Donald M. Gallant

Electrographic and behavioral effects of diazepam during alcohol withdrawal stage in cats.

Abstract CNS