Neuroleptics

Tardive dyskinesia (TD), a serious complications of neuroleptic chronic use, has no effective therapy yet. We performed an experiment to study the action on TD, of the calcium channel blockers (CCB) drugs, verapamil and flunarizine. We obtained the TD model in rats, administering haloperidol for a 21-day period. After this, the stereotyped movement induced by apomorphyne was rated. The CCB drugs were administered in acute (in the 28th. day) and chronic (for 8 days, after the 25th day) experiments. Acutely, verapamil increased the stereotyped behaviour, and promoted a reduction of it in the chronic experiment. The results suggest that CCB drugs should be tested in clinical trials of TD.

Les résultats d’une enquête et l’examen des sources statistiques montrent que, tout au long du XIXe siècle, les femmes entraient en moins grand nombre que les hommes à l’asile, et pourtant leurs effectifs permanents y étaient plus importants. L’article examine quelques-uns des résultats  non conformes aux représentations communes de la destinée des femmes placées à tort et de force en asile, puis empêchées d’en sortir. Les sureffectifs se fabriquaient à l’asile et la question se déplace alors sur ce qui y retenait ainsi les femmes un peu plus que les hommes. Comment expliquer ces sureffectifs alors que médecins et familles développaient des stratégies pour faire sortir les intéressées en particulier celles qui étaient dites « améliorées ». L’examen des processus de décisions tant des sorties que des maintiens à l’asile montrent chaque fois des configurations où l’isolement ou au contraire des ressources familiales à la sortie vont s’avérer décisives. Cette enquête dévoile des logiques de genre qui ne sont pas propres à l’asile et renvoient, hors asile, aux rôles sociaux féminins de cette époque, à la question de l’autonomie et surtout de son manque qui est renforcée par l’épisode asilaire et la fragilisation sociale qui s’ensuit.
Mots clés.
Carrières asilaires, sortir de l’asile, maintien à l’asile, guérison, rôle des familles, stratégies et négociations, décisions médicales, âge, durée de séjour.

 Background: Research has increasingly focused on wild animals, and this requires the use of chemical restraints that are safe for both the species and the team involved. Dextroketamine is the levorotatory ketamine isomer that has been used on domestic species as an alternative that is more potent and safer than the racemic form. Midazolam is a benzodiazepine that induces muscle relaxation and minimal cardiorespiratory changes. The purpose of this study was to determine whether a combination of dextroketamine and midazolam can be safely used for the chemical restraint of agoutis (Dasyprocta prymnolopha), and the effects of this protocol on physiological and anesthetic parameters. Materials, Methods & Results: This study was carried out under conditions similar to those found for wild animals in captivity or in zoos. A pre-evaluation was also made to compare the baseline values of this study with those of other studies on the same species. Nine healthy adult agoutis were used, weighi...

ANESTHESIA IN HAMSTERS (Mesocricetus auratus) WITH TILETAMINE ZOLAZEPAM ASSOCIATED OR NOT WITH LEVOMEPROMAZINE Aiming the assessment of the combination of tiletamine and zolazepam (TZ) with or without levomepromazine as an anesthetic protocol for painful surgery in hamsters (Mesocricetus auratus), 60 animals were divided into six groups with five males and five females. Three groups were treated with TZ in different doses (groups TZ180, TZ300, TZ400: 180; 300 e 400mg/kg), and the other three with 4mg/kg of levomepromazine cloridrate added with different doses of TZ in the same syringe (groups TZL120, TZL140, TZL160: 120, 140 e 160mg/kg), all administered by intramuscular route. Onset of anesthesia, duration of anesthesia, recovery time, posture and other physiological and clinical changes manifested by the animals were evaluated. The analgesia was confirmed when the execution of laparotomy and visceral manipulation was possible. TZ promoted anesthesia only in the higher dose (400mg/...

Artikel om et foredrag af Peter Lehmann på Galelejr 1985 i Nykøbing, hvor han informerede det danske psykiatriske miljø om, at neuroleptikummet Penfluridol (salgsnavn Semap), som stadig er godkendt i Danmark, allerede måtte trækkes tilbage fra markedet i Forbundsrepublikken Tyskland på grund af mistanken om, at det forårsager kræft (translated by DeepL).

Suicide is the most frequent death cause in people diagnosed as „schizophrenics”. Psychiatrists administer neuroleptics to people diagnosed as “schizophrenics”. A main effect of neuroleptics is depression up to suicidality. It is understandable, that members of the psychiatric-pharmaceutical complex taboo this topic in their general denial of responsibility and their greed of gain. But should it be ignored in the circles of humanistic antipsychiatry? As one of many proposed measures to combat discrimination faced by people with mental health problems in health care services – developed within the “Community Action Programme to Combat Discrimination in 2001-2006” with support from the European Union –, was the introduction of a suicide register.

