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British Medical Journal Nov 1967
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Schizophrenia; Tranquilizing Agents
PubMed: 6055751
DOI: 10.1136/bmj.4.5577.489-b -
Journal of Research in Pharmacy Practice Oct 2013Antipsychotic medications are the frontline treatment for the most psychotic disorders. The aim of this study is to compare the onset of action of the first and second...
OBJECTIVE
Antipsychotic medications are the frontline treatment for the most psychotic disorders. The aim of this study is to compare the onset of action of the first and second generation antipsychotics and the rate of their side-effects in the treatment of acute psychosis.
METHODS
In a double-blind, controlled clinical trial, 40 acute psychotic patients were randomly allocated in four groups and treated with each of the four antipsychotics: olanzapine, risperidone, haloperidol or thiothixene. The onset of action of each drug was assessed by the Positive and Negative Symptoms Scale. The data were analyzed by Wilcoxon (Gehan) survival and Log Rank analysis, using SPSS version 20.0.
FINDINGS
Initial response was observed in 97.5% (N = 39) of subjects during 2 weeks of intervention. The mean time to the first response was 6.15 ± 2.9 days and this was significantly shorter for risperidone than others. The most common side-effects were sedation and drug induced Parkinsonism.
CONCLUSION
Risperidone represented shorter onset of action for the treatment of acute psychotic symptoms compared with olanzapine, haloperidol and thiothixene.
PubMed: 24991622
DOI: 10.4103/2279-042X.128142 -
Therapeutic Advances in... 2022Antipsychotics are the treatment of choice in the therapy of schizophrenia. These drugs can be associated with changes in heart rate, but this question has never been...
BACKGROUND
Antipsychotics are the treatment of choice in the therapy of schizophrenia. These drugs can be associated with changes in heart rate, but this question has never been examined systematically.
OBJECTIVE
We aimed to analyse changes in heart rate during treatment with antipsychotics using the frequency of tachycardia and bradycardia events.
DESIGN
For this systematic review and meta-analysis, we included all randomized controlled trials for the acute treatment of schizophrenia comparing antipsychotics head-to-head or with placebo.
DATA SOURCES AND METHODS
We searched Embase, MEDLINE, PsycINFO, PubMed, BIOSIS, Cochrane Central Register of Controlled Trials (CENTRAL), WHO International Clinical Trials Registry Platform and ClinicalTrials.gov (last search June 2021). Two authors independently selected studies and extracted data. We conducted pairwise meta-analyses using a random-effects model. Outcomes were tachycardia and bradycardia events.
RESULTS
We found 469 trials meeting the inclusion criteria. Seventy-seven studies with 16,907 participants provided data on tachycardia or bradycardia events. We found no significant differences between antipsychotics and placebo or between antipsychotics for bradycardia events based on sparse data. Antipsychotics had a higher risk for tachycardia events compared with placebo [ = 37, = 7827, risk ratio (RR) = 1.83, 95% confidence interval (CI) = 1.40-2.41], with large differences between the individual substances (iloperidone RR = 14.05, chlorpromazine RR = 4.84, loxapine RR = 4.52, risperidone RR = 3.38, quetiapine RR = 2.64, paliperidone RR = 1.65). Some head-to-head comparisons were also significantly different: olanzapine haloperidol RR = 2.87, chlorpromazine thiothixene RR = 2.92, quetiapine lurasidone RR = 3.22, risperidone aripiprazole RR = 4.37, iloperidone ziprasidone RR = 4.65).
CONCLUSION
Many studies do not report data for cardiac outcomes, but the available evidence indicates that treatment with antipsychotics raises the risk for tachycardia. Therefore, especially patients with cardiac risk factors should be monitored closely during antipsychotic treatment.
REGISTRATION
PROSPERO: CRD42014014919.
