- MeSH
- Antidepressive Agents pharmacology therapeutic use MeSH
- Antipsychotic Agents pharmacokinetics pharmacology adverse effects MeSH
- Depressive Disorder drug therapy complications MeSH
- Flupenthixol administration & dosage adverse effects MeSH
- Middle Aged MeSH
- Humans MeSH
- Neuroleptic Malignant Syndrome diagnosis etiology drug therapy MeSH
- Parkinson Disease * diagnosis drug therapy complications MeSH
- Parkinsonian Disorders * etiology drug therapy complications MeSH
- Psychotic Disorders drug therapy complications MeSH
- Quetiapine Fumarate pharmacology MeSH
- Anxiety Disorders drug therapy complications MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Antipsychotic Agents administration & dosage therapeutic use MeSH
- Bipolar Disorder * drug therapy complications MeSH
- Diagnosis, Differential MeSH
- Adult MeSH
- Flupenthixol pharmacokinetics adverse effects MeSH
- Delayed-Action Preparations pharmacokinetics adverse effects MeSH
- Humans MeSH
- Akathisia, Drug-Induced * etiology physiopathology prevention & control MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
V článku je diskutován význam edukace pacientů se schizofrenií a jejich rodinných příslušníků při zahájení terapie a v průběhu udržovací léčby dlouhodobě působícími injekčními antipsychotiky. Předně je důležité vybrat vhodnou subpopulaci pacientů pro tento způsob léčby. Edukaci by měl provádět zkušený profesionál, který má sám k této léčbě pozitivní postoj. V průběhu diskuze je třeba s pacienty a jejich rodinnými příslušníky probrat výhody (ale také nevýhody) terapie dlouhodobě působícími injekčními antipsychotiky spíše než se zaměřit jen na způsob aplikace. Edukovat je vhodné i další členy terapeutického týmu. V edukaci je třeba pokračovat po celou dobu léčby, protože jedině tak lze dosáhnout lepších a stabilnějších výsledků celé terapie.
The article discusses the importance of education aimed to patients with schizophrenia and their family members during the initiation and during the course of maintenance treatment with long-acting injectable antipsychotics. It is very important to choose the optimal subpopulation of patients for this type of treatment. Education should be led by experienced professional with positive attitude to this treatment. It is necessary to discuss with patients and their family members the advantages (and disadvantages) of treatment with long-acting injectable antipsychotics rather than only injection procedure. Education is needed for other staff members too. The continuation of education is necessary during the whole course of treatment because only this procedure can provide better and more stable treatment outcome.
- MeSH
- Antipsychotic Agents administration & dosage therapeutic use MeSH
- Fluphenazine administration & dosage pharmacology MeSH
- Flupenthixol administration & dosage pharmacology MeSH
- Haloperidol administration & dosage pharmacology MeSH
- Injections MeSH
- Clopenthixol administration & dosage pharmacology MeSH
- Delayed-Action Preparations MeSH
- Humans MeSH
- Olanzapine administration & dosage pharmacology therapeutic use MeSH
- Risperidone analogs & derivatives administration & dosage pharmacology MeSH
- Schizophrenia * drug therapy MeSH
- Maintenance Chemotherapy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
Článek shrnuje základní údaje o dlouhodobě působících neboli depotních antipsychoticích, která jsou v současnosti dostupná v České republice. Jedná se o čtyři antipsychotika I. generace (flufenazin, flupentixol, haloperidol a zuklopentixol) a čtyři antipsychotika II. generace (aripiprazol, olanzapin, risperidon a paliperidon). Zaměřuje se zejména na zahájení léčby a dávkování. Diskutovány jsou rovněž i základní výhody a nevýhody depotní formy, její účinnost v prevenci relapsu a riziko nežádoucích účinků ve srovnání s perorální formou antipsychotik.
The article summarizes basic data concerning long-acting injectable or depot antipsychotics, which are currently available in theCzech Republic. They include four first generation antipsychotics (fluphenazine, flupenthixol, haloperidol and zucklopenthixol)and four second generation antipsychotics (aripiprazole, olanzapine, risperidone and paliperidone). It focuses especially on thetreatment initiation and dosage regimen. Basic advantages and disadvantages of depot formulation are discussed as well as itsefficacy in the prevention of relapse and the risk of adverse-events compared to oral formulation of antipsychotics.
