A population-based case-control teratologic study of nitrazepam, medazepam, tofisopam, alprazolum and clonazepam treatment during pregnancy.

OBJECTIVE: To study the association between nitrazepam, medazepam, tofisopam, alprazolum and clonazepam treatments during pregnancy and prevalence of different congenital abnormalities (CAs). MATERIALS AND METHODS: A matched case-control study using cases with CAs and population controls from the dataset of the nationwide Hungarian Case-Control Surveillance of Congenital Abnormalities (HCCSCA), 1980-1996. RESULTS: Of 38,151 pregnant women who had babies without any defects (population control group), 75 (0.20%) were treated with these five benzodiazepines during pregnancy. Of 22,865 pregnant women who delivered offspring with CAs, 57 (0.25%) had benzodiazepine treatment. The occurrence of five benzodiazepine treatments during the second and third months of gestation, i.e. in the critical period for most major CAs did not show significant differences in matched case-control pairs. CONCLUSION: Treatment with five benzodiazepines studied during pregnancy did not present detectable teratogenic risk to the fetus in humans but the amount of information was limited for different CAs.

Agorafobia simple y agorafobia compleja: estudio de tres casos / Simple agoraphobia and complex agoraphobia: study of three cases

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Psychological stress and cardiovascular diseases.

Mental stress may directly influence coronary heart disease (CHD) and also a number of its etiologic risk factors. Research work carried out by the Psychopharmacology Research Group in the United Kingdom indicates that antianxiety drugs may have an application in the management of the stress factors influencing CHD. In one study there was a significant reduction in the glyceryl trinitrate requirements of patients treated with a tranquilizer, but this result was not confirmed in two other studies. However, out of a total of 77 patients treated with a placebo, there were five cases of myocardial infarction during the trial periods as compared to no such cases among 81 patients treated with the antianxiety drugs.

[Acute acoustic trauma. The therapeutic effect of bencyclan in a controlled clinical trial (author's transl)]. / Akutes akustisches Trauma: Die therapeutische Wirksamkeit von Bencyclan im kontrollierten klinischen Vergleich.

In a retrospective study 103 patients with acute acoustic trauma (AAT) were investigated. The control group (53 patients) was treated with Dextran 40 (10% solution), neurotrop vitamins and Betahistin. Bencyclan was administered additionally in the test group (50 patients). Statistical analysis of the audiometric data showed the following results: 1. Mean hearing levels of the test group showed better improvement of threshold shifts, if the therapy started within 2 days or after more than 10 days after the AAT. 2. Regression-and correlation coefficients, however, in a regression analysis of absolute hearing gains and hearing losses before therapy, did not indicate a substantial effect of Bencyclan. 3. Neither did statistical tests with relative hearing gains show any significant differences between test-and control groups. Consequently Bencyclan is not likely to have a positive effect in AAT, if it is administered in the above mentioned way.

[Hemorrhagic rectocolitis. Attempt at programmed therapy]. / Retto colite emorragica. Tentativo di terapia programmata.

Planned treatment of 30 cases of haemorrhagic colitis is reported. Its protocol included salazopyrine and benzodiazepine per os, salazopyrine and prednisone per rectum, and parenteral ACTH depot. Administration for 60 days brought good results in cases of slight or average severity. Recurrences, albeit less severe, were not prevented, however. Attention is drawn to the need to follow up this group of patients for a longer period. Even so, it is felt that the effect of this form of treatment is primarily symptomatic.

[Inhibitory processes in the cerebral cortex and the anticonvulsive action of benzodiazepine derivatives]. / Protsessy tormozheniia v kore golovnogo mozga i protivosudorozhnoe deistvie benzodiazepinovykh proizvodnykh.

A comparative study of the effect of some benzodiazepine deprivatives (chlonazepam, lorazepam, diazepam, and medazepam) on the recovery cycles of the interzonal response was carried out on unanesthetized curare-immobilized cats. These drugs proved to selectively inhibit the testing potential within the range of 20 to 100 msec. between the conditioning and the testing stimuli. This indicates that potentiation of GABA-ergic inhibition in the cerebral cortex. The threshold doses of the drugs inducing the depression of the test response and of ED50, preventing the development of convulsions, caused by GABA deficiency or by GABA-ergic receptor block, were compared; a correlation between the mentioned effects was demonstrated. The significance of GABA-positive effect of benzodiazepines in the mechanism of their anticonvulsive activity is suggested.

Medazepam and the driving ability of anxious patients.

A double-blind crossover trial of Medazepam was carried out in 14 anxious hospital patients. The mean self-adjusted dosage was 16.5 mg daily. The active drug was no more effective than placebo in relieving anxiety, which was rated both clinically and by the Middlesex Health Questionnaire (M.H.Q.) (Crown and Crisp, 1970). This may have been because the dose was relatively low for chronically anxious hospital patients. Even this dosage caused significantly higher scores on the M.H.Q. scale for depression. Braking and driving simulator tests were not adversely affected by Medazepam. In real driving conditions those taking the drug made significantly more technical, but not dangerous, errors. Pulse and blood pressure also were not affected.

Withdrawal psychosis: a study of 30 consecutive cases.

A study was carried out of 30 consecutive patients with withdrawal psychosis who in the period 1972 to 1975 were admitted to a psychiatric department or were attended by the department while hospitalized in a somatic department. There was a clear majority of women among cases of psychosis following drug withdrawal (15 as against four) and a clear majority of men among cases of psychosis following alcohol withdrawal (nine as against two). Competing pathogenetic factors could be considered present in most cases in the last mentioned group. In most cases the abrupt cessation took place in conjunction with admission to hospital, most frequently surgical cases or cases of acute drug toxication. In other cases abrupt cessation was decided upon by the patient himself. Frequently predelirium treatment was either omitted or was given in the form of neuroleptics. Approximately a quarter of the patients initially denied their abuse. The study indicates that withdrawal psychosis can make its debut or become manifest at so late a stage as about the 14th day of the withdrawal phase following use of benzodiazepines and d-propoxiphene. It is further indicated that abrupt cessation of benzodiazepines taken in "therapeutic" doses for several years in some instances can give rise to a withdrawal psychosis.