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  • Apomorphine  (4)
  • Suicide  (3)
  • Treatment  (3)
  • 1
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Psychopharmakologie ; Suizid ; Schizophrenie ; Risikofaktoren ; Psychopathologie ; Keywords Psychopharmacology ; Suicide ; Schizophrenia ; Risk facotrs ; Psychopathology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract For all 5.352 patients treated for schizophrenia at the Psychiatric Hospital of the University of Munich in 1981 and 1992, detailed routine and data processing-assisted documentations were made of the psychopharmacological therapies. Nineteen of the patients committed suicide while undergoing inpatient treatment; the control group consisted of all other patients (n=5.333). More than 77 sociodemographic and anamnestic variables as well as 195 items from the admission summaries were taken into account while comparing the groups. Furthermore, the pharmacological data were classified according to drug groups and comparison was based on the mean frequency of prescription of each group. We analyzed the mean number of prescriptions for neuroleptics, tranquilizers, and antidepressants, which were further differentiated into sedating and nonsedating types. For frequently administered drugs, mean daily doses were also compared. Bivariate analysis of the data suggests that the suicide cases presented depressive signs, symptoms, and tendencies already present on admission more frequently than with controls; the same applies to previously attempted suicides. Discriminating analysis showed that the variables “feeling of loss of feelings,“ thought insertion,”“visible depression,”“free-floating anxiety,”“suicidal tendencies,” and “previously attempted suicide” have the greatest predictive value with respect to suicide, in descending order. No differences in psychopharmacological treatment between suicides and controls were found, apart from a significantly higher percentage of antidepressive treatments and a higher mean number of antidepressant prescriptions for the suicides.
    Notes: Zusammenfassung Bei allen 5.352 im Zeitraum 1981–1992 in der Psychiatrischen Klinik der Universität München stationär aufgenommenen schizophrenen Patienten wurde systematisch sowohl eine Routinedokumentation mit dem AMDP-System als auch eine computergestützte Dokumentation der pharmakologischen Behandlung durchgeführt. 19 dieser Patienten suizidierten sich während des stationären Aufenthaltes, wobei die Kontrollgruppe aus allen übrigen Patienten gebildet wurde (n=5.333). In den Gruppenvergleich gingen alle soziodemographischen und krankheitsanamnestischen Variablen sowie alle Items des AMDP-Aufnahmebefundes ein. Ferner wurden die pharmakologischen Daten nach Medikamentengruppen zusammengefasst und hinsichtlich der Verordnungshäufigkeiten der jeweiligen Pharmakagruppen verglichen. Die bivariate Auswertung zeigte neben häufigeren Suizidversuchen in der Vorgeschichte ein bei den säteren Suizidenten bereits bei Aufnahme häufiger vorliegendes depressiv-suizidales Syndrom, wobei diskriminanzanalytisch in absteigender Reihenfolge die Variablen “Gefühl der Gefühllosigkeit”, “Gedankeneingebung”, “beobachtete Depression”, “frei flottierende Angst”, “Suizidalität” und “Suizidversuch in der Vorgeschichte” die größte prädiktive Kraft in Richtung Suizid entfalteten. Mit Ausnahme einer signifikanten Erhöhung sowohl des prozentualen Anteils der antidepressiv behandelten Patienten als auch der mittleren Anzahl der Antidepressivaverordnungen in der Suizidgruppe fanden sich keine Anhaltspunkte für eine zwischen den beiden Gruppen wesentlich differierende psychopharmakologische Behandlung.
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  • 2
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Transkranielle Magnetstimulation ; Elektrokrampftherapie ; Depression ; Therapie ; Key words Transcranial magnetic stimulation ; Electro convulsive therapy ; Depression ; Treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Transcranial magnetic stimulation (TMS) has been used since a decade to investigate the central motor system in the neurological routine diagnostic. From this experience TMS has prooved to be a save and well tolerated procedure. In the past few years several studies investigated TMS to electrically stimulate deeper brain regions to find antidepressive effects in analogy to electro convulsive therapy (ECT). This could be of great advantage as TMS is well tolerated and does not require general anesthesia. There have been some case reports and also some controlled clinical studies on TMS as a therapeutic tool. The results of these studies have been promising. Many questions regarding technical and clinical aspects remain to be answered. In the future however TMS could be a valuable addition in the treatment of depression.
    Notes: Zusammenfassung Die transkranielle Magnetstimulation (TMS) ist ein Verfahren, das seit nunmehr einer Dekade in der neurologischen Diagnostik zur Untersuchung der motorischen Bahnsysteme routinemäßig eingesetzt wird. Aus dieser Zeit ist die TMS bezüglich der Sicherheit in der Anwendung am Menschen gut untersucht und hat sich als sicher und nebenwirkungsfrei erwiesen. Seit wenigen Jahren wird die Möglichkeit untersucht, mittels der TMS nichtinvasiv tiefere Hirnregionen elektrisch zu stimulieren und so, in Analogie zur Elektrokrampftherapie, eine antidepressive Wirkung zu erzielen. Dies hätte große Vorteile, da dieses Verfahren schonend und ohne Narkose angewendet werden kann. Mehrere Einzelfallanwendungen, aber auch schon mehrere klinisch kontrollierte Studien lassen z. Z. die begründete Hoffnung zu, daß dieses Verfahren zu einer Erweiterung des Spektrums antidepressiver Behandlungsverfahren führen könnte.
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Der Anaesthesist 48 (1999), S. 507-518 
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Postoperatives Delir ; Postoperative psychiatrische Störungen ; Therapie ; Prophylaxe ; Key words Postoperative delirium ; Postoperative psychiatric disturbance ; Treatment ; Prophylaxis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract After surgical operations delirium can occur as a serious and possible lethal complication in about 5–15% of patients. Additionally, risk factors such as old age, polymedication, organic and psychiatric diseases raise the incidence. After open-heart- and orthopedic surgery more than half of the patients are affected. Delirium has negative effects on postoperative mobilization and reconvalescence and prolongs treatment on the ward. It is discussed in the literature that delirium may induce dementia in older patients. The correction of metabolic- and electrolyte imbalances, as well as the therapy of neurologic and psychiatric diseases, belongs to prophylactic treatment. Environmental conditions which facilitate reorientation of the patient after operation have beneficial effects. Some success has been achieved by using the nootropic substance piracetam as a prophylactic. In acute treatment, the butyrophenon-neuroleptic haloperidol is the drug of choice. In delirium caused by intoxication with anticholinergic agents, physostigmin is indicated. Benzodiazepines, clonidine and clomethiazole are used in particular for the treatment of withdrawal delirium.
    Notes: Zusammenfassung Nach operativen Eingriffen kommt es bei 5 bis 15% der Patienten zu einem Delir, welches eine ernste und potentiell tödliche Komplikation darstellt. Bei zusätzlich bestehenden Risikofaktoren wie hohem Alter, medikamentöser Mehrfachtherapie, somatischen und psychiatrischen Störungen findet sich eine noch wesentlich höhere Inzidenz. Bei Operationen am offenen Herzen und orthopädischen Eingriffen sind über die Hälfte der Patienten betroffen. Das Delir beeinträchtigt die postoperative Mobilisierung und Rekonvaleszenz der Patienten und führt zur Verlängerung des stationären Aufenthalts. Die Gefahr einer dementiellen Entwicklung als Spätfolge des Delir bei älteren Patienten wird in der Literatur diskutiert. Zu den Maßnahmen der Prophylaxe zählen die Behandlung von metabolischen Entgleisungen, Ausgleich von Elektrolytstörungen und Therapie von neurologischen und psychiatrischen Erkrankungen. Verhaltensmaßnahmen, die die Orientierung des Patienten nach der Operation erleichtern, haben eine günstige Wirkung. Erfolge wurden durch die prophylaktische Verabreichung des Nootropikums Piracetam berichtet. In der Akutbehandlung ist das Butyrophenon-Neuroleptikum Haloperidol Mittel der Wahl zur Sedierung. Bei Delirien auf der Grundlage einer Intoxikation mit anticholinerg wirkenden Pharmaka ist Physostigmin indiziert. Benzodiazepine, Clonidin und Clomethiazol kommen v.a. bei der Behandlung des Entzugsdelir zum Einsatz.
