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Titolo:
FDA MEDWATCH REPORT - LITHIUM AND NEUROLEPTICS IN COMBINATION - THE SPECTRUM OF NEUROTOXICITY
Autore:
GOLDMAN SA;
Indirizzi:
US FDA,MEDWATCH,HF-2,5600 FISHERS LANE,ROOM 9-57 ROCKVILLE MD 20857
Titolo Testata:
Psychopharmacology bulletin
fascicolo: 3, volume: 32, anno: 1996,
pagine: 299 - 309
SICI:
0048-5764(1996)32:3<299:FMR-LA>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
MALIGNANT SYNDROME; EXTRAPYRAMIDAL SYMPTOMS; CONSECUTIVE INPATIENTS; HALOPERIDOL; FREQUENCY; TOXICITY;
Keywords:
NEUROTOXICITY; NEUROLEPTIC; LITHIUM; DIAGNOSIS; CLASSIFICATION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Physical, Chemical & Earth Sciences
Physical, Chemical & Earth Sciences
Science Citation Index Expanded
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
34
Recensione:
Indirizzi per estratti:
Citazione:
S.A. Goldman, "FDA MEDWATCH REPORT - LITHIUM AND NEUROLEPTICS IN COMBINATION - THE SPECTRUM OF NEUROTOXICITY", Psychopharmacology bulletin, 32(3), 1996, pp. 299-309

Abstract

Classifying neurotoxicity in relation to neuroleptic use has been a longstanding concern with clinical, research, and epidemiologic import. This study examines the clinical manifestations of neurotoxicity and current concepts regarding its classification. The Food and Drug Adminstration (FDA) Spontaneous Reporting System data base and extant literature were reviewed for lithium/neuroleptic neurotoxicity spectrum cases. Lithium-alone (Li), lithium/haloperidol (LIHal), and lithium/non-haloperidol neuroleptics (LiNonHal) groups, each paired for recovery and sequelae, were established for 237 cases. Data on demographic factors, psychiatric diagnosis, and symptoms/signs/findings were tabulated. Neuroleptic malignant syndrome (NMS) was used as a paradigm for severeneurotoxicity; the cases were evaluated by two strict, published setsof NMS diagnostic criteria and two ''probable'' classifications (one published and one established for study) based on these criteria. Altered consciousness was prominent in all groups. Hypertonia/rigidity wasmost pronounced in both LiHal groups, possibly reflecting higher relative neuroleptic dosing; Li and LiNonHal recovery and sequelae pairs showed lower, similar percentages. Among other physical findings, tremor was either most common or prominent, Neither set of strict criteria diagnosed NMS in more than 30 percent of cases in any group. Expansionof classifications to include ''probable'' diagnoses resulted in appreciable global group percentage increases for only one set of criteria. The high percentage of study cases not meeting even ''probable'' NMScriteria, despite marked clinical morbidity that at times resulted inpermanent sequelae, provides a cautionary note regarding the limitations of formulated diagnostic criteria. Data base caveats notwithstanding, study findings support the consideration of a spectrum approach toclassifying and diagnosing psychotropic-related neurotoxicity.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/01/20 alle ore 22:13:21