Conjunctival naloxone is no decision aid in opioid addiction.
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Administration, Topical↗
Biomedical subjects
L Linzmayer
Publications and source records attributed to L Linzmayer.
Static and dynamic pupillometry for determination of the course of gradual detoxification of opiate-addicted patients.
In order to assess the course of methadone (Heptadone) substitution therapy, 29 inpatients at the Vienna Psychiatric University Clinic (21 males, mean age = 27 years, SD 4 years; 8 females, mean age 29.75 years, SD 5.28 years) who were addicted to opium tea or to a mixture of opium and heroin were investigated by means of computer-assisted "static"- and "light-evoked dynamic" pupillometry. Pupillary measurements were carried out before the start of withdrawal, on the 2nd day 48 h after the administration of 10 mg methadone, and again after the maximum and half of the maximum dose of methadone had been administered. The constricted pupils (the effect of opiate) showed dilatation after the withdrawal syndrome appeared, but immediately after the start of the detoxification treatment, as well as 1 day after administration of the maximum methadone dose a decrease of pupillary diameter was observed. The narrowing of the pupil was followed by an increase in pupillary diameter, which peaked 48 h after the last minimal dose of methadone and nearly reached the normal level. The widening of the pupil reflects an increase of noradrenergic activity under conditions of opiate withdrawal. An increase of spontaneous fluctuations was observed during withdrawal and was only inhibited by the maximum dose of methadone. Finally, pupillary dynamics (shortening of latency time and increase of relative changes) improved during therapy. The pupillary measurement corresponded with clinical observations as well as with self-evaluation during treatment. Thus pupillometry seems to be a useful instrument for assessment of treatment of opiate-addicted patients.
Adult↗
Naloxone induces miosis in normal subjects.
In a placebo-controlled trial, pupillary constriction was measured in healthy non-addicted subjects and in opiate addicts by using static computer-assisted pupillometry. In contrast to earlier reports, a clear-cut pupillary constriction was observed in healthy persons after a single intravenous injection of 0.4 mg naloxone. No significant changes of pupillary size were recorded in the same subjects after the administration of a placebo. In methadone-maintained subjects, the IV administration of 0.4 mg naloxone caused a significant pupillary dilatation. From these data it can be concluded that naloxone seems to have a central pharmacological action not only in opiate addicts, but also in healthy persons. This is demonstrable by studying the miotic response.
Adult↗
Brain protection of nicergoline against hypoxia: EEG brain mapping and psychometry.
In a double-blind, placebo-controlled trial human brain function and mental performance as well as the antihypoxidotic properties of nicergoline were studied utilizing blood gas analysis, EEG brain mapping and psychometry. Hypoxic hypoxidosis was experimentally induced by a fixed gas combination of 9.8% oxygen (O2) and 90.2% nitrogen (N2) equivalent to 6,000 m altitude, which was inhaled for 23 min under normobaric conditions by 16 healthy volunteers. They received randomized after an adaptation session placebo, 10 mg, 30 mg and 60 mg nicergoline (NIC). Evaluation of blood gases, brain mapping and psychometry was carried out at 0, 2, 4, 6, 8 hrs oral drug administration. Blood gas analysis demonstrated a drop in PO2 from 95 to 35 and 34 mm Hg in the 14 and 23 min of inhalation, respectively. PCO2 decreased too (38 to 34 and 34 mm Hg), while pH increased (7.39 to 7.44 and 7.44). Base excess increased (-0.6 to 0.6 and 0.4) while standard bicarbonate decreased (24.4 to 24.1 and 23.8 mmol/l). Thus, blood gases remained stable between the 14 and 23 min of hypoxia during which time the neurophysiological and behavioral evaluations were carried out. EEG brain mapping exhibited an increase in delta/theta activity mostly over the parietal, temporal and central regions (left more than right), while alpha activity decreased (mostly over the parietal, central, frontal, fronto-temporal and temporo-occipital regions). 30 and 60 mg NIC attenuated this deterioration of vigilance. At the behavioral level, hypoxic hypoxidosis induced a deterioration of the noo- and thymospsyche which was mitigated by NIC. Based on 13 psychometric variables, the hypoxia-induced performance decrement was on the overall (2nd-8th hr) 43% after placebo as compared with pretreatment normoxic values, while only 29, 24 and 31% after 10, 30 and 60 mg nicergoline, respectively. The difference between placebo and the optimal dosage of nicergoline 30 mg reached the level of statistical significance (p less than 0.01, multiple Wilcoxon).
