Biomedical subjects
Publications and source records attributed to J Sramek.
Carbamazepine alone or carbamazepine plus neuroleptic was administered to 20 chronic schizophrenic patients. Upon abrupt discontinuation two of the 20 patients had exacerbations of their psychoses characterized by paranoia, hostility, and agitation. The authors discuss the possibility of a carbamazepine withdrawal syndrome.
Oral liquid formulations of neuroleptic medications have been claimed to offer advantages in treatment of psychotic patients, particularly as a means of ensuring compliance. After a review of the literature, this 900-bed psychiatric facility found no substantial support to indicate that liquids are superior to solid dosage forms. Because of their higher cost, liquid neuroleptics were removed from this formulary. Few changes in prescribing practices were measured after removal of liquids; dosages remained constant and injectable neuroleptic and sedative use actually decreased. Replacing liquid neuroleptic dosage forms with solid dosage forms resulted in an estimated annual savings of nearly $60,000 at this institution. The authors conclude that liquid neuroleptics appear to offer no benefits over solid dosage forms in adult psychiatric patients and can be removed from drug formularies without disruptive effects on psychotropic prescribing practices or clinical care. However, further research is needed to determine the benefits of liquid neuroleptics in special clinical or psychiatric settings.
The study of phage-sensitive strains of group A streptococci of different serological types, isolated from glomerulonephritis patients in Czechoslovakia, has confirmed the data previously obtained in Moscow. As revealed in this study, all strains of type 12, containing M-antigen, are sensitive to group 1 phage from the phage collection used in the investigation. Some of the strains of type 12, containing M-antigen and isolated from healthy carriers, have also proved to be sensitive to group 1 phages. Thus, streptococcal strains of type 12, containing M-substance and found to be the main causative agents of glomerulonephritis, have shown similar phage sensitivity when isolated in different geographical zones. For this reason, group 1 phages can be used for the detection of some "nephritogenic" strains among the population.
Explore the source record for details and available documents.
A retrospective review was conducted to assess the effect of molindone on weight. Monthly weights and neuroleptic dosages during the first three months of psychiatric hospitalization were compared between matched groups of patients receiving molindone, a combination of molindone and other neuroleptics, or other neuroleptic drugs. We found no significant differences in weight gain among the three groups. Our results challenge the common opinion that molindone can be associated with a lack of weight gain compared to other antipsychotics.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Recent studies suggest that minorities may have higher plasma levels caused by ethnic variations in pharmacokinetics under standard neuroleptic treatment; they would be at increased risk for extrapyramidal side effects and more likely to be treatment noncompliant. This study examined the prescribing pattern of antipsychotic medication to minority schizophrenics in outpatient psychiatric programs developed to meet their treatment needs. A computer search was conducted of registered clients in a Hispanic and Asian outpatient clinic(s). Hispanic and Asian patients with schizophrenia were identified and for purposes of comparison, a third sample of consecutively drawn outpatients with a diagnosis of "schizophrenia" registered in the outpatient clinic proper were selected. All outpatient medical records were secured and neuroleptic dosing patterns extracted and quantified. Neuroleptic doses were converted to chlorpromazine equivalents and corrected for body weight to a standard of 68 kg. One way analysis of variance procedures were used to compare both the actual and standardized neuroleptic doses across the three samples and revealed a significant main effect for both actual (p < 0.05) and standardized dose (p < 0.05). With regard to the former secondary analysis yielded significant differences between the clinic sample and the Hispanic (p < 0.05) and Asian (p < 0.05) samples, which did not differ significantly from each other but which received significantly less drugs than the other patient population. These results were similar to the standardized dose comparison. The findings replicate previous inpatient reports and have implications for cross-cultural treatment programs.
This study is the second in a series examining the prescribing of antipsychotic medication to patients with schizophrenia in cross-cultural clinical programs. A computer search identified all patients with the diagnosis of "schizophrenia" treated during a 1-year period in an inpatient Hispanic and Asian psychiatric unit(s); second computer search identified a matched (admission date) sample of Anglo patients from the general inpatient psychiatry services. The medication variables included type of neuroleptic drug used, the maximum dose, the stabilized dose (i.e., neuroleptic dose at discharged and the dose associated with first report of extrapyramidal symptoms. Neuroleptic doses were converted to chlorpromazine (CPZ) equivalents and corrected for body weight to a standard of 68 kg. Oneway analysis of variance procedures were used to compare both actual and standardized neuroleptic CPZ across the three samples, these statistical comparisons were completed for both maximum and stabilized dose(s). The analysis with maximum dose revealed a significant main effect for both actual (p < 0.05) and standardized CPZ (p < 0.05). Similar results were also found for stabilized dose with both actual (p < 0.05) and standardized CPZ (p < 0.05). Examination of the direction of mean differences for both medication dosing variables using both CPZ comparisons revealed that the patients in general sample received significantly larger doses of antipsychotic medication than either Asian or Hispanic patients.