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Dose-response analysis of the behavioral effects of diazepam: II. Psychomotor performance, cognition and mood.

The psychomotor, cognitive, and mood effects of orally administered diazepam and placebo were measured over approximately equal to 3.5 h. A total of 120 volunteers were assigned to 12 groups of 10 each, representing the combination of four treatments (placebo, 0.1, 0.2, and 0.3 mg/kg diazepam) and three testing sessions (7 AM, 1 PM, and 7 PM). A variety of cognitive tasks, tapping and postural stability tests, and a mood evaluation scale were used. Psychomotor and cognitive functions showed consistent dose-response effects, while for subjective evaluations, the only effect of dose level was in the duration of sedation. The pattern of impairment of cognitive functions suggests that the drug affects speed rather than accuracy, and it primarily blocks acquisition of new information or skills. Use of repeated testing may therefore be necessary to detect subtle drug effects. Subjects reported no tranquilization , which suggests that the anxiolytic action of the drug cannot be studied in healthy volunteers. There was no circadian influence on the actions of the drug.

Adolescent↗

Age-related changes in perceptual and psychomotor performance: implications for engineering design.

Increased age is associated with declines in perceptual and psychomotor performance. We review several surveys of health and disability that provide functional descriptions on population trends in vision, hearing, fitness, mobility, and agility that complement laboratory studies of perceptual threshold functions. Women report and exhibit significantly greater disability than men (the exceptions being disabilities associated with hearing and flexibility), with the disability progression accelerating with age. For the growing proportion of older adults in the labor force, visual improvements can be achieved through improved lighting, increased size of visual detail, and glare avoidance. For hearing, restricting the frequency of sounds to the 1000- to 2000-Hz range, minimizing background noise, and eliminating reverberation seem prudent. For the retired population, emphasis should be placed on minimizing disability by promoting greater use of assistive devices and environmental redesign. Future laboratory studies of perceptual and psychomotor functions should attempt to sample more representatively and target underrepresented groups of older adults. New field studies are needed to bridge the gap between survey self-reports and laboratory studies and to determine the cost and benefits of redesign.

Aged↗

The effects of psychomotor performance of fluvoxamine versus mianserin in depressed patients in general practice.

This study examined the psychomotor and antidepressant effects of fluvoxamine in a depressed, GP patient population, compared to those of mianserin. It was a single centre, double-blind, six-week study, preceded by a one-week pre-treatment placebo washout, in 59 patients suffering from major depressive episode (DSM III) and scoring over 24 on MADRS. The starting dose was 100 mg fluvoxamine or 60 mg mianserin daily for one week, rising to 300 mg fluvoxamine or 180 mg mianserin. Both treatment groups showed significant improvement over time with no differences between drugs in terms of efficacy. Fluvoxamine and mianserin were both shown to be effective in the treatment of depressive illness. Some psychomotor impairment in the first few days and weight gain over a longer period could affect compliance with mianserin. Fluvoxamine does not reduce psychomotor performance or cause weight gain.

Adolescent↗

The effects of temazepam and ethanol on human psychomotor performance.

We have studied the effects of temazepam, alone and in combination with ethanol, on psychomotor performance in six healthy men and women using a battery of five microcomputer-based tasks before and 30, 90, and 150 min after treatment. The tests were pursuit tracking, divided attention, two four-choice reaction time tests and tapping rate. The entire battery required 25 min. The subjects also reported their mood at each testing time using a computerized bipolar mood scales test. Temazepam (15 mg) plus ethanol (peak blood concentration of 11 mmol.l-1) significantly impaired divided attention, tracking, and reaction time over a 3 h period. There was significant impairment versus placebo for each drug alone on some of the tests. Plasma and urine concentrations of temazepam and temazepam glucuronide were measured, but there was no significant temporal correlation between impairment and drug or metabolite concentration in either plasma or urine. The subjects knew when they had taken ethanol, but could not discriminate temazepam from ethanol whether alone or in combination. The subjects rated their performance similarly after each of the four treatment conditions. The performance on the tracking, divided attention, and PAB reaction time tasks used in this study was impaired by a combination of temazepam and ethanol in doses which may not cause impairment when each is given alone.

Adult↗

[Research on the psychomotor performance of patients with vertebral syndromes at spas].

The influence of radon balneotherapy on the psychomotor performance of 169 male and female patients with vertebral syndromes was investigated. The speed and skill of motor response to various stimuli was measured by the Schoppe apparatus and the Viennese determination apparatus. The analysis of "steadiness" brought no results, whereas all the other parameters tested by the Schoppe and the Viennese devices showed highly significant improvements in the course of spa treatment. It was not possible to differentiate to which specific factors of spa treatment this positive influence can be ascribed.

