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Biomedical subjects

I Koga

Publications and source records attributed to I Koga.

At least 19 recordsLinked to original sources

Naloxone attenuates drinking behavior in a schizophrenic patient displaying self-induced water intoxication.

This study was performed to examine the effect of naloxone on drinking behavior in a schizophrenic inpatient with psychosis, intermittent hyponatremia, and polydipsia (PIP syndrome). His body weight was checked five times daily, and the maximum and minimum weight gains during a day were chosen as an index of polydipsia. Both daily (0.6 mg) and repeated (0.6 mg for 6 days) injections of naloxone suppressed his weight gain significantly for 2 weeks. Withdrawal of the drug for 4 weeks resulted in weight gain recovering to control level. Thereafter, a second trial was performed to examine the long-term effect of this treatment. A daily naloxone (0.6 mg) injection series was performed once every 2 weeks for six series (12 weeks). This drug regimen also suppressed his weight gain in a continuous fashion. The study showed that naloxone seems to be a potential treatment for PIP syndrome and that endogenous opioid systems play a part in the compulsive drinking behavior of the PIP syndrome.

Drinking Behavior

Distinguishing acute and tardive akathisia by monitoring microvibration: a pilot study.

One acute and one tardive akathisia patients, respectively, and 10 neuroleptic-treated schizophrenic patients were injected with biperiden 5 mg or saline and the response to anticholinergics was monitored by microvibration (MV) as an indicator of muscle tonus. These data were subjected to the Fast Fourier Transform and an averaged power spectrum was computed. The biperiden injection markedly reduced the power spectral values of MV in acute akathisia. In contrast with acute akathisia, the biperiden injection significantly increased the power spectral values of MV in tardive akathisia. The subjective feelings of akathisia patients were parallel to the power spectral values of MV. Control patients were not affected by such treatment. The present findings show that the subjective symptoms of akathisia can be well defined by the objective, differential response to anticholinergics in a manner similar to the visible extrapyramidal symptoms (dystonia, dyskinesia) induced by neuroleptics.

Acute Disease

Respiratory dyskinesia: a variety of clinical forms differentially diagnosed by using a spirograph.

Four cases of respiratory dyskinesia were investigated by using a spirograph before and after biperiden injection. The abnormal respiratory patterns in four cases appeared to be in two types and these abnormalities were abolished after biperiden injection. The present study showed that respiratory dyskinesia could be defined more clearly by using a spirograph and these results are useful for the diagnosis of patients with respiratory discomfort while undergoing neuroleptic drug treatment.

Adult

Evidence for a direct adverse reaction of neuroleptics in self-induced water intoxication of psychiatric patients.

A mentally retarded patient who developed polydipsia and hyponatremia following the long-term use of neuroleptics is described. Before the investigation, he was treated with a combination of five drugs: diazepam, propericiazine, carbamazepine, lithium carbonate and trihexyphenidyl. The treatment was switched to diazepam alone; to propericiazine, trihexyphenidyl and diazepam; to carbamazepine and diazepam; and finally to lithium carbonate with diazepam. Under the five drug treatment protocols, his weight gains during the day were monitored, every day as an index of the water he drank in the day time. The combination of the five drugs caused the greatest weight differences per day and the other drug regimens, except diazepam alone, seemed to increase the weight differences to some extent. These findings indicate that a drug combination such as the neuroleptics, lithium and carbamazepine used for emotional stabilization must be carefully monitored to avoid the induction of compulsive drinking.

Adult

Chronic treatment with talipexole dihydrochloride on abnormal involuntary movement in humans.

Two cases of severe dystonia and dyskinesia were treated with talipexole, a dopamine autoreceptor agonist, and the metabolites of dopamine, norepinephrine, and serotonin in cerebrospinal fluid (CSF) were determined. Despite significant reductions in these metabolites in CSF, behavioral amelioration of these cases could not be observed. The present findings argue for further studies to explore the clinical usefulness of dopaminergic agonists such as talipexole.

3,4-Dihydroxyphenylacetic Acid

Treatment of tardive akathisia with clonidine.

Two cases of tardive akathisia, which were misdiagnosed as anxiety originating from a schizophrenic disorder, had been treated with anxiolytics in addition to neuroleptics and anticholinergics. The diagnoses were changed to tardive akathisia, the anticholinergics were discontinued, and the patients were treated with clonidine successfully. In view of the similar effects of clonidine and anticholinergics, the pathophysiology of tardive akathisia must be very similar to that of tardive dyskinesia.

Adult

Prophylactic effects of neuroleptics in symptom-free schizophrenics: a comparative dose-response study of timiperone and sulpiride.

Remitted schizophrenic outpatients were prophylactically treated to prevent relapse with three different doses of timiperone or sulpiride for a year in a double-blind controlled study employing a randomized design. Each drug's ability to prevent relapse was by counting the number of subjects with different outcomes (remission, relapse, adverse reactions) during the trial and/or the number of symptom-free days for each patient before any sign of relapse or adverse reactions appeared. Patients were randomly assigned to the following drugs, which were orally administered once every night: placebo; timiperone 1 mg, 3 mg, 6 mg; sulpiride 100 mg, 300 mg, 600 mg. Data from previous studies involving haloperidol and propericiazine were utilized as a retrospective placebo group to compare the characteristics of the four drugs for maintenance treatment of remitted schizophrenic outpatients. Both timiperone and sulpiride increased the number of patients in remission and decreased the number of patients who relapsed, compared with the placebo group. With timiperone, there was an especially marked increase in the number of patients who showed signs of adverse reactions compared with sulpiride. Sulpiride was the only drug that increased the number of dose-dependent symptom-free days. However, both of these drugs significantly increased the number of symptom-free days compared with placebo. By comparing the dose-response curves of four drugs tested in the same fashion, haloperidol and sulpiride were superior to propericiazine and timiperone because they displayed a wider dose range for the maintenance treatment of remitted schizophrenic outpatients.

