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Jorgen G Bramness - One of the best experts on this subject based on the ideXlab platform.
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the use of antipsychotic and anticholinergic Antiparkinson drugs in norway after the withdrawal of orphenadrine
British Journal of Clinical Pharmacology, 2009Co-Authors: Pal Gjerden, Lars Slordal, Jorgen G BramnessAbstract:WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Extrapyramidal side-effects induced by antipsychotic agents are treated with dose reduction, switching of antipsychotic medication or the addition of anticholinergic Antiparkinson drugs. WHAT THIS STUDY ADDS • The use of anticholinergic Antiparkinson drugs appears to be superfluous in a large number of patients. AIMS Extrapyramidal side-effects induced by antipsychotic drugs are treated with dose reduction or substitution with another antipsychotic drug or by the addition of anticholinergic Antiparkinson agents. The withdrawal of orphenadrine from the Norwegian market provided a possibility to investigate to what degree these alternative measures were taken in clinical practice. METHODS Data were drawn from the Norwegian Prescription Database on the sales of antipsychotics and one of the two anticholinergic Antiparkinson agents marketed in 2004, orphenadrine and biperiden, to a total of 39 758 outpatients. The patients were reinvestigated in 2007. The consequences of the withdrawal of orphenadrine from the Norwegian market in 2005 regarding dosing, switching and cessation of antipsychotics and use of anticholinergics were assessed for orphenadrine users compared with biperiden users. RESULTS Of the patients originally using orphenadrine, 28.4% stopped using the drug without reducing the antipsychotic dose or replacing orphenadrine with another anticholinergic agent. The corresponding number for biperiden users was 19.3%. Only 11.8% of patients switched to another antipsychotic drug, but they used significantly lower antipsychotic doses than those who stayed on the same drug. CONCLUSION The use of anticholinergic Antiparkinson agents could be seen as superfluous for at least one-third of patients.
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association between the use of anticholinergic Antiparkinson drugs and safety and receptor drug binding profiles of antipsychotic agents
European Journal of Clinical Pharmacology, 2009Co-Authors: Pal Gjerden, Lars Slordal, Jorgen G BramnessAbstract:PURPOSE: The use of anticholinergic Antiparkinson drugs is almost exclusively confined to treating antipsychotic-induced extrapyramidal side effects (EPS). We investigated the prevalence of concomi ...
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effect of warnings in a medical journal on the use of orphenadrine
Journal of Evaluation in Clinical Practice, 2008Co-Authors: Pal Gjerden, Jorgen G Bramness, Lars SlordalAbstract:This thesis is based on two fundamental questions: Which patients are currently using anticholinergic Antiparkinson drugs? Does it matter which anticholinergic Antiparkinson drug they are using? These questions were further investigated, using a variety of methods, as follows: Are anticholinergic Antiparkinson agents predominantly used to treat Parkinson’s disease or antipsychotic induced extrapyramidal side-effects (EPS)? Is there a high risk of abuse of anticholinergic Antiparkinson agents? Can alleged differences in receptor binding profiles of typical first- (FGA) and atypical second (SGA) -generation antipsychotic agents predict concomitant use of anticholinergic agents? Can long-term co-prescription of anticholinergic Antiparkinson agents shed some light on the efficacy of antipsychotic agents? Does the literature indicate differences in toxicity and fatality rates of anticholinergic Antiparkinson agents? Does an autopsy material indicate differences between anticholinergic agents regarding toxicity and fatality risk? Are warnings in a medical journal against the use of the most toxic anticholinergic agent enough to reduce its use? Can patients stop using anticholinergic agents without further remedies? The thesis has the following conclusions: The overwhelming majority of anticholinergic users were patients concomitantly using antipsychotic agents, presumably for the alleviation of antipsychotic induced EPS. The use of anticholinergics was not particularly skewed and we could not find any other indication of abuse, indicating that concomitant use of anticholinergics can be a proxy for the liability of specific antipsychotic agents to cause EPS. For patients using only one antipsychotic agent, the concurrent use of anticholinergics varied between 0.4% and 26.0%, but largely independently of the distinction between typical and atypical antipsychotics. High D2-receptor antagonism and a high 5-HT2A/D 2- receptor-affinity ratio coincided with the use of anticholinergics. Clozapine and zuclopentixol demonstrated the highest level of prescription persistence in a three-year period. The high prevalence of concomitant use of anticholinergics and zuclopentixol may indicate that the latter was considered efficacious enough to outweigh its probable side-effects. Haloperidol was associated with a mortality three times that of any other antipsychotic agent in the study. Orphenadrine is by far the most toxic anticholinergic Antiparkinson agent with a high mortality risk. Warnings in a medical journal against the use of a toxic drug can have an impact on prescription patterns. At least one-third of the patients using anticholinergic Antiparkinson agents do not need them.
