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H Allain - One of the best experts on this subject based on the ideXlab platform.
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Clinical management of agitation in the elderly with Tiapride.
European psychiatry : the journal of the Association of European Psychiatrists, 2001Co-Authors: P H Robert, H AllainAbstract:Agitated behaviors such as uncooperativeness with necessary care, motor hyperactivity, and verbal or physical aggression are some of the most commonly reported complications in dementia and organic disorders in elderly subjects. These symptoms present greater clinical challenges and management issues than the cognitive deficits. Antipsychotics are the most commonly used psychotropic agents for treating these types of symptoms. The aims of this article are to review clinical studies with Tiapride, a substituted benzamide, and more specifically to present recent data coming from two double-blind, randomized studies in elderly subjects. The first study versus melperone was conducted in Germany, with over 176 hospitalized demented patients, and indicated that Tiapride was as effective and safe as melperone. More recently, a multicentre, international, double-blind, three-parallel group study compared a 21-day treatment of Tiapride to haloperidol and placebo and included 306 demented elderly patients with agitation and aggressiveness. The results showed that Tiapride and haloperidol were significantly effective in the treatment of agitation and aggressiveness compared to placebo. The Tiapride safety profile was found to be better than haloperidol for clinical acceptability, particularly for significantly fewer extrapyramidal symptoms in the Tiapride group.
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double blind study of Tiapride versus haloperidol and placebo in agitation and aggressiveness in elderly patients with cognitive impairment
Psychopharmacology, 2000Co-Authors: H Allain, P H J Dautzenberg, K Maurer, S Schuck, D Bonhomme, D GérardAbstract:Objective: The aim of the present study was to compare the efficacy and safety of Tiapride versus haloperidol and placebo in the treatment of agitation and aggressiveness in elderly patients with mild or moderate mental impairment. Method: This international, multicentre, randomized, double blind, three parallel groups study compared efficacy and safety of a 21-day regimen of Tiapride 100–300 mg/day versus haloperidol 2– 6 mg/day and placebo in 306 elderly patients with mild or moderate dementia according to DSM III R and behavioural troubles with the Multidimensional Observation Scale for the Elderly Subjects (MOSES) irritability/aggressiveness subscore ranging from 16 to 30. Results: The percentage of responders (defined as patients with at least a 25% MOSES irritability/aggressiveness subscore decrease between the inclusion and the end of the treatment) was significantly greater in the Tiapride (63%, P=0.04) and haloperidol (69%, P=0.004) groups than in the placebo group (49%), with no significant difference between the active drugs. Similar results were observed for the mean MOSES irritability/aggressiveness subscores on D7, D21 and at Dend which were significantly smaller in the Tiapride and haloperidol groups than in the placebo group. The decrease between D0 and Dend was significantly greater in the Tiapride (6.57, P=0.009) and haloperidol groups (6.75, P=0.005) than in the placebo group (4.71). The global improvement CGI was significantly better in the Tiapride and haloperidol groups than in the placebo group (P=0.03 and P=0.02). No significant difference was observed between the two active drugs or among the three treatment groups for the Folstein’s Mini Mental Status scale (MMS) total score, and there was no notable change during treatment. The number of patients with adverse events, assessed on the Udvalg Kliniske Undersogelser scale (UKU), and the number of UKU symptoms were smaller in the Tiapride group (62 patients, 61%, 212 events) than in the haloperidol group (77 patients, 76%, 305 events) and identical to that observed in the placebo group (69 patients, 67%, 234 events). Of interest, the number of patients with at least one extrapyramidal symptom was significantly lower (P=0.003) in the Tiapride group (16 patients, 16%) than in the haloperidol group (34 patients, 34%) and similar to that of the placebo group (18 patients, 17%); the difference observed between the haloperidol and placebo groups was significant (P=0.008). Conclusion: Tiapride is not different from haloperidol in the treatment of agitation and aggressiveness in elderly patients and better tolerated, in particular with significantly fewer extrapyramidal symptoms.
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Effects of Tiapride on electroencephalograms and cognitive functions in the elderly.
