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Biomedical subjects

R L Borison

Publications and source records attributed to R L Borison.

At least 19 recordsLinked to original sources
PubMed1992

Ventricle-to-brain ratio and symptoms at the onset of first-break schizophrenia.

Ventricle-to-brain ratio (VBR) was measured from the computed tomographic (CT) scans of 33 very recent-onset psychotic patients. Illness severity and positive and negative symptoms were also assessed in 21 of these patients with schizophreniform disorder. Forty-five neurology patients served as controls. Analyses revealed no significant differences between the VBR of the psychotic group as a whole, the schizophreniform subgroup, the affective psychotic subgroup, and the controls. Control subjects with a neurological diagnosis of vertigo or syncope had significantly higher VBR than the remainder of the control group and the psychotic group. When the psychotic group was compared to the control group minus those controls with syncope or vertigo, the psychotic group had significantly higher VBR. The schizophreniform subgroup also had significantly higher VBR than the control group minus subjects with vertigo or syncope. In the schizophreniform subgroup, positive symptoms and illness severity were associated with smaller VBR. There was no association between negative symptoms and VBR.

Adolescent↗
PubMed1992

Risperidone: clinical safety and efficacy in schizophrenia.

Risperidone represents a unique pharmacology of potent antagonism of both serotonin and dopamine receptors. In a randomized, parallel-group, double-blind trial of risperidone vs. haloperidol and placebo in 36 schizophrenic patients in acute exacerbation, risperidone showed a quicker onset of antipsychotic activity than did haloperidol. Risperidone treatment was statistically superior to placebo, with a trend toward superiority to haloperidol. Risperidone did not differ from placebo on assessment scales of extrapyramidal side effects, but produced significantly less than did haloperidol. There were no major adverse reactions associated with risperidone use, but it was noted to reduce the signs of tardive dyskinesia. This study suggests that risperidone may offer a superior side-effect profile, and possibly greater efficacy, than a standard neuroleptic such as haloperidol.

Adult↗
PubMed1991

A comparative study of alpidem, a nonbenzodiazepine, and lorazepam in patients with nonpsychotic anxiety.

The use of benzodiazepines for generalized anxiety disorder (GAD) is a safe and effective treatment; however, their potential to produce dependence and impair psychomotor and cognitive functions is a drawback. In this study the efficacy and safety of alpidem, a nonbenzodiazepine, was assessed. Thirty patients who met DSM-III-R criteria for GAD were randomized to either alpidem (225 mg), lorazepam (4.5 mg), or placebo. The primary efficacy measure was the Hamilton Rating Scale for Anxiety (HAM-A). A repeated measures multivariate analysis of variance (MANOVA) was used to determine differences in HAM-A scores over time. The results showed a trend for alpidem to be more effective. Half of the alpidem group had a decrease of 50 percent or greater in their HAM-A scores with an almost equal effect on psychic and somatic symptoms. The most common side effects with alpidem and lorazepam were lightheadedness, drowsiness, and daytime tiredness. Moreover, treatment with alpidem did not manifest any withdrawal symptoms. Thus nonbenzodiazepine treatments are effective and safe for GAD.

Adult↗
PubMed1991

Does sigma receptor antagonism predict clinical antipsychotic efficacy?

The psychotogenic actions of sigma receptor agonists, such as pentazocine, have led to the hypothesis that sigma receptor antagonists may be putative antipsychotic agents. In this study, BW234U, a selective but relatively weak sigma receptor antagonist was compared at two different dosage ranges with chlorpromazine and placebo in a double-blind randomized treatment trial in schizophrenic patients undergoing acute exacerbation. During the 4-week blinded treatment period, there was a modest drop in Brief Psychiatric Rating Scale (BPRS) score in the chlorpromazine group, however, neither dosage range of BW234U, nor placebo produced a significant drop in the BPRS. Our results suggest that BW234U is an ineffective anti-psychotic agent in schizophrenics experiencing acute exacerbation of their illness. Due to BW234U's relatively weak antagonism at the sigma recognition site, this does not rule out the possibility that more potent and equally selective sigma antagonists may possess antipsychotic efficacy.

Adult↗
PubMed1990

Efficacy and safety of a putative anxiolytic agent: ipsapirone.

Ipsapirone is an azopirone derivative that selectively interacts with serotonin-1A (5-HT1A) receptors and fails to affect other neurotransmitter receptors. In this study, ipsapirone at 15 mg or 30 mg was compared with diazepam at 15 mg and placebo in a double-blind, random assignment study design in patients with generalized anxiety disorder (GAD). During 4 weeks of treatment, both active drugs were therapeutically superior to placebo, without significant drug vs. drug therapeutic differences. The side-effect profile of ipsapirone at 15 mg was favorable compared to diazepam, but at 30 mg ipsapirone produced significant gastrointestinal disturbances.

Adult↗
PubMed1990

New advances in psychotherapeutic agents: clozapine.

Clozapine offers several very distinct clinical advantages, namely a therapeutic profile that appears to be superior to typical neuroleptic agents. This is particularly true in otherwise treatment refractory schizophrenics. Unfortunately, not all schizophrenic patients respond to clozapine therapy. The second major advantage of clozapine is its paucity of acute neurological effects and its apparent unlikelihood to produce tardive dyskinesia. The clinical benefits of clozapine must be weighed against the risk of cardiovascular side-effects that can occur with too rapid a titration, and the possibility of AGC. Given the fact that careful titration of dosage and white blood cell count monitoring can easily be used to avoid the serious side-effects of clozapine, it would appear that the clinical advantages of this medication clearly outweigh its risks.

Clozapine↗
PubMed1990

The use of midazolam in acutely agitated psychiatric patients.

Agents currently used for acutely agitated patients such as sodium amytal and haloperidol are disadvantageous because of their adverse effects on the respiratory and extrapyramidal systems. Because of this, a rapid, safe, well-absorbed agent such as midazolam would be useful. This study compares the effectiveness of midazolam, sodium amytal, and haloperidol in agitated schizophrenic patients. Five male patients between 28 and 59 years were randomly assigned to each group. They were administered intramuscularly either 10 mg of haloperidol, 250 mg of sodium amytal, or 5 mg of midazolam. Over a 2-hour period, patients were rated for motor agitation, hostility, auditory hallucinations, and flight of ideas. Both midazolam and sodium amytal were significantly more effective than haloperidol in controlling motor agitation. There were no treatment differences on any other symptom rated. These results indicate that further studies on the use of midazolam to achieve rapid tranquilization would be useful.

Adult↗
PubMed1987

Neuropharmacology of the extrapyramidal system.

The neuropharmacology and neuroanatomy of the extrapyramidal system are complex; however, in its most reductionistic state, this system is often described as a balance between the actions of dopamine and acetylcholine. In this paper, a thorough investigation of the neuroanatomy and neuropharmacology of the extrapyramidal system is undertaken, and an attempt is made to delineate the roles of other neurotransmitters and neuromodulators that play an important role in its functioning. To demonstrate the therapeutic complexity of extrapyramidal system movement disorders, clinical literature is briefly reviewed to show the relative efficacies of anticholinergic and prodopaminergic antiparkinsonian agents in treating neuroleptic-induced extrapyramidal side effects and to show how drugs that affect alternative neurotransmitter systems have also been used to treat these same side effects.

Acetylcholine↗
PubMed1985

Pharmacology of antipsychotic drugs.

Data on the pharmacologic dissimilarities of antipsychotic drugs, and the clinical consequences of these differences, are reviewed briefly, with an emphasis on the interaction of these drugs with dopaminergic systems. Although differential anticholinergic activity has been proposed as an explanation for purported differences in the incidence of anticholinergic side effects of various neuroleptics, a more plausible explanation relates to site specificity. The so-called atypical neuroleptics show far less dopamine blocking potency in human striatum compared to haloperidol, with equal receptor blocking potency in the limbic system. The model of site-specificity will be of major importance in the development of future antipsychotics, with the goal of decreasing the incidence of side effects.

Animals↗