摘要:

AbstractClinicians who have contact with patients taking medications which produce cholinergic blockade may need to consider possible links between increased anticholinergic levels and problems in judgement. Although it appears that there has as yet been no direct experimental test of the impact of anticholinergic agents on the judgement of normals or psychiatric patients, a review is offered of two types of basic cognitive findings which strongly suggest that the risk of such a link should figure in clinical cost—benefit analysis. It is then argued that, in the absence of definitive findings, several clinical considerations suggest that the clinician should consider the possible impact of anticholinergics on judgement in his or her practic

ISSN:0885-6222    

DOI:10.1002/hup.470060302

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractThe content, criterion and face validity of human performance tests in psychopharmacology research were examined in an earlier paper. Most evidence on test meaning and interpretation, however, comprises construct validity. This is critically scrutinized here, through a brief analysis of human performance theory (Broadbent, Sanders, Sternberg), and taxonomies of human performance function (Fleishman, Holding). While much construct evidence is rather nebulous and untestable (non‐disprovable), it is probably the most accurate representation of current views on performance assessment. Tests gradually fall out of favour (or) into favour, rather than being shown to be clearly invalid (or) valid. Factor analysis, and task discrimination, are, however, two procedures for placing test interpretation/meaning on a sounder empirical basis. Returning to the overall problem of how best to investigate test validity, several proposals are made. Further criterion information should be sought, in large‐scale studies, designed specifically to compare the practical utility of different tests and test batteries. There needs to be greater atmosphere of critical debate on test meaning, in order to clarify the performance functions being assessed. Factor analysis and task discrimination procedures also need to be more widely employed. Lastly, although many tests can be seen as measures of ‘information processing’, the inference that they provide indices of ‘real‐life performance’, can rarely be made on cur

ISSN:0885-6222    

DOI:10.1002/hup.470060303

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractAdequate car driving ability is essential for accident avoidance. Driving ability means the capability of the driver to keep a technically safe vehicle on a safe road without accident and free of danger to himself and to other traffic participants. Driving ability is influenced by the overall state of motivation, experience and fatigue of the driver, and is dependent on higher cognitive functions, perception, response selection and sensorimotor functioning. The large number of traffic accidents attributed to so‐called ‘driver failure’ include a high percentage of accidents in which the driver had taken drugs within the last 24‐hour period before the accident occurred. Results are presented from various studies showing different effects on driving performance and reaction time following nighttime application of long‐acting and short‐acting hypnotics. Furthermore, alcohol was used as an agent interfering with the test drugs. Different benzodiazepines were tested in two different situations characterized by high and low loads of motor coordination and vigilance level. In both experimental approaches it was revealed that in comparison to other hypnotics lormetazepam belongs to the group which do not exert hangover effects on drivingrelated skills. Even if lormetazepam were taken together with alcohol in the evening no driving‐related decrements were discovered the next morning. In conclusion it could be stated that lormetazepam belongs to the class of safe hypnotics inducing driving impairment far less than that produced by 0·8 BAC mg/ml, which is the upper legal limit for driv

ISSN:0885-6222    

DOI:10.1002/hup.470060304

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractThe effects of alprazolam l mg alone and in combination with 0·5 g/kg of alcohol for males and 0·42 g/kg for females were examined on a range of psychological tasks 90 and 180 min post‐drug (45 and 135 min post‐alcohol). Forty‐eight healthy volunteers were assigned randomly to four independent groups who received: alprazolam and placebo drink, alprazolam and alcohol, placebo capsule and alcohol, placebo capsule and placebo drink, respectively. Alprazolam caused subjective sedation, unsteadiness, dizziness and physical tiredness and impaired performance on all tasks. Alcohol caused similar subjective effects but little objective impairment. The effects of the combination were generally no greater than predicted from the sum of the single

