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Biomedical subjects

M J Tueth

Publications and source records attributed to M J Tueth.

26 records · Page 2Linked to original sources
PubMed1993

Delirium: diagnosis and treatment in the older patient.

Delirium is more common in older adults because of normal physiologic changes, increased incidence of medical illnesses, and increased medication use in this population. Older dementing patients are particularly predisposed to delirium because of associated neurologic abnormalities. Delirium often is superimposed on a dementing condition and may be difficult to differentiate from atypical dementia or a catastrophic reaction. Accurate diagnosis is essential, as is a thorough search for an underlying cause. The delirium will usually resolve if the underlying cause is properly treated. Treatment also requires maintaining a comfortable environment for the patient and, when necessary, administering a high-potency neuroleptic.

Age Factors↗
PubMedDate not supplied

Revisiting fluoxetine (Proxac) and suicidal preoccupations.

Several reports were published in the psychiatric literature in 1990 and 1991 documenting fluoxetine (Prozac) causing patients to consider or attempt suicide. During the following 2 years, retrospective studies appeared in the medical literature that seemed to indicate that suicidal preoccupation was not related to the antidepressant fluoxetine (Prozac) but was probably a symptom of the depressive illness. Recent studies have suggested, however, that fluoxetine (Prozac) may in fact lead to suicidal behavior because the drug appears to adversely affect serotonergic neuronal discharge and induce an akathisia-like extrapyramidal reaction. While fluoxetine (Prozac) has a very favorable side effect profile compared to the tricyclic antidepressants, it may cause akathisia and induce a small subset of patients to consider or attempt suicide.

Akathisia, Drug-Induced↗
PubMedDate not supplied

Schizophrenia: Emil Kraepelin, Adolph Meyer, and beyond.

Prior to 1800, insane persons often lived on the streets or were incarcerated in asylums, jails, or prisons. The 19th century witnessed progression in the understanding of psychosis, and the hospital management of psychotic patients began. While Kraepelin in Europe described the symptoms of what would later be called schizophrenia, Meyer developed humanistic treatment for the illness in the United States. The early 20th century treatments for schizophrenia included insulin coma, metrazol shock, electro-convulsive therapy, and frontal leukotomy. Neuroleptic medications were first used in the early 1950s. Deinstitutionalization, beginning in the 1960s, resulted in medicated, stable schizophrenics being released from state hospitals. However, lack of stable living arrangements, misuse of funds, poor medical follow-up, and drug use resulted in deterioration of a large segment of this outpatient schizophrenic population. The 1990s have seen the development of newer, more effective antipsychotic agents and managed care. Both have impacted the state of health of schizophrenics in our society.

Europe↗
PubMedDate not supplied

Dementia: diagnosis and emergency behavioral complications.

Dementia is a relatively common syndrome seen in the elderly emergency department population. The emergency physician usually sees demented patients secondary to behavioral complications. Diagnosing the syndrome of dementia principally consists of ruling out treatable causes, which can be performed either in an in-patient or out-patient location. The emergency presentations of dementia include disturbances of activity, aggression, and psychosis. Complications that are primarily treated non-pharmacologically include circadian rhythm disturbance, catastrophic reaction (excessive emotional response), and wandering, as well as some mild verbal outbursts and delusions. Pharmacologic interventions are usually necessary for agitation, physical attacks, and significant delusions or hallucinations. Neuroleptic medication is the principal pharmacologic class with which to treat these symptoms, although benzodiazepines are also effective.

Aged↗
PubMedDate not supplied

Successful treatment with pimozide of Capgras syndrome in an elderly male.

A case of Capgras syndrome in a 67-year-old man who failed to improve on haloperidol, but responded to pimozide, is described. The patient's paranoid delusions abated with 8 mg per day of pimozide. We believe pimozide's established benefit in the treatment of delusional disorders warrants its consideration in alleviating other delusions, including "the delusion of doubles."

Capgras Syndrome↗
PubMedDate not supplied

Successful treatment with captopril of an elderly man with polydipsia and hyponatremia.

A case of severe hyponatremia in a polydipsic 64-year-old man is described. He was unsuccessfully treated with both demeclocycline and lithium carbonate. However, low-dose captopril reversed the polydipsia and resulted in sustained normal serum sodium levels. We believe the antidipsogenic effect of captopril may benefit some patients with polydipsia and hyponatremia.

Brain Damage, Chronic↗