Pal Gjerden - One of the best experts on this subject based on the ideXlab platform.
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the use of antipsychotic and anticholinergic Antiparkinson drugs in norway after the withdrawal of orphenadrine
British Journal of Clinical Pharmacology, 2009Co-Authors: Pal Gjerden, Lars Slordal, Jorgen G BramnessAbstract:WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Extrapyramidal side-effects induced by antipsychotic agents are treated with dose reduction, switching of antipsychotic medication or the addition of anticholinergic Antiparkinson drugs. WHAT THIS STUDY ADDS • The use of anticholinergic Antiparkinson drugs appears to be superfluous in a large number of patients. AIMS Extrapyramidal side-effects induced by antipsychotic drugs are treated with dose reduction or substitution with another antipsychotic drug or by the addition of anticholinergic Antiparkinson agents. The withdrawal of orphenadrine from the Norwegian market provided a possibility to investigate to what degree these alternative measures were taken in clinical practice. METHODS Data were drawn from the Norwegian Prescription Database on the sales of antipsychotics and one of the two anticholinergic Antiparkinson agents marketed in 2004, orphenadrine and biperiden, to a total of 39 758 outpatients. The patients were reinvestigated in 2007. The consequences of the withdrawal of orphenadrine from the Norwegian market in 2005 regarding dosing, switching and cessation of antipsychotics and use of anticholinergics were assessed for orphenadrine users compared with biperiden users. RESULTS Of the patients originally using orphenadrine, 28.4% stopped using the drug without reducing the antipsychotic dose or replacing orphenadrine with another anticholinergic agent. The corresponding number for biperiden users was 19.3%. Only 11.8% of patients switched to another antipsychotic drug, but they used significantly lower antipsychotic doses than those who stayed on the same drug. CONCLUSION The use of anticholinergic Antiparkinson agents could be seen as superfluous for at least one-third of patients.
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association between the use of anticholinergic Antiparkinson drugs and safety and receptor drug binding profiles of antipsychotic agents
European Journal of Clinical Pharmacology, 2009Co-Authors: Pal Gjerden, Lars Slordal, Jorgen G BramnessAbstract:PURPOSE: The use of anticholinergic Antiparkinson drugs is almost exclusively confined to treating antipsychotic-induced extrapyramidal side effects (EPS). We investigated the prevalence of concomi ...
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effect of warnings in a medical journal on the use of orphenadrine
Journal of Evaluation in Clinical Practice, 2008Co-Authors: Pal Gjerden, Jorgen G Bramness, Lars SlordalAbstract:This thesis is based on two fundamental questions: Which patients are currently using anticholinergic Antiparkinson drugs? Does it matter which anticholinergic Antiparkinson drug they are using? These questions were further investigated, using a variety of methods, as follows: Are anticholinergic Antiparkinson agents predominantly used to treat Parkinson’s disease or antipsychotic induced extrapyramidal side-effects (EPS)? Is there a high risk of abuse of anticholinergic Antiparkinson agents? Can alleged differences in receptor binding profiles of typical first- (FGA) and atypical second (SGA) -generation antipsychotic agents predict concomitant use of anticholinergic agents? Can long-term co-prescription of anticholinergic Antiparkinson agents shed some light on the efficacy of antipsychotic agents? Does the literature indicate differences in toxicity and fatality rates of anticholinergic Antiparkinson agents? Does an autopsy material indicate differences between anticholinergic agents regarding toxicity and fatality risk? Are warnings in a medical journal against the use of the most toxic anticholinergic agent enough to reduce its use? Can patients stop using anticholinergic agents without further remedies? The thesis has the following conclusions: The overwhelming majority of anticholinergic users were patients concomitantly using antipsychotic agents, presumably for the alleviation of antipsychotic induced EPS. The use of anticholinergics was not particularly skewed and we could not find any other indication of abuse, indicating that concomitant use of anticholinergics can be a proxy for the liability of specific antipsychotic agents to cause EPS. For patients using only one antipsychotic agent, the concurrent use of anticholinergics varied between 0.4% and 26.0%, but largely independently of the distinction between typical and atypical antipsychotics. High D2-receptor antagonism and a high 5-HT2A/D 2- receptor-affinity ratio coincided with the use of anticholinergics. Clozapine and zuclopentixol demonstrated the highest level of prescription persistence in a three-year period. The high prevalence of concomitant use of anticholinergics and zuclopentixol may indicate that the latter was considered efficacious enough to outweigh its probable side-effects. Haloperidol was associated with a mortality three times that of any other antipsychotic agent in the study. Orphenadrine is by far the most toxic anticholinergic Antiparkinson agent with a high mortality risk. Warnings in a medical journal against the use of a toxic drug can have an impact on prescription patterns. At least one-third of the patients using anticholinergic Antiparkinson agents do not need them.