PubMed: 35774251
DOI: 10.1177/20451253221097261 -
Blood Nov 1990
Topics: Bone Marrow Transplantation; Granulocyte Colony-Stimulating Factor; Granulocyte-Macrophage Colony-Stimulating Factor; Humans; Interferon Type I; Melphalan; Multiple Myeloma; Thiothixene
PubMed: 1699619
DOI: No ID Found -
Journal of Community Hospital Internal... 2016A 71-year-old female accidentally received thiothixene (Navane), an antipsychotic, instead of her anti-hypertensive medication amlodipine (Norvasc) for 3 months. She...
CASE DESCRIPTION
A 71-year-old female accidentally received thiothixene (Navane), an antipsychotic, instead of her anti-hypertensive medication amlodipine (Norvasc) for 3 months. She sustained physical and psychological harm including ambulatory dysfunction, tremors, mood swings, and personality changes. Despite the many opportunities for intervention, multiple health care providers overlooked her symptoms.
DISCUSSION
Errors occurred at multiple care levels, including prescribing, initial pharmacy dispensation, hospitalization, and subsequent outpatient follow-up. This exemplifies the Swiss Cheese Model of how errors can occur within a system. Adverse drug events (ADEs) account for more than 3.5 million physician office visits and 1 million emergency department visits each year. It is believed that preventable medication errors impact more than 7 million patients and cost almost $21 billion annually across all care settings. About 30% of hospitalized patients have at least one discrepancy on discharge medication reconciliation. Medication errors and ADEs are an underreported burden that adversely affects patients, providers, and the economy.
CONCLUSION
Medication reconciliation including an 'indication review' for each prescription is an important aspect of patient safety. The decreasing frequency of pill bottle reviews, suboptimal patient education, and poor communication between healthcare providers are factors that threaten patient safety. Medication error and ADEs cost billions of health care dollars and are detrimental to the provider-patient relationship.
PubMed: 27609720
DOI: 10.3402/jchimp.v6.31758 -
Journal of Neurology, Neurosurgery, and... Oct 1986Positron emission tomography (PET) with 11C-2-deoxyglucose (11DG) was used to compare regional brain metabolism in four patients with chronic schizophrenia who had no...
Positron emission tomography (PET) with 11C-2-deoxyglucose (11DG) was used to compare regional brain metabolism in four patients with chronic schizophrenia who had no history of psychotropic medication and in 12 normal controls. Patients had a second PET scan after an injection of thiothixene to evaluate the effects of acute neuroleptics on glucose metabolism. The patients showed higher glucose metabolic values than the normals and did not show the metabolic hypofrontality reported in chronic medicated patients with schizophrenia. Administration of the neuroleptic did not have a significant effect in the metabolic pattern of the patients. These results give support to the hypothesis that prolonged medication may contribute to the metabolic hypofrontal pattern seen in patients with schizophrenia.
Topics: Adult; Basal Ganglia; Brain; Cerebral Cortex; Chronic Disease; Deoxyglucose; Glucose; Humans; Male; Schizophrenia; Thiothixene; Tomography, Emission-Computed
PubMed: 3491182
DOI: 10.1136/jnnp.49.10.1199 -
Biological Psychiatry Jan 1991The effects of 11 antipsychotic drugs on the pyruvate dehydrogenase complex (PDHC) prepared from bovine heart and rat brain were investigated. All inhibited PDHC to...
The effects of 11 antipsychotic drugs on the pyruvate dehydrogenase complex (PDHC) prepared from bovine heart and rat brain were investigated. All inhibited PDHC to varying extents. With clinically equivalent doses, chlorpromazine and thioridazine inhibited the most and fluphenazine and thiothixene the least. The relationship of degree of inhibition of PDHC by neuroleptics to clinical improvement of 32 outpatients treated with acetazolamide and thiamine (A + T) ancillary therapy for chronic mental illness suggests that patients treated with psychoactive drugs that inhibit PDHC the least are most likely to have a favorable response with A + T treatment.