Adult

Treatment of tardive dyskinesia with ceruletide.

1. Seven patients with TD were treated with a single dose of ceruletide 0.8 microgram/kg i.m. 2. EMG and MV were recorded, and the average power spectrum was computed. 3. Effect of ceruletide on TD within 2 hr after injection was varied (3 cases: inhibitory, 2 cases: facilitatory, 2 cases: no effect). 4. Two patients with severe TD, who showed improvement after a single administration, received repeated administration of ceruletide (0.6 microgram/kg i.m.) and their TD symptoms were recorded on videotape for blind consensus ratings. In both patients ceruletide caused a marked decrease in severity of TD, and the effects lasted for several weeks. 5. The present findings might contribute to further understanding of the role of CCK in the brain and to the treatment of TD.

Adult

Monovision contact lens wear and occupational task performance.

The effects of monovision (MV) contact lens wear on the performance of occupational-type nearpoint tasks was evaluated on 18 presbyopic subjects (ages 44 to 67 years) by comparing MV performance (MV condition) to that with distance contact lenses with reading glasses (BV condition). Each subject had correctable distance visual acuity of 6/6 (20/20) in each eye, at least 60 sec arc of near stereopsis, good ocular health, and no previous MV experience. Time performance and error performance for 3 nearpoint occupational tasks (pointers and straws, card filing, and letter editing) were measured with the MV correction and BV correction. Measurements were taken at dispensing and at 2 weeks and 8 weeks after dispensing. Subjects were instructed to wear the MV soft spherical contact lenses at least 8 h per day. We measured BV time performance to be better than MV time performance by 2.8 to 5.7% and also measured an increased number of errors with MV.

Aged

Effect of ceruletide on tardive dyskinesia: a pilot study of quantitative computer analyses on electromyogram and microvibration.

Seven patients with bucco-lingual dyskinesia were treated with a single dose of ceruletide 0.8 micrograms/kg IM, a potent analogue of cholecystokinin octapeptide. Time-course effects of the drug were then followed up to 6 weeks after injection in the longest case. To assess changes in severity of dyskinesia objectively, electromyogram and microvibration were recorded. These data were subjected to the Fast Fourier Transform and an averaged power spectrum was computed. The effect of ceruletide on dyskinesia within 2 h after injection differed (three cases: inhibitory, two cases: facilitatory, two cases: no effect). It was notable that a long-lasting inhibitory effect of this peptide was observed in two severe irreversible cases. The present findings might contribute to further understanding of the physiopathophysiological role of cholecystokinin-like peptides in the brain and to practical treatment of tardive dyskinesia.

Adult

Biphasic and long-lasting effect of ceruletide on tardive dyskinesia.

A 55-year-old schizophrenic inpatient with buccolingual dyskinesia was treated with a single dose of ceruletide 0.8 micrograms/kg IM. Time-course effects of the drug were then followed for up to 6 weeks after injection. To assess changes in severity of bucco-lingual dyskinesia objectively, electromyogram (EMG) and microvibration (MV) were recorded. Simultaneously, bucco-lingual dyskinesias were also evaluated by using a five-point rating scale. Before injection of ceruletide, severity of dyskinesia was "moderate" and 3-4 Hz of dyskinetic oral movements were dominant. "Extremely severe" and repetitious gross oral movements (around 1 Hz) were observed within a few minutes after injection and continued for up to 1 h. Thereafter, oral movements tended to decrease, and they disappeared completely 3 weeks after injection. This biphasic and long-lasting effect of ceruletide on tardive dyskinesia might contribute to further understanding of the physio-pathophysiological role of cholecystokinin-like peptides in the brain, and provide a basis for practical treatment of tardive dyskinesia.

Ceruletide

Prophylactic effects of neuroleptics in symptom-free schizophrenics: roles of dopaminergic and noradrenergic blockers.

A clinical trial was undertaken to determine the role of dopaminergic and noradrenergic blockers in the maintenance treatment of remitted schizophrenics. One hundred and six remitted schizophrenic outpatients were treated with one of nine treatments, viz., thioridazine 25 mg or 75 mg, pimozide 2 mg or 6 mg, and their respective combinations, for 1 year in a double-blind controlled study employing a randomized design. The data from a previous study were utilized as a retrospective placebo group. Pimozide prolonged the number of symptom-free days in a dose-dependent manner and did so more markedly than thioridazine. Combined administration of pimozide and thioridazine prolonged the number of symptom-free days to a greater extent than their single administration. However, an inverted U-shaped dose-response curve was obtained with the combined administration of these agents. These data suggest that both the dopaminergic and noradrenergic blocking action of neuroleptics are important in preventing relapse in remitted schizophrenics.

Adult