Drug interactions involving psychotropic drugs.
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Drug Interactions↗
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Side effects on fetus and infant of psychotropic drug use during pregnancy.
Psychotropic drugs are used frequently for the treatment of emotional as well as other disorders. With usage so widespread, many pregnant women receive psychotropic drugs. Maternal ingestion of these drugs may produce, in the fetus, side effects including withdrawal symptoms. Withdrawal signs in the fetus as a result of maternal intake of opiates, hypnotics, analgesics, and tricyclic antidepressant drugs have been reported. Fetal side effects can occur by maternal ingestion of nuroleptic medications, lithium, antidepressants, anxiolytic sedatives, anticonvulsants, and bromides. The author feels that even though these drugs are generally safe, they must only be administered to pregnant women when absolutely needed, and then under vigilance.
Analgesics↗
Enhancement of the antitumor effect of 1,3-bis(2-chloroethyl)-1-nitrosourea by various psychotropic drugs in combination with caffeine.
Certain psychotropic drugs when combined with caffeine significantly enhanced the antitumor effect of 1,3-bis(2-chloroethyl)-1-nitrosourea in murine leukemia L1210. Enhancement required that all three drugs be given together and optimal results were obtained when the psychotropic drug was given 6 hours before 1,3-bis(2-chloroethyl)-1-nitrosourea and caffeine. Thus, 1,3-bis(2-chloroethyl)-1-nitrosourea alone or with caffeine resulted in 5% cures. Addition of chlorpromazine increased the cure rate to 51% while prochlorperazine gave 30% cures. Chlordiazepoxide produced 39% cures while the dibenzazepine compounds studied were ineffective. For the phenothiazine, benzodiazepine and dibenzazepine compounds studied, tentative conclusions could be drawn on the relationship of chemical structure to enhancing activity. For phenothiazines, the substituent in the R2 position of the phenothiazine ring determined activity to a greater extent than did the substituent in the R1 position. For the benzodiazepine compounds, chlordiazepoxide was superior to diazepam. Although the mechanism of action of psychotropic drugs in this system is unknown, these preliminary results suggest the possibility of a change transfer reaction between the free radical form of the psychotropic drug and one or more intracellular constituents.
Animals↗
Appropriate use of psychotropic drugs in physical illness.
Psychotropic drugs have a useful place as an adjunct to the treatment of patients with certain categories of physical illness, but must never substitute for an integrated and coherent approach to the patient.
Anxiety↗
Patient-drug monitoring. Laboratory studies for psychotropic drugs.
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Clinical Laboratory Techniques↗
[Use and control of psychotropic drugs is given priorty in Scandinavian drug research].
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Drug Information Services↗
[Interaction between antihypertensive agents and psychotropic drugs (author's transl)].
The present review paper is dealing with the interaction between antihypertensive agents and various psychotropic drugs. Various psychotropic drugs enhance certain-side-effects of the antihypertensive substances, like sedation, extrapyramidal disorders and orthostatic hypotension. On the other hand, the blood-pressure lowering effect of clonidine, guanethidine and related drugs, and possibly also that of alpha-methy-dopa is reduced by phenothiazine-neuroleptics and tricyclic antidepressants (thymoleptics), but not by benzodiazepine tranquilizers or by butyrophenone-like neuroleptics. The pharmacological background and the clinical relevance of these interaction phenomena are discussed.
Antihypertensive Agents↗
Why are psychotropic drugs prescribed to out-patients? A methodological study.
The prescription of psychotropic drugs at a multidoctor district health centre in northern Sweden in 1973, was analysed by means of problem-oriented medical records. Of the 22,000 inhabitants of the district 10,700 consulted the health centre. Psychotropic drugs were prescribed for 11.3% of the patients, corresponding to 5% of the inhabitants of the area. Sixty per cent of the patients received one psychotropic prescription and 90% not more than three. Two-thirds of prescriptions were for women. Hypnotics, sedatives and minor tranquillisers constituted 64% of all prescriptions, major tranquillisers 24% and antidepressants 12%. One fifth of the patients obtained drugs belonging to more than one of the major psychotropic groups during the year. Insomnia, psychoneurosis and depression made up two-thrids of the indications for psychotropic drug therapy. More than thirty different psychotropic drugs were prescribed for the two major indications. There was considerable variation in how the different doctors prescribed drugs for the same indication. Fifty-nine different drug products were prescribed, of which the commonest five constituted more than half of the total number. Individual doctors used from 22 to 38 different psychotropic drugs.
Adolescent↗
[The treatment of chronic pain with psychotropic drugs].
The results of long experience with psychotropic drugs in the treatment of chronic and severe pain resistant to ordinary therapy are reported. In 103 in-patients with chronic and severe pain caused by neurological conditions and treated with a combination of thymoleptics and neuroleptics, 82% showed a marked improvement. These encouraging results are compared with the results of other studies published in this field. The pharmacological basis of this good action is briefly discussed, together with the advantages of the use of psychotropic drugs and especially the combination of thymoleptics and neuroleptics. A clearcut dosage schedule for in- and out-patients using imipramine (Tofranil) or chlorimipramine (Anafranil) and haloperidol (Haldol) is established.
Clomipramine↗
HZI systems for EEG parametrization and classification of psychotropic drugs.
The EEG effects of twenty, clinically most frequently used psychotropic drugs and five placebos were studied in 75 male volunteers in five simultaneously designed basic studies. In each of the five studies single oral dosages of five drugs (well known representatives of neuroleptics, antidepressants, anxiolytics and psychostimulants, as well as placebos) were investigated in 15 subjects in a double-blind latin-square research design using the methods of the Quantitative Pharmaco-EEG. The results demonstrated that the therapeutically equivalent effective compounds also have similar effects on human EEG. With a classification rule, based on discriminant function 20, and with a classification rule, based on correlation statistics 19 of 25 compounds could be reclassified into correct clinical-therapeutic psychotropic drug groups. It is suggested that CEEG is an important tool in predicting and describing psychotropic properties of compounds, and should routinely be used in psychotropic drug development.
Adult↗
The effects of psychotropic drugs in different populations.
Although psychotropic drugs are known to be effective in all populations, the known differences in terms of health and disease in different parts of the world have not been related to the effectiveness of such drugs. Nutritional/metabolic, genetic, cultural, and ecological/climatic factors that could be important in this respect are discussed. The benefits that could accrue from a knowledge of proper drug dosage, namely, fewer side effects and reduction in cost, particularly for developing countries, are highlighted.
Genetics↗
Frequency of psychotropic drug prescribing for children in Tampere, Finland.
The purpose of the present study was to determine the frequency with which psychotropic drugs are prescribed for children under 10 years of age in outpatient care in Finland. This frequency was estimated from the reimbursements paid by the Social Insurance Office of Tampere City in 1974. Every third psychotropic drug prescribed for children born in 1965-74 was included. This resulted in 319 children with 375 psychotropic drug prescriptions. About 4% of children under 10 years old in the Tampere area had received within one years's time one or more psychotropic drugs in outpatient care. About half of the psychotropic drugs were prescribed by general practitioners. Sedatives were the most frequently prescribed drugs, especially in the younger are groups. Antidepressants and antiepileptics were common in the older age groups. The most commonly specified indications were fever and restlessness.
Ambulatory Care↗
The use of psychotropic drugs in rheumatology.
The possible role of various psychotropic drugs in the management of rheumatic diseases is considered--tranquillizers, sedatives, tricyclic antidepressants and monoamine oxidase inhibitors. The dilemma of which anti-depressant for which patient is considered. The possible association between rheumatoid disease and disorders of the brain, brain-stem and autonomic nervous system is discussed. Psychotropic drugs may effect the disease itself as well as the patient's mood. The author is opposed, however, to the idea that rheumatoid arthritis may be regarded as a psychosomatic disease.
Anti-Anxiety Agents↗
Pain infirmity and psychotropic drugs in oncology.
The treatment of cancer pain by psychotropic drugs is a method which has been employed for a long time [8] and in which the results obtained have appeared very interesting from the beginning: there is a high percentage of success, rapid action, absence of addiction, and although there are sometimes unpleasant side-effects, they are reversible when the treatment is stopped. Even after several years of application, this therapy still sets some unsolved problems. Some consider that psychotropics are not real analgesics, but that they work on the emotional reaction rather than on the pain itself [3]. Still others consider that the results are obtained only at the price of a state of prostration of the patient similar to that obtained after lobectomy. Finally, this procedure is reproached as having unpredictable results and indications difficult to define. We think that what has, up to now, prevented these types of problems from being solved has been the absence of a really objective evaluation of the pain in the patients observed. We have wrestled with this problem for several years [1,2], and offer the following hypothesis: what is important in considering chronic pain is, above all, the infirmity conferred upon the patient. If "pain" in the broad sense of the term lends itself to objective evaluation with difficulty, it is not the same with respect to infirmity. A method of evaluation of the physical disability intended for routine practice in a cancer center has been used on a series of 100 patients. The results obtained in this series have been analyzed and give the answer to questions such as mechanism of action, indications of psychotropic drugs and prognosis of cancer pain.
Activities of Daily Living↗
Psychotropic drug use in the Boston area. A report from the Boston Collaborative Drug Surveillance Program.
During 1972, adults admitted to general medical and surgical wards in Boston area hospitals were interviewed to determine their use of prescribed psychotropic drugs prior to hospitalization. Patients hospitalized for psychiatric disorders or psychogenic ("functional") disease were excluded. Patients who had taken prescribed drugs that could not be identified were considered nonusers. Of the total sample, 20% gave a histroy of psychotropic drug use. Antianxiety drugs were taken by 15% of the patients and accounted for two thirds of total psychotropic drug use. Hypnotics were taken by another 4% of the sample. Slightly over half of antianxiety and hypnotic drug use was for a year or more. Use was more frequent in patients with potentially chronic medical disorders. The findings, in general, are consistent with other studies employing other methods to investigate the use of psychotropic drugs. Simple studies of use, however, do not provide a sole or adequate definition of treatment option, need, or efficacy.
Adult↗
The use of psychotropic drugs in other painful conditions.
Many studies have suggested that psychotropic drugs may be valuable in the managment of chronic painful conditions and of the pain due to neoplastic disease. An opiate-sparing effect has been postulated. Most of the studies are, unfortunately, uncontrolled. The question arises as to whether psychotropic drugs, in addition to allaying anxiety and depression, alter pain threshold or the appreciation of pain.
Chronic Disease↗
Psychotropic drugs as behavioral teratogens.
Three psychotropic drugs were administered to pregnant rats and were then evaluated for their behavioral and reproductive effects in the offspring. Control rats received either saline or vitamin A. Prochlorperazine had the most disruptive effects on reproduction and growth, but had the least effect on behavior. Propoxyphene had no apparent effects on reproduction or growth, but produced a variety of behavioral changes. Fenfluramine was intermediate in its effects on reproduction and growth and had behavioral effects that were revealed in tests of preweaning development. The data suggest that systematic tests of behavior add important information to evaluations of reproductive toxicity that cannot, at present, be obtained by other means.
Animals↗
Psychotropic drug use among women.
The consistent 2:1 ratio of women to men in the receipt of prescriptions for psychotropic drugs is reflected in the higher rates for women of neurotic illness, symptoms of both physical and mental discomfort, and help-seeking and drug-taking behaviour. Physicians' perceptions of the problems presented by their male and female patients influence their prescribing of these drugs. Recent statistics in Ontario indicate that greater use of physicians' services by women is an inadequate explanation of the higher rate of prescribing of psychotropic drugs to women. A longitudinal study of a large insured population in Ontario showed that almost twice the proportion of females, compared with males, received a prescription for psychotropic drugs in 1970-71 and in 1973-74, a higher proportion of females received multiple prescriptions for each drug class, and males were more likely than females to have received only one prescription in a year.
Adolescent↗