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 335 (1987), S. 673-679 
    ISSN: 1432-1912
    Keywords: Apomorphine ; Conditioning ; Dopamine receptors ; Stereotyped behaviour ; Akinesia ptosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Interactions between the direct (unconditioned) behavioural effects apomorphine and its conditioned effects after pairing with previously neutral stimuli were studied. Rats were injected once daily for 3–12 times, with apomorphine (2.0 mg/kg or 0.5 mg/kg or 0.07 mg/kg s.c. the dose kept constant in each series), in the presence of defined environmental stimuli (a wire cage in association with an acoustic and an olfactory stimulus) as conditional stimuli. The two larger doses produced stereotyped sniffing, licking, and gnawing, the smallest dose akinesia, ptosis, yawning and penile erections. During the conditioning phase, the drug produced most of the effects with increasing intensity and in the case of the stereotypies, there also was a shift to higher scores of stereotypy, with a reduced latency in onset of the signs. On the test day, 1 day after the last administration of apomorphine, the conditioned rats as well as “pseudoconditioned” controls were treated with a test dose of apomorphine in the presence of the conditional stimuli. Pseudoconditioned rats had been treated with the same pharmacological schedule of apomorphine and had the same familiarity with the stimuli, but both were kept separate. A test dose of 0.5 mg/kg of apomorphine produced stereotypies with a significantly higher score and shorter latency in onset in conditioned than in pseudoconditioned rats. Rats conditioned with the lowest dose showed a significantly longer total duration and a shorter latency in onset of akinesia and ptosis. In rats conditioned with the largest dose (2.0 mg/kg), administration of the lowest dose on the test day produced no stereotypies; neither the akinesia nor the ptosis were different between conditioned and pseudoconditioned rats, but yawning occurred with a higher frequency and a shorter latency in pseudoconditioned rats. When rats were conditioned with the lowest dose and tested with 0.5 mg/kg, the level of stereotypies was identical in both groups of rats, whereas akinesia and ptosis were not observed. Yawning and penile erections occurred more frequently, but for short periods only, in conditioned rats. The results showed that apomorphine-induced stereotypies, akinesia and ptosis could be conditioned, and the conditioned effects mimicked the unconditioned responses, which depended on the dose. Conditioned and unconditioned signs of an increased dopaminergic neurotransmission, observed after large doses of apomorphine, thus acted in a synergistic way; the same applied to conditioned and unconditioned signs observed after a small dose and were perhaps due to a decreased dopaminergic transmission. In contrast, when conditioned and unconditioned signs acted in a mutually antagonistic way (increased vs. decreased dopaminergic transmission), the unconditioned signs predominated.
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  • 5
    ISSN: 1432-2072
    Keywords: Apomorphine ; Conditioned dopaminergic activity ; Stereotyped behaviour ; Dopamine autoreceptors ; Dopamine metabolism ; Rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We investigated whether pharmacological effects of the dopamine agonist apomorphine can be conditioned by establishing an association of apomorphine administration with exteroceptive cues. Apomorphine was repeatedly administered and subsequently, the rat was put into a test cage and exposed to an acoustic and an olfactory stimulus (“conditioned rats”). Control animals (“pseudoconditioned” rats) were treated with the same pharmacological schedule of apomorphine not temporally associated with the stimuli. On the test day, both groups were injected with saline and exposed to the stimuli described. The stereotyped behaviour produced by large doses of apomorphine (0.5 or 2.0 mg/kg SC), namely sniffing, licking and gnawing, could be conditioned in a pronounced way. During the conditioning period, a change in the stereotypies was observed with regard to the time-course (earlier occurrence) and to the character of the stereotypies (from sniffing to licking and gnawing), when 0.5 mg/kg apomorphine was used, but not with the dose of 2.0 mg/kg. The conditioned responses showed a relatively uniform distribution during the observation period with some increase towards the end of the observation period. Some signs produced by a low dose of apomorphine (0.07 mg/kg SC), namely hypomotility and ptosis, but not yawning, could also be conditioned, although in a less pronounced way. An intermediate dose of apomorphine (0.18 mg/kg SC) produced both signs observed after large doses and those observed after a small dose, occurring alternatingly. Both types of signs could be conditioned using this dosage. Conditioning did not alter striatal or mesolimbic dopamine turnover. These results suggest that only behavioural signs due to an activation of postsynaptic dopamine receptors, but also some symptoms produced by an activation of dopamine autoreceptors can be conditioned.
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 144 (1985), S. 370-373 
    ISSN: 1432-1076
    Keywords: Chronopharmacology ; Congenital adrenal hyperplasia ; Hydrocortisone ; 9α-Fluorhydrocortisone ; Treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The conventional treatment of CAH with hydrocortisone (16–19 mg/m2 per day) and 9α-F-cortisol (just enough to normalise renin concentrations, started at 07:00 h) was inffective in suppressing the early morning rise of 17-OH-progesterone and in turn androgens in about 20% of our patients. The present work explored the effect of a modified dosage regimen of the drug in five patients. The schedule was: 03:00 h F 33%+9α-F-F 33%; 07:00 h F 30%; 12:00 h F 22%+9α-F-F 33%; 17:30 h F 15%+9α-F-F 33%. Monitored levels of circulating 17-OH-progesterone, testosterone, and individual urinary 17-ketosteroids showed significant improvement, which was not achieved by giving higher or later evening doses. Menarche was induced in two girls (bone age 15 years). The modified dosage schedule offers on the one hand the possibility of better management of CAH, and on the other, cuts down the risk of enhanced Cushing-like effects, which in animal models have been related frequently to dosage schedules not corresponding to the circadian rhythm. The difficulty of administering the drugs at 03:00 h should be overcome by the development of a late-releasing preparation.
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  • 7
    ISSN: 1432-2072
    Keywords: Apomorphine ; Stereotypy ; Environmental influence ; Automatic recording ; Dopamine ; Rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The topography of stereotyped behaviour produced by apomorphine in rats was studied by using either a scoring system, based on observation in a wire cage, or by quantification of horizontal and vertical activities, and of the total distances run in an open field, using an automatic recording system. The latter design was combined with a classification of the type of stereotyped behaviour observed during recording. In addition, the reproducibility of the nature of the stereotyped behaviour and its dose-dependence in individual animals was evaluated. In rats observed in a wire cage, apomorphine at lower doses (0.25 or 0.50 mg/kg SC) produced stereotyped sniffing. Increasing the doses led to stereotyped licking and the largest dose (5.00 mg/kg SC) produced predominantly stereotyped gnawing, as was demonstrated graphically. The type of behaviour produced by 2 mg/kg apomorphine in the open field was reproduced well in individuals after a second administration 4 days later. The shift from sniffing to gnawing was observed in most, but not all of the individually classified animals after administration of the largest dose (5 mg/kg). The locomotor part of motility was highest in “sniffing animals” and lower when gnawing occurred. The non-locomotor part of motility was low in “sniffing rats” and increased when licking and gnawing occurred. In some of the animals a characteristic “climbing” behaviour was observed in addition after the larger doses, which did not interfere with sniffing, licking or gnawing. A combination of classification by observation and automatic recording seems the most appropriate way to study the topography of stereotyped behaviour produced by apomorphine.
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    European archives of psychiatry and clinical neuroscience 250 (2000), S. 257-261 
    ISSN: 1433-8491
    Keywords: Key words Unipolar ; Bipolar ; Depression ; Suicidality ; Suicide
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of the present analyses was to evaluate differences in suicidality (past suicide attempts, suicidal thoughts at time of admission and completed suicides during the hospital stay) between bipolar and unipolar depressed inpatients. Apart from a higher frequency of past suicide attempts in bipolar depressed patients (26.6% in bipolar vs. 17.8% in unipolar patients), findings do not indicate any further differences in suicidality (suicidal thoughts (about 40% in both groups) and completed suicides during the hospital stay (0.8% in both groups)) between bipolar and unipolar patients. Factors with a predictive value for suicidal thoughts at the time of admission were a positive family history for affective disorders, past suicide attempts, and the depressive and paranoid hallucinatory syndrome (all associated with an increased risk). Female gender, an older age at hospitalisation and a longer duration of the illness were found to be associated with a lower probability for having suicidal tendencies at the time of admission. The risk for committing suicide during the hospital stay was increased if the patients had a history of past suicide attempts and suicidal thoughts at the time of admission. A more pronounced depressive syndrome at time of admission was slightly associated with a lower risk of committing suicide.
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  • 9
    ISSN: 1433-8491
    Keywords: Suicide ; Attempted suicide ; Suicidal act ; Parasuicidal act ; Suicide prevention services ; Suicid ; Suicidversuch ; Suicidale Handlung ; Parasuicidale Handlung ; Selbstmordverhütungsinstitutionen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung An 150 Patienten mit Tablettenselbstmordversuch warden soziale und psychiatrische Daten analysiert. Die sozialen Daten werden in Beziehung gesetzt zu einer Vergleichsgruppe von Suicidenten. Bei den psychiatrischen Daten werden insbesondere Informationen über das Selbstmordverhalten herausgearbeitet. Der letzte Teil der Untersuchung beschäftigt sich mit der Bekanntheit und der Inanspruchnahme von Selbstmordverhütungsinstitutionen.
    Notes: Summary Social and psychiatric data on patients who attempted suicide are analysed and compared with social data on a control group of persons who succeeded in committing suicide. Among the psychiatric data, information about presuicidal and suicidal behavior is elaborated. The last part of the analysis describes how many people know about and use suicide prevention services.
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 334 (1986), S. 452-457 
    ISSN: 1432-1912
    Keywords: Apomorphine ; Morphine ; Lisuride ; Stereotyped behaviour ; Dopamine metabolites
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The interactions of morphine with the agonist at dopamine receptors apomorphine were studied on the behavioural and biochemical level. Apomorphine (0.5 mg/kg s.c.) produced stereotyped sniffing and some licking behaviour. Pretreatment with morphine enhanced licking behaviour and, in addition, produced some gnawing behaviour, a sign which is seen after a larger dose of apomorphine alone as well. This enhancement by morphine was maximal after 3.3 mg/kg i.p. and less pronounced after smaller or larger doses of morphine; naloxone (1 mg/kg i.p.) antagonized the enhancement. Morphine did not affect the decrease in the concentration of 3,4-dihydroxyphenylacetic acid (DOPAC) produced by apomorphine in striatum and nucleus accumbens. In contrast, morphine increased the concentration of 3-methoxytyramine (3-MT) in both areas after pretreatment with pargyline (75 mg/kg i.p.), suggesting that it increased the release of dopamine, which might explain the enhancement of apomorphine-induced stereotyped behaviour. The enhancement by morphine of stereotyped behaviour produced by lisuride (2 or 4 mg/kg i.p.), another agonist at dopamine receptors, was much less pronounced than on apomorphine-induced stereotypies.
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