Neuropsychopharmacologia Hungarica : a Magyar Pszichofarmakológiai Egyesület lapja = official journal of the Hungarian Association of Psychopharmacology
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Neuropsychopharmacol Hung · Mar 2014
Review[Catatonia and neuroleptic malignant syndrome in view of a psychopathological and pathophysiological overlap: a brief review].
Catatonia was first described in the 19th century as a syndrome with motor, affective and behavioral symptoms. During the 20th century it was rather regarded as a rare motoric manifestation of schizophrenia and that classification has almost resulted in the disappearance of catatonia among patients outside of the schizophrenia spectrum. With the introduction of neuroleptics, the incidence of catatonic schizophrenia also declined which was attributed to effective treatment. ⋯ The similarities and the possible shifts may suggest a neuropathological and pathophysiological overlap in the background of the two syndromes. Electroconvulsive therapy and benzodiazepines seem to be an effective treatment in both syndromes. These two treatment approaches can be highly valuable in clinical practice, especially if one considers the difficulties of differential diagnosis.
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Neuropsychopharmacol Hung · Mar 2013
Review[New data for the pathomechanism of neuropathic pain: therapeutic evidences].
The present work is based on literature data from PubMed. Neuropathic pain is caused by a lesion or disease of the somatosensory system. ⋯ The clinical symptoms are mainly characterized by burning and throbbing pain and sensory disturbances like hyperalgesia and allodynia. Therapeutic recommendations are antidepressants, antiepileptics, opioids and neuro-stimulation methods.
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Annually about 50,000 patients are hospitalized for acute stroke in Hungary. Of all stroke cases 85% are ischemic, and 15% are hemorrhagic (intracerebral or subarachnoid). In acute ischemic stroke the only registered causal treatment with proven efficacy is thrombolysis with intravenous administration of recombinant tissue plasminogen activator with a 3-hour time window. ⋯ In subarachnoid hemorrhage nimodipine was found effective in preventing vasospasm and thus secondary ischemic cerebral damage. Although the results of individual trials are conflicting, a systematic review on the effects of statins suggests a similar effect. Due to the limited options of evidence based treatments of acute stroke primary prevention has utmost importance.
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Neuropsychopharmacol Hung · Dec 2010
Review[Trazodone--its multifunctional mechanism of action and clinical use].
Trazodone is an antidepressant of the serotonin (5-HT2) antagonist and reuptake inhibitor class, and has been considered to act as a multifunctional drug. It is generally approved for the treatment of major depression, its efficacy is well-documented in elderly patients, and it has been widely used for replacement of benzodiazepines or benzodiazepine-type sleeping drugs due to its anxiolytic efficacy and sleep normalizing effect in depression. ⋯ It is weight neutral and does not decrease sexual function. The introduction of trazodone to the Hungarian market may decrease the widespread use of benzodiazepines in antidepressive treatment.
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Neuropsychopharmacol Hung · Dec 2006
Review[New formulations of olanzapine in the treatment of acute agitation].
Agitation is common in patients with acute schizophrenia or bipolar mania, and when severe can result in aggressive or violent behaviour. Pharmacotherapy for acute psychotic agitation includes the use of antipsychotic and benzodiazepine drugs, either alone or in combination. Although oral treatment is preferred, options in the pharmacotherapy of acute agitation include the parenteral administration of antipsychotics in order to facilitate onset of drug action and quickly alleviate symptoms. Until recently only conventional antipsychotic and benzodiazepine drugs were available as intramuscular injections. Olanzapine has been one of the first atypical antipsychotics available for intramuscular administration. Four randomized placebo and comparator controlled , double-blind clinical trials have demonstrated the efficacy of olanzapine in reducing acute agitation in patients with schizophrenia, bipolar mania and Alzheimer and vascular dementia. Evidence from these clinical trials has shown that IM olanzapine associated with faster onset of action and more favorable profile of adverse events, than monotherapy with IM haloperidol. Current clinical experience and one naturalistic study with intramuscular olanzapine suggest that it is efficacious and can be safely used in "real world" patients with severe agitation. Intramuscular olanzapine have shown ease of transition to same agent oral therapy once the acute agitation has diminished. The orally disintegrating tablet formulation of olanzapine was effective rapidly reducing psychopathology, while improving medication compliance, attitudes and behaviours. This new formulation of olanzapine may offer an alternative strategy in the treatment of acutely ill, noncompliant schizophrenic patients. Evidence suggests that the new formulations of olanzapine should be among the first-line choices in the treatment of agitation in acute psychosis. ⋯ olanzapine, intramuscular, orally disintegrating tablet, agitation, psychosis.