Adolescent↗

Psychomotor performance and antihypertensive treatment.

1. The aim of treatment of hypertension is prevention of cardiovascular complications without adverse drug reactions. Psychomotor performance can be measured objectively yet there remains uncertainty concerning the psychomotor effects of antihypertensive drugs during chronic treatment. This uncertainty is partly due to the confounding adverse effects of cerebrovascular disease and hypertension itself. There are as yet insufficient good quality data on psychomotor effects with which to differentiate between the commonly used agents. However, in general, the beneficial effect of lowering blood pressure tends to more than offset any adverse effects of the agent used.

Angiotensin-Converting Enzyme Inhibitors↗

The effect of single doses of penbutolol and propranolol L.A. on psychomotor performance.

The effect of single oral doses of penbutolol (40 mg) and propranolol L.A. (160 mg) on psychomotor performance of 12 normal individuals has been investigated. Subjects were randomly administered penbutolol, propranolol L.A. and placebo according to a double-blind, three-part cross-over design. At 3 h post-dosing both penbutolol and propranolol L.A. significantly increased (P less than 0.001) complex reaction times when compared to placebo. By 24 h post-dosing the mean complex reaction times for penbutolol and propranolol L.A. were not significantly different from placebo.

Adult↗

Effects of ethanol on psychomotor performance.

Three separate doses of alcohol (0.2, 0.4 and 0.8 g kg-1) were given to eight volunteers and compared with the effects of a placebo. The order of administration was randomized and the study performed double-blind. A battery of psychometric tests sensitive to central nervous system depression was repeatedly performed for 3.5 h. Alcohol, even in the highest dose, had little effect on psychomotor performance.

Adult↗

Psychomotor performance and sequence planning in anorexia nervosa before and after weight restoration.

BACKGROUND: In the study of psychomotor performance in anorexia nervosa (AN), motor control has not been studied extensively. The present study explores sequence planning in a sample of AN patients. METHOD: A group of 26 female restricting AN inpatients, aged 14 to 25, was compared with 24 healthy women matched for age and educational level. During the performance of a simple copying task, in which movement planning, but not working capacity, was challenged, the ease with which generally favored graphic production rules could be applied was manipulated. Computerized recordings of the drawing movements allowed detailed analyses of reaction and movement times and of drawing sequences. Fifteen patients were retested after weight restoration, as were 15 controls. RESULTS: Copying patterns that normally elicit a conflict between preferred graphic production rules induced significantly less slowing in the reaction times of the anorexia nervosa patients than in the controls, both before and after weight restoration. There were no group differences as regards the consistency with which the implicit production rules were applied. DISCUSSION: AN patients seem to show a fast response style combined with good sequence planning capacity.

Adaptation, Psychological↗

Interaction between ethanol and dextroamphetamine: effects on psychomotor performance.

The objective of this study was to investigate the interaction between ethanol and dextroamphetamine with regard to psychomotor performance. Twelve healthy, male, paid volunteers, moderate users of ethanol and amphetamines, participated in this study. Ethanol (0.85 g/kg or placebo) was administered over a 30-min interval. Five minutes before the termination of ethanol or placebo ingestion, dextroamphetamine elixir (0.09 mg/kg, 0.18 mg/kg or placebo) diluted in 50 ml of orange juice was administered. Subjects were tested in a single-blind, latin-square, crossover design with each of the following six conditions: placebo ethanol/placebo dextroamphetamine; placebo ethanol/low-dose dextroamphetamine; placebo ethanol/high-dose dextroamphetamine; ethanol/placebo dextroamphetamine; ethanol/low-dose dextroamphetamine; and ethanol/high-dose dextroamphetamine. The variables measured in this study were: subjective rating of ethanol and dextroamphetamine intoxication, accuracy and latency of response in the Simulator Evaluation of Drug Impairment (SEDI task), blood ethanol concentration by breath analyzer, and plasma concentrations of dextroamphetamine by gas chromatography. Results indicate ethanol induced decrements in performance of the skills necessary to drive an automobile were significantly decreased by dextroamphetamine in a dose-response fashion. The administration of dextroamphetamine did not decrease the subjective ratings of ethanol intoxication.

Adult↗

Effects of clobazam and clonazepam on saccadic eye movements and other parameters of psychomotor performance.

