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At least 469 records · Page 26Linked to original sources
PubMed1997

Altered consciousness states and endogenous psychoses: a common molecular pathway?

Interest in the role of indolamines in the pathogenesis of psychoses has been renewed in recent years by the development of atypical antipsychotic drugs such as clozapine, olanzapine, and risperidone, which act on serotonin receptors. Discovery of the hallucinogenic compounds called methylated indolealkyalamines (MIAs) (e.g. N,N-dimethylserotonin, or bufotenin, and N,N-dimethyltryptamine, or DMT) led proponents of the transmethylation hypothesis of schizophrenia to theorize that through some inborn error of metabolism, serotonin or tryptamine might undergo the addition of extra methyl radicals, thereby forming MIAs with hallucinogenic properties. Various studies have attempted to detect the excretion of MIAs, especially DMT, in the body fluids of psychotic patients and normal controls. Some of these studies have demonstrated elevated MIA concentrations in psychotic patients, including those with schizophrenia, compared with normal persons, and others have not. A number of variables may account for these contradictory findings. The mechanism whereby the beverage ayahuasca, which is used in certain cure and divination rituals in the Amazon Basin, exerts its hallucinogenic effects may serve as a model to explain the mechanism underlying hallucinogenic symptoms in schizophrenia and may lend support to the transmethylation hypothesis. Certain studies suggest that specific perceptual disturbances manifested by schizophrenic patients could contribute to progressive deterioration and negative symptomatology. All these findings point to the need for further study of the neurophysiology of MIAs and their pathogenetic role in endogenous psychoses.

Consciousness↗
PubMed1979

Psychopharmacological treatment of psychotic children. A survey.

Controlled investigations on the psychopharmacological treatment of psychotic children are reviewed. Children with infantile autism might benefit from psychopharmacological medication when they grow older, e.g. above the age of 7 years. Learning might be facilitated when the psychoactive medication is able to inhibit psychotic preoccupations and idiosyncratic reactions. Schizophrenic and manic-depressive psychoses are rarely seen in childhood. A subgroup of the children with infantile autism might develop schizophrenic symptoms. Schizophrenia and manic-depressive psychosis in children are treated as in adults. Special caution must be paid to the toxic effects of imipramine.

Antipsychotic Agents↗
PubMed1979

[Poisoning due to tricyclic antidepressants in children and adolescents].

During the last decade there has been a substantial increase in the number of poisonings due to tricyclic antidepressants in both children and adults. The main toxic manifestations are of anticholinergic origin, and the most frequent constitute the so-called central anticholinergic syndrome. Most of the deaths result from the cardiac complications. Three cases are presented that illustrate chiefly the toxic manifestations related to the central nervous system. The therapeutic management is reviewed in the light of the metabolism of the tricyclic antidepressants, their pharmacologic action and the mechanism of their toxic effects.

Adolescent↗
PubMed2003

Seizures associated with quetiapine treatment.

OBJECTIVE: To report a case of seizures in a patient with Alzheimer disease, who was receiving quetiapine for psychoses. CASE SUMMARY: A 75-year-old white man with Alzheimer disease was observed to have seizures while receiving quetiapine 500 mg/d and carbamazepine 200 mg/d. He had been taking quetiapine for 18 months prior to the event. No other toxic, metabolic, or anatomic abnormalities were identified to explain the seizures. After cessation of quetiapine treatment, the patient remained seizure free. An objective causality assessment revealed that the adverse drug reaction was possible. DISCUSSION: The patient was taking a relatively high dose of quetiapine. An increased risk of seizures has been associated with Alzheimer disease. Using a relatively high dose of quetiapine may have resulted in seizures in our patient with Alzheimer disease. CONCLUSIONS: As with other antipsychotics, quetiapine should be used cautiously in elderly patients with conditions that can lower the seizure threshold, and special monitoring should be performed for this serious adverse effect.

Aged↗
PubMed1980

Phase II trial of prednimustine, L-1031, (NSC-134087) in advanced breast cancer.

The therapeutic effect of prednimustine was studied in 35 patients with advanced breast cancer resistant to previous cytotoxic and/or endocrine therapy. Response (PR + CR) was obtained in 14 patients (40%) of a median duration of five months. Among the 14 responding patients, 10 were resistant to previous endocrine therapy and chemotherapy, in all cases including alkylating agents, and 4 were resistant to previous endocrine therapy. Hematologic toxicity was rather pronounced, but other toxicities were only moderate.

Adult↗
PubMedDate not supplied

Vitamin A toxicity and hypercalcemia.

A patient hospitalized with hypercalcemia and a history of chronic vitamin A ingestion was studied in order to investigate the rarely reported association between elevated serum calcium and vitamin A toxicity. The clinical presentation marked by profound weight loss, a psychiatric disturbance, total body alopecia, erosive dermatitis, and liver disease, was compatible with hypervitaminosis A. The diagnosis of vitamin A toxicity was established by elevated total vitamin A levels and the component due to retinyl esters. Other etiologies for hypercalcemia were excluded. In view of these results and the well-known effects of vitamin A on bone metabolism, it is concluded that the most likely etiology of the hypercalcemia in this patient was vitamin A toxicity.