Adult↗
Habituation of skin conductance response in a methadone population.
By measurement of the habituation to the skin conductance response (SCR) no reduction of activation could be observed between stable patients in methadone maintenance therapy and healthy normal subjects, but significant differences were obtained between the well-performing group and poly-drug users treated with methadone. The findings are discussed within the context of previous research on outcome of methadone maintenance. Measurement of habituation to SCR is a useful instrument for detecting polydrug addicts in methadone maintenance programmes.
Adult↗
[Electrodermal activity--"psychovegetative resonance" in AIDS patients].
The habituation of the electrodermal reaction (EDR) is one of the most used variables among psychophysiological indicators in investigations in men. In our department a specific computer assisted technique for measuring habituation, mean amplitude, area underneath the line and "emotional reflection" was developed. 15 acoustic stimuli (500 Hz tone at 72 db intensity lasting for 500 msec) are presented to the patient. The habituation criterion is reached when there are no reactions to 3 consecutive stimuli. Since the first reports in 1981 AIDS has become an expanding major public health problem. Therefore the aim of our investigation was to study electrodermal activity in AIDS-patients, especially the habituation of the EDR. 37 addicted AIDS-patients participated in the study voluntarily and were compared to 30 drug addicted HIV-negative patients, 30 homosexual AIDS-patients and 20 healthy normals. Furthermore the patients were divided according to the stages of their disease. The drug addicted AIDS-patient group habituated earlier than the addicted HIV-negative group, the healthy normals, and the homosexual patients. The drug dependent AIDS-patients were more psychovegetatively suppressed. As compared to the healthy normals and addicted HIV-negative patients the homosexual AIDS-patients differed in emotional reflection; they showed a higher degree of excitement, while in drug dependent AIDS-patients a lower emotional reflection was found. Concerning emotional intensity similar results were obtained. Differences in the mean amplitudes reached the level of statistical significance between homosexual AIDS-patients and the healthy normals and addicted HIV-negative patients respectively. Within as well as between both groups differences concerning stage III and IV could be observed.(ABSTRACT TRUNCATED AT 250 WORDS)
Acoustic Stimulation↗
[Psychometric and psychophysiologic studies in AIDS patients with reference to the "declining performance syndrome"--level reduction].
It has been reported that the acquired immune deficiency syndrome can present neuropsychiatric symptoms of major depressive disorders, adjustment disorder with depressed mood and organic brain syndromes with affective, delusional and demented features. The aim of the present study was to determine deficits in performance and to measure psychophysiological variables in drug addicted AIDS-patients. 28 drug addicted AIDS-patients and 17 homosexual AIDS-patients participated in the study voluntarily and were compared to healthy normals. 18 patients belonged to stage III, 27 to stage IV. Performance was measured by numerical memory test, Benton test, Alphabetic reaction test and computer-assisted rigidity test. Psychophysiological parameters were evaluated by computer-assisted "static" and "dynamic" pupillometry, computer-assisted measurements of skin conductance-level, -reaction and habituation; and critical flicker frequency analyses. Performance in drug addicted AIDS-patients differed from controls and especially from healthy normals within a minimal range ("Denivellierungssyndrom"--decline of level of performance). No AIDS-dementia could be objectivated. Furthermore drug-dependent AIDS-patients demonstrated autonomous desactivation, reduced pupillary reagibility and suppressed vegetative irritability.
Acquired Immunodeficiency Syndrome↗
On the central effects of a new partial benzodiazepine agonist Ro 16-6028 in man: pharmaco-EEG and psychometric studies.