The effects of two benzodiazepine anticonvulsants clobazam (20 mg) and clonazepam (2 mg) in a variety of psychomotor performance tests were compared in a placebo controlled double-blind acute oral dose study in ten healthy volunteers. Assessments included critical flicker fusion (CFF) threshold, the Sternberg memory scanning and choice reaction time (CRT), peak saccadic velocity (PSV) and visual analogue scales, all previously shown to be sensitive to the effects of benzodiazepines. Clobazam did not significantly impair saccadic eye movements, CFF threshold, Sternberg memory scanning and CRT compared to placebo. Clonazepam significantly lowered PSV, reduced the CFF threshold, slowed the Sternberg CRT and decreased an alertness factor in the visual analogue scales compared to placebo. Clonazepam significantly increased memory scanning time compared to clobazam. Clobazam was remarkably free of cognitive and psychomotor side-effects.

Adult↗

Effect of fluoxetine on psychomotor performance, physiologic response, and kinetics of ethanol.

The effects of fluoxetine, a specific serotonin reuptake inhibitor, on the psychomotor performance, physiologic response, and kinetic disposition of ethanol were examined. Fluoxetine (30 or 60 mg) with ethanol (45 ml absolute alcohol per 70 kg body weight) did not alter the plasma or blood concentrations of fluoxetine or ethanol, respectively, when compared with levels after either drug alone. There was no significant effect on standing or recumbent blood pressure or heart rate after single or multiple doses of fluoxetine alone or in the combination. Single or multiple doses of fluoxetine had no effect on the psychomotor activity (stability of stance, motor performance, or manual coordination) or subjective effects of alcohol. Data indicate that fluoxetine does not inhibit ethanol metabolism nor does it have any effects on its psychomotor activity.

Adult↗

Abrupt and brief discontinuation of antidepressant treatment: effects on cognitive function and psychomotor performance.

The abrupt discontinuation of antidepressants can result in a syndrome of adverse events, including somatic, mood and psychomotor reactions. This study examined the effects of discontinuing and resuming antidepressant treatment with four selective serotonin reuptake inhibitors (SSRIs) on cognitive and psychomotor function. Eighty-seven patients receiving maintenance therapy with fluoxetine, sertraline, paroxetine or citalopram had their treatment interrupted for 4-7 days using double-blind placebo. Assessments of aspects of cognitive and psychomotor performance, mood and symptoms were carried out at each visit. Following interruption of treatment, significant differences between the groups emerged. Paroxetine treated patients experienced significantly more cognitive failures (P = 0.007), poorer quality of sleep (P = 0.016), and an increase in depressive symptoms, as rated both subjectively, using the Zung scale (P = 0.006) and by the clinician, using the Montgomery-Asberg Depression Rating Scale (P = 0.0003) and Clinical Global Impression (P = 0.0003), compared to some or all of the other drugs. All changes were reversed on reinstatement of treatment. Abrupt discontinuation of treatment with paroxetine leads to deterioration in various aspects of health and functioning, which may be related to the antidepressant discontinuation syndrome. These effects are not evident in patients receiving fluoxetine, sertraline and citalopram, suggesting they are not an SSRI class phenomenon.

Adult↗

The effects of acute doses of standardized Ginkgo biloba extract on memory and psychomotor performance in volunteers.

This study investigated the effects of acute doses of Ginkgo biloba extract (GBE) on memory and psychomotor performance in a randomized, double-blind and placebo controlled 5-way cross-over design. Thirty-one volunteers aged 30-59 years received GBE 150 mg (50 mg t. d.s), GBE 300 mg (100 mg t.d.s.), GBE 120 mg mane and GBE 240 mg mane and placebo for 2 days. Following baseline measures, the medication was administered at 0900 h for the single doses and at 0900, 1500 and 2100 h for the multiple doses. The psychometric test battery was administered pre-dose (0830 h) and then at frequent intervals until 11 h post dose. The results confirm that the effects of GBE extract on aspects of cognition in asymptomatic volunteers are more pronounced for memory, particularly working memory. They also show that these effects may be dose dependent though not in a linear dose related manner, and that GBE 120 mg produces the most evident effects of the doses examined. Additionally, the results suggest that the cognitive enhancing effects of GBE are more likely to be apparent in individuals aged 50-59 years.

Adult↗

Correlations between serum ami- and nortriptyline concentrations and psychomotor performance.

