Assessment of Drug Therapy in Parkinsonism

Onuaguluchi, G

doi:10.1136/bmj.1.5328.443

Cited by 10 publications

(7 citation statements)

References 14 publications

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“…In addition to scopolamine, two other muscarinic receptor antagonists, orphenadrine and its major metabolite, tofenacine, have also been reported to exhibit an antidepressant effect [99][100][101]. Orphenadrine is beneficial in treating multiple symptoms of Parkinsonism.…”

Section: Muscarinic Receptor Antagonistsmentioning

confidence: 99%

Treating Anxiety with either Beta Blockers or Antiemetic Antimuscarinic Drugs: A Review

Dooley¹

2015

Ment Health Fam Med

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Beta adrenergic receptor antagonists and antiemetic muscarinic receptor antagonists are useful for mental health in primary care and family medicine settings, as they provide favorable risk/benefit profiles, and especially so relative to benzodiazepines. Beta blockers (e.g., propranolol) prescribed off-label have been known for decades to provide some, albeit limited, anxiolytic benefit for patients affected by social anxiety disorder (social phobia), including performance anxiety. Blockage of adrenaline's binding to cardiovascular beta adrenergic receptors inhibits tachycardia, reduces blood pressure, and thus diminishes palpitations in acute anxiety and panic. However, beta blockers are not effective against the psychic (CNS) symptoms, such as anxiousness, fear, and avoidance. Another approach involves antiemetic muscarinic receptor antagonists that are available by prescription (e.g., scopolamine) or over-the-counter (e.g., meclizine) for the treatment of non-cardiovascular symptoms that manifest in anxiety disorders. Antiemetic agents inhibit nausea, vomiting, sweating, and in some instances other psychic (CNS) symptoms. The symptoms affected by antimuscarinic agents represent the "inverse" of the symptoms of acute anxiety affected by beta blockers. Thus, anxiety disorders can be treated by alternative biochemical pathways, as well as by affecting alternative symptoms thereof. The results of human clinical studies are summarized for both classes of anxiolytic agents that display complementary pharmacologic approaches to a diverse array of symptoms.

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Section: Muscarinic Receptor Antagonistsmentioning

confidence: 99%

Treating Anxiety with either Beta Blockers or Antiemetic Antimuscarinic Drugs: A Review

Dooley¹

2015

Ment Health Fam Med

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“…However, in the writer's experience, items such as 'arm dropping', 'leg pendulousness' and 'shoulder shaking' are difficult to rate in practice, especially in the face of variable co-operation by the patient. Others have tried to tackle the problem of assessment by including in their scales certain objective performance tests such as a timed walk, inflation of sphygmomanometer cuff, manipulating beads and tapping a stylus (Mindham, Gaind, Anstee & Rimmer, 1972;Simpson, Amuso, Blair & Farkas, 1964;Horne, 1973;Onuaguluchi, 1964;Mindham, 1976). Various tests of handwriting have been claimed to be particularly sensitive to extrapyramidal disorder and have the virtue of ease of administration.…”

Section: Assessing Extra-pyramidal Complicationsmentioning

confidence: 99%

Assessment of Anti-Psychotic Drugs

Mackay¹

1981

Methods in Clinical Pharmacology—Central Nervous System

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“…The role of emotion in precipitating such attacks has been observed by various workers. Onuaguluchi (18) states that a "distinction is made between the initial phase and the latter stage of recurring crisis. The initial or first crisis is not a direct result of an emotional upset or mental trauma, but due to some form of vestibular stimulation."…”

Section: Introductionmentioning

confidence: 99%

“…We have, however, described a placebo response in the investigation of drugs for the treatment of parkinsonism (see page 44). The role of suggestion in the precipitation of oculogyric crises in post-encephalitic parkinsonism has been well documented ( 18). It is possible that the first experience is organically determined, but that once the reaction has taken place psychological events may precipitate its recurrence.…”

Section: Introductionmentioning

confidence: 99%