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M Gelder

Publications and source records attributed to M Gelder.

30 records · Page 2Linked to original sources

Neuroendocrine tests during treatment with neuroleptic drugs I. Plasma prolactin response to haloperidol challenge.

The plasma prolactin (PRL) response to haloperidol 2 or 4 mg i.m. was studied in 18 schizophrenic men during their routine treatment with neuroleptic drugs. A substantial rise of the PRL level above the treatment baseline occurred in all but four of the 20 tests showing that the PRL elevation induced by treatment was not maximal. The challenge was ineffective only in patients receiving very high daily doses of medication. The increment was inversely correlated to the daily dose of medication but unrelated to plasma haloperidol concentrations during the test. Chronic schizophrenics who were receiving long term treatment and had low basal PRL levels did not show tolerance to the prolactin stimulating effect of haloperidol. That prolactin rose during the test in patients who had improved during their current treatment indicates that the degree of dopamine receptor blockade required for therapeutic effects is below that which produces a maximal PRL response.

Adult↗

Neuroendocrine tests during treatment with neuroleptic drugs. III. Plasma growth hormone and prolactin responses to apomorphine.

Hormonal responses to apomorphine 0.005 and/or 0.01 mg/kg body weight were studied in 17 schizophrenic patients during their routine treatment with neuroleptic drugs. Plasma growth hormone (GH) rose in 9 of the 20 tests and in 4 of these GH peak exceeded 5 ng/ml. This preserved GH response to apomorphine was significantly but weakly associated with lower daily doses of neuroleptics. It was unrelated to the extrapyramidal side-effects, plasma prolactin (PRL) level, duration of treatment or its therapeutic effect. In 13 of the 20 tests, plasma PRL declined by more than 20 per cent of the baseline level. This was similar to the fall in PRL observed after placebo in the group studied previously. The absolute decline in plasma PRL following apomorphine correlated positively with the baseline PRL concentration and was unrelated to the daily doses of neuroleptics or to any other variable considered.

Adult↗

Clinical significance of plasma drug and prolactin levels during acute chlorpromazine treatment: a replication study.

Nineteen patients with acute psychoses, the majority schizophrenics, were studied in the course of chlorpromazine (CPZ) treatment. Plasma levels of the drug, plasma prolactin (PRL), extrapyramidal side-effects (EPS) and changes in mental state were monitored weekly, as in our earlier study. The results confirm some of our previous findings: (a) plasma CPZ levels vary widely among patients and correlate poorly with daily doses of CPZ; (b) increased plasma PRL is associated with higher plasma CPZ levels and is more common among the patients who develop EPS; and (c) none of these three variables differ between groups of patients with good and poor treatment outcome. However we did not confirm our previous finding of a significant association between EPS and higher plasma CPZ, nor did we find that the ratio of CPZ-sulphoxide to CPZ differed between the improved patients and the rest.

Adult↗