ISSN:0885-6222    

DOI:10.1002/hup.470060305

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractThis was a double‐blind, placebo‐controlled crossover study in 15 healthy female volunteers. It consisted of five sessions, separated by 1 week wash‐out between sessions. The purpose of the trial was to study the potential amnesic and sedative activity of clobazam and lorazepam, and the potential antagonism between these effects under the joint influence of a high noise level and intense intermittent light stimulation (ILS), aimed at increasing the level of alertness. The study drugs were administered as a single daily oral dose. The amnesic and sedative effects were evaluated by objective measurements (digit span, Buschke selective reminding test, critical flicker fusion, reaction time, tapping, mental arithmetic test) and subjective measurements (visual analogue scale and adverse effect questionnaire) before each administration, then 1 h, 2 h, 2·5 h, 3 h, 4 h and 7 h post‐dosing. An analysis of variance according to a balanced Latin square design was performed. Clobazam, at a dosage of 10 mg, was devoided of sedative and amnesic effects; at a dosage of 30 mg it induced only moderate memory disturbances. In contrast, lorazepam, administered at doses of 1 and 3 mg, produced marked and dose‐dependent disturbances of memory, alertness and cognitive functions. The use of visual and sound stimuli, designed to increase the level of alertness, did not counteract the sedative effects induced by

ISSN:0885-6222    

DOI:10.1002/hup.470060306

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractThe relationship between clinical effects and plasma concentrations of mianserin and desmethylmianserin was studied in 29 cases of major depression during 3 weeks of mianserin treatment. The daily dose of mianserin was 30 mg in 27 cases and 20 mg in two cases. There was a significant U‐shaped relationship between the final Montgomery Åsberg Depression Rating Scale (MADRS) score and the steady‐state plasma concentration of mianserin (p<0·05) or desmethylmianserin (p<0·05). A much stronger relationship was observed for mianserin plus desmethylmianserin (p<0·001). A theoretical therapeutic window (where a final MADRS score was expected to be 10 or less) was 71–128 nmol/1 for mianserin, 34–61 nmol/1 for desmethylmianserin, and 101–183 nmol/1 for mianserin plus desmethylmianserin. The proportion of responders was significantly higher inside than outside the window for mianserin plus desmethylmianserin (p=0·0033), but not for mianserin (p=0·063) or for desmethylmianserin (p=0·077). The occurrence of subjective side‐effects was not dependent on the plasma concentrations of these compounds. The present study suggests that desmethylmianserin contributes substantially to the overall antidepressant effects of mianserin treatment, and that the therapeutic response is most dependent on the combined plasma concentration of mianserin and desmethylmianserin, with an optimal therapeutic response occurring in the

ISSN:0885-6222    

DOI:10.1002/hup.470060307

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractThe pharmacokinetics of moclobemide were examined in 19 depressed patients following a single oral dose of 50 mg. Ten patients were aged>60 years and nine<59 years. Plasma concentrations were analysed by gas chromatography with nitrogen‐specific detection. Pharmacokinetic parameters calculated were peak concentration, time to reach the peak, terminal disposition half‐life, area under the curve, oral clearance and apparent volume of distribution. No clinically significant differences were found betwen the two patient groups for these parameters. Thus there is no requirement for dosage adjustment in the older patient for moclobemide. This contrasts with some tricyclic and tetracyclic antidepressants which show significant age effects. Further studies of moclobemide for the treatment of elderly depression are warran

ISSN:0885-6222    

DOI:10.1002/hup.470060308

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractGroups of university students were exposed acutely to alcohol (100 ml vodka) and their performance in the Bexley Maudsley Automated Psychological Screening Tests (BMAPS) was assessed. Blood samples were also taken to assess platelet aggregation to 5‐HT challenge. After 1 week administration of Evening Primrose Oil (EPO) or placebo under double‐blind conditions the students were re‐assessed. No mean difference was found in the psychometric testing of any of the groups either before or after the administration of EPO; however 5‐HT‐induced platelet aggregation was significantly potentiated in those groups exposed to alcohol, and was further increased in the group receiving EPO. These results suggest that platelet aggregation in response to 5‐HT is more sensitive than psychometric tests commonly used to assess alcoholism in detecting changes due to acute alcohol i

ISSN:0885-6222    

DOI:10.1002/hup.470060309

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractThe association of neuroleptic malignant syndrome with neoplasia has not been previously reported. We report the case of a 64‐year‐old female patient who developed the classical picture of neuroleptic malignant syndrome in relation to a uterine leiomyosarcoma. This raises the question as to whether a biological predisposition exists in patients who develop neuroleptic malignant syndr

ISSN:0885-6222    

DOI:10.1002/hup.470060310

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

ISSN:0885-6222    

DOI:10.1002/hup.470060311

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY