PubMed Health⌕ Search

Biomedical subjects

S J Dencker

Publications and source records attributed to S J Dencker.

At least 73 records · Page 4Linked to original sources

Three years' maintenance neuroleptic treatment in schizophrenia--before and beyond.

A group of patients with schizophrenia, initially 67 patients, was studied over a period of 3 years. After three years 36 out of 67 patients were still on the same depot neuroleptic. The main aim was to describe and compare maintenance neuroleptic therapy using two depot neuroleptics, fluphenazine decanoate and pipotiazine palmitate, given monthly. Before the outpatient care the patients had participated in the department's comprehensive hospital treatment including depot neuroleptic medication. After a 1-year clinical trial with frequent assessments of the patients, significant symptom reductions were found on all rating scales. During the last 2 years of the study only drug therapy was given. Improvement concerning social function in the community and work level as well as the low-rated psychopathology noted at the start of study also persisted at the 3-year follow-up. The side effects were low in frequency and quality. These results show the clinical value of long-term maintenance treatment with depot neuroleptics. The results also confirm that the favourable effects of the hospital treatment demonstrated before the start of the clinical trial could be maintained. The possibilities of further improving aftercare and outpatient treatment beyond medication alone are discussed.

Adolescent↗

How schizophrenic patients change during 3 years' treatment with depot neuroleptics.

A group of patients, initially 67 individuals, with chronic schizophrenia were studied on repeated occasions during 1 year and followed up after 3 years. The patients were given depot neuroleptics, either fluphenazine decanoate or pipotiazine palmitate, at intervals of 1 month. The symptom scores from three rating scales were subjected to factor analysis. Four factors were found to explain the variance satisfactorily: one comprising psychopathological symptoms specific for schizophrenia, one relating to contact disturbances, one psychomotor activity and one representing neurotic symptoms. Analysis of these factors revealed certain differences between the treatment groups over time and demonstrated the effect of combination of psychotherapy and neuroleptic drugs in a subgroup of patients. This type of analysis of treatment results might contribute to improving our knowledge of rehabilitation of schizophrenic patients and help us to draw up giudelines for selection of suitable measures.

Antipsychotic Agents↗

High doses of fluphenazine enanthate in schizophrenia. A controlled study.

The results from this controlled study of 12 schizophrenics refractory to ordinary doses of neuroleptics indicate that treatment with fluphenazine enanthate in higher doses than normal (10--20 times higher) might give reduction in psychopathology beyond what can be obtained with normal doses. In four patients the symptom reduction on high doses was pronounced. Moreover, we found that the high fluphenazine plasma levels demonstrated did not increase extrapyramidal and general side effects. The results presented also speak in favour of certain "non-responding" patients needing a higher plasma level of a neuroleptic drug than the average patient.

Adult↗

Piracetam and chlormethiazole in acute alcohol withdrawal: a controlled clinical trial.

Sixty in-patient alcoholics, presenting with an alcohol withdrawal syndrome after at least one week's drinking bout, were randomly allocated to fixed dose regimens of either piracetam or chlormethiazole in a one-week double-blind trial. The patients were studied in respect to physical and biochemical parameters as well as symptom reduction and side-effects. The battery of rating scales demonstrated a good symptom reduction in both drug groups. On the whole a small tendency to more symptom items being reduced on piracetam in comparison with chlormethiazole was found. But the tree items, sleep disturbances, decreased libido at the initial phase, and the staff's assessment showed statistically significant differences in favour of chlormethiazole. This study demonstrated that piracetam was just as efficient as chlormethiazole in patients not requiring sedation.

Adult↗

Plasma levels and antidepressive effect of imipramine.

The relationship between the antidepressive effect of imipramine and the plasma concentrations of imipramine and the active metabolite desipramine was studied in 24 patients suffering from endogenous depression. After a placebo period of 7 days, the patients received imipramine, 75 mg 3 times a day. The dose was reduced in patients with pronounced side effects. Blood samples for drug assay were drawn in the morning, 15 hr after the last drug intake. Imipramine and desipramine in plasma were assayed by quantitative in situ thin-layer chromatography. Individual variations in plasma concentration were 20- to 30-fold in both imipramine and desipramine. Severity of depression was assessed on the Hamilton Rating Scale (HRS). Eleven of 12 patients who responded satisfactorily to the treatment (HRS post-treatment score less than 8) had plasma concentration of imipramine greater than or equal to 45 mug/L, and desipramine greater than 75 mug/L, whereas the 12 patients not responding satisfactorily (post-treatment score on HRS greater than or equal to 8) all had concentrations of imipramine or desipramine or both below these limits.

Adult↗

Intestinal absorption, demethylation, and enterohepatic circulation of imipramine.

The intestinal absorption and metabolism of single oral doses of imipramine (ip) have been studied in man by portal catheterization. The concentration of ip and the formed desipramine (dmi) was followed in blood-plasma obtained from the portal and cubital veins. The absorption of ip seemed to be completed 80 min after the administration of the drug. There was no sign of demethylation of ip during the passage across the intestinal wall. Evidence was found of an enterohepatic circulation of both ip and dmi.

Dealkylation↗

Investigation of the orthostatic reaction after intravenous administration of imipramine, chlorimipramine, and inimpramine-N-oxide.

Three age- and sex-matched groups of 10 patients were treated intravenously with imipramine, chlorimipramine, and imipramine-N-oxide respectively, in increasing doses from 25 mg to 150-175 mg given as single daily infusions during 1 hour. No systemic changes of heart frequency and blood pressure were found during the infusions in spite of the high dosage of tricyclic antidepressants given such a short period as 1 hour. The patients were examined regarding orthostatic reactions as well as ECG changes before, after 4-5 infusions and after 8-10 infusions. There were more orthostatic abnormalities and ECG changes in the patients treated with imipramine than in those treated with imipramine-N-oxide and there were practically no changes in the chlorimipramine group. However, no statistically significant orthostatic changes were found.

Adult↗

High-dose treatment with neuroleptics in the acute phase of mental disease.

More than 300 patients have been observed during treatment with either flupenthixol, haloperidol, fluphenazine enanthate or perphenazine enanthate in high doses, whilst suffering from severe mental disease, usually of psychotic nature. Used correctly, high-dose treatment gives a rapid control of psychotic symptoms, an earlier discharge from the ward, and (when using long-acting neuroleptics) pharmacological control even during a follow up period. This means a social availability gain of 30-50%. We have not seen any severe somatic effects except those of parkinsonian type which can be treated successfully by the well trained psychiatrist and a skilled staff.

Antipsychotic Agents↗

Hemodynamic effects of thiothixene and chlorpromazine in schizophrenic patients at rest and during exercise.

The hemodynamic effects and plasma levels of noradrenaline were studied in schizophrenic patients at rest and during exercise after long-term treatment with chlorpromazine (150-600 mg daily) and thiothixene (60-80 mg daily). The results are compared with those from previous studies in untreated patients and patients receiving very large doses of chlorpromazine. The effects of thiothixene on the different hemodynamic variables were very moderate, and the observed differences between this group and the control group may be due to the different patient materials. In the two groups of patients receiving chlorpromazine, the heart rate at rest and durng exercise tended to be higher than in the control group. There was also a tendency towards a lower stroke volume after this drug and thiothixene during exercise. The noradrenaline levels in plasma were highest after the high dose of chlorpromazine both at rest and during exercise, while they were lower after the moderate chlorpromazine dose. After thiothixene, the values were between those of the group on the low chlorpromazine dose and those of the control group.

Adult↗