- MeSH
- Treatment Adherence and Compliance MeSH
- Dopamine Antagonists administration & dosage pharmacokinetics pharmacology MeSH
- Antipsychotic Agents * administration & dosage pharmacokinetics pharmacology MeSH
- Aripiprazole administration & dosage pharmacokinetics pharmacology MeSH
- Benzodiazepines administration & dosage pharmacokinetics pharmacology MeSH
- Fluphenazine administration & dosage pharmacokinetics pharmacology MeSH
- Flupenthixol administration & dosage pharmacokinetics pharmacology MeSH
- Haloperidol administration & dosage pharmacokinetics pharmacology MeSH
- Injections, Intramuscular MeSH
- Delayed-Action Preparations MeSH
- Humans MeSH
- Risperidone analogs & derivatives administration & dosage pharmacokinetics pharmacology MeSH
- Schizophrenia Spectrum and Other Psychotic Disorders drug therapy MeSH
- Maintenance Chemotherapy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
Článek shrnuje základní údaje o dlouhodobě působících neboli depotních antipsychoticích, která jsou v současnosti dostupná v České republice. Jedná se o čtyři antipsychotika I. generace (flufenazin, flupentixol, haloperidol a zuklopentixol) a čtyři antipsychotika II. generace (aripiprazol, olanzapin, risperidon a paliperidon). Zaměřuje se zejména na zahájení léčby a dávkování. Diskutovány jsou rovněž i základní výhody a nevýhody depotní formy, její účinnost v prevenci relapsu a riziko nežádoucích účinků ve srovnání s perorální formou antipsychotik.
The article summarizes basic data concerning long-acting injectable or depot antipsychotics, which are currently available in the Czech Republic. They include four first generation antipsychotics (fluphenazine, flupenthixol, haloperidol and zucklopenthixol) and four second generation antipsychotics (aripiprazole, olanzapine, risperidone and paliperidone). It focuses especially on the treatment initiation and dosage regimen. Basic advantages and disadvantages of depot formulation are discussed as well as its efficacy in the prevention of relapse and the risk of adverse-events compared to oral formulation of antipsychotics.
- Keywords
- zuklopentixol, postinjekční syndrom,
- MeSH
- Patient Compliance MeSH
- Antipsychotic Agents * administration & dosage pharmacology classification blood adverse effects MeSH
- Administration, Oral MeSH
- Aripiprazole administration & dosage pharmacology MeSH
- Fluphenazine administration & dosage pharmacology blood adverse effects MeSH
- Flupenthixol administration & dosage pharmacology adverse effects MeSH
- Haloperidol administration & dosage pharmacology blood adverse effects MeSH
- Injections MeSH
- Delayed-Action Preparations * administration & dosage pharmacology classification adverse effects MeSH
- Humans MeSH
- Meta-Analysis as Topic MeSH
- Olanzapine administration & dosage pharmacology adverse effects MeSH
- Paliperidone Palmitate administration & dosage pharmacology MeSH
- Recurrence MeSH
- Risperidone administration & dosage pharmacology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
Herein, we present a case of 53-year-old psychotic woman with acute esophageal necrosis (black esophagus), who was found lying on the floor in the living room of her flat. Pillboxes of antipsychotic drugs were located in the bin. External examination of the body was unremarkable. On internal examination, we found acute esophageal necrosis. Histologically, there was complete epithelial necrosis with focal involvement of muscularis mucosae, dense infiltrate of leukocytes, and ulcerations without any viable cells. There was no evidence of underlying organic diseases or trauma. Toxicological analysis revealed a fatal blood level of antipsychotics (haloperidol, zotepine, and chlorprothixene). Death of the deceased was attributed to fatal intoxication with three various types of antipsychotics. As far we know, this is the first described association between so-called black esophagus and fatal blood level of neuroleptics.