Knowing what to expect during withdrawal is vitally important. When individuals have come to a firm personal decision to stop taking psychiatric drugs, before reducing their dose, it is important that they educate themselves about the many problems that can arise during withdrawal. Withdrawal symptoms are problems that were never experienced before treatment with psychoactive drugs or not to such an extent. Knowing exactly what to expect during withdrawal should enable the person, and those who are helping him/her, to assess problems realistically and to react appropriately, so as to bring the withdrawal process to a positive end (Lehmann 1996b, pp. 353-456). In addition to the usual withdrawal symptoms, another problem often arises temporary rebound symptoms (sometimes more intense reappearance of the original symptoms present before treatment). The appearance of these somewhat mirror-like rebound symptoms makes it particularly difficult to see the difference between the withdrawal symptoms and the original problems. It should be taken into consideration (as it should be before starting such a treatment) when coming off psychoactive drugs, that supersensitivity (delirium, withdrawal-related psychoses) is a serious risk. Sleeplessness, mental symptoms, symptoms of the central nervous System, muscular and motor disturbances and troublesome and even lethal disorders of the autonomous nervous system have to be taken into account, leading medical professionals to recommend gradual withdrawal. David Richman, M.D., of California writes, for example, the best way to minimize drug withdrawal is to reduce drug intake gradually, especially if the drug has been taken for more than one or two months (Network Against Psychiatric Assault 1984).

Treatment with toxic psychiatric drugs and electroshocks, bearing risks of irreversible brain damage, are dangerous interventions into the bodily intactness. Especially neuroleptics, the atypical ones included, can cause diseases and death. In general psychiatric treatment doesn't deal with the causal problems that lead to the commitment. Often human and civil rights are offended in psychiatry. Funding for user-run or user-controlled alternatives are necessary. The Berlin Runaway-house, beside other alternative institutions, shows that psychic crises, which usually lead to commitment and forced treatment, can be managed without psychoactive drugs and means of coercion. Psychiatrists asked what they would want for themselves in psychic crises were afraid to be treated as their patients are. "Participation of the users" and "innovative approaches" should be the key words of reforms, new approaches should be based on the needs and interests of clients and users. Information, prevention and activities focusing on the major threats to health should have high priority, human beings in psychosocial emergency should have choices. Especially the withholding of choices turns psychiatric emergency-wards into dictatorial institutions, undignified in a society understanding itself as free and democratic.

There are plenty of rational reasons to decide to come off neuroleptics. Liver damage, pigmentation of inner organs, eye and brain damage, chromosome damage, receptor-changes, modification of the personality and “broken-wing” syndrome are other possible dangerous effects of psychopharmacological treatment. This paper reflects also measures to encourage withdrawal, withdrawal-risks of neuroleptics, low risks possibilities how to come off neuroleptics and alternatives beyond psychiatry.

