Changing patterns of neuroleptic dosage over a decade

Article Abstract:

Neuroleptic (antipsychotic) drugs are used to modify psychotic behavior, especially in schizophrenics. The charts of 206 schizophrenic inpatients from three centers were reviewed to evaluate changes in neuroleptic drug protocol over a 10-year period. The three centers comprised a general hospital, a community mental health center (CMHC), and a state hospital. They found that the drug potencies and dosages had gone up, and that the length of inpatient stay had gone down. They also found that the overall average neuroleptic dosage had doubled at each center between 1973 and 1982. In general, the CMHC gave the lowest doses, and the state hospital gave the highest. There was a dramatic increase in average dose given at the CMHC and state hospital between 1973 and 1977; the general hospital showed the largest increase between 1977 and 1982. There were also significant increases in the average discharge dose prescribed at all three centers. The use and doses of high-potency drugs increased, while prescriptions and doses of low-potency drugs decreased. The average length of stay at the general hospital decreased significantly during this 10-year period from 52.6 to 29.7 days, and from 60.1 to 34.7 days at the CMHC. Other studies have concluded that most schizophrenic patients do well on moderate doses of neuroleptics, and that higher doses of low-potency drugs may cause more side effects with less positive clinical effects. There is not sufficient documentation to support the increase in potency and dosages of neuroleptics commonly used today. Prescribing practices may be a response by staff to the moods and attitudes of the patients. The prescribing changes reported were not the result of changes in clinical practice based on new research data; use of higher doses of neuroleptics must be validated with clear evidence of their benefit. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Evaluation, Drug therapy, Dosage and administration, Schizophrenia, Antipsychotic drugs, Antipsychotic agents, Schizophrenics

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The prevalence of anxiety disorders in patients with chronic obstructive pulmonary disease

Article Abstract:

The psychiatric morbidity rates were examined in 50 patients diagnosed with chronic obstructive pulmonary disease. The pulmonary symptoms included airflow obstructions attributable to chronic bronchitis, emphysema, or chronic asthma. No organic brain syndromes were evident in these patients and they were not taking any medication that might have resulted in psychiatric symptoms. On the whole, lower rates of depression, dysthymic disorder (depressive neurosis), and alcohol dependence were observed in these patients than in the general population. Also, 18 percent of these individuals had a current or past diagnosis of some type of mood disorder, comparable to the rates observed in the general population. Consistent with expectations, higher rates of mood disorders were noted among the women. However, the incidence of panic disorder was more than five times greater in these subjects with chronic obstructive pulmonary disease compared with general population averages. Although it is not clear if the onset of the respiratory condition of these patients coincided with the onset of the panic attacks, it is suggested that there may be an association between the two conditions. Because of the abnormally high rates of panic disorder in these patients (eight percent), it is recommended that individuals with chronic obstructive pulmonary disease be carefully monitored for the occurrence of panic disorders. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Physiological aspects, Lung diseases, Obstructive, Chronic obstructive lung disease, Stress (Psychology), Panic disorders, Panic disorder

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