In a double-blind placebo-controlled study, the encephalotropic and psychotropic properties of a new partial benzodiazepine agonist Ro 16-6028 were investigated as compared to a pure agonist diazepam utilizing quantitative EEG and psychometric analysis as well as clinical observations. Ten normal volunteers received randomized (latin square design) and at weekly intervals, single oral doses of placebo, 0.05 mg, 0.1 mg and 0.2 mg Ro 16-6028 and 10 mg diazepam as reference substance. EEG-recordings, psychometric tests and evaluation of blood pressure, pulse and side effects were carried out at 0, 1, 2, 3, 4 and 6 h. Computer-assisted spectral analysis of the EEG demonstrated after 10 mg diazepam, a typical "anxiolytic" pharmaco-EEG profile characterized by an increase of beta activity, decrease of alpha activity and acceleration of the centroid total activity. Ro 16-6028 induced in the vigilance-controlled recordings a similar profile thereby exhibiting tranquilizing properties too. However, in the resting condition we observed also an increase of delta/theta activity along with a decrease of alpha activity while the beta augmentation was observed mostly in the fast frequency bands and not so much in the middle fast frequency bands as is the case with the known full agonists. The latter findings were somewhat reminiscent of the pharmaco-EEG profiles seen often in certain neuroleptics. Our data indicate a selective sedation after the novel partial agonist. Dose/treatment-efficacy calculations demonstrated 10 mg diazepam as the most CNS-effective drug followed closely by 0.2 mg Ro 16-6028, 0.1 mg and 0.05 mg, while placebo induced the least changes. Only 0.2 mg Ro 16-6028 and the reference compound differed from placebo at all times. Time-efficacy calculations showed a peak effect of the novel partial agonist around the 3rd h and that of diazepam in the 1st h. Psychometric tests demonstrated similar findings. After 0.2 mg Ro 16-6028 a decrease of attention, numerical memory, psychomotor activity, wakefulness and CFF was observed, while mood improved at later time periods outlasting the sedation. After 10 mg diazepam 10 out of 13 psychometric and psychophysiological variables showed significant findings previously described as typical for anxiolytic sedatives in normals. On the whole, the partial agonist induced less sedation than the full agonist, which is reflected in its superiority in regard to noopsychic and thymopsychic functions. Evaluation of pulse and blood pressure showed no clinically relevant findings. The new partial agonist was well tolerated.
Adult↗
[Stress management in migraine].
The aim of this study was to investigate the physiological and psychological mechanisms underlying migraine, 21 patients with migraine, 21 healthy controls and a group of 21 asthmatics participated in the investigation. All patients and controls were female. Using flicker frequency analysis we determined unspecific cortical activation, whereas autonomic activation was measured by means of the skin conductance level and the skin conductance response. Furthermore, stress management was objectivated by a self-rating scale (SVF). Our findings suggest the hypothesis of inadequate regulation of autonomic especially sympathetic reactions, which along with inadequate stress overcoming mechanisms appear to be of importance in the triggering of migraine attacks.
Adaptation, Psychological↗
[Computer-assisted determination of rigidity in the differentiation of psychopathologic groups].
The measurement of rigidity and perseveration respectively gets increasing importance in clinical psychodiagnostics. Recently we have developed a computer-assisted technique which allows to get information about inadequate persisting in psychic processes and behaviour within shortest time and to differentiate between psychopathological groups. 257 patients of both sexes who came for elucidation of their disorders to the department of clinical psychodiagnostics were investigated. The most significant differences between the groups were found in redundance of second degree (the patient has to press 10 buttons indiscriminately according to the beat of a metronom--standard condition) and in personal speed (the patient has to press 10 buttons as fast as possible--speed condition). Furthermore the psychopathological groups were ranged in the particular variables of rigidity according to their mean values and their average ranges the schizophrenics and effective psychoses were characterized by a high tendency of perseveration while the neurotics, patients with organic brain syndrome and alcohol and drug dependents showed more flexibility.
Affective Disorders, Psychotic↗
Double-blind, placebo-controlled quantitative EEG and psychometric studies in elderlies on vigilance-promoting effects of an almitrine/raubasine combination (Duxil).
In a double-blind, placebo-controlled study the encephalotropic and psychotropic properties of an acutely and 3-weeks subacutely administered novel drug Duxil (consisting of 30 mg of the antihypoxic almitrine which increases the oxygenation of the arterial blood by specific action on the pulmonary exchange system and of 10 mg raubasine, which potentiates this effect via increase in peripheral circulation), were investigated in 12 elderly subjects in their 70s. Each subject had a treatment of 3 weeks with Duxil and placebo (1 tablet b.i.d.) with an interval of 1 week in between (the order of drug sequence was randomized). EEG recordings, psychometric and psychophysiological tests as well as evaluation of pulse, blood pressure and side effects were carried out at 0, 2, 4, 6 and 8 h after the administration of one single dose on day 1 (acute effect), at the 0 h on day 21 (subacute effect) as well as at the 2, 4, 6, and 8 h after one additional superimposed dosage on day 21 (superimposed effect). Computer-assisted spectral analysis of the EEG demonstrated after single doses of two tablets of Duxil only subtle changes in the resting EEG, while after subacute administration and even more so after one superimposed dosage highly significant changes were observed, which were characterized by an increase of total power, alpha and alpha-adjacent beta activity, decrease in fast beta activity, and by an augmentation of absolute and relative power of the dominant frequency. These findings are indicative of an improvement in vigilance. The latter was seen also at the behavioral level, as psychometric tests showed specifically in noopsychic variables a significant improvement in intellectual, mnestic and psychomotor performance after the novel antihypoxic compound, as compared with placebo. There were practically no changes in thymopsychic variables. Evaluation of psychophysiological variables and side effects showed extremely good tolerability of the drug.
