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Laboratory Animals Jan 1994The results of a preliminary evaluation of etorphine/methotrimeprazine ('Small Animal Immobilon') and midazolam in rats and mice are reported, and this regimen is...
The results of a preliminary evaluation of etorphine/methotrimeprazine ('Small Animal Immobilon') and midazolam in rats and mice are reported, and this regimen is compared to fentanyl/fluanisone/midazolam in mice. In rats, a surgical plane of anaesthesia with good muscle relaxation was produced, but blood gas analysis showed the presence of severe hypoxia, hypercapnia and acidosis. In mice etorphine/methotrimeprazine/midazolam and fentanyl/fluanisone/midazolam produced adequate anaesthesia, but blood gas analysis showed severe respiratory depression with both regimens. Since etorphine/methotrimeprazine/midazolam produced severe respiratory depression in rats and mice it is suggested that this regimen is used with caution. Administration of supplemental oxygen would seem advisable when using either etorphine/methotrimeprazine/midazolam or fentanyl/fluanisone/midazolam in rats and mice.
Topics: Anesthesia; Animals; Animals, Laboratory; Blood Gas Analysis; Etorphine; Male; Methotrimeprazine; Mice; Mice, Inbred BALB C; Midazolam; Rats; Rats, Wistar; Respiration
PubMed: 8158972
DOI: 10.1258/002367794781065735 -
The British Journal of Clinical Practice Sep 1985
Topics: Drug Therapy, Combination; Female; Humans; Male; Methotrimeprazine; Middle Aged; Narcotics; Pain; Terminal Care; Vomiting
PubMed: 4063129
DOI: No ID Found -
Journal of Pain and Symptom Management Jun 2009
Topics: Aged; Analgesics, Non-Narcotic; Antipsychotic Agents; Carcinoma, Non-Small-Cell Lung; Female; Humans; Lung Neoplasms; Lupus Erythematosus, Systemic; Methotrimeprazine; Palliative Care
PubMed: 19500717
DOI: 10.1016/j.jpainsymman.2008.12.001 -
Current Medical Research and Opinion Dec 2004This is a review of the uses of levomepromazine in psychiatry, based upon MEDLINE, PSYCLIT and EMBASE literature searches. The main indications for this drug in... (Review)
Review
This is a review of the uses of levomepromazine in psychiatry, based upon MEDLINE, PSYCLIT and EMBASE literature searches. The main indications for this drug in psychiatry are schizophrenia and schizoaffective disorder. Levomepromazine's sedative properties particularly fit it to use in psychiatric intensive care. There is also some evidence to suggest it has efficacy in drug-resistant psychosis, although this property of the drug does require further research. In other areas of medicine levomepromazine has been used in: alleviating bronchoconstriction; as a preoperative sedative; in terminal pain control and postoperative analgesia; and in the control of nausea. Some antimycobacterial properties have been recorded. The drug should not be prescribed to patients at high risk of accidental or suicidal overdose.
Topics: Antipsychotic Agents; Bronchoconstriction; Contraindications; Drug Resistance; Humans; Methotrimeprazine; Nausea; Pain; Schizophrenia; Suicide; Treatment Outcome
PubMed: 15701205
DOI: 10.1185/030079904X12708 -
The Cochrane Database of Systematic... Oct 2010Levomepromazine is an 'older' typical antipsychotic medication licensed for use in schizophrenia but sparingly prescribed in the United Kingdom. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Levomepromazine is an 'older' typical antipsychotic medication licensed for use in schizophrenia but sparingly prescribed in the United Kingdom.
OBJECTIVES
To determine the clinical effects and safety of levomepromazine compared with placebo or antipsychotic medications for schizophrenia and schizophreniform psychoses.
SEARCH STRATEGY
We searched the Cochrane Schizophrenia Group's Register (December 2008) which is based on regular searches of, amongst others, BIOSIS, CENTRAL CINAHL, EMBASE, MEDLINE and PsycINFO. References of all identified studies were inspected for further trials. We also contacted relevant pharmaceutical companies for additional information.
