Assuntos
Encéfalo/diagnóstico por imagem , Encéfalo/metabolismo , Transtorno Depressivo Maior/metabolismo , Transtorno Depressivo Maior/terapia , Psicoterapia/métodos , Receptores 5-HT1 de Serotonina/metabolismo , Adulto , Análise de Variância , Antidepressivos de Segunda Geração/uso terapêutico , Encéfalo/efeitos dos fármacos , Química Encefálica/efeitos dos fármacos , Feminino , Finlândia , Fluoxetina/uso terapêutico , Humanos , Imageamento Tridimensional/métodos , Masculino , Tomografia por Emissão de Pósitrons/métodos , Receptores 5-HT1 de Serotonina/efeitos dos fármacosRESUMO
Three-channel actometry was used to study neuroleptic-induced akathisia (NIA), a common and often serious disorder in association of traditional neuroleptic therapy. The aim was to explore the diagnostic possibilities of actometry in NIA and to examine in detail the motor phenomenology of the disorder in detail. The actometers were attached to the ankles and waists of ten patients, suffering from NIA, and to ten matched healthy controls. Five of the patients were changed to olanzapine treatment, and these patients were re-examined during the no-NIA condition. NIA was associated with manyfold movement activity during controlled rest (sitting) but not with increased daily overall motor activity. Movement frequencies in NIA seemed to be pathognomonic. Actometry is promising for investigation and clinical assessment of NIA. Olanzapine proved to be an adequate treatment choice for NIA patients.
Assuntos
Acatisia Induzida por Medicamentos/diagnóstico , Acatisia Induzida por Medicamentos/fisiopatologia , Antipsicóticos/efeitos adversos , Atividade Motora/efeitos dos fármacos , Adulto , Benzodiazepinas , Estudos de Casos e Controles , Diagnóstico Diferencial , Feminino , Humanos , Quimografia , Masculino , Pessoa de Meia-Idade , Olanzapina , Pirenzepina/efeitos adversos , Pirenzepina/análogos & derivados , Agitação Psicomotora/diagnóstico , Agitação Psicomotora/fisiopatologia , Índice de Gravidade de DoençaRESUMO
BACKGROUND: Tramadol is a central analgesic that seems to have fewer side effects and a lower abuse potential than classical opioids. Since the treatment of restless legs syndrome (RLS) with levodopa or classical opioids is problematic, new treatment possibilities would be valuable. METHOD: We treated 12 patients who fulfilled at least the minimal diagnostic criteria proposed by the International Restless Legs Syndrome Study Group as well as the criteria proposed by Gibb and Lees, some of them treatment resistant or prone to side effects of previous medications, with 50 to 150 mg of tramadol per day in an open study. The follow-up lasted from 15 to 24 months. RESULTS: Ten patients reported clear amelioration and 1 reported slight amelioration of their symptoms, while 1 reported no effect. Tramadol was described to be the most effective treatment and free of side effects when compared with several other treatments. No major tolerance against treatment effect emerged among those who needed only a single evening dose. CONCLUSION: Compared with other treatments for RLS, tramadol seems to be superior in some cases, possibly because of its unique pharmacodynamic profile. Controlled studies are needed. Meanwhile, we believe that tramadol should be considered before other opioids are prescribed. We recommend intermittent treatment and careful monitoring.
Assuntos
Analgésicos Opioides/uso terapêutico , Síndrome das Pernas Inquietas/tratamento farmacológico , Tramadol/uso terapêutico , Adulto , Idoso , Esquema de Medicação , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
Six cases of restless legs syndrome in association to mianserin are presented. Similarities and differences to previously reported cases are described. Some theoretical and methodological topics on restless legs syndrome in relation to drug-induced akathisia are discussed.
Assuntos
Antidepressivos de Segunda Geração/efeitos adversos , Mianserina/efeitos adversos , Síndrome das Pernas Inquietas/induzido quimicamente , Adulto , Idoso , Braço/fisiopatologia , Feminino , Humanos , Perna (Membro)/fisiopatologia , Masculino , Pessoa de Meia-Idade , Síndrome das Pernas Inquietas/fisiopatologia , Sono/fisiologiaRESUMO
Conceptions among the general public in Finland regarding the etiology and prevention of dental caries and periodontal disorders were surveyed in two interviews in 1971 and 1972. Both population samples interviewed comprised about 1,000 people aged 15 years and over. Inadequate oral hygiene was the most common (65%) possible cause chosen by the subjects among the causes of dental caries. Only 44% of the interviewees considered sugar to be a cause of cariers. Thorough cleaning of the teeth (83%) and dentist's check-ups twice a year (67%) were the factors most frequently chosen in caries prevention. Avoidance of sugar (56%) ranked as the third in frequency. As regards symptoms of periodontal disorders, tender gingiva, gingival bleeding, and loosening of the teeth were correctly suggested as symptoms by 62, 61 and 45%, respectively. Poor oral hygiene (77%) was the cause of gingivitis most commonly chosen by the interviewees, while simultaneous systemic disease (37%) was considered more important than, for example, dental calculus (31%). As regards treatment of periodontal disorders, careful toothcleaning (73%) received most support. However, this factor was closely followed by misconceptions regarding the supposed advantageous value of drug and rinses (50%), chewing of fibrous foods (45%), and vitamin therapy (38%).