Διάλεξη του Peter Lehmann με αφορμή την αναγόρευση του σε επίτιμο διδάκτορα σε αναγνώριση της "εξαιρετικής επιστημονικής και ανθρωπιστικής συμβολής στη διεκδίκηση των δικαιωμάτων των ανθρώπων που πλήττονται από την ψυχιατρική" από το Αριστοτέλειο Πανεπιστήμιο Θεσσαλονίκης, στην οποία ο τιμώμενος εξηγεί την αντίληψή του για την ανθρωπιστική αντιψυχιατρική ως ένα σύγχρονο, υποστηριζόμενο από τους χρήστες και μη δογματικό κίνημα, το οποίο δεσμεύεται, μεταξύ άλλων, για την οικοδόμηση επαρκούς και αποτελεσματικής υποστήριξης των ανθρώπων που βρίσκονται σε ψυχοκοινωνική δυσπραγία, για τη νομική τους ισοτιμία με τους φυσιολογικούς ασθενείς, για την υποστήριξη της αυτοκαθοριζόμενης διακοπής των δυνητικά τοξικών ψυχιατρικών ψυχοτρόπων φαρμάκων και της χρήσης εναλλακτικών ψυχοτρόπων, δηλαδή που επιδρούν στον ψυχισμό, και για την ανοχή, το σεβασμό και την εκτίμηση της διαφορετικότητας σε όλα τα επίπεδα της ζωής. Το πρόβλημα της έλλειψης υποστήριξης στην ψυχική δυσφορία δεν αφορά μια μειονότητα, αλλά την ευρεία μάζα της κοινωνίας: τους ίδιους τους πάσχοντες, τους συγγενείς, τα παιδιά, τους ηλικιωμένους και τους κάθε είδους κοινωνικά αποκλεισμένους. Η κατανόηση του πόνου των ψυχωτικών ή καταθλιπτικών ανθρώπων, ο οποίος πηγάζει από την εσωτερική εμπειρία του πολιτισμού μας, θα οδηγούσε γενικά σε μεγαλύτερη κατανόηση του εαυτού μας και θα απέτρεπε την απομόνωση και την αποξένωση. Δεδομένου ότι προς το παρόν δεν υπάρχουν εναλλακτικές προσφορές ανθρώπινης βοήθειας, οι άνθρωποι που πλήττονται από την ψυχιατρική πρέπει να μάθουν να αντιμετωπίζουν τις υπάρχουσες προσφορές. Αν δεν θέλουν να τους διαθέσουν άλλοι, θα πρέπει να προστατεύσουν τον εαυτό τους από την αυθαίρετη ψυχιατρική θεραπεία και τη σωματική βλάβη συντάσσοντας εκ των προτέρων οδηγίες, να προσπαθήσουν να επηρεάσουν την ποιότητα των υπηρεσιών θεραπείας ή να αρχίσουν να δημιουργούν εναλλακτικές λύσεις. (Translated with DeepL)

Problems at withdrawal from neuroleptics ("antipsychotics") and antidepressants are well known from animal research and experiments in normal subjects. The existence of dependence is denied from pharmaceutical industry and mainstream medicine. People withdraw with or without problems. Older studies did not distinguish between withdrawal problems and so-called true relapse. Meanwhile there is some knowledge about reducing risks in withdrawal, especially on the side of ex-users and survivors of psychiatry. But there is still a mass of open questions for physicians and natural healers, carers, therapists, social workers, jurists, pharmacologist, relatives and experts by experience. Until today, teaching withdrawal is passing knowledge and experiences, but also teaching the open questions and staying involved decision processes of future research.

In this article the author – board-member of the European Network of (ex-) Users and Survivors of Psychiatry (ENUSP) – explains, what is needed to guarantee a minimal level of involvement of users and survivors of psychiatry into issues relating to psychiatric drugs. He reflects demands of their organisations, and compares these demands with the current involvement level. Considering the concrete circumstances in psychiatry, he reflects the risks and dangers of the administered drugs – especially the widely used neuroleptics – for example enhanced breast cancer risk in women, suicidal effects, receptor changes, tardive dyskinesia and other toxic reactions. Results  –  Considering the unique situation of psychiatric patients to receive treatment in general without informed consent and in a violent way or through bullying and threat, he argues for to provide their involvement in all aspects of psychiatric drug issues – especially registration and monitoring, for example by their involvement in creating and running a suicide register. And he argues for involvement in ethics committees, licensing processes and providing guidelines and decision making about effectiveness and reimbursement of costs. As first steps towards these aims he proposes independent and user-controlled research, independent and user-controlled education and independent and user-controlled information about the effects of psychiatric drugs.

Beside imbalance and use of power, medicalization – the social definition of human problems as medical problems – is the basic flaw at the heart of the psychiatric discipline in the opinion of many social scientists, of users and survivors of psychiatry and critical psychiatrists. Like everywhere, in the discussion of medicalization there are many pros and cons as well as intermediate positions. When we discuss medicalization, we should have a very clear view, what medicalization can mean in a concrete way for an individual and which other factors are connected with medicalization; so we can move from talk to action. Medicalization and irresponsibility often go hand in hand. Psychiatry as a scientific discipline cannot do justice to the expectation of solving mental problems that are largely of a social nature. Its propensity and practice are not appropriate, and have to use force, which constitutes a threat. Its diagnostic methods obstruct the view of the real problems of individuals. This I will show through an example – the medicalization of K.K. by Uwe Henrik Peters.

Depression can have many causes: psychosocial and political conditions, neurological diseases, metabolic disorders, aging, toxic substances and drugs. Physicians generally focus on organic or supposed organic depressions, for which they prescribe psychiatric drugs and electroshocks. It is hard for them to accept that many psychiatric drugs can cause or increase depression and suicidality. But in the medical and pharmacological specialist literature there are many reports about the depressive effects of psychiatric drugs. In particular neuroleptics, so-called antipsychotic drugs like haloperidol (one brand name for which is Haldol) and clozapine (one brand name for which is Leponex) often initiate depression and suicide. A suicide-register with special consideration of associated psychiatric drugs, electroshocks, restraint, and other forms of psychiatric compulsion could be effective as a form of prevention and lower the occurrence of depression and suicides.