SELECTION CRITERIA
All randomised trials comparing levomepromazine with placebo or other antipsychotics for schizophrenia and schizophreniform psychoses were included.
DATA COLLECTION AND ANALYSIS
Data were extracted independently. For dichotomous outcomes, we calculated relative risk (RR) (random-effects model), 95% confidence intervals (CI) and, where appropriate, number needed to treat (NNT) was calculated. We avoided the use of number needed to harm (NNH), as an alternative we used number needed to treat for an additional beneficial outcome (NNTB) and number needed to treat for an additional harmful outcome (NNTH) to indicate the direction of effect. For continuous outcomes, we calculated weighted mean differences (WMD).
MAIN RESULTS
The review currently includes 4 RCTs with 192 participants. For our primary outcome of leaving the study early, levomepromazine was not significantly different compared with other antipsychotics. The levomepromazine arm was significantly better on CGI severity compared with chlorpromazine (n=38, 1 RCT, WMD -0.80 CI -1.51 to -0.09). Risperidone was better for CGI endpoint scores (n=42, 1 RCT, RR 2.33 CI 1.11 to 4.89, NNT 3 CI 2 to 10) compared with levomepromazine. Recipients given levomepromazine had a better BPRS endpoint score (n=38, 1 RCT, WMD -9.00, CI -17.46 to -0.54) and PANSS total score (n=38, 1 RCT, WMD -15.90, CI -30.30 to -1.50) than chlorpromazine. Risperidone recipients noticed a significant difference for the outcome 'at least 20% reduction' on BPRS endpoint score (n=42, 1 RCT, RR 3.33 CI 1.07 to 10.42, NNT 3 CI 2 to 14) compared with levomepromazine. Levomepromazine caused less tremor (n=41, 1 RCT RR 0.12 CI 0.02 to 0.87 NNTB 3 CI 2 to 8), less antiparkinsonian medication administration (n=79, 2 RCTs, RR 0.39 CI 0.17 to 0.90, NNTB 5, CI 2 to 21) compared with haloperidol. Levomepromazine caused less akathisia compared with chlorpromazine, but more hypotension compared with risperidone (n=42, 1 RCT, RR 2.50 CI 1.21 to 5.18, NNTH 3, CI 2 to 7). Dizziness was common with levomepromazine compared with other antipsychotic medications.
AUTHORS' CONCLUSIONS
Available data does not enable us to confidently comment on the effectiveness of levomepromazine for schizophrenia. Larger, more robust, studies comparing levomepromazine with other antipsychotics including clozapine are much needed.
Topics: Antipsychotic Agents; Chlorpromazine; Humans; Methotrimeprazine; Randomized Controlled Trials as Topic; Risperidone; Schizophrenia
PubMed: 20927765
DOI: 10.1002/14651858.CD007779.pub2 -
The Journal of Pharmacology and... Apr 1968
Topics: Adipose Tissue; Animals; Brain Chemistry; Chromatography, Thin Layer; Countercurrent Distribution; Humans; Kidney; Liver; Lung; Male; Methotrimeprazine; Muscles; Rats; Spectrum Analysis; Time Factors; Ultraviolet Rays
PubMed: 5647306
DOI: No ID Found -
Journal of Clinical Psychopharmacology Feb 1996The subjects were 62 patients hospitalized for acute exacerbations of schizophrenia and were randomly assigned to receive risperidone (mean dose, 7.4 mg/day),... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
The subjects were 62 patients hospitalized for acute exacerbations of schizophrenia and were randomly assigned to receive risperidone (mean dose, 7.4 mg/day), haloperidol (7.6 mg/day), or methotrimeprazine (100 mg/day) for 4 weeks. Clinical improvement, defined a priori as a 20% reduction in total Positive and Negative Syndrome Scale (PANSS) scores at end point, was attained by 81% of the risperidone patients, 60% of the haloperidol patients, and 52% of the methotrimeprazine patients (p < 0.05). The reductions in total PANSS and Clinical Global Impression Scale severity scores from baseline to end point were significantly greater in the risperidone patients than in the other two groups. Reductions in scores on the Psychotic Anxiety Scale were significantly greater in the risperidone patients than the methotrimeprazine patients; the difference between haloperidol and methotrimeprazine was not significant. Extrapyramidal symptoms (scores on the Extrapyramidal Symptom Rating Scale) were more severe in the haloperidol patients than in the other two groups, but few differences were apparent between risperidone and methotrimeprazine patients. It is concluded that risperidone is an effective antipsychotic and anxiolytic agent in schizophrenic patients.
