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Biomedical subjects

T Kolakowska

Publications and source records attributed to T Kolakowska.

At least 37 records · Page 2Linked to original sources
PubMed1980

Drug-related and illness-related factors in the outcome of chlorpromazine treatment: testing a model.

Patients who presented with acute psychoses and were treated with chlorpromazine were first divided into 2 groups with good (23) and poor (13) outcome. These outcome groups differed little in their initial clinical features and showed no difference in 2 indices of dopamine receptor blockade (extrapyramidal symptoms and plasma prolactin concentrations). The group which improved was then subdivided on the basis of evidence of dopaminergic blockade into 15 who had improved and also showed anti-dopamine effects ('responders') and 8 who had improved but showed no anti-dopamine effects ('remitters'). The remainder were eventually classified as 'resistant' to the effects of the drug. The group of 'remitters' contained no patients with nuclear schizophrenia; the 'responders' were mainly nuclear schizophrenics; and the 'resistant' patients were schizophrenic or schizo-affective. The 3 groups who were defined in this way also differed in their subsequent clinical course. It is suggested that this scheme for dividing patients may be useful in clinical work and could also assist research worker to identify the patients who can most appropriately be studied to determine mechanisms of drug action.

Acute Disease↗
PubMed1979

Plasma cortisol levels in depression and other psychiatric disorders: a study of newly admitted psychiatric patients.

Morning and evening plasma cortisol levels were checked in 123 consecutively newly admitted psychiatric patients with a variety of diagnoses. Questions asked were whether there were differences among groups with more severe illness, type of depression, alcohol abuse, or particular symptoms. Morning cortisol elevation was found in 33% of patients and was not associated with any particular diagnostic category. Evening cortisol elevation occurred in 85% of the subjects. It was significantly higher in those with unipolar depression and organic brain syndrome, also in those patients who abused alcohol regardless of diagnosis. Evening cortisol elevation was twice as common in patients with diagnoses of more severe psychiatric illness than in those with minor disorders. Further study is suggested to see if these patterns of cortisol elevation are sustained beyond the stress-of-admission period.

Adjustment Disorders↗
PubMed1979

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↗
PubMed1977

Thyroid function in depression and alcohol abuse: a retrospective study.

Admission thyroid function tests were reviewed in 115 euthyroid patients with depression (66), depression and alcohol abuse (30), or alcohol abuse (19). Estimated free thyroxine (EFT) levels ranged from 0.7 to 2.7 ng/100 ml (normal, 1.0 to 2.1). Levels above 2.1 ng/100 ml were associated with agitation and values under 1.1 with alcohol abuse. Mean EFT levels differed significantly among six diagnostic subgroups and paralleled rank order for severity of depression (none, secondary, reactive, single uncategorized, recurrent, psychotic). Alcohol abuse negatively affected EFT: there was a significant decrease of mean EFT level from nonabusers to abusers and, further, to intoxicated abusers. A positive association between EFT level and severity of depression, and a negative one with alcohol use, were significant when other variables considered were controlled. These two factors accounted from 28.2% of variability in EFT levels, with a minimal additional contribution of medication effect.

Adjustment Disorders↗
PubMed1976

Clinical significance of plasma chlorpromazine levels. II. Plasma levels of the drug, some of its metabolites and prolactin in patients receiving long-term phenothiazine treatment.

Plasma levels of chlorpromazine (CPZ), 3 of its metabolites and prolactin were measured repeatedly in 18 chronic schizophrenic patients. The patients were studied while on chronic phenothiazine medication (chlorpromazine in 8, other phenothiazines in 10), during 4-6 weeks on placebo and during 6-12 weeks of CPZ treatment. The findings were compared with those obtained during acute CPZ treatment in patients who had received similar CPZ doses but no previous long-term phenothiazine medication. Plasma CPZ levels were similar in the chronic and the acute groups and so was their relation to dose. In neither group was therapeutic effect related to plasma CPZ level. In these chronic patients, in contrast to findings during acute CPZ treatment, neither prolactin level nor the appearance of parkinsonian symptoms was related to plasma drug level. In the chronic group both these effects were less pronounced during the period on CPZ which followed the placebo than were the corresponding effects during CPZ treatment in the acute group. Since plasma CPZ levels of the two groups were similar, these differences may be due to an acquired tolerance of the nervous system to some of the antidopaminergic effects of the drug.

Adult↗
PubMed1976

Clinical significance of plasma chlorpromazine levels. I. Plasma levels of the drug, some of its metabolites and prolactin during acute treatment.

Seventeen acute psychotic patients were studied in the course of chlorpromazine (CPZ) treatment. Blood samples were taken weekly both before and two hours after the morning CPZ dose. Plasma levels of CPZ, CPZ sulphoxide (CPZ SO) monodesmethylated CPZ (NOR1CPZ) and 7-hydroxy CPZ (7OH CPZ) were estimated by gas chromatography. Plasma prolactin, luteinizing hormone, testosterone and oestrogens were measured by radioimmunoassay. Six of the seven patients who showed no clinical improvement had plasma CPZ levels equal to or higher than those of patients who improved. 'Non-responders' has a greater proportion of CPZ SO in pre-dosage samples. The occurrence of parkinsonian side effects was associated with a mean plasma CPZ of greater than 50 ng/ml and a mean plasma prolactin of greater than 30 ng/ml two hours after dosage. The elevation of prolactin preceded the onset of parkinsonian symptoms by 1-2 weeks. There was a significant positive correlation between mean plasma prolactin and mean plasma CPZ levels. The prolactin response may prove a useful index of the central antidopaminergic effect of neuroleptic drugs.

Acute Disease↗
PubMed1975

Correlation between plasma levels of prolactin and chlorpromazine in psychiatric patients.

Plasma levels of chlorpromazine (CPZ) and prolactin were measured repeatedly in 14 psychiatric patients throughout CPZ treatment. Mean prolactin level was elevated in 11 subjects (all six women and five of eight men). Mean plasma prolactin correlated significantly with mean plasma CPZ but not with the dose of the drug. Only patients with mean plasma prolactin above 35 ng/ml developed Parkinsonian side-effects.

Administration, Oral↗
PubMed1975

Effect of long-term phenothiazine treatment on drug metabolism.

1 The half-life of plasma antipyrine was measured in twelve chronic schizophrenic patients during long-term phenothiazine treatment and again following 4-5 weeks on placebo. 2 The mean antipyrine half-life was low during phenothiazine administration (6.1 +/- 4.2 h), rising after withdrawal of drugs to the range reported for untreated subjects by other authors (9.5 +/- 4.2 h). The prolongation of antipyrine half-life following the drug-free period occurred in nine of twelve subjects and the difference was significant for the group at P less than 0.05. 3 The finding suggests that prolonged administration of phenothiazines stimulates the rate of drug metabolism.

Adult↗