Lars Slordal - One of the best experts on this subject based on the ideXlab platform.
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the use of antipsychotic and anticholinergic Antiparkinson drugs in norway after the withdrawal of orphenadrine
British Journal of Clinical Pharmacology, 2009Co-Authors: Pal Gjerden, Lars Slordal, Jorgen G BramnessAbstract:WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Extrapyramidal side-effects induced by antipsychotic agents are treated with dose reduction, switching of antipsychotic medication or the addition of anticholinergic Antiparkinson drugs. WHAT THIS STUDY ADDS • The use of anticholinergic Antiparkinson drugs appears to be superfluous in a large number of patients. AIMS Extrapyramidal side-effects induced by antipsychotic drugs are treated with dose reduction or substitution with another antipsychotic drug or by the addition of anticholinergic Antiparkinson agents. The withdrawal of orphenadrine from the Norwegian market provided a possibility to investigate to what degree these alternative measures were taken in clinical practice. METHODS Data were drawn from the Norwegian Prescription Database on the sales of antipsychotics and one of the two anticholinergic Antiparkinson agents marketed in 2004, orphenadrine and biperiden, to a total of 39 758 outpatients. The patients were reinvestigated in 2007. The consequences of the withdrawal of orphenadrine from the Norwegian market in 2005 regarding dosing, switching and cessation of antipsychotics and use of anticholinergics were assessed for orphenadrine users compared with biperiden users. RESULTS Of the patients originally using orphenadrine, 28.4% stopped using the drug without reducing the antipsychotic dose or replacing orphenadrine with another anticholinergic agent. The corresponding number for biperiden users was 19.3%. Only 11.8% of patients switched to another antipsychotic drug, but they used significantly lower antipsychotic doses than those who stayed on the same drug. CONCLUSION The use of anticholinergic Antiparkinson agents could be seen as superfluous for at least one-third of patients.
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association between the use of anticholinergic Antiparkinson drugs and safety and receptor drug binding profiles of antipsychotic agents
European Journal of Clinical Pharmacology, 2009Co-Authors: Pal Gjerden, Lars Slordal, Jorgen G BramnessAbstract:PURPOSE: The use of anticholinergic Antiparkinson drugs is almost exclusively confined to treating antipsychotic-induced extrapyramidal side effects (EPS). We investigated the prevalence of concomi ...
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effect of warnings in a medical journal on the use of orphenadrine
Journal of Evaluation in Clinical Practice, 2008Co-Authors: Pal Gjerden, Jorgen G Bramness, Lars SlordalAbstract:This thesis is based on two fundamental questions: Which patients are currently using anticholinergic Antiparkinson drugs? Does it matter which anticholinergic Antiparkinson drug they are using? These questions were further investigated, using a variety of methods, as follows: Are anticholinergic Antiparkinson agents predominantly used to treat Parkinson’s disease or antipsychotic induced extrapyramidal side-effects (EPS)? Is there a high risk of abuse of anticholinergic Antiparkinson agents? Can alleged differences in receptor binding profiles of typical first- (FGA) and atypical second (SGA) -generation antipsychotic agents predict concomitant use of anticholinergic agents? Can long-term co-prescription of anticholinergic Antiparkinson agents shed some light on the efficacy of antipsychotic agents? Does the literature indicate differences in toxicity and fatality rates of anticholinergic Antiparkinson agents? Does an autopsy material indicate differences between anticholinergic agents regarding toxicity and fatality risk? Are warnings in a medical journal against the use of the most toxic anticholinergic agent enough to reduce its use? Can patients stop using anticholinergic agents without further remedies? The thesis has the following conclusions: The overwhelming majority of anticholinergic users were patients concomitantly using antipsychotic agents, presumably for the alleviation of antipsychotic induced EPS. The use of anticholinergics was not particularly skewed and we could not find any other indication of abuse, indicating that concomitant use of anticholinergics can be a proxy for the liability of specific antipsychotic agents to cause EPS. For patients using only one antipsychotic agent, the concurrent use of anticholinergics varied between 0.4% and 26.0%, but largely independently of the distinction between typical and atypical antipsychotics. High D2-receptor antagonism and a high 5-HT2A/D 2- receptor-affinity ratio coincided with the use of anticholinergics. Clozapine and zuclopentixol demonstrated the highest level of prescription persistence in a three-year period. The high prevalence of concomitant use of anticholinergics and zuclopentixol may indicate that the latter was considered efficacious enough to outweigh its probable side-effects. Haloperidol was associated with a mortality three times that of any other antipsychotic agent in the study. Orphenadrine is by far the most toxic anticholinergic Antiparkinson agent with a high mortality risk. Warnings in a medical journal against the use of a toxic drug can have an impact on prescription patterns. At least one-third of the patients using anticholinergic Antiparkinson agents do not need them.