- MeSH
- Antipsychotic Agents blood poisoning MeSH
- Chlorprothixene blood poisoning MeSH
- Dibenzothiepins blood poisoning MeSH
- Esophagus pathology MeSH
- Haloperidol blood poisoning MeSH
- Middle Aged MeSH
- Humans MeSH
- Necrosis chemically induced pathology MeSH
- Mucous Membrane pathology MeSH
- Forensic Pathology MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
- MeSH
- Chlorprothixene administration & dosage MeSH
- Humans MeSH
- Obsessive-Compulsive Disorder diagnosis drug therapy MeSH
- Paroxetine administration & dosage MeSH
- Psychophysiologic Disorders diagnosis drug therapy MeSH
- Anxiety Disorders diagnosis drug therapy MeSH
- Check Tag
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Vodítka vydaná různými psychiatrickými společnostmi doporučují nově vyvinutá antipsychotika (tzv. atypická či 2. generace) jako léky první linie pro léčbu psychóz schizofrenního okruhu. Tato studie zpětně analyzuje dekurzové záznamy 355 pacientů hospitalizovaných se schizofrenií v oblastní nemocnici v r. 2001. Polovina z nich byla léčena klasickými neuroleptiky, polovina antipsychotiky 2. generace. Cílem bylo zjistit, zda se mezi sebou liší co do účinnosti a snášenlivosti (ukazatelem byl v tomto případě počet pacientů propuštěných do ambulance bez předchozí změny medikace pro neúčinnost nebo nežádoucí účinky), klinickým zlepšením či délkou pobytu. Nenalezli jsme žádné statisticky významné rozdíly mezi oběma skupinami. Rada kontrolovaných studií vybraných pacientů ukázala, že „atypická" antipsychotika jsou účinnější a lépe snášena, což opodstatňuje jejich užití u schizofrenních nemocných v první volbě. Naše šetření každodenní klinické praxe tyto závěry nepotvrzuje.
The guidelines issued by different psychiatric associations recommend newly developed (“atypical” or 2nd generation) antipsycho - tics as first-line medication for the neuroleptic treatment of schizophrenic psychoses. This study retrospectively analyzed the medical records of 355 inpatients treated for schizophrenic psychoses at a Regional District Hospital in 2001. Half of the patients wer e treated with “typical” and half with “atypical“ neuroleptics. The objective was to establish whether they differed with regard to effic acy and tolerability (measured by the number of patients discharge as outpatients without any change in antipsychotic medication due to lack of efficacy or side effects), clinical improvement, and duration of stay. No statistically significant differences between trea tment groups were found. Controlled studies in selected patients have been reported to show that „atypical“ neuroleptics have advantages wit h regard to efficacy and tolerability, justifying their use as “first-line” medication in schizophrenic patients. Our investigation in e veryday clinical practice did not confirm these results.
- MeSH
- Antipsychotic Agents classification therapeutic use MeSH
- Financing, Organized MeSH
- Flupenthixol administration & dosage therapeutic use MeSH
- Haloperidol administration & dosage therapeutic use MeSH
- Clozapine administration & dosage therapeutic use MeSH
- Humans MeSH
- Retrospective Studies MeSH
- Risperidone administration & dosage therapeutic use MeSH
- Schizophrenia drug therapy MeSH
- Statistics as Topic MeSH
- Check Tag
- Humans MeSH
- MeSH
- Antipsychotic Agents administration & dosage therapeutic use MeSH
- Chlorpromazine therapeutic use MeSH
- Chlorprothixene therapeutic use MeSH
- Adult MeSH
- Humans MeSH
- Perphenazine therapeutic use MeSH
- Risperidone therapeutic use MeSH
- Schizophrenia diagnosis etiology drug therapy MeSH
- Sulpiride administration & dosage adverse effects therapeutic use MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- Keywords
- VIREGIT K, AKINETON, BISTON,
- MeSH
- Dopamine Agonists therapeutic use MeSH
- Antipsychotic Agents adverse effects therapeutic use MeSH
- Benzodiazepines therapeutic use MeSH
- Chlorprothixene blood adverse effects therapeutic use MeSH
- Cholinergic Agonists therapeutic use MeSH
- Dantrolene MeSH
- Child MeSH
- Humans MeSH
- Neuroleptic Malignant Syndrome diagnosis etiology therapy MeSH
- Risk Factors MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- Review MeSH