Aged↗
[Psychological changes in alcohol abuse].
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Alcoholism↗
[Psychopathology of patients with delusions of ectoparasitic infestation].
This paper presents a literature review as well as a study in 13 patients suffering from delusion of infestation. Symptoms found in MMPI are related to clinical experience. Our results suggest the distinction of three different groups of these patients: 1. Patients with predominantly hypochondric traits, with a distinct conviction to suffer from a severe, physical illness that is often looked at as incurable (hypochondriacal delusion of parasitosis). 2. Patients with paranoid symptoms and without hypochondric apprehensions. These patients usually hopelessly fight against their parasites, that impair their sphere of existence. Physical illness is denied. ("delusion of infestation"). 3. Patients with signs of both, hypochondrical as well as paranoid delusions ("hypochondriacal delusion of infestation").
Adult↗
[Computer-assisted static and dynamic pupillometry for the characterization of tricyclic antidepressive agent, cianopramine].
Utilizing static and light-evoked dynamic pupillometry, in a placebo-controlled study 14 normal volunteers (9 males and 5 females) in the age range between 22 to 40 years were studied before and after administration of one single dose of 2 mg cianopramine (Ro 11-2465), further after 3 weeks therapy with 1, 2 and 3 mg cianopramine, respectively, and after a superimposed single dose of 3 mg cianopramine on the top of chronic administration. After acute administration of 2 mg cianopramine, marked pupillary changes started already in the 2nd h, peaked in the 4th h and lasted up to the 10th h. While the widening of the pupil indicates the adrenergic and possible noradrenergic effect of cianopramine on the pupil, the attenuation of spontaneous fluctuations suggests concomitant fatigue. The attenuation of the light-evoked narrowing of the pupillary diameter as well as the reduction of pupillary dynamics (increase of latency time and decrease of relative changes) reflect the direct and/or indirect efficacy of cianopramine on the light reaction of the pupil. After chronic administration the changes (as compared with baseline) are still visible although less pronounced than after acute therapy which suggests adaptation phenomena. A superimposed single dose of 3 mg cianopramine in addition to the 3-week chronic treatment did not result in further changes as compared with the chronic effect--with one exception of an additional decrease of spontaneous fluctuations.
Adult↗
[Factor analytic study and determination of rehabilitation of static and dynamic pupillometry in normal persons and psychopathologic groups].
Variables measured during static and dynamic pupillometry were factor-analyzed. Following factors were obtained regardless whether investigations were carried out in normals or in psychiatric patients: A static factor, a dynamic factor, a stimulus-specific factor and a restitution-dependent factor. Evaluation of reliability in normals demonstrated a high reliability for the static variables of pupillometry.
Adolescent↗
Comparative placebo-controlled pharmacodynamic studies with zotepine and clozapine utilizing pharmaco-EEG and psychometry.