International clinical psychopharmacology, 1999Co-Authors: A. Patat, H Allain, D Bonhomme, H Alberini, C Soubrane, J.m. GandonAbstract:Abstract: Tiapride is a substituted benzamide with selective dopamine D2 and D3-antagonist properties which appears to have preferential affinity for extra-striatal dopamine receptors. Tiapride is used in the treatment of agitation, aggressiveness and anxiety in the elderly. To define the effects of a single dose of Tiapride 100 mg on psychomotor peformance and cognitive functions and electroencephalogram (EEG), a randomized, double-blind, three-way crossover, placebo-controlled study using lorazepam 1 mg as a positive control was carried out in 12 elderly individuals (six women and six men, mean age ± SD: 69 ± 3 years). A 1-week wash-out interval was allowed between each administration. Psychomotor and cognitive functions were assessed using both objective [EEG, critical flicker fusion, simple reaction time, tapping, body sway, continuous performance task (CPT), digit symbol substitution test, Sternberg memory scanning and a learning memory test using word lists] and subjective (visual analogue scales) measures before and up to 6 h after dosing. Tiapride was devoid of any detrimental or sedative effects on EEG and all of the performance tasks used and did not impair memory compared withplacebo. In contrast, a single dose of lorazepam produced significant deleterious effects on psychomotor performance (decrease in tapping and in sustained attention (CPT) and an increase in reaction time and body sway), and sedative effects on EEG (significant increase in delta and decrease in alpha waves) as well as significant impairment in working memory (Sternberg) and anterograde amnesia (decrease in immediate and delayed free recall) up to 6 h after dosing compared with placebo and Tiapride. In conclusion, the present study showed that in contrast to lorazepam 1 mg there is no evidence to suggest that a single dose of Tiapride 100 mg has any sedative and amnestic effects in the elderly which may interfere with everyday life activities.
Fengjuan Zhao - One of the best experts on this subject based on the ideXlab platform.
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Simultaneous electrochemiluminescence determination of sulpiride and Tiapride by capillary electrophoresis with cyclodextrin additives.
Journal of chromatography. B Analytical technologies in the biomedical and life sciences, 2006Co-Authors: Fengjuan ZhaoAbstract:Sulpiride and Tiapride are often used in the treatment of depression, schizophrenia and psychopathology of senescence, gastric or duodenal ulcers and are also partly excreted by kidney. This work developed a simple and sensitive method for their simultaneous monitoring in human urine based on capillary electrophoresis coupled with electrochemiluminescence detection by end-column mode. beta-Cyclodextrin (beta-CD) was used as an additive to the running buffer to obtain the absolute separation of sulpiride and Tiapride. Under optimized conditions the proposed method displayed a linear range from 1.0 x 10(-7) to 1.0 x 10(-4) M for both sulpiride and Tiapride with the correlation coefficients more than 0.995 (n = 6). Their limits of detection were 1.0 x 10(-8) M (45 amol) and 1.5 x 10(-8) M (68 amol) at a signal to noise ratio of 3, respectively. The relative standard deviations for six determinations of 2.0 microM sulpiride and 3.0 microM Tiapride were 1.8 and 2.5%, respectively. For practical application an extract step with ethyl acetate at pH 11 was performed to eliminate the influence of ionic strength in sample. The recoveries of sulpiride and Tiapride at different levels in human urine were between 84 and 95%, which showed that the method was valuable in clinical and biochemical laboratories for monitoring sulpiride and Tiapride for various purposes.
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Simultaneous electrochemiluminescence determination of sulpiride and Tiapride by capillary electrophoresis with cyclodextrin additives.
