Abnormal movements are common and accepted complications of phenothiazine therapy. They are usually regarded as of extrapyramidal origin, develop soon after medication is started and are often abolished by stopping the drug or giving specific chemotherapy. The commonly occurring syndromes are:
MEDICAJLJOURNAL solution-for example, 0 5 ,ug./ml. It seems probable that the outstanding prophylactic effectiveness of silver nitrate compresses is due to the high concentration of silver ions present in the dressings for a short while after each replenishment of silver nitrate solution.The tests on Ps. aeruginosa showed that the lowest concentration of silver ions associated with bactericidal action was considerably higher than that associated with bacteriostasis. This difference can probably be ascribed in part to the shorter exposure of bacteria in the tests for bactericidal action; it is possible, too, that a higher concentration of silver ions is required for killing than for inhibition of the bacteria. REFERENCES Cason, J. S., Jackson, D. M., Lowbury, E. J. L., and Ricketts, C. R. (1966 British Medical_Journal, 1970, 2, 446-449 Summary: Forty-eight patients with anxiety states were treated with oxazepam (Serenid-D), which was administered in tablets of three different colours-red, yeliow, and green. Every patient received one week's treatment with each colour, according to a random programme. A latin square design was used to ensure complete balance between the colours and between the weeks. The patients' symptoms were categorized and then assessed by both weekly physicians' ratings and daily self-rating, which showed close agreement. Colour preference was shown on both these scales in that symptoms of anxiety were most improved with green, whereas depressive symptoms appeared to respond best to yellow. Such colour preferences, however, did not reach levels of statistical significance, except for phobias as rated on the physicians' assessment.The results indicate that colour may play a part in the response to a drug.
SynopsisThe hypothesis has recently been advanced that increased activity of central dopaminergic mechanisms underlies the symptomatology of the schizophrenias. The evidence that dopaminergic transmission in the corpus striatum is impaired in Parkinson's disease suggests that observations on the relationship between Parkinson's disease and schizophrenia may illuminate the pathophysiology of the latter disease. Four cases are reported in which an illness with schizophrenic features developed in the setting of longstanding Parkinson's disease; attention is drawn to earlier reports of schizophrenic illnesses occurring as.postencephalitic sequelae in the presence of a parkinsonian syndrome. These observations appear to conflict with the view that increased dopamine release in the striatum is necessary for the expression of schizophrenic psychopathology, but do not exclude the possibility that increased transmission may occur at other dopaminergic sites in the brain, for example the nucleus accumbens, tuberculum olfactorium or cerebral cortex. Similarly the dopamine receptor blockade hypothesis of the therapeutic effects of neuroleptic drugs cannot be maintained with respect to an action in the striatum in view of the differences between the actions of thioridazine and chlorpromazine in this structure, but may be tenable for actions at extra-striatal sites.
Phenothiazines and other neuroleptic drugs are known to cause extrapyramidal side-effects. Consequently antiparkinsonian (AP) drugs are commonly prescribed at the same time as antipsychotic medication in order to prevent these complications. Once this medication has been started it may be continued for prolonged periods.
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