The effect of neuroleptics on cognitive and psychomotor function

Article Abstract:

Although studies do not point to a single mechanism which explains how neuroleptics (antipsychotic drugs) function, three hypotheses dominate the literature: (1) they inhibit dopamine and psychomotor activity while leaving higher cognitive function fairly intact; (2) they affect the limbic system (specifically, temporohippocampal functions); and, (3) they improve ability in attention processing, even though they slow down the ability to respond quickly. A review of the literature demonstrates many inconsistencies between studies in regard to the long-term beneficial effects of neuroleptics on psychomotor and cognitive function of psychotic patients. Experimental studies have yielded confusing results, due to the different diagnostic criteria used to classify patients and the variety of unstandardized tests and investigative methods employed across studies. Also, many studies have failed to include important individual variables such as age, gender, personality, attention, and motivation, so that results are weakened. Nevertheless, the majority of studies of schizophrenic patients demonstrated that neuroleptic treatment improved cognitive function and attentional capacity by accelerating information processing. Many studies also found that neuroleptic treatment led to some improvement in deficit, or negative, symptoms such as flattened mood, loss of drive, and social withdrawal. Studies also indicate that tardive dyskinesia (a syndrome of impaired and involuntary body movements), traditionally believed to be induced solely by the long-term use of neuroleptics, has other associated risk factors, including age, gender, and cognitive impairment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation

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Responses of growth hormone to desipramine in endogenous and non-endogenous depression

Article Abstract:

A relationship has been noted between the endogenous features (i.e. the biological processes originating in the body) of depression and suppression of the release of growth hormone (GH). A widely accepted test of the functioning of noradrenergic alpha-2 receptors, which are responsible for the release of growth hormone, is the clonidine/GH challenge test. Like clonidine, two other substances also normally stimulate the release of GH: desipramine and clomipramine. These work by blocking the re-uptake of noradrenaline, another hormone. To determine whether desipramine could be used as a suitable alternative to the unpleasant clonidine/GH challenge test, 29 patients diagnosed with major depression and 10 healthy controls were subjected to an oral desipramine challenge. At issue was whether the blunted secretion of GH could be used to distinguish between so-called endogenous and nonendogenous depressives. Twelve of the patients diagnosed with endogenous depression and six of the nine whose depression was considered nonendogenous had suppressed release of GH in response to the test. Thus, a test using desipramine cannot distinguish between the two classes of depression. In addition, no relationship was found between GH response and severity of depression. However, it appears that some patients with nonendogenous depression undergo abnormal biological changes relative to the release of GH. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Depression, Mental, Depression (Mood disorder), Somatotropin, Noradrenaline, Norepinephrine, Antidepressants, Tricyclic, Tricyclic antidepressants, Somatotropin receptors

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Orofacial dyskinesia in Down's syndrome

Article Abstract:

Down's syndrome is a congenital disorder, characterized by mild to severe mental retardation and certain obvious physical characteristics. Patients with this genetic disease may suffer from orofacial dyskinesia, abnormal involuntary motions of the face and mouth. Previous research has shown that orofacial dyskinesia is correlated with intellectual impairment, and further, that age may play a role in the incidence of the condition. Fifty-four patients between 30 and 60 years of age who had been diagnosed with Down's syndrome were evaluated to examine the prevalence of orofacial dyskinesia among Down's syndrome patients. The patients were classed by severity of retardation, as well as by extent of abnormal movements (as evidenced on the Abnormal Involuntary Movement Scale). It was discovered that a high percentage of the patients (29 women, 9 men) had evidence of orofacial dyskinesia, and that age did not seem to be a factor. These results have implications for the drug therapies used to treat the behavioral disturbances associated with Down's syndrome, as many neuroleptic drugs might exaggerate involuntary movements. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Measurement, Down syndrome, Face, Movement disorders

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