Use of psychotropic drugs for the treatment of chronic severe pains.
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Biomedical subjects
Publications and source records attributed to R Kocher.
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The results of long experience with psychotropic drugs in the treatment of chronic and severe pain resistant to ordinary therapy are reported. In 103 in-patients with chronic and severe pain caused by neurological conditions and treated with a combination of thymoleptics and neuroleptics, 82% showed a marked improvement. These encouraging results are compared with the results of other studies published in this field. The pharmacological basis of this good action is briefly discussed, together with the advantages of the use of psychotropic drugs and especially the combination of thymoleptics and neuroleptics. A clearcut dosage schedule for in- and out-patients using imipramine (Tofranil) or chlorimipramine (Anafranil) and haloperidol (Haldol) is established.
In 15 lithium-treated psychotic patients, the following variables were examined over two years at 6-monthly intervals; seru lithium levels, serum electrolytes, thyroid function, urinary creatinine and urea, and clinical EEG. The mean serum lithium level was 0.64 mval/l and did not change during the two years. When compared to the pretreatment EEG, visual analysis did not indicate any specific potentials, focal signs, or asymmetrical phenomena such as have been reported in the literature. Only at the beginning of treatment could a small increase in unspecific, abnormal changes be demonstrated, which, however, decreased during the following 18-month period of investigation.
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With modern techniques (membrane marking by indirect immunofluorescence and identification by morphological criteria) Toxoplasma gondii can be reliably identified in the CSF. Identification of the causative agent confirms the diagnosis of toxoplasmosis of the meninges, the central nervous system and the nerve roots. Toxoplasma encephalomyelitis associated with meningoradiculitis has hitherto only rarely been described. Our own cases afford evidence of the fact that even in the most typical cases of multiple sclerosis this possibility must be considered. Fansidar (a combination of an ultralong-acting sulfonamide with pyrimethamine combined with spiramycine is recommended as the treatment of choice.
The results are reported of many years' experience in the treatment of severe chronic painful conditions, including low back pain, with psychotropic drugs. Out of 103 inpatients with severe chronic painful states, 82 showed considerable improvement after treatment with a combination of antidepressants and neuroleptics. There were also 9 patients with chronic back pains, 8 of whom recorded a good effect. The treatment of chronic painful conditions with psychotropics, especially with a combination of antidepressants and neuroleptics, offers, among other things, the advantages of analgesic potentiation, analgesic saving and the avoidance of misuse or dependence on analgesics. A concrete plan of treatment with chlorimipramine and haloperidol for outpatients and inpatients in presented.
The results of longlasting experience in the treatment of severe chronic pain are reported. 82% of 103 in-patients with chronic pain responded to a combined treatment with neuroleptic and antidepressant drugs. A dosing strategy for the combbination of clomipramine and haloperidol is described.
The results of long experience in the treatment of chronic and severe pains resistant to ordinary therapy with psychotropic drugs are reported. Out of 103 impatients with chronic and severe pains caused by neurological conditions, who were treated with a combination of thymoleptics and neuroleptics, 82 (approx. 82%) showed marked improvement. These encouraging results are compared with others published in this field. The pharmacological basis of this good action is briefly discussed, also the advantages of the use of psychotropic drugs, especially of the combination of thymoleptics and neuroleptics. A dosage schedule for in- and outpatients has been established, using imipramine (Tofranil) or chlorimipramine (Anafranil), and haloperidol (Haldol).