Long-term treatment with neuroleptics in psychiatry.
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In the last twenty years, the study of long-acting neuroleptic drugs has been active and promising progress in maintenance of psychotic patients. At present, there are several long-acting derivatives of phenothiazines, e.g. thioridazine, or drugs that allow the esterification of phenothiazine, e.g. perphenazine, fluphenazine and pipothiazine. Other esterifiable product is flupenthizol, which is a thioxanthene, and other long-acting drug is chlofluperol, which is a butyrophenone derivative. There is also a new series of neuroleptics, diphenilbultilpiperidine derivatives, such as fluspirilene, pimocide and penfluridol. Our clinical studies with these drugs allows us to state that there is a new revolution in pharmacological psychiatry, with important perspectives in the ways of helping patients.
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Release rates of testosterone, estrone, and estradiol placed in chambers made from polydimethylsiloxane (PDS) tubing (Dow Corning "Silastic," 3.35 mm ID x 4.65 mm OD) were studied in 14 freemartin cattle with minimal or non-detectable endogenous hormone secretion, and in 0.9% saline:methanol (1:1) baths shaken at 38 degree C. Eighty-seven implants, varying in length from 2 to 10 cm, were placed in 14 animals for 27 to 235 days. The average release rates +/- standard errors, in microgram/cm/day, were testosterone, 55.9 +/- 2.4, estrone, 12.6 +/- 1.8, and estradiol, 11.1 +/- 1.1. A relatively constant release rate was found over the period of time studied and sufficient steroid remained for potential release over periods exceeding 1 year. The dose of hormone delivered was sufficient to increase mounting activity in testosterone-treated animals and estrual activity in those receiving estrogens. Corresponding release rates in vitro for four 10-cm implants containing either testosterone, estrone, or estradiol were 94.3 +/- 1.9, 15.5 +/- 0.7, and 12.7 +/- 0.6 microgram/cm/day, respectively. The general magnitude of release rate in animals could be predicted from laboratory tests.
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Today it is impossible accurately to predict susceptibility to space sickness of crew members making their first transition into orbit, for want of a ground-based validated model of free fall. Even assuming that space sickness is simply a specific designation for motion sickness that may be experienced in orbital flight (and here agreement is not general), preventive therapy poses difficult problems because, for a priori reasons, either all crew members or none should receive treatment. If all receive preventive therapy, everyone should execute head movements in a programmed manner to ensure rapid adaptation to the environment; at least a large minority will not benefit but rather will experience whatever sideeffects inevitably accompany administration of a drug. If none receive preventive therapy prelaunch, at least a large minority will pose two problems--treatment for acute motion sickness and rapid acquisition of adaptation. Trade-offs will involve the identification of long-acting antimotion sickness drugs for use prelaunch that will be efficacious for at least 90% of those going aloft for the first time and the effectiveness of combining rapid adaptation with treatment of motion sickness. The following report describes recent experiments dealing with these problems.