Suicide is a frequent cause of death in people diagnosed with “schizophrenia.” These patients generally receive so-called antipsychotic drug (neuroleptics), which have an intrinsic depressive effect. There are placebo studies, epidemiological surveys, first-hand reports, test subject experience and clinical research providing evidence about neuroleptic-caused depression and suicidality. Current suicide registers have limited effectiveness, and meaningful programs to prevent suicide due to psychiatric treatment are needed. Effective suicide registers involving users and survivors of psychiatry would gather findings that could be used to warn the public, consumers, and caregivers. More research and especially research with meaningful participation of users and survivors of psychiatry has to be done to develop a suicide-register with special consideration of associated psychiatric drugs, electroshocks, restraint, and other forms of psychiatric compulsion. It could be effective as a powerful form of prevention and lower the occurrence of depression and suicides.

Recovery is a relatively new concept within the psychosocial arena which is used by those critical of psychiatry as well as by mainstream psychiatry itself, and turns against the therapeutic pessimism of the past decades. “Recovery” can mean, among others things, rediscovery, healing, improvement, salvation or the regaining of independence. A positive connotation of hope is common to all uses of this term, but it has many different implications, especially in combination with the administration or intake of psychiatric drugs. For some, recovery means recovering from a mental illness, a reduction of symptoms, or a cure. Others use it to signify an abatement of unwanted effects of psychiatric drugs after their discontinuation, or the regaining of freedom after leaving the mental health system, or “being rescued from the swamp of psychiatry” (see Stastny & Lehmann, 2007a, p. 41). Members of mainstream psychiatry base their hope on the conviction that mental problems are largely of a brain/organic nature, not of a social nature, and that psychiatry as a scientific discipline can do justice to the expectation of solving mental problems. They believe that its diagnostic methods do not obstruct the view of the real problems of individuals in society and that their propensity and practice of using force are completely justified and compatible with human rights declarations and the UN Convention on the Rights of Persons with Disabilities. They believe that electroshock does not harm the brain and that synthetic psychodrugs are helpful in principle and – apart from benzodiazepines – do not cause bodily dependence. What psychiatric workers do with their patients – the objects of their treatment – has taken many names with different facets and nuances over years: psychiatric custodianship, therapy, empowerment, psycho-education, recovery. Apart form psychiatric mass murders during the time of Hitler’s fascism, which were also called “treatment,” the goal was to manage the treated ones’ diagnosed illness by psychiatric measures, to release them from their symptoms, or to alleviate them and to re-establish the condition before the outbreak of the illness. Progressive psychiatric workers would probably understand psychological symptoms as a part of a change of the personality (although fragile) that contains the chance for advancement and stabilization.

Neuroleptics, the so-called antipsychotic drugs, are conductive factors for the high mortality of psychiatric patients. In general they are administered without informed consent, especially without information about unwanted effects which could be identified as early warning symptoms for developing chronic and lethal diseases. Without being able to identify these warning symptoms, the patients, their relatives, supporters and carers cannot react appropriately in case of. But rapid activity would eventually be life-saving.

In this study we have investigated the pathophysiology of two idiopathic focal dystonias: hand cramp with excessive cocontractions of agonist and antagonist hand or forearm muscles during specific tasks, such as writing, and facial dystonia manifested by involuntary eyelid spasms (blepharospasm) and lower facial and jaw spasms (oromandibular dystonia). We used positron emission tomography (PET) to measure thein vivobinding of the dopaminergic radioligand [18F]spiperone in putamen in 21 patients with these two focal dystonias and compared the findings with those from 13 normals. We measured regional cerebral blood flow and blood volume in each subject as well as the radiolabeled metabolites of [18F]spiperone in arterial blood. A stereotactic method of localization, independent of the appearance of the images, was used to identify the putamen in all of the PET images. We analyzed the PET and arterial blood data with a validated nonsteady-state tracer kinetic model representing thein v...

“Deprescribing in Psychiatry” is of great importance to mainstream psychiatrists worldwide. Here, representatives of mainstream psychiatry argue that their colleagues should reduce prescriptions, they name anxieties of patients that oppose a reduction, they name withdrawal and discontinuation symptoms that make a reduction difficult, they name wellness supports that may be suggested by the prescriber but are essentially put in place by the patient to support a deprescribing process that improves the chances of success for the reduction. Because of the disastrous prescription practice in mainstream psychiatry and even more so because of the authors’ reserved, moderate style of argumentation, and with the above concerns, I can recommend the book as a  step in the right direction for psychiatrists. Especially for prescribers of psychiatric drugs.

