Insulin and Chlorpromazine in Schizophrenia: A Ten Year Comparative Survey

Markowe, Morris; Steinert, J.; Heyworth-Davis, Freda

doi:10.1192/bjp.113.503.1101

Cited by 28 publications

(4 citation statements)

References 5 publications

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“…1982;Biehlet al 1986) and because of the increased morbidity and effect on outcome which may be attributable to the interaction. Markowe et al (1967) found the rate of suicide in schizophrenics to be almost fifty times that reported for the normal population. Markowe et al (1967) found the rate of suicide in schizophrenics to be almost fifty times that reported for the normal population.…”

Section: Depressive Disorder and Schizophreniamentioning

confidence: 86%

The natural history of schizophrenia: a five-year follow-up study of outcome and prediction in a representative sample of schizophrenics

Shepherd¹,

Watt²,

Falloon³

et al. 1989

Psychol. Med. Monogr. Suppl.

261

136

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Longitudinal studies of schizophrenia based on at least 70 subjects and a minimum five-year follow-up period are reviewed in respect of the requirements of adequate method. A cohort of 121, PSE-diagnosed, schizophrenic admissions from a defined population was identified. The sex-distribution of the subjects was almost equal. Forty per cent were first admissions; 65% of the men and 24% women were unmarried; the mean age of onset for men was 28.6 years, for women 33.2 years. Almost half (48%) were continuously employed (including house and child care) for 2 years prior to admissions. First rank symptoms of schizophrenia were present in 79% of the men and 86% of the women. Comprehensive, standardized assessments of clinical state and social function were made on discharge from hospital and at follow-up by home interview of patient and relative(s). Outcome was also assessed by duration and frequency of readmission and by duration of employment. First admissions were analysed separately from the whole cohort. There were 49 first admissions generating an incidence of 7.4 per 100,000 general population per annum. Sixty-nine per cent of men and 13% of women were unmarried. The mean age of admission for men was 30.8 years, women 40.3 years and the mean age of onset 30.7 and 38.6 respectively. After 5 years first rank symptoms were present in 46% of the males and 35% of the females. The proportion showing depressive symptoms fell from 39% at intake to 22% at five years. In terms of a combination of symptoms and readmissions there was a good outcome in 50% of men and 65% of women, a trend comparable to that found in the whole cohort. For the whole cohort a combination of the number of symptoms and admissions disclosed a good outcome for 48%. The mean total duration of readmissions during the five years for men was 76 weeks and for women 27 weeks. Depressive symptoms were present in 38% at intake and 21% after 5 years. An overall rating of social functioning at 5 years showed no more than mild impairment for 47% of men and 74% of women, although individual items were more impaired. However, 38% of the group showed no more than mild impairment in any aspect of social functioning rated. Clinical and social outcome were, in general, closely correlated. The difference in outcome between men and women and the relations between clinical and social outcome are discussed. By means of an application of measures of association between independent and dependent variables to the onset data the clinical and social categories of pathology and impairment at 5 years were forecast.(ABSTRACT TRUNCATED AT 400 WORDS)

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Section: Depressive Disorder and Schizophreniamentioning

confidence: 86%

The natural history of schizophrenia: a five-year follow-up study of outcome and prediction in a representative sample of schizophrenics

Shepherd¹,

Watt²,

Falloon³

et al. 1989

Psychol. Med. Monogr. Suppl.

261

136

View full text Add to dashboard Cite

show abstract

“…Schizophrenia in itself carries some risk of suicide (Fremming, 1951 ;Helgason, 1964;Markowe et al, 1967) and this risk will be greater if the patient is misdiagnosed as schizophrenia when in fact he is suffering from a depressive illness. Extra care should be taken, therefore, when administering a drug with a potential mood-depressant effect to a patient already at risk.…”

Section: Discussionmentioning

confidence: 99%

Severe Depressive Mood Changes Following Slow-release Intramuscular Fluphenazine Injection

Alarcón¹,

Carney²

1969

BMJ

147

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“…The earliest classes of antidepressant medications, which dominated the clinical landscape from the 1950s through the 1970s, were discovered serendipitously . Tricyclic antidepressants (TCAs) were developed in the 1950s in the wake of the discovery that chlorpromazine 16 , derived from early synthetic antihistamines, acted as an antipsychotic agent (Figure ). ,,− This breakthrough led to the synthesis and pharmacological evaluation of other analogues of 16 , such as imipramine 17 , the first TCA to be developed. − Numerous efforts followed the development of 17 , including the introduction of amitriptyline 18 by Merck in 1961. − For many years, TCAs were the standard of care for depression. , It was later discovered that TCAs exert their antidepressant affects by blocking both the serotonin transporter (SERT) and the norepinephrine transporter (NET), increasing extracellular concentrations of serotonin 19 and norepinephrine 20 , with little effect on dopamine (DA) 21 . − ,− However, TCAs have promiscuous pharmacology, with agonist or antagonist activity at multiple muscarinic, adrenergic, histamine, serotonin, and NMDA receptor subtypes, which engender significant adverse effects (e.g., agitation, dry mouth, and seizure). ,, Moreover, TCAs are potent inhibitors of L-type calcium and sodium channels, leading to potentially lethal hypertension and arrhythmias . Thus, TCA overdose is often fatal, which limits the use of these compounds in a patient population which is at risk for suicidal behavior.…”

Section: History and Importance In Neurosciencementioning

confidence: 99%

Classics in Chemical Neuroscience: Fluoxetine (Prozac)

Wenthur

Bennett

Lindsley

2013

ACS Chem. Neurosci.

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Fluoxetine (Prozac) was the first major breakthrough for the treatment of depression since the introduction of tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) nearly 30 years earlier. It was the first selective serotonin reuptake inhibitor (SSRI) approved by the United States Food and Drug Administration, offering superior efficacy and reduced side effects relative to TCAs and MAOIs. Though a debate remains regarding the exact mechanism by which the clinical efficacy of fluoxetine is manifested, the importance of fluoxetine and related SSRIs to the field is unquestionable. The trade name Prozac has permeated popular culture, helping to raise awareness of depression and to diminish the prevalence of long-standing stigmas associated with this illness. In this Review, we will showcase the history and importance of fluoxetine to neuroscience in general, as well as for the treatment of depression, and review the synthesis, pharmacology, drug metabolism, and adverse effects of fluoxetine.

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Insulin and Chlorpromazine in Schizophrenia: A Ten Year Comparative Survey

Abstract: It is now just over a decade since chlorpromazine came into general use in psychiatry. Insulin coma treatment is no longer popular in the treatment of schizophrenia, yet no long-term comparative evaluation has been carried out.

Cited by 28 publications

References 5 publications

The natural history of schizophrenia: a five-year follow-up study of outcome and prediction in a representative sample of schizophrenics

The natural history of schizophrenia: a five-year follow-up study of outcome and prediction in a representative sample of schizophrenics

Severe Depressive Mood Changes Following Slow-release Intramuscular Fluphenazine Injection

Classics in Chemical Neuroscience: Fluoxetine (Prozac)

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