Journal of psychopharmacology
-
J. Psychopharmacol. (Oxford) · May 2005
ReviewAntipsychotic drug-induced acute laryngeal dystonia: two case reports and a mini review.
Antipsychotic-induced laryngeal dystonia is a life-threatening side-effect of both high- and low-potency classical antipsychotics, and its diagnosis often remains elusive. We review all cases of acute laryngeal dystonia due to antipsychotics available in the literature, including controversial ones, and add two new cases. There are no reports of acute laryngeal dystonia due to atypical antipsychotics. ⋯ There have been reports of acute laryngeal dystonia due to metoclopramide. Differential diagnosis includes other extrapyramidal side-effects and allergic reactions. Treatment consists of the administration of anticholinergic agents.
-
J. Psychopharmacol. (Oxford) · Mar 2005
Clinical TrialEffects of peripheral sympathetic blockade with dapiprazole on the fear-inhibited light reflex.
Fear (e.g. associated with the threat of an electric shock) causes an increase in initial pupil diameter (IPD) and a decrease in the amplitude of the light reflex response. There is evidence for dissociation between the two responses to threat: only the reduction in light reflex response amplitude is sensitive to the anxiolytic drug diazepam. We examined the effects of peripheral sympathetic blockade with the alpha(1)-adrenoceptor antagonist dapiprazole on both responses to threat on the basis of the hypothesis that only the response of the IPD will be affected, whereas the response of the light reflex will remain unaffected. ⋯ The inhibition of the light reflex by threat is likely to reflect central parasympathetic inhibition and is unlikely to involve the peripheral sympathetic innervation of the iris. The threat-induced increase in IPD is likely to reflect mainly central sympathetic excitation. The different central autonomic mechanisms underlying the two pupillary responses to threat may explain the dissociation between the separate effects of threat on IPD and light reflex amplitude.
-
J. Psychopharmacol. (Oxford) · Mar 2005
Case ReportsClozapine-induced type-2 diabetes mellitus: possible mechanisms and implications for clinical practice.
The atypical antipsychotic clozapine has been reported to be associated with metabolic adverse effects, including type-2 diabetes mellitus. We present two cases of diabetes mellitus associated with clozapine treatment. One case resolved entirely upon withdrawal of the drug, whereas the other did not. We discuss the molecular basis of the diabetogenic action of clozapine and recommendations for monitoring.
-
J. Psychopharmacol. (Oxford) · Jan 2005
Randomized Controlled Trial Clinical TrialPreliminary evidence of the cardiovascular effects of polysubstance misuse in nightclubs.
Adverse reactions to polysubstance misuse are common in nightclubs, yet little is known of the physiological effects of polysubstance misuse in this environment. This study examined the heart rate, blood pressure and oral temperature of 50 participants recruited in a nightclub on four separate nights. In addition, the increase in environmental temperature was recorded throughout each night. ⋯ On the other hand, there were significant differences in both heart rate and blood pressure between the two groups. These data suggest that polysubstance misusers may be at risk from cardio- and cerebrovascular toxicity. Further field/on-site work is clearly needed to investigate the effects of polysubstance misuse.
-
J. Psychopharmacol. (Oxford) · Jun 2004
ReviewPharmacokinetic interactions of drugs with St John's wort.
There is a worldwide increasing use of herbs which are often administered in combination with therapeutic drugs, raising the potential for herb-drug interactions. St John's wort (Hypericum perforatum) is one of the most commonly used herbal antidepressants. A literature search was performed using Medline (via Pubmed), Biological Abstracts, Cochrane Library, AMED, PsycINFO and Embase (all from their inception to September 2003) to identify known drug interaction with St John's wort. ⋯ It also caused serotonin syndrome when coadministered with selective serotonin-reuptake inhibitors (e.g. sertaline and paroxetine). Both pharmacokinetic and pharmacodynamic components may play a role in these interactions. Because the potential interaction of St John's wort with other drugs is a major safety concern, additional systematic research on herb-drug interactions and appropriate regulation in herbal safety and efficacy is needed.