Psychiatric drugs (also known as psychotropic medications) are prescribed by psychiatrists and general practitioners to almost everyone with a psychiatric diagnosis. The effects of such drugs are associated with significantly reduced quality of life and life expectancy. Drug lists – such as the British National Formulary, the Latin American Vademecum, the US-American Physicians’ Desk Reference, the German Rote Liste, the French Vidal, and the African Dictionnaire Therapeutique – cite more or less identical risks and adverse effects for all doses of psychiatric drugs, including antidepressants, mood stabilisers, psychostimulants, and tranquilizers. The United Nations’ Sustainable Development Goal 3 (SDG3) of the 2030 Agenda for Sustainable Development requires states to improve citizens’ well-being. However, the perpetuation of discrimination against psychiatric patients and persons in severe emotional distress through the compulsory administration of psychotropic drugs will inhibit attemps to meet it. Accordingly, this chapter will suggest alternatives to psycho-pharmacological psychiatry, and will argue that education about the risks of psychiatric drugs and problems associated with withdrawal, as well as physical health monitoring, can reduce mortality in psychiatric patients, and enhance well-being. Supporting the self-help efforts of people in severe emotional distress and collaborating with dedicated family members, community members, and professionals in the development of humanistically-oriented support systems should be strategies of first choice for all countries in their approaches to SDG3, including lower and middle income countries (LMICs). Such strategies will safeguard psychiatric patients’ civil rights simultaneously.
Published in: Laura Davidson (ed.), The Routledge Handbook of International Development, Mental Health and Wellbeing. London & New York: Routledge 2019

Commercialisé sous le nom Esidrex ® , l'hydrochlorothiazide est de plus en plus utilisé dans le sport. Du fait de son pouvoir diurétique, les sportifs l'utilisent pour perdre du poids ou pour éliminer plus rapidement des substances anabolisantes ou encore stimulantes. L'analyse des cheveux permet de discriminer une prise unique d'une prise répétée. Les auteurs rapportent ici deux cas de dopage. Le cas 1 concerne un sportif pratiquant les arts martiaux mixtes et le cas 2 un rugbyman. Les urines des deux athlètes ont montré des résultats anormaux pour l'hydrochlorothiazide. Des poils de bras et des cheveux ont été prélevés respectivement pour les cas 1 et 2. Les phanères ont été analysés selon une méthode précédemment publiée faisant appel à la chromatographie liquide couplée à de la spectrométrie de masse en tandem, avec une limite de quantification (LOQ) à 5 pg/mg. Les analyses pour le cas 1 (poils de bras) n'ont pas mis en évidence la présence d'hydrochlorothiazide. Ce résultat ne contredit pas les analyses urinaires. Il pourrait s'agir d'une prise unique. Pour le cas 2 (cheveux), l'hydrochlorothiazide est retrouvé dans plusieurs segments consécutifs avec des concentrations supérieures à la limite de quantification dans trois segments : 15 pg/mg (0-1 cm), 7 pg/mg (1-2 cm), < LOQ (2-3 cm) et 6 pg/mg (3-4 cm). Ces résultats peuvent être interprétés en tant qu'expositions répétées. Ces observations permettent de montrer que l'analyse des phanères est un bon complément de l'analyse urinaire.

For the calculation period for the IF, 175 manuscripts have been citied. Our 5 most citied articles (1-5) deal with different aspects of neurology, including epilepsy, stroke, migraine, and others. The majority of our articles included in the calculation scores were submitted by Polish authors. Authors from 4 other countries, Turkey, Italy, USA, and China, were listed in the first five positions.

Aiming to assess the combination tiletamine/zolazepam with or without levomepromazine as an anesthetic protocol for painful surgery in mice (Mus musculus), 60 animals were divided into six groups, with five males and five females each. Three groups were treated with ...

