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The Neurologic Disorders in Film
Published in Eelco F. M. Wijdicks, Neurocinema—The Sequel, 2022
The film suggests that Max’s headaches started at the age of six years, when he was staring at the sun and became “blind”; his headaches are repetitive. In rapid succession, we see crosscuts of Max popping pills, screeching sounds, and hallucinations of moving doors that unlock and open to a bright light. This scene specifically mentions his medications. He uses promazine and sumatriptan followed by dihydroergotamine mesylate by subcutaneous injection. Multiple attacks are shown and include Max banging his head against a mirror to relieve the pain and injecting dihydroergotamine into the skin of his skull. Notable here is the large (nail gun–like) injector that must have been deliberately chosen by the director to add drama. The film shockingly ends with trepanning and drilling a burr hole during a severe headache attack.
Anesthesia and analgesia and the curse of Eve
Published in Michael J. O’Dowd, The History of Medications for Women, 2020
Atarexic (Greek ataraxia, peace of mind) drugs were combined with pethidine by Hayward-Butt (1957 p. 972) and he coined the term ‘ataralgesia’. He used pecazine (pectal), a phenodiiazine derivative, with the intention of combining very effective pain relief while retaining normal physical and mental functions. This appeared to be an ideal situation, especially for obstetric cases, and was in vogue for about 20 years. Promazine (sparine) was another much used ataractic drug. Ataralgesia was overtaken by conduction analgesia and also by the increasing safety of general anesthesia.
Surgical Facilities, Peri-Operative Care, Anesthesia, and Surgical Techniques
Published in Yuehuei H. An, Richard J. Friedman, Animal Models in Orthopaedic Research, 2020
Alison C. Smith, M. Michael Swindle
Tranquilizers are used to sedate animals and to reduce the dosage of general anesthetic agents. They are generally administered 15-30 min. prior to general anesthesia. The phenothiazine derivative tranquilizers are the most common ones used in veterinary anesthesia, in particular, acepro-mazine. Other agents such as promazine and chlorpromazine may induce undesirable side effects in some species. The phenothiazine derivatives are mild a-adrenergic blockers and also cause peripheral vasodilation. Their effects generally last approximately 8-12 hours.11-16
Psychiatric and non-psychiatric drugs causing false-positive amphetamines urine test in psychiatric patients: a pharmacovigilance analysis using FAERS
Published in Expert Review of Clinical Pharmacology, 2023
Vera Battini, Giovanna Cirnigliaro, Luca Giacovelli, Maria Boscacci, Silvia Massara Manzo, Giulia Mosini, Greta Guarnieri, Michele Gringeri, Beatrice Benatti, Emilio Clementi, Bernardo Dell’Osso, Carla Carnovale
Many psychoactive drugs, ranging from antidepressants to antipsychotics, were listed as a cause for false-positive results, such as bupropion [52], trazodone [43], atomoxetine [29], promethazine [51] and selegiline [61,75]. Most of the detected drugs were first-generation antipsychotics, such as promethazine, perazine, chlorpromazine, and promazine; these agents work on dopaminergic neurotransmission, but are less selective, with noradrenergic, cholinergic, and histaminergic blocking actions [76]. Many of these drugs are today rarely used but remain a good choice for their sedative effects and for the treatment of more resistant and acute psychiatric patients [77]. All of them showed similarities with the structure of amphetamine [51]. Of note, some studies included in the review reported also false-positive results associated with the use of newer antipsychotics, such as Aripiprazole [18,33], a third-generation drug known for their partial agonism of dopamine receptor, suggesting that further evaluation on recently introduced new drugs of this class (Brexpiprazole, Cariprazine) may lead to similar issues or, conversely, the changes apported in the chemical structures may be sufficient to avoid the mis-interpretation of the drug. At the same time, many drugs involved in false-positive UDS emerged in our literature review are commonly used in the clinical practice of general medicine, for example beta blockers, fenofibrate, and ranitidine.
Antipsychotics as a method of suicide: population based follow-up study of suicide in Northern Finland
Published in Nordic Journal of Psychiatry, 2021
Arja Mainio, Liisa Kuusisto, Helinä Hakko, Pirkko Riipinen
Another major finding was in the gender differences. Females more often used quetiapine and SGAs in suicides than males, while promazine as a method of suicide was more common in males than females. Within our study population, promazine was the single most used antipsychotic drug in self-poisoning suicides among males. In Finland, promazine is primarily prescribed for treating alcohol abuse, to ease withdrawal symptoms [21]. Koski et al. [21] studied the interactions of alcohol and drugs in fatal poisonings and found that promazine is particularly toxic with alcohol. The fatal toxicity index for promazine was distinctly high compared to other common drugs that were included in the study [21]. In our study, about half of the study population of FGA users were under the influence of alcohol at the time of their suicide using antipsychotics. This might also explain our finding of the high incidence of promazine use and may help explain the gender difference. It is notable that toxicity of promazine has recognized and newer antipsychotics have replaced promazine. In Finland, promazine can now only be prescribed with a special license.
A systematic review of antipsychotic agents for primary delusional infestation
Published in Journal of Dermatological Treatment, 2022
Meghan L. McPhie, Mark G. Kirchhof
Pimozide was used in nineteen studies, with a total of 109 patients treated (8,23–40). Dosages ranged from 1 to 16 mg/day. Approximately 93 patients (85%) showed some degree of improvement in symptoms. Fourteen patients treated with pimozide had no response and two were lost to follow-up. Another study examined the treatment effect of pimozide or olanzapine in 30 patients with DI, but did not specify the number of patients receiving each antipsychotic (41). Of the 24 patients followed-up, the majority had improvement in symptoms with either olanzapine or pimozide. Eight studies examined haloperidol, with a total of 19 patients treated (39,40,42–47). Doses ranged from 1–10 mg/day or 25–50 mg IM injection/4 weeks. Eighteen patients (94%) demonstrated an improvement in delusional symptoms, while one patient had no response to treatment. Three studies used trifluoperazine (44,48,49). A total of nine patients were treated with trifluoperazine with doses ranging from 10–15 mg/day. Eight patients (88%) showed overall improvement in their symptoms, while one patient had no response. A single study looked at the effectiveness of 7.5–25 mg of fluphenazine decanoate or 6–20 mg of cis-flupentixole decanoate injections (50). Of the 15 patients treated with fluphenazine decanoate, 14 showed improvement and one of the five patients treated with cis-flupentixole had no response. One study looked at the use of chlorpromazine treatment in three patients, with doses ranging from 150–300 mg/day (44). Two patients had moderate improvement in symptoms, while the other patient demonstrated a minimal response. Other studies found symptom improvement in a single patient treated with a 50–150 mg/day dose of sulpride (26) and a patient treated with a 150 mg/day dose of promazine (51).