A study was carried out of 30 consecutive patients with withdrawal psychosis who in the period 1972 to 1975 were admitted to a psychiatric department or were attended by the department while hospitalized in a somatic department. There was a clear majority of women among cases of psychosis following drug withdrawal (15 as against four) and a clear majority of men among cases of psychosis following alcohol withdrawal (nine as against two). Competing pathogenetic factors could be considered present in most cases in the last mentioned group. In most cases the abrupt cessation took place in conjunction with admission to hospital, most frequently surgical cases or cases of acute drug toxication. In other cases abrupt cessation was decided upon by the patient himself. Frequently predelirium treatment was either omitted or was given in the form of neuroleptics. Approximately a quarter of the patients initially denied their abuse. The study indicates that withdrawal psychosis can make its debut or become manifest at so late a stage as about the 14th day of the withdrawal phase following use of benzodiazepines and d-propoxiphene. It is further indicated that abrupt cessation of benzodiazepines taken in "therapeutic" doses for several years in some instances can give rise to a withdrawal psychosis.
This article sketches the planning of psychotherapy as a treatment for neurotic excoriations (NE). The program is developed on the basis of information collected in an investigation of 63 consecutive, first-time referrals of NE patients to a dermatology department, and the findings from a follow-up after 1 to 5 years. The offer of social advice and support, but not psychotherapy, was included in the investigation program. At the time of follow-up, NE had healed for 13 of the 63 patients. The information gathered indicates that a treatment model should be eclectic in form so as to allow for individual variances in, for example, age, intelligence level, and motivation for psychiatric intervention.
A comparison of loxapine and haloperidol parenterally in acute psychotic, agitated patients was carried out as a randomized double‐blind trial. The trial covered 15 patients in each group, and the diagnoses were psychogenic psychosis (18 cases) and acute schizophrenia (12 cases). The patients received 25–50 mg loxapine or 2.5–5 mg haloperidol combined with biperiden 2.5–5 mg every 6–12 hours over a 72‐hour period. The average daily dose was 130 mg loxapine or 12 mg haloperidol. Sedation, agitation/excitement and aggressive behavior were scored prior to treatment and at specified time intervals after the first two injections. As far as sedation is concerned a significantly stronger effect and a more rapid onset of action were seen in the loxapine group when compared with the haloperidol group. The differences were most accentuated in cases of acute schizophrenia. Furthermore there was a tendency to a better control of agitation/excitement and aggression in the loxapine group. Scores on Brief Psychiatric Rating Scale and Clinical Global Impression scale showed no significant differences between the two groups. In spite of prophylactic treatment with biperiden, seven of 15 patients in the haloperidol group experienced extrapyramidal side effects. The most frequent side effect in the loxapine group was atypical dizziness. Loxapine i.m. appears to be a valuable drug in cases of acute psychosis where strong sedation as well as strong antipsychotic effect are necessary for behavioral control.
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