Topics: Adolescent; Adult; Anti-Anxiety Agents; Antipsychotic Agents; Anxiety; Double-Blind Method; Drug Therapy, Combination; Dyskinesia, Drug-Induced; Female; Haloperidol; Humans; Male; Methotrimeprazine; Middle Aged; Psychiatric Status Rating Scales; Risperidone; Schizophrenia; Schizophrenic Psychology
PubMed: 8834417
DOI: 10.1097/00004714-199602000-00007 -
Anesthesia and Analgesia 1975Methotrimeprazine (MTM) (0.5 mg/kg) and meperidine (1.5 mg/kg) was administered to four groups of 10 patients each. Two of these groups (I and II) received MTM or... (Comparative Study)
Comparative Study
Methotrimeprazine (MTM) (0.5 mg/kg) and meperidine (1.5 mg/kg) was administered to four groups of 10 patients each. Two of these groups (I and II) received MTM or meperidine 12 minutes before, two other groups (III and IV), 3 minutes after, induction of thiopental anesthesia. N2O-O2 was administered after thiopental induction, and fractional doses of meperidine and muscle relaxants were used as required for maintenance of anesthesia. The preliminary administration of MTM or meperidine decreased the induction dose of thiopental by about 60 percent. When administered before thiopental, both had similar effects on heart rate, but whereas MTM moderately decreased, meperidine moderately increased systolic and diastolic blood pressure MTM had little or no effect on respiratory rate, which was significantly depressed by meperidine. When given after an induction dose of thiopental, the circulatory effects of MTM and meperidine were similar. Respiratory measurements were little affected by MTM but were markedly depressed by meperidine. The mug/kg/min maintenance doses of meperidine were about the same in the four groups. Postanesthetic recovery of consciousness was delayed in the two MTM groups. The incidence of postoperative nausea and vomiting was less in the MTM than in the meperidine groups. MTM appears to have several advantages over meperidine as a component of balanced anesthesia, but is not desirable if rapid postanesthetic recovery or early ambulation is important. Its use is indicated in patients in whom even transient respiratory depression is undesirable and in those in whom prolonged postoperative sedation is desired.
Topics: Adolescent; Adult; Aged; Anesthesia, Endotracheal; Anesthesia, General; Anesthesia, Intravenous; Blood Pressure; Drug Interactions; Female; Heart Rate; Humans; Male; Meperidine; Methotrimeprazine; Middle Aged; Nausea; Nitrous Oxide; Pentobarbital; Respiration; Succinylcholine; Thiopental; Vomiting
PubMed: 1239212
DOI: 10.1213/00000539-197511000-00018 -
Intensive Care Medicine Jan 2012
Topics: Adolescent; Analgesics, Non-Narcotic; Benzodiazepines; Child, Preschool; Drug Therapy, Combination; Female; Haloperidol; Humans; Infant; Intensive Care Units, Pediatric; Male; Methotrimeprazine; Psychomotor Agitation
PubMed: 22109654
DOI: 10.1007/s00134-011-2414-y -
Anesthesia and Analgesia 1967
Clinical Trial Comparative Study
Topics: Adolescent; Adult; Aged; Clinical Trials as Topic; Female; Humans; Male; Meperidine; Methotrimeprazine; Middle Aged; Nausea; Pain; Postoperative Care; Vomiting
PubMed: 5335723
DOI: No ID Found