Drug prescribing for schizophrenic out-patients on depot injections: repeat surveys over 18 years

Article Abstract:

Surveys between the years 1970 and 1986 concerning drug prescribing practices of psychiatrists treating schizophrenic out-patients in the UK were evaluated for changing trends over time and for differences between the prescribing practices of teaching and non-teaching hospitals. Patients' ages ranged from 18 to 65 years, and all were receiving neuroleptics (antipsychotic drugs) by long-acting depot injections (injections placed in body areas that store fat, so drugs stored and are distributed slowly). From 1970 to 1983, there was a noticeable reduction in the use of multi-neuroleptics and a reduction in prescribing more than one drug group at a time (polypharmacy). In this time period, the total dose of neuroleptics prescribed also fell, while the proportion administered by depot injection increased. Major side effects of neuroleptics include Parkinson's disease symptoms such as tremor and muscular rigidity. Since neuroleptic dose was reduced in this period, there was a substantial, concurrent reduction in prescriptions for anti-Parkinsonian drugs, as well as a reduction in prescriptions for tricyclic antidepressants (such as Elavil) and benzodiazepines (anti-anxiety agents such as Valium). However, since 1983, there have been many reversals in the this low-medication trend, including a large rise in polypharmacy practices. An exception to this reversal was a steady reduction in the use of anti-Parkinsonian drugs, which can have some serious side effects of their own, so that by 1988, less than half the teaching hospitals surveyed used them. However, the non-teaching sample used anti-Parkinsonian drugs more, and 77 percent of their patients were on regular prescriptions. These hospitals also consistently utilized more polypharmacy than the teaching institutions. It is indicated that prescribing practices may vary greatly between teaching and non-teaching hospitals. (Consumer Summary produced by Reliance Medical Information, Inc.)

Surveys, Drug therapy, Aggressiveness (Psychology), Schizophrenics

---

Kluver-Bucy syndrome and psychiatric illness

Article Abstract:

In 1939, Kluver and Bucy described what happens to rhesus monkeys when both temporal lobes of their brains are removed: they become unable to recognize familiar beings and objects, hyperreactive to every visual stimulus, emotionally unresponsive, and oversexed. In addition, they show abnormal oral exploratory behavior. A similar syndrome occurs in man in the presence of temporal lobe abnormalities, but may be accompanied by verbal hypersexuality and manual, rather than oral, exploratory behavior. Rage may also develop. A case is presented of an unfortunate woman to illustrate the consequences of misdiagnosing Kluver-Bucy syndrome as schizophrenia or affective disorder. In 1951, a 15-year-old girl complaining of a cloudy feeling and voices in her head was treated with shock therapy, after which she became withdrawn and began to giggle to herself. A year later, as her condition deteriorated, she was diagnosed as a hebephrenic schizophrenic, for which the treatment was deep insulin therapy. This 'therapy' induced 30 separate episodes of coma. Eventually she became continually restless, began to eat her clothes and excrement, and stopped speaking. At age 38, she was subjected to prefrontal lobotomy, after which she improved a little. Now, at age 52, her activity is minimal and purposeless, she hardly speaks, does not recognize her father, and is incontinent of feces and urine. EEG and brain biopsy have revealed no conclusive abnormalities. It is a matter for speculation that in this woman's case, deep insulin therapy to treat schizophrenia may have induced a chronic psychotic syndrome. Features of Kluver-Bucy occurring in an otherwise uncomplicated case of schizophrenia should alert the physician to possible abnormalities of the temporal lobe structures. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Physiological aspects, Psychoses, Psychotic disorders, Temporal lobes

---

Similar abstracts:

• Abstracts: Effects of birthweight and sociodemographic variables on mental development of neonatal intensive care unit survivors
• Abstracts: Changes in the prescription patterns of psychotropic drugs for cancer patients during a 10-year period. Epidemiologic perspectives on life-style modification and health promotion in cancer research
• Abstracts: Social adjustment of remitted bipolar and unipolar out-patients: a comparison with age- and sex-matched controls
• Abstracts: Depression and previous alcoholism in the elderly. Prognosis of depression in the elderly. The depressed elderly living in the community: a follow-up study
• Abstracts: The continuum of psychosis and its genetic origins: the sixty-fifth Maudsley lecture. Post-partum psychosis in the Assir Region of Saudi Arabia

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.