Seit den 1970er Jahren findet das Konzept der &quot;Therapieresistenz&quot; zunehmend Verbreitung in medizinisch-psychiatrischen Fachdiskursen. Der Beitrag beschaftigt sich mit der sozialen Funktion dieser neuen Semantik im Kontext des psychiatrisches Diskurses rund um die Diagnose und Behandlung schwerwiegender Depressionen. Im Anschluss an leibphanomenologische und gesellschaftstheoretische Uberlegungen wird die These vertreten, dass es sich dabei um eine Form der abstrakten Handlungskoordination handelt. Mit Ruckgriff auf die vier Dimensionen der Explikation, Abstraktion, Differenzierung und Inklusion wird dem Konzept der Therapieresistenz eine Scharnierfunktion zwischen psychiatrischem Fachdiskurs und klinischer Praxis zugeschrieben. Demnach handelt es sich nicht um eine Tatsache im Sinne einer evidenzbasierten Medizin, sondern um ein epistemisches Konzept, das verschiedene soziale Kontexte uberbruckt und integriert.

The dopamine partial agonist aripiprazole is increasingly used to treat pathologies for which other antipsychotics are indicated because it displays fewer side effects, such as sedation and depression-like symptoms, than other dopamine receptor antagonists. Previously, we showed that aripiprazole may protect motivational function by preserving reinforcement-related signals used to sustain reward-maximization behaviour in a simple action-outcome learning task. However, the effect of aripiprazole on more cognitive facets of human reinforcement learning, such as learning from the hypothetical outcomes of alternative courses of action (i.e., counterfactual learning), is unknown.To test the influence of aripiprazole on counterfactual learning, we administered a reinforcement-learning task that involves both direct learning from obtained outcomes and indirect learning from forgone outcomes to two groups of Gilles de la Tourette (GTS) patients, one consisting of patients who were completel...

-Un enfant de 6 ans est hospitalisé en réanimation pédiatrique en raison d'une encéphalite d'aggravation rapide l'ayant mené dans le coma, sans diagnostic précis. Le quatrième jour, une recherche sanguine de toxiques révèle la présence d'halopéridol et de rispéridone non prescrits a priori à l'enfant, à des concentrations thérapeutiques. Cinq mois plus tard, cet enfant est transféré pour rééducation à l'hôpital de Garches. Devant le contexte psychiatrique familial, les médecins évoquent la possibilité d'un syndrome de Münchausen par procuration. Une analyse de cheveux est demandée afin de confirmer l'éventuelle administration des deux neuroleptiques. Les cheveux étant relativement courts, un prélèvement de poils de jambe est également réalisé. L'halopéridol et la rispéridone n'ont pas été retrouvés en chromatographie liquide couplée à la spectrométrie de masse (CL-SM/SM) ni dans les cheveux ni dans les poils, ne permettant pas d'éclairer le diagnostic. En revanche, il a été retrouvé les molécules correspondant au traitement reçu durant l'hospitalisation. Ont ainsi été mis en évidence dans les deux segments de cheveux étudiés et les poils du métoclopramide (301 et 210 pg/mg dans les cheveux, 799 pg/mg dans les poils), de la dompéridone (respectivement 703 pg/mg, 1176 pg/mg et 108 pg/mg), et du diazépam ainsi que ses métabolites le nordiazepam et l'oxazepam dans les cheveux, (respectivement 373 et 391 pg/mg, 271 et 249 pg/mg, et 68 et 111 pg/mg). Il s'agit des premières concentrations en dompéridone et métoclopramide décrites dans les cheveux et les poils d'un enfant blond de type caucasien lors d'une utilisation thérapeutique chronique.

Este artigo apresenta os resultados de um protocolo de contenção farmacológica para orquiectomia eletiva realizada em campo pela técnica aberta, na Região Noroeste do Estado do Paraná, em 106 cavalos (sendo cinco pôneis) e 29 muares, utilizando abraçadeira de náilon 6.6 (poliamida) para ligaduras vasculares hemostáticas. Os 135 equídeos foram contidos por meio de injeção intravenosa da associação de cloridrato de detomidina, cloridrato de cetamina e diazepam, acondicionados em uma mesma seringa, o que facilita o manejo, especialmente quando se trabalha com animais inquietos ou agressivos. O método empregado teve fácil execução e baixo custo, e os resultados permitem sugerir seu uso em orquiectomias e outras pequenas cirurgias de campo em equídeos domésticos.

