Tardive dyskinesia and antiparkinsonian medication.
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Biomedical subjects
Publications and source records attributed to L Annable.
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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.
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A total of 54 schizophrenic patients, 27 male and 27 female, satisfying study criteria, were randomly assigned to one of three treatments: placebo; perphenazine, 20 mg/day; or the combination of amitriptyline, 125 mg/day, with perphenazine, 20 mg/day. Medication was administered under double-blind conditions for 12 weeks, after which ECGs were taken following an overnight fast and again following a 600-calorie meal. Among patients receiving perphenazine or amitriptyline-perphenazine, there was a statistically significant increase in repolarization abnormally after eating, whereas placebo-treated patients incurred no such increases. This supports the hypothesis that phenothiazine-induced ECG changes may be caused or facilitated by the glucose load. The incidence of increase in repolarization abnormality after the meal was higher among female patients than among male patients. The findings are of practical significance for readings of abnormality in the ECG of phenothiazine-treated patients.
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In a double-blind controlled study lasting 6 weeks, 32 schizophrenic patients were randomly assigned to one of two treatments: chlorpromazine or benserazide, a dopa decarboxylase inhibitor. Results on each measure were subject to multifactorial analysis of covariance. Benserazide did not appear to be as effective an antipsychotic medicaiton as chlorpromazine. In fact, chlorpromazine was significantly better on measures of tension, excitement, hallucinatory behavior, thinking disturbance, social interest, and drop-out rate. At the relatively low dosages used in this study, it would seem that benserazide had little effect on the cerebral dopa decarboxylase, and it would be worthwhile trying higher dosages.
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Twenty-four volunteer college students, who were regular drug users, were randomly allocated to three training groups of equal size: alpha feedback, EMG feedback and a joked control group. Subjects, who were unaware of which feedback condition they received, were asked to practice at home during a six month follow-up period to achieve a relaxed state similar to that experienced during training. No group was successful in retaining gains made in their alpha levels during each session. The EMG group, however, significantly reduced their muscular activity during training and retained the improvement during follow-up. The alpha and joked groups did not significantly improve their EMG during training but at follow-up achieved the same levels as the EMG group. There was evidence to suggest a reduction in drug use among light and medium users that was maintained during follow-up. Significant and lasting improvements were made by each group in the duration and quality of their sleep. Anxiety levels were also reduced.