On trespassing ethical boundaries.
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Biomedical subjects
Publications and source records attributed to W A Alvarez.
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Clonazepam was added to the neuroleptic regimen of 3 treatment-resistant schizophrenic patients with schizoaffective features. Manic symptoms improved but returned following discontinuation of clonazepam. The drug appears to benefit positive psychotic symptoms but worsens negative symptoms.
The prevalence of bestiality (both actual sexual contacts and sexual fantasy) was investigated in an experimental group (psychiatric in-patients) and two control populations (medical in-patients and psychiatric staff). Psychiatric patients were found to have a statistically significant higher prevalence rate (55%) of bestiality than the control groups (10% and 15% respectively). Implications of these findings are discussed. It is recommended that due to the obvious prevalence of this condition, questions exploring this previously ignored topic should be routinely included in the psychiatric interview.
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Rhabdomyolysis is a potentially lethal syndrome that follows skeletal muscle injury, both traumatic and nontraumatic. The literature on this syndrome remains sketchy, and rhabdomyolysis may often go unrecognized. The history, clinical presentation, laboratory findings, etiology, and treatment of rhabdomyolysis are reviewed. Factors which predispose psychiatric patients in particular to this syndrome are discussed. Recommendations to reduce morbidity and mortality are offered.
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Three agitated, confused, elderly patients with organic brain syndromes were successfully treated with low-dose clonazepam. Plausible mechanisms of action include its influence on serotonin levels and seizure threshold.
Rhabdomyolysis is a potentially lethal syndrome that psychiatric patients seem predisposed to develop. The clinical signs and symptoms, typical laboratory features, and complications of rhabdomyolysis are presented. The case of a schizophrenic patient is reported to illustrate massive rhabdomyolysis and subsequent acute renal failure following molindone administration. Physicians who prescribe molindone should be aware of this reaction.
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22 combat Viet Nam veterans with post-traumatic stress disorder were investigated for alexithymia. Of those subjects examined, 41% proved to be alexithymic. Theoretical implications for this finding are discussed.
Clonazepam, a unique benzodiazepine with anticonvulsant and serotonin enhancing capacity, can be used in conjunction with conventional psychopharmacologic agents to treat a variety of psychiatric conditions including schizophrenia, borderline personality disorder, and psychotic mania. Three representative case studies are presented and specific guidelines for the use of clonazepam are discussed.