The Crab-eating Fox (Cerdocyon thous) is a neotropical carnivorous that requires chemical restraint for handling due to its susceptibility to stress and characteristics of defensive behavior. Ten Crab-eating Fox (9 males and 1 female) weighing 5.85 ± 0.83 kg were given the combination of six protocols (tiletamine-zolazepam-xylazine-atropine and azaperone; dextroketamine-diazepam-xylazine-atropine and azaperone; racemic ketamine-diazepamxylazine-atropine and azaperone; tiletamine-zolazepam-detomidine-atropine and azaperone; dextroketamina-diazepam-detomidine-atropine and azaperone; racemic ketamine-diazepamdetomidine-atropine and azaperone) by i.m. injection during field procedures that included identification, physical examination, blood sampling, bone marrow harvesting and other mildly invasive procedures of moderate duration in Cerdocyon thous of captivity. After checking the weights of each Crab-eating Fox, the individual dose of each drug was calculated by means of interspecific allometric extrapolation. The proposed method was safe for both the animal and the human personnel and it is recommended for routine management and stressful but not painful medical procedures like physical examination, measuring, sexing, and bone marrow and blood collection in Cerdocyon thous.

Este estudo avalia, comparativamente, os efeitos de dois protocolos anestésicos em macacos prego (Sapajus sp.), sobre as variáveis fisiológicas, qualidade da anestesia e recuperação anestésica1. Participaram do estudo dezesseis espécimes de macacos prego, os quais foram divididos, aleatoriamente, em dois grupos experimentais: SX (10 mg/Kg de cloridrato de cetamina + 3 mg/Kg meperidina + 0,5 mg/Kg de cloridrato de xilazina) e SD (10 mg/Kg de cloridrato de cetamina + 3 mg/Kg de meperidina + 0,005 mg/Kg de cloridrato de dexmedetomidina). Mensurou-se os parâmetros fisiológicos durante 45 minutos no trans-anestésico: frequências cardíaca (FC) e respiratória (f), temperatura corpórea interna (TR), pressão arterial sistólica (PAS) e diastólica (PAD), saturação periférica de oxihemoglobina (SpO2) e glicemia2. Para os parâmetros referidos não foi possível observar alteração significativa entre os grupos SX e SD, p&gt; 0,05. No entanto, houve diferença considerável entre os momentos anestésic...

Dé veloppement professionnel continu Histoire et fonctions des Unité s pour Malades Difficiles (1 re partie). Du quartier de sû reté à l'Unité pour Malades Difficiles de Villejuif, plus d'un siè cle de prise en charge History and functions of ''Units for Difficult Patients'' (Part 1). From ''secure ward'' to ''Unit for Difficult Patients'': Over a century of care in Villejuif, France

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The Crab-eating Fox (Cerdocyon thous) is a neotropical carnivorous that requires chemical restraint for handling due to its susceptibility to stress and characteristics of defensive behavior. Ten Crab-eating Fox (9 males and 1 female) weighing 5.85 ± 0.83 kg were given the combination of six protocols (tiletamine-zolazepam-xylazine-atropine and azaperone; dextroketamine-diazepam-xylazine-atropine and azaperone; racemic ketamine-diazepamxylazine-atropine and azaperone; tiletamine-zolazepam-detomidine-atropine and azaperone; dextroketamina-diazepam-detomidine-atropine and azaperone; racemic ketamine-diazepamdetomidine-atropine and azaperone) by i.m. injection during field procedures that included identification, physical examination, blood sampling, bone marrow harvesting and other mildly invasive procedures of moderate duration in Cerdocyon thous of captivity. After checking the weights of each Crab-eating Fox, the individual dose of each drug was calculated by means of interspecific allometric extrapolation. The proposed method was safe for both the animal and the human personnel and it is recommended for routine management and stressful but not painful medical procedures like physical examination, measuring, sexing, and bone marrow and blood collection in Cerdocyon thous.

Cette recherche aborde la médication psychiatrique à partir du point de vue des usagers. Des entrevues en profondeur ont été réalisées auprès de dix personnes utilisatrices en provenance d'une ressource communautaire et alternative en santé mentale. Les répondants éprouvent ou ont éprouvé des problèmes importants de santé mentale. La majorité des usagers de notre échantillon consomme des neuroleptiques. Les participants sélectionnés ont cheminé avec l'approche de la gestion autonome de la médication en santé mentale (GAM). La GAM constitue un terrain fertile, car l'approche favorise la réflexion critique, la diversité de pratiques autour de la médication psychotrope. Un état des connaissances portant sur l'expérience subjective de la médication est présenté. Les effets de la médication sur les personnes et leur contexte de vie ainsi que les aspects symboliques ont été analysés. Parmi les effets majeurs de la médication, on compte : l'effet de « gel », la grande fatigue, les difficultés d'attribution, le désir d'arrêt et les effets paradoxaux. La médication peut avoir des effets positifs ou négatifs sur l'entourage, le travail, les études ou autres implications sociales. Le rapport des usagers relatif à la médication a évolué vers un usage planifié, modulé et moindre. À cet effet, les dix usagers sont passés d'une phase de « novice » à une « d'expert ». Les résultats de cette recherche indiquent que la notion d'observance au traitement doit être revisitée et la notion d'efficacité élargie. Cette étude qualitative démontre que les versants « intérieurs » de la médication, l'expérience subjective et l'intersubjectif apportent une perspective plutôt rare, mais riche, du médicament en tant qu'objet social. Mots-clefs : santé mentale, psychiatrie, expérience subjective, point de vue des usagers, médicaments psychotropes, médicaments psychiatriques, neuroleptiques, antipsychotiques, gestion autonome des médicaments en santé mentale (GAM).

