Adverse effects of anticholinergic medication on positive schizophrenic symptoms

Psychological Medicine - Tập 13 Số 3 - Trang 513-527 - 1983
Eve C. Johnstone1, Timothy J. Crow1, I. Nicol Ferrier1, Chris Frith1, David Owens1, Rachel C. Bourne1, Stephen J. Gamble1
1Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Harrow, Middlesex

Tóm tắt

SynopsisIn a series of 36 patients with acute schizophrenia flupenthixol dosage was blindly adjusted to give a fixed level of sedation. Patients were then randomly allocated to procyclidine or placebo. The patients receiving procyclidine experienced more positive schizophrenic symptoms and less severe extrapyramidal features by comparison with placebo patients. Blood levels of prolactin and flupenthixol estimated by radloimmunoassay were not significantly changed by the addition of procyclidine. Flupenthixol dosage and levels and prolactin levels were significantly related. There was no significant association between clinical and laboratory measures, with the exception that a curvilinear (inverted U) relationship was demonstrated between flupenthixol levels and antipsychotic and extrapyramidal effects. This relationship may be due to the fact that, in a study of this design, patients resistant to the effects of neuroleptic medication are likely to be given the highest doses. The findings support earlier claims that anticholinergic medication has adverse effects on schizophrenic symptoms.

Từ khóa


Tài liệu tham khảo

10.1192/bjp.131.3.310

Cole, 1961, Extrapyramidal side effects and clinical response to the phenothiazines, Review Canadienne Biologie, 20, 565

Webster, 1968, Clinical analysis of the disability in Parkinson's disease, Modern Treatment, 5, 257

10.1192/bjp.113.495.213

10.1007/BF00421208

10.1001/archpsyc.1974.01760130040006

10.1001/archpsyc.1980.01780150095010

Simpson, 1976, Psychotic exacerbations produced by neuroleptics, Diseases of the Nervous System, 37, 367

de Belleroche, 1981, Contrasting effects of both acute and chronic neuroleptic administration on A.Ch release from corpus striatum and nucleus accumbens of rat, Journal of Physiology, 312, 15

Robinson, 1977, Radioimmunoassay for flupenshixol in plasma, Clinical Chemistry, 23, 2085, 10.1093/clinchem/23.11.2085

Haase, 1962, Intensity and equivalence of neuroleptic effect and its therapeutic importance, Nervenarzt, 33, 213

10.1001/archpsyc.1968.01740040098013

Johnstone, 1980, Drug Concentrations in Neuropsychiatry, 99

10.1111/j.1749-6632.1957.tb40764.x

10.1001/archpsyc.1976.01770030003001

10.1111/j.2044-8317.1980.tb00779.x

Ladinsky, 1978, Interactions between Putative Neurotransmitters in the Brain, 3

10.1111/j.1600-0447.1977.tb00174.x

10.1001/archpsyc.1978.01770250110011

Gautier, 1977, Influence of the antiparkinsonian drug on the plasma level of neuroleptics, Biological Psychiatry, 12, 389

Flugel, 1953, Thérapeutique par medication neuroleptique obtenue en realisant systematiquement des états Parkinsoniformes, L'Encéphale, 45, 1090

10.1038/248596a0

El-Yousef, 1974, The effect of benztropine mesylate on plasma levels of butaperazine maleate, American Journal of Psychiatry, 131, 471, 10.1176/ajp.1974.131.4.471b

10.1176/ajp.131.3.310

10.1111/j.1365-2265.1976.tb01953.x

Davis, 1975, Neurolransmitter Balances Regulating Behaviour, 135

10.1017/S0033291700018869

10.1007/BF00426949

Chouinard, 1977, Antiparkinsonian drug administration and plasma levels of penfluridol – a new long acting neuroleptic, Communicable Psychopharmacology, 1, 325

10.1176/ajp.123.12.1490

10.1111/j.2042-7158.1972.tb08912.x

10.1159/000117699

10.1017/S0033291700029287

Kornetsky, 1959, A comparison of hypnotic and residual psychological effects of single doses of chlorpromazine and secoborbital in man, Journal of Pharmacology and Experimental Therapeutics, 127, 51

10.1136/bmj.2.4985.138

10.1016/0010-440X(73)90034-5

Siris, 1978, Serum prolactin and antipsychotic responses to pimozide in schizophrenia, Psychopharmacology Bulletin, 14, 8

Howard, 1974, Haloperidol for chronically hospitalized psychotics: a double blind comparison with thiothixene and placebo: a follow up open evaluation, Diseases of the Nervous System, 35, 458

10.1016/S0140-6736(69)91417-2

10.1001/jama.1949.02910060015004

10.1017/S0033291700015841

10.1136/jnnp.13.1.47

10.1001/archpsyc.1965.01730020057007

Miller, 1974, The action of neuroleptic drugs on dopamine-stimulated adenosine cyclic 3', 5'-monophosphate production in rat neostriatum and limbic forebrain, Molecular Pharmacology, 10, 759

10.1080/00325481.1960.11716488

Rivera-Calimlim, 1976, Effect of dose, dosage schedules and drug interactions on plasma chlorpromazine levels, American Journal of Psychiatry, 133, 646, 10.1176/ajp.133.6.646

10.1007/BF00453508

10.1017/S0033291700045220

10.1016/S0140-6736(70)90634-3

10.1007/BF00422403

Delay, 1952, Utilisation en thérapeutique psychiatrique d'une phénothiazine d'action central élective (4560 UP), Annales Médico-Psychologiques, 110, 112

10.1038/266639a0

10.1001/archpsyc.1970.01740280001001

Shader, 1971, Uses and toxicity of Belladonna alkaloids and synthetic anticholinergics, Seminars in Psychiatry, 3, 449

10.1017/S0033291700056488

10.1016/0024-3205(78)90580-5

10.1192/bjp.135.4.352

10.1111/j.1365-2125.1975.tb01576.x

10.1159/000117667

Johnson, 1967, Mystical force of the nightshade, International Journal of Neuropsychiatry, 3, 268

10.1176/ajp.130.12.1370

10.1016/S0140-6736(78)91740-3

10.1001/jama.1954.02940500014005

10.1176/ajp.130.10.1155

10.1016/S0010-440X(60)80013-2

10.1001/archpsyc.1964.01720210028005

10.1038/261717a0

10.1007/BF00433807

Macvicar, 1977, Abuse of antiparkinsonian drugs by psychiatric patients, American Journal of Psychiatry, 134, 809, 10.1176/ajp.134.7.809

Forsman, 1977, Applied pharmacokinetics of haloperidol in man, Current Therapeutic Research, 21, 396

10.1001/jama.1972.03200010109024

Davis, 1978, Pharmacological investigations of the cholinergic imbalance hypotheses of movement disorders and psychosis, Biological Psychiatry, 13, 23

Kolakowska, 1976, Clinical significance of plasma chlorpromazine levels. II: Plasma levels of the drugs: some of its metabolites and prolactin in patients receiving long term phenothiazine treatment, Psychopharmacology, 49, 101, 10.1007/BF00427479

10.1001/archpsyc.1974.01760070080012

10.1097/00005053-197504000-00005

Friedhoff, 1973, A dopaminergic–cholinergic mechanism in production of psychotic symptoms, Biological Psychiatry, 6, 165

10.1192/bjp.137.6.518

Wing, 1974, Measurement and Classification of Psychiatric Symptoms

Crow, 1979, Recent Advances in Clinical Psychiatry, 1

Thông tin
Thông tin xuất bản

Psychological Medicine

Tập 13 Số 3

513-527

Thông tin tác giả