The management of adolescents with diabetes mellitus involves specific aspects at diagnosis and during follow-up. A type 2 diabetes should be excluded at diagnosis since this condition is increasingly observed in closed relationhip with the progression of obesity in young people. During initial education process, the parents should be involved while a specific space and time for interaction with the adolescents is required. During follow-up, all aspects of the adolescent process should be taken into account together with diabetes. This includes risk-taking or exploratory behaviours, feeling of being different, angryness and difficulties for the adolescents to consider the long-term complication risk. Special attention should be devoted to the transition towards adult care.

Adolescent↗

PubMedDate not supplied

[The practitioner faced with anxiety and somatic symptoms (author's transl)].

In order to determine the psychopharmacological profile of tiapride, the authors carried out 3 studies. The first study of ten resistant psychiatric cases permitted us to detect the direction of later studies. The object of the second was to analyse the neurovisceral properties and the action of tiapride on somatic symptoms due to anxiety in 25 ambulatory patients. The last study was a therapeutic approach. Tiapride appears to be one of the best drugs for anxiety in one of the 3 following circumstances: a paroxysmal or chronic somatic expression, depression, or behaviour suggesting latent and masked psychosis or early psychosis. Tiapride is tolerated in the same way as a neuroleptic for even in low dosage (150-300 mg/day) may appear undesirable side effects of extrapyramidal type. On the other hand, and contrary to sulpiride, neuro-endocrine effects are exceptional.

Antipsychotic Agents↗

PubMedDate not supplied

[Novel comparative profile of the clinical activity of antidepressive agents].

In order to develop practical criteria to guide in the selection of antidepressant medication according to depressive symptomatology, we propose a graphical representation of the clinical activity of 24 antidepressants according to a "star" model. Six parameters have been evaluated from 0 to 5 in comparison to reference drugs (rated 5) by 11 independent "blind" psychiatrists expert in pharmacotherapy. Three parameters were used as measures of therapeutic activity: antidepressant, psychostimulant, and anxiolytic, with iproniazide 75 mg/d, metamphetamine 15 mg/d, and diazepam 20 mg/d as reference drugs respectively. Three additional parameters assessed the level of side-effects: anticholinergic, sedative, and hypotensive, with atropine 0.75 mg/d, phenobarbital 200 mg/d, and iproniazide 75 mg/d as reference drugs respectively. The defined dose represented the standard maintenance daily dose for depressive outpatients. Mean values for each parameter, rounded off to the closest number, were used for the graphical representation. Results showed an excellent agreement among evaluators for the clinical profile of classical tricyclic and MAOI antidepressants, but serious divergences for the more recent drugs (e.g., viloxazine and mianserine), possibly reflecting more atypical or more variable clinical profile of these compounds.

Antidepressive Agents↗

PubMedDate not supplied

Pimozide in the treatment of some "social maladjustments" in "personality disorders".

Forty patients with some "social maladjustments" or disturbed interpersonal relationship under 2 mg pimozide (Orap: a 24 h long-acting neuroleptic) for six to twelve months. Concomitant but complementary medication was kept unchanged. Control was based on: long-term investigation (1/2 - 1 year), quantification, use of two scales. Statistical evaluation of the changes in "cardinal symptoms" showed a significant improvement in tension, disorders of sleep, intellectual disturbances, cardiovascular symptoms and gastrointestinal complaints. More detailed analysis of the other 27-item rating scale revealed a dramatic improvement in anxiety and paranoidism. The overall appreciation shows that: 25 patients responded well or very well to pimozide, eight did moderately, seven poorly. Neurasthenia and related states with predominant asthenia turned out to be no indication for pimozide treatment. Except for some cases of increased fatigue, tolerance was exceptionally good. The trial showed that extra patience is required from the therapist as a clinical onset of one to two months is not uncommon.

Adult↗

PubMedDate not supplied

[Apropos of neuroleptanalgesia in the psychiatric clinic].

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Adolescent↗

PubMedDate not supplied

Biochemical and neuroendocrine approaches to a malignant syndrome of neuroleptics.

A 20 year old patient who has been hospitalized for depressive schizoidia is treated by nomifensine (75 mg/d) plus pimozide (4 mg/d). Four days later, he shows a typical neuroleptic malignant syndrome (Syndrome malin de Delay et Deniker). The biological explorations show that inflammatory blood tests are increased, hepatic tests are disturbed and the pituitary tests suggest a hypothalamic disturbance of the balance between NE and DA (reduced STH, FHS and LH) with a relative NE predominance, but also an increase of DA (increased HVA in CSF. A pathogenic interaction between nomifensine, an antidepressant inhibiting the reuptake of NE and DA, and pimozide, a neuroleptic blocking dopaminergic postsynaptical receptors is to be considered.

Adult↗