Journal of Chromatography B, 2006Co-Authors: Fengjuan ZhaoAbstract:Abstract Sulpiride and Tiapride are often used in the treatment of depression, schizophrenia and psychopathology of senescence, gastric or duodenal ulcers and are also partly excreted by kidney. This work developed a simple and sensitive method for their simultaneous monitoring in human urine based on capillary electrophoresis coupled with electrochemiluminescence detection by end-column mode. β-Cyclodextrin (β-CD) was used as an additive to the running buffer to obtain the absolute separation of sulpiride and Tiapride. Under optimized conditions the proposed method displayed a linear range from 1.0 × 10 −7 to 1.0 × 10 −4 M for both sulpiride and Tiapride with the correlation coefficients more than 0.995 ( n = 6). Their limits of detection were 1.0 × 10 −8 M (45 amol) and 1.5 × 10 −8 M (68 amol) at a signal to noise ratio of 3, respectively. The relative standard deviations for six determinations of 2.0 μM sulpiride and 3.0 μM Tiapride were 1.8 and 2.5%, respectively. For practical application an extract step with ethyl acetate at pH 11 was performed to eliminate the influence of ionic strength in sample. The recoveries of sulpiride and Tiapride at different levels in human urine were between 84 and 95%, which showed that the method was valuable in clinical and biochemical laboratories for monitoring sulpiride and Tiapride for various purposes.
H J Freyberger - One of the best experts on this subject based on the ideXlab platform.
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alcohol withdrawal treatment in intoxicated vs non intoxicated patients a controlled open label study with Tiapride carbamazepine clomethiazole and diazepam
Alcohol and Alcoholism, 2003Co-Authors: Michael Lucht, K U Kuehn, J Armbruster, G Abraham, M Gaensicke, Sven Barnow, H Tretzel, H J FreybergerAbstract:— Aims and Methods: Alcohol withdrawal treatment efficacy of Tiapride/carbamazepine (A) vs clomethiazole (B) vs diazepam (C) in non-intoxicated patients and vs Tiapride/carbamazepine in intoxicated patients (D; breath alcohol concentration ≥ 1 g/l) was tested ( n = 127) in a controlled randomized open-label study. Results: Efficacy and safety were not different between groups (total group: delirium, 3.9%; seizure, 0.8%), except for a lack of efficacy in 18% of intoxicated Tiapride/carbamazepine patients. A change of medication in this group was necessary only when primarily intoxicated patients had reached the non-intoxicated range. Conclusions: Treatment with Tiapride/carbamazepine in alcohol-intoxicated patients proved to be safe.
D Gérard - One of the best experts on this subject based on the ideXlab platform.
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double blind study of Tiapride versus haloperidol and placebo in agitation and aggressiveness in elderly patients with cognitive impairment
Psychopharmacology, 2000Co-Authors: H Allain, P H J Dautzenberg, K Maurer, S Schuck, D Bonhomme, D GérardAbstract:Objective: The aim of the present study was to compare the efficacy and safety of Tiapride versus haloperidol and placebo in the treatment of agitation and aggressiveness in elderly patients with mild or moderate mental impairment. Method: This international, multicentre, randomized, double blind, three parallel groups study compared efficacy and safety of a 21-day regimen of Tiapride 100–300 mg/day versus haloperidol 2– 6 mg/day and placebo in 306 elderly patients with mild or moderate dementia according to DSM III R and behavioural troubles with the Multidimensional Observation Scale for the Elderly Subjects (MOSES) irritability/aggressiveness subscore ranging from 16 to 30. Results: The percentage of responders (defined as patients with at least a 25% MOSES irritability/aggressiveness subscore decrease between the inclusion and the end of the treatment) was significantly greater in the Tiapride (63%, P=0.04) and haloperidol (69%, P=0.004) groups than in the placebo group (49%), with no significant difference between the active drugs. Similar results were observed for the mean MOSES irritability/aggressiveness subscores on D7, D21 and at Dend which were significantly smaller in the Tiapride and haloperidol groups than in the placebo group. The decrease between D0 and Dend was significantly greater in the Tiapride (6.57, P=0.009) and haloperidol groups (6.75, P=0.005) than in the placebo group (4.71). The global improvement CGI was significantly better in the Tiapride and haloperidol groups than in the placebo group (P=0.03 and P=0.02). No significant difference was observed between the two active drugs or among the three treatment groups for the Folstein’s Mini Mental Status scale (MMS) total score, and there was no notable change during treatment. The number of patients with adverse events, assessed on the Udvalg Kliniske Undersogelser scale (UKU), and the number of UKU symptoms were smaller in the Tiapride group (62 patients, 61%, 212 events) than in the haloperidol group (77 patients, 76%, 305 events) and identical to that observed in the placebo group (69 patients, 67%, 234 events). Of interest, the number of patients with at least one extrapyramidal symptom was significantly lower (P=0.003) in the Tiapride group (16 patients, 16%) than in the haloperidol group (34 patients, 34%) and similar to that of the placebo group (18 patients, 17%); the difference observed between the haloperidol and placebo groups was significant (P=0.008). Conclusion: Tiapride is not different from haloperidol in the treatment of agitation and aggressiveness in elderly patients and better tolerated, in particular with significantly fewer extrapyramidal symptoms.