Topics: Acetazolamide; Ambulatory Care; Animals; Brain; Cattle; Chronic Disease; Drug Therapy, Combination; Humans; In Vitro Techniques; Mental Disorders; Psychotropic Drugs; Pyruvate Dehydrogenase Complex; Pyruvate Dehydrogenase Complex Deficiency Disease; Rats; Thiamine
PubMed: 1995086
DOI: 10.1016/0006-3223(91)90046-o -
Analytical Sciences : the International... Nov 2001A flow-injection (FI) methodology using tris(2,2'-dipyridyl)ruthenium(II), [Ru(dipy)3(2+)], chemiluminescence (CL) was developed for the rapid and sensitive...
Flow-injection chemiluminometric determination of some thioxanthene derivatives in pharmaceutical formulations and biological fluids using the [Ru(dipy)3(2+)]-Ce(IV) system.
A flow-injection (FI) methodology using tris(2,2'-dipyridyl)ruthenium(II), [Ru(dipy)3(2+)], chemiluminescence (CL) was developed for the rapid and sensitive determination of three thioxanthene derivatives, namely zuclopenthixol hydrochloride, flupentixol hydrochloride and thiothixene. The method is based on the CL reaction of the studied thioxanthenes with [Ru(dipy)3(2+)] and Ce(IV) in a sulfuric acid medium. Under the optimum conditions, calibration graphs were obtained over the concentration ranges 0.002-6 migrograms/ml for zuclopenthixol hydrochloride, 0.5-15 micrograms/ml for flupentixol hydrochloride and 0.05-7.5 micrograms/ml for thiothixene. The limits of detection (s/n = 3) were 4.2 x 10(-9) mol/l zuclopenthixol hydrochloride, 2 x 10(-8) mol/l flupentixol hydrochloride and 4.5 x 10(-8) mol/l thiothixene. The method was successfully applied to the determination of these compounds in dosage forms and biological fluids.
Topics: Antipsychotic Agents; Cesium; Clopenthixol; Flow Injection Analysis; Flupenthixol; Luminescent Measurements; Organometallic Compounds; Oxidation-Reduction; Ruthenium Compounds; Thiothixene
PubMed: 11759505
DOI: 10.2116/analsci.17.1257 -
Behavioural Neurology 1993Akathisia is frequently reported to be caused by neuroleptic drugs and sometimes by certain other agents such as fluoxetine. Benzodiazepines are a common treatment. The...
Paradoxical akathisia caused by clonazepam, clorazepate and lorazepam in patients with traumatic encephalopathy and seizure disorders: a subtype of benzodiazepine-induced disinhibition?
Akathisia is frequently reported to be caused by neuroleptic drugs and sometimes by certain other agents such as fluoxetine. Benzodiazepines are a common treatment. The principal mechanism of akathisia is thought to be neurochemical, probably dopaminergic with serotonin also playing an important role. It is not usually thought to be related to benzodiazepine-caused disinhibition. Four episodes of atypical or paradoxical benzodiazepine-induced akathisia in three patients are reported and analyzed. All four episodes of akathisia were atypical because they were caused by clonazepam, clorazepate, or lorazepam. In one patient neither thiothixene nor lorazepam caused akathisia, but clonazepam and clorazepate did. In another patient both lorazepam and fluoxetine caused akathisia. It is also noted that all three patients had a history of traumatic brain injury and seizure disorder. The data support the hypothesis that atypical benzodiazepine-induced akathisia exists. Its mechanism may be different from neuroleptic-induced akathisia, but may still involve serotonergic systems or the forced normalization phenomenon. The similarity of these cases to reports of benzodiazepine-induced disinhibition raises the possibility that in some patients they may be the same entity.
PubMed: 24487139
DOI: 10.3233/BEN-1993-6408 -
Biological Psychiatry Jun 1990
Comparative Study
Topics: Adult; Female; Haloperidol; Humans; Male; Psychiatric Status Rating Scales; Psychometrics; Schizophrenia; Schizophrenic Psychology; Thiothixene
PubMed: 2364120
DOI: 10.1016/0006-3223(90)90502-s