Next to Edward Shorter's History of Psychiatry: From the Era of the Asylum to the Age of Prozac (1997) about the usa and several European countries, and Mark Micale's and Roy Porter's historiographic collection Discovering the History of Psychiatry (1994), collections have appeared-to mention some recent examples-on the 'confinement of the insane' in the nineteenth and early twentieth centuries worldwide, in the uk and some of its former colonies; on neurasthenia around 1900 in Great Britain, Germany, and the Netherlands; on social psychiatry and psychotherapy in the twentieth century in these same three countries; and on postwar psychiatry and mental health care in the uk and the Netherlands. 8 Some conferences of the European Society for the History of Psychiatry, founded in 1990, have resulted in collections of papers about several European countries-albeit without any systematic comparison. 9 Whereas most comparative historical studies on psychiatry are about the nineteenth and early twentieth centuries, this volume focuses on the twentieth century. Comparing national psychiatric cultures or aspects of these cultures has proved to be rewarding but also difficult, for at least two different reasons. Firstly, we are faced with the problem of the availability of historical research with a sufficiently similar focus, especially when relating to fairly recently developed research interests such as the patient's view, the role of the family, the different options for care and treatment, the way patients were admitted to and discharged from mental institutions, psychiatric nursing, psychopharmacology, social psychiatry, outpatient services, and the financial aspects of mental health care. Secondly, we are confronted with methodological problems relating to the availability of sources, and the translation and comparability of terminology and data from different countries and periods. 10 The term 'mental health care', for example, does not have the same meaning in various national cultures. In some, it refers to a wide sphere of activity, including the care for the mentally handicapped and demented elderly as well as outpatient facilities and counseling centres for psychological and social problems. In others, it mainly concerns psychiatry in a narrower sense: the care and treatment of the mentally ill. The way the boundaries of the mental health domain were and are drawn as well as its relation to adjacent fields, such as poor relief, general health care, social work, pastoral care, education, and justice, vary from nation to nation. Concepts like 'social psychiatry', 'psychotherapy', and 'de-institutionalisation' may give rise to confusion. In some countries, psychotherapy and counseling were part and parcel of psychiatry and (public) mental health care, but in others they developed in the context of private practice, psychosomatic medicine, or social work. In general, comparative research seems to be most rewarding when it is problem-orientated and focuses on a particular subject. The present volume is the result of an international workshop entitled Cultures of Psychiatry and Mental Health Care in the Twentieth Century: Comparisons Marijke Gijswijt-Hofstra and Harry Oosterhuis care (such as in-and outpatients, chronic and acute, the mentally handicapped and demented elderly); self-organisation and influence of patients; and patients' rights. The authors were thus confronted with an ambitious list of queries and issues as a heuristic framework. For the individual author, it was impossible to answer all of these, simply because of lack of space or of relevant research. Covering a whole century and the whole range of intramural and outpatient mental health care is quite a challenge. The Dutch authors had the advantage of participating in the running research project The Disordered Mind. Yet, as will become clear, both the national overviews and the contributions on special topics are very uk, France, Germany, and the usa-the major countries with which the Netherlands is compared. The patient's perspective should receive more attention, including the role of the family and patient's 'careers'. Also, the perspective of psychiatric nurses or attendants, the professional group that is most intensively other. If and to what extent this public/voluntary mix was specific to the Netherlands remains a question for future research. With respect to the therapeutic regime, Dutch asylum doctors tended to follow international medical developments. However, the very prominent role of 'more active therapy' (in German: aktivere Therapie) in the Netherlands, from the 1920s until the 1960s, is striking. Although this form of occupational therapy uk: the mental hygiene movement, child guidance clinics, psychiatric social work, counseling methods and new forms of psychotherapy, and the therapeutic community. Again, some of these were longer lasting in the Netherlands than in the countries in which they originated. * We are indebted to our co-editor Joost Vijselaar for his comments on earlier drafts of this introduction and to Hugh Freeman for correcting the English.