Valentin A Stonik - One of the best experts on this subject based on the ideXlab platform.
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lissodendoric acids a and b manzamine related alkaloids from the far eastern sponge lissodendoryx florida
Organic Letters, 2017Co-Authors: Ekaterina G Lyakhova, Sophia A Kolesnikova, Anatoly I Kalinovsky, Dmitrii V Berdyshev, Evgeny A Pislyagin, Aleksandra S Kuzmich, Roman S Popov, Pavel S Dmitrenok, Tatyana N Makarieva, Valentin A StonikAbstract:The first representatives of a new group of manzamine-related alkaloids with a previously unknown skeletal systems, namely, lissodendoric acids A (1) and B (2), were isolated from the sponge Lissodendoryx florida collected from the Sea of Okhotsk. The structures and absolute configurations have been elucidated by extensive spectroscopic analysis together with chemical transformations and quantum-chemical modeling. The lissodendoric acids show a potent capability to decrease the production of reactive oxygen species in neuroblastoma Neuro 2a and somewhat increase the survival of these cells upon treatment with 6-hydroxydopamine (an in vitro Antiparkinson biotest).
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Lissodendoric Acids A and B, Manzamine-Related Alkaloids from the Far Eastern Sponge Lissodendoryx florida
2017Co-Authors: Ekaterina G Lyakhova, Sophia A Kolesnikova, Anatoly I Kalinovsky, Dmitrii V Berdyshev, Evgeny A Pislyagin, Aleksandra S Kuzmich, Roman S Popov, Pavel S Dmitrenok, Tatyana N Makarieva, Valentin A StonikAbstract:The first representatives of a new group of manzamine-related alkaloids with a previously unknown skeletal systems, namely, lissodendoric acids A (1) and B (2), were isolated from the sponge Lissodendoryx florida collected from the Sea of Okhotsk. The structures and absolute configurations have been elucidated by extensive spectroscopic analysis together with chemical transformations and quantum-chemical modeling. The lissodendoric acids show a potent capability to decrease the production of reactive oxygen species in neuroblastoma Neuro 2a and somewhat increase the survival of these cells upon treatment with 6-hydroxydopamine (an in vitro Antiparkinson biotest)
Ekaterina G Lyakhova - One of the best experts on this subject based on the ideXlab platform.
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lissodendoric acids a and b manzamine related alkaloids from the far eastern sponge lissodendoryx florida
Organic Letters, 2017Co-Authors: Ekaterina G Lyakhova, Sophia A Kolesnikova, Anatoly I Kalinovsky, Dmitrii V Berdyshev, Evgeny A Pislyagin, Aleksandra S Kuzmich, Roman S Popov, Pavel S Dmitrenok, Tatyana N Makarieva, Valentin A StonikAbstract:The first representatives of a new group of manzamine-related alkaloids with a previously unknown skeletal systems, namely, lissodendoric acids A (1) and B (2), were isolated from the sponge Lissodendoryx florida collected from the Sea of Okhotsk. The structures and absolute configurations have been elucidated by extensive spectroscopic analysis together with chemical transformations and quantum-chemical modeling. The lissodendoric acids show a potent capability to decrease the production of reactive oxygen species in neuroblastoma Neuro 2a and somewhat increase the survival of these cells upon treatment with 6-hydroxydopamine (an in vitro Antiparkinson biotest).
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Lissodendoric Acids A and B, Manzamine-Related Alkaloids from the Far Eastern Sponge Lissodendoryx florida
2017Co-Authors: Ekaterina G Lyakhova, Sophia A Kolesnikova, Anatoly I Kalinovsky, Dmitrii V Berdyshev, Evgeny A Pislyagin, Aleksandra S Kuzmich, Roman S Popov, Pavel S Dmitrenok, Tatyana N Makarieva, Valentin A StonikAbstract:The first representatives of a new group of manzamine-related alkaloids with a previously unknown skeletal systems, namely, lissodendoric acids A (1) and B (2), were isolated from the sponge Lissodendoryx florida collected from the Sea of Okhotsk. The structures and absolute configurations have been elucidated by extensive spectroscopic analysis together with chemical transformations and quantum-chemical modeling. The lissodendoric acids show a potent capability to decrease the production of reactive oxygen species in neuroblastoma Neuro 2a and somewhat increase the survival of these cells upon treatment with 6-hydroxydopamine (an in vitro Antiparkinson biotest)