RESUMEN
Two typical recurrent episodes of neuroleptic malignant syndrome (NMS) in the same patient are described. The first episode was caused by a sulpiride derivative, tiapride. This is the first case in which a drug of the benzamide group has been reported to have caused such adverse drug reaction. In the second episode, NMS occurred due to haloperidol in the lowest dose ever reported and was accompanied by highly excessive levels of various muscle enzymes. Involvement of hypothalamic and striatal dopamine system, and particularly of D-2 subtype receptors, is suggested by this case.
Asunto(s)
Enfermedades de los Ganglios Basales/etiología , Benzamidas/efectos adversos , Haloperidol/efectos adversos , Síndrome Neuroléptico Maligno/etiología , Receptores Dopaminérgicos/efectos de los fármacos , Clorhidrato de Tiapamilo/efectos adversos , Ganglios Basales/efectos de los fármacos , Ganglios Basales/fisiopatología , Relación Dosis-Respuesta a Droga , Femenino , Haloperidol/administración & dosificación , Humanos , Hipotálamo/efectos de los fármacos , Hipotálamo/fisiopatología , Persona de Mediana Edad , Síndrome Neuroléptico Maligno/fisiopatología , Receptores Dopaminérgicos/fisiología , Receptores de Dopamina D2 , Recurrencia , Esquizofrenia Paranoide/tratamiento farmacológico , Esquizofrenia Paranoide/psicología , Clorhidrato de Tiapamilo/administración & dosificaciónRESUMEN
In psychosomatic medicine the indication of tiapridal may appear incomplete if it is based only on symptoms. This study takes into account certain psychopathological tendancies of the patient which are always present in a more or less attenuated form. Numerous psychosomatic manifestations are thus found to be episodic expressions of minor depression or moderate psychoneurotic disorders. Tiapridal is remarkably effective in resolving these symptoms.
Asunto(s)
Benzamidas/uso terapéutico , Trastornos Psicofisiológicos/tratamiento farmacológico , Clorhidrato de Tiapamilo/uso terapéutico , Adulto , Anciano , Ensayos Clínicos como Asunto , Quimioterapia Combinada , Femenino , Humanos , Masculino , Persona de Mediana Edad , Clorhidrato de Tiapamilo/efectos adversosRESUMEN
Two groups of medically comparable patients at the Pelgrim Centre were used to study the use of tiapridal in alcoholic detoxication. The first group of nearly 450 patients were treated with traditional medication between 1973 and mid-1976, and second group of some 540 subjects displaying somato-dependency were treated with tiapridal between mid-1976 and mid-1979. 40 % of the latter group required IM injections, but 4 tablets per day were sufficient for the remainder, with Nootropil and benzodiazepine soporifics where necessary ; medication was discontinued when symptoms disappeared (after 1 week in 40 % of the cases). Tiapridal was found to be especially useful for the 9.9 % who had a history of delirium tremens, and for sub-acute alcoholic delirium, the average stay due to this being reduced from 4 to 3 days and the incidence decrease from 7,8 to 1,4 %. There was also a great reduction in gastro-intestinal disorders and general physical craving. However, it was found that tiapridal increased the incidence of all forms of epilepsy by alcohol deprivation from 3.18 to 4.19, and detoxication epilepsy increased from 0.58 to 1.47, therefore anti-epileptic medication is indicated in many cases. On the whole, general recovery was smoother and quicker and tiapridal was highly satisfactory.