Alopecia↗
PubMed1989

[Acute psychosis caused by poisoning with cyclopentolate].

The authors report on a 17-year-old female patient who suffered an acute psychotic attack after local application of cyclopentolate 1.0% in both eyes. The literature is reviewed with regard to systemic side effects of local application of cyclopentolate. Toxicity of cyclopentolate may be found in every age group even if tolerated without side effects before and it has no specificity for patients with certain (especially brain) diseases. The rapid short-term cycloplegic effect and the rare cases of systemic toxicity support the authors opinion that cyclopentolate is a very useful and well-tolerated diagnostic substance.

Adolescent↗
PubMed1977

Toxic psychosis due to cyproheptadine in a child on hemodialysis: a case report.

In 1971 Simmons et al. presented evidence that children receiving regular dialysis therapy required approximately seventy percent of recommended caloric intake to achieve normal growth. Since that time, pediatric nephrologists and dietitians have strived to meet that requirement. In an effort to attain adequate caloric intake, cyproheptadine, a known appetite stimulant, was prescribed to a child on chronic hemodialysis. The following reports the unexpected complication of toxic psychosis that resulted.

Child↗
PubMed1980

Dialysis dementia in Europe. Report from the Registration Committee of the European Dialysis and Transplant Association.

The diagnosis of dialysis dementia was confirmed in 150 patients treated in sixty-five dialysis centres in Europe in 1976 and 1977. The prevalence was approximately 600 per 100,000 European dialysis patients. The illness was confined to certain geographical areas, 90 of the patients being treated in only fifteen centres. It occurred more frequently in patients dialysed with unprocessed and softened water than in those treated with water processed by deionisation or reverse osmosis. Two-thirds of the patients had osteodystrophy, often painful and fracturing. Morbidity was severe and progressive and only 23 patients were still alive in 1978. The condition seems to be due to aluminium toxicity and should be preventable by water processing in centres where water aluminium content is raised.

Aluminum↗
PubMed1978

Parenteral treatment of acute psychotic patients with agitation: a review.

Representative studies which elucidate present treatment principles regarding parenteral administration of neuroleptics for acute psychoses with agitation are reviewed. "Rapid tranquillization" with drugs such as haloperidol generally appears preferable, but controlled comparisons with more conservative types of treatment are lacking. It is suggested that parenteral chlorpromazine should be avoided because of its tendency to provoke severe hypotension, whereas loxapine apparently is a valuable drug if strong sedation is required for behavioural control. Possible advantages of ultra-high-dose therapy need to be proved in controlled trials, and the occurrence of toxic side-effects requires further evaluation. From an ethical and psychological point of view, it is recommended that antiparkinsonian medication should be administered simultaneously with neuroleptics which induce a high incidence of acute dystonia. Several types of acute psychosis with agitation which do not require treatment with a neuroleptic as drug treatment of first choice are briefly mentioned.

Acute Disease↗
PubMed1974

Neurological manifestations of organophosphorous insecticide poisoning.

Neurological findings are described in 200 consecutive cases of suicidal ingestion of organophosphorous insecticides. Miosis is almost universal. We found impairment of consciousness in 10%, fasciculations in 27%, convulsions in 1%, toxic delirium in 50%, and paralysis in 26%. Toxic delirium was attributed to treatment with atropine. Paralytic signs were divided into type 1 signs (present on admission) and type 2 signs (appearing later while on atropine treatment). Type 1 signs, chiefly impaired consciousness and bilateral pyramidal tract signs, respond to atropine. The most common type 2 signs are proximal limb weakness, areflexia, and cranial nerve palsies. EMG studies during type 2 paralysis show a myasthenic response in some cases. Of 36 cases with type 2 signs 15 died from respiratory paralysis after a variable period of artificial respiration. Twenty-one recovered and no residual neurological deficit has been noted. Atropine did not influence type 2 paralysis. It is claimed that type 2 signs differ significantly from those described before as `delayed neurotoxicity' and may represent an alternative mode of human toxicity with organophosphorous compounds.

Facial Paralysis↗
PubMed1977

Methyl bromide intoxication: neurologic features, including simulation of Reye syndrome.

Three family members intoxicated with methyl bromide presented with a variety of neuropsychiatric manifestations including coma, severe status epilepticus, hyporeflexia, and acute psychosis. The simulation of Reye syndrome in the child emphasizes the need for careful toxicologic screening of all children presenting with this syndrome. The initial diagnostic difficulty encountered in these cases emphasizes the need for heightened awareness of the toxic chemicals used in local industries and the clinical manifestations of their intoxication.

Adult↗