Correlations of serum nortriptyline (NT) and amitriptyline (AT) levels with psychomotor performance choice reaction performance, eye-hand coordination, and divided attention was studied in two experiments each with 20 healthy subjects. In the first experiment serum NT level was measured with an isotope derivative method after treatment for 14 days with NT. In the second trial plasma AT and NT concentrations were measured with gas-chromatography after treatment for 14 days with AT. No linear correlations between the levels of the antidepressants and performance variables were found. Low levels of NT (less than 50 ng/ml) tended to shorten reaction time, and intermediate levels (50--80 ng/ml) to prolong it, when compared with the reaction times during placebo. The correlation between serum NT levels and the increase of the tyramine dose in the tyramine pressor test was not significant. A new assay method for AT and NT is presented.

Adult↗

Cerebral blood flow velocity and psychomotor performance during acute hypoxia.

INTRODUCTION: The physiological effects of hypoxic environments can help determine safe limits for workers where cognitive and motor performance is important. We investigated the effects of a PIO2 of 15 kPa and 10 kPa on medial cerebral artery blood flow velocity (CBFV) and psychomotor performance. METHODS: Over 3 sessions, each involving 3 separate test batteries, 13 subjects breathed either 21 kPa PIO2 (control), 15 kPa PIO2, or 10 kPa PIO2. The tests measured reaction time, spatial orientation, voluntary repetitive movement, and fine manipulation. CBFV, PETCO2, PETO2, Sa02, and BP were recorded throughout. RESULTS: ANOVA analysis showed that 15 kPa PIO2 did not significantly change psychomotor test performance. The mean number of incorrect responses in the reaction time test significantly increased to 5.6 (SD - 4.0) while breathing 10 kPa PIO2, as did the mean number of errors (7.7 +/- 5.0) in the fine manipulation test. Only 10 kPa PIO2 affected CBFV, causing a significant increase in flow from 50 +/- 6.5 cm x s(-1) to 55 +/- 10.3 cm x s(-1). CBFV significantly increased during three psychomotor tests while breathing air; however, it did not increase further during psychomotor testing in hypoxia. DISCUSSION: A PIo2 of 15 kPa did not affect subject performance, and should not cause operational risk. At 10 kPa PIO2, accuracy and vigilance were slightly affected; however, the reduction in oxygenation was not great enough to cause major decrements. CBFV was not a good indicator of mental stress during hypoxia.

Adult↗

Effects of beta blockers on psychomotor performance--a review.

There is a possibility that beta-receptor blocking drugs may modify psychomotor performance, either peripherally or centrally. The inherent problems in evaluating the effects of drugs on performance are mainly due to interpretation of what is meant by "psychomotor" as the term embraces many mental and physical skills. In addition, statistical validation is often difficult. The current literature is reviewed with these provisos in mind and 24 studies of the effects of beta blockade are discussed. Of these 15 could be assessed as showing "no effect" and, of the remaining 9, improved performance was reported in 6 and impairment in 3. There is a wide variation in the results of such studies but, in general, it would appear that while the clinical use of beta-blocking drugs in aviation may produce an adverse effect on performance, it should be no greater than ordinary day-to-day variation.

Adrenergic beta-Antagonists↗

Effects of habitual variations in napping on psychomotor performance, memory and subjective states.

Effects of habitual variations in napping on psychomotor performance, short-term memory and subjective states were investigated. The subjects were 32 healthy male university students who napped twice or more weekly in themorning and at night. Sixteen were randomly assigned to a control group and 16 to a nap(treatment) group. The experiment comprised two conditions of electrographically (EEG) recorded sleep for the nap group and two EEG monitored conditions of wakefulness for the controls. These conditions were scheduled from 9:35 to 11:35 a.m. and 12 hr later between 9:35 p.m. and 11:35 p.m. Measurements were obtained from: (a) a continuous 10-min auditory reaction time task, (b) a free recall task of short-term memory, (c) an activation-mood adjective check list, and (d) the Stanford Sleepiness scale. Except for memory the dependent variables of waking function were assessed 20 min before and 20 min after all conditions. Following each sleep condition the nap group as opposed to the controls showed a statistically significant improvement in reaction time performance, higher short-term retention, less reported sleepiness and elevated subjective states reflected by fice factors on the adjective mood-activation check list. Among the correlations computed the largest significant coefficients were of stage 4 and REM with posttreatment Stanford Sleepiness ratings. After naps, increased postdormital sleepiness was correlated with stage 4 and decreased sleepiness with REM sleep. Although few strikingly divergent functional effects were associated with morning and nocturanal naps, these did covary with sleep psychophysiology. It is postulated that the phase, the EEG-sleep stages and possibly the duration of accustomed naps are less salient factors influencing performance when the time since awakening until behavioral assessment can be kept constant.

Adult↗