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Value of Tiapride for agitation in the elderly. Review of published studies
L'Encephale, 1998Co-Authors: Roger M, D GérardAbstract:Among elderly disruptive behavior agitation and aggressiveness are frequent and often related to dementia. They are known for increasing the risk of patients' institutionalization and causing distress to families and care givers. When a drug prescription is required, physicians have to take into account the high sensitivity of elderly. Tiapride is an atypical neuroleptic which acts preferentially on D2 and D3 dopaminergic receptors. Several papers concerning results of clinical trials conducted in Europe and Japan have been published and reviewed in this article. The interest of Tiapride in the treatment of elderly agitation and aggressiveness has been assessed in four double blind clinical trials including more than 700 patients. The efficacy of Tiapride (aggressiveness, agitation, delusion and wandering) was demonstrated in a trial versus placebo (p = 0.027) including 324 patients treated for 28 days with 75 to 150 mg/d. Furthermore the superiority of Tiapride (175 to 450 mg/d) on chlorpromazine (18 to 112.5 mg/d) was shown in two trials where 262 patients were treated for four weeks, and a recent survey highlighted that Tiapride (400 mg/d) is as efficient as melperone (100 mg/d), the only neuroleptic to be indicated in treatment of elderly agitation and aggressiveness in Germany. Besides, 30 open clinical trials including around 1,000 patients have been conducted and have shown homogeneous and positive results. In the two trials versus chlorpromazine, the safety of Tiapride was better, with especially less drowsiness, extrapyramidal symptoms, and dry mouth. Compared to lorazepam, in healthy subjects, Tiapride caused less memory impairment. European and Japanese open studies confirmed the safety of Tiapride in the elderly. In conclusion, Tiapride at doses of 100 to 300 mg/d, appeared to be a therapy of elderly agitation and aggressiveness, at less as efficient as the other drugs used in this indication. Furthermore, the safety of Tiapride is an advantage compared to benzodiazepines and neuroleptics.
Magda Tsolaki - One of the best experts on this subject based on the ideXlab platform.
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evaluation of Tiapride in agitated elderly outpatients an open study
Human Psychopharmacology-clinical and Experimental, 2001Co-Authors: Magda TsolakiAbstract:The aim of this study was the evaluation of the efficacy and safety of Tiapride 50–100 mg administered 3 times a day to elderly patients with aggressive behavior. Data from 425 questionnaires concerning aggressive behavior in Greek elderly patients were evaluated before and after treatment. The Brief Agitation Rating Scale (BARS), which has 10 items, was used to evaluate the effectiveness of Tiapride. To test the overall effectiveness of the drug during the trial, the statistical method of repeated measures ANOVA was applied to the total score and the very small F-value (p < 0.0005) led us to accept the hypothesis that Tiapride significantly improves the condition of elderly patients with aggressive behavior. Only 6.2% of patients developed an adverse event during the trial. With 95% probability one may state that the probability of an adverse event occurring during the administration of Tiapride is between 5% and 7.4%. We conclude that Tiapride, apart from being very efficient in ameliorating aggressive behavior in elderly patients, is also very safe to administer. Copyright © 2001 John Wiley & Sons, Ltd.