In a double-blind, placebo-controlled study the encephalotropic and psychotropic properties of zotepine - a new tricyclic dibenzothiepine with antidopaminergic, adrenolytic and antiserotoninergic properties - were investigated utilizing quantitative EEG, psychometric and psychophysiological tests as well as clinical observations. Fifteen normal volunteers received randomized (latin square design) and at weekly intervals single oral doses of placebo, 25 mg, 50 mg and 100 mg zotepine as well as 50 mg clozapine as reference compound. Plasma samplings for blood levels, EEG recordings, and evaluation of blood pressure, pulse rate and side-effects were carried out at the hours 0, 1, 2, 4, 6 and 8, while psychometric data were recorded at the same time except the first hour. Computer-assisted spectral analysis of the EEG demonstrated after all three doses significant changes as compared with placebo characterized by an augmentation of delta and theta activity, decreased of alpha and beta activity, slowing of the centroid of the total activity and alpha activity, and decrease of the dominant frequency and its absolute and relative power. Such changes are typical for low-potency basic neuroleptics of the sedative type such as chlorpromazine. Clozapine also augmented slow activities, decreased alpha activity, the dominant frequency and the alpha centroid, but induced in contrast to zotepine a concomitant increase of fast beta activity, acceleration of the beta centroid and no slowing of the dominant frequency, while the total power was significantly attenuated. These findings confirm earlier reports about the pharmaco-EEG profile of clozapine, which has a resemblance to profiles of anticholinergic antidepressants of the amitriptyline type. Psychometric tests demonstrated after the higher doses of zotepine and clozapine a deterioration of noopsychic and thymospsychic functions which was more pronounced after the reference compound than after zotepine. The lowest dose of zotepine, 25 mg, even produced an improvement in numerical memory and complex reaction. CFF, skin conductance, pupillary diameter and pupillary response measurements decreased after both compounds. Dose-efficacy calculations showed 100 mg zotepine and clozapine to be the most CNS-effective compounds, followed by 50 mg and 25 mg zotepine, while placebo induced the least changes. Time-efficacy calculations showed neurophysiological and behavioral peak effects after zotepine at the 4th and 6th hour, as compared with the 2nd and 4th hour after clozapine. Pulse rate increased with both compounds; blood pressure decreased after clozapine but remained unchanged after zotepine.(ABSTRACT TRUNCATED AT 400 WORDS)
Adult↗
[Dynamic light-evoked pupillometry for the differentiation of psychotropic substances].
In a double-blind placebo-controlled study 100 mg zotepine (neuroleptic) were administered to 15 young healthy volunteers; another 15 volunteers received 200 mg moclobemide (Ro 11-1163) (MAO-inhibitor). At the certain days of investigation the light-evoked pupillary reactions were recorded prior to and 2, 4, 6, and 8 h after medication. Using the dynamic pupillometric method it was possible to differentiate between zotepine and moclobemide in view of autonomous activation.
Adult↗
On central effects of serotonin re-uptake inhibitors: quantitative EEG and psychometric studies with sertraline and zimelidine.
In a double-blind placebo-controlled cross-over study the encephalotropic and psychotropic properties of sertraline--a new potent and highly selective inhibitor of synaptosomal serotonin uptake--were studied along with blood levels of the parent drug and main metabolite in ten normal healthy volunteers. They received randomized at weekly intervals oral single doses of placebo, 100, 200 and 400 mg setraline and 100 mg zimelidine as reference drug. Blood sampling, EEG recordings, psychometric tests and evaluation of pulse, blood pressure and side-effects were carried out at the hours 0, 2, 4, 6, and 8. Blood level investigations demonstrated that sertraline is slowly absorbed with dose-dependent blood concentrations peaking in the 4th to 6th hour and remaining high thereafter, while the main metabolite, CP-53261 exhibited an even slower rise in plasma concentration up to the 8th hour. Computer-assisted spectral analysis of the EEG demonstrated slight effects of 100 mg zimelidine and 100 mg sertraline on human brain function, but moderate to marked effects after 200 and 400 mg sertraline as compared with placebo. Changes after 100 mg sertraline and the reference compound resembled the pharmaco-EEG profiles of antidepressants of the desipramine type and were indicative of some vigilance-improving properties while higher doses of sertraline induced alterations reminiscent of those after antidepressants of the imipramine type, thereby reflecting vigilance changes of the dissociative type. This neurophysiological conclusion was supported by the psychometric and psychophysiological data showing partly after 100 mg sertraline and zimelidine an improvement in psychometric performance, while 200 and 400 mg sertraline induced a deterioration of noopsyche and thymopsyche of the normal volunteers. Psychophysiological variables exhibited a dose-dependent change in CNS activation and a widening of the pupillary size. Time-efficacy calculations based on pharmacodynamic changes demonstrated maximal encephalotropic effects after 100 mg zimelidine in the 2nd to 4th hour, and after setraline in the 4th to the 6th hour, which is in agreement with the blood level data. Pulse, systolic and diastolic blood pressure showed no clinically relevant findings. Side-effects were non-existent to minimal after 100 mg zimelidine and sertraline, but marked after 200 and 400 mg sertraline characterized by nausea, vomiting, diarrhea, giddiness, restlessness, tremor and trismus.
1-Naphthylamine↗