, neuroleptics represent a valuable and effective tool in the treatment of various psychotic disorders, namely schizophrenia. Their main pharmacological property is their ability to induce extrapyramidal side effects. In this respect, the prophylactic administration of an antiparkinsonian agent remains a controversial issue. Finally, the occurrence of tardive dyskinesia has given rise to civil litigation and ethical considerations should be borne in mind in their use.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

[Ethics and clinical drug trials].

During the last decade, biomedical ethics has known a rapid development. Research in man, including clinical drug trials, must now take into account ethical and legal requirements. The concept of the inviolability of the human person constitutes the basic tenet of biomedical ethics. Four main principles ensue: the principles of autonomy, of nonmaleficience, of beneficience and of justice. Some rules derive from them, for instance veracity, confidentiality, fidelity and respect of intimacy with regard to the subject of an experiment. From a practical standpoint, the design of a clinical trial must be scientifically sound, otherwise it cannot be ethical. An informed consent must be obtained, in written form, from the subject in a clinical trial and he must be aware of his right to withdraw from it at any moment. Moreover, the clinical trial must be monitored throughout its duration with respect to ethics. An ethics of the methodology of clinical trials must therefore exist. Ethics in research should be a way of thinking and behaving, inherent to the research training. The researcher should be keenly conscious of the ethical requirements involved in his work, if he wishes to avoid eventual external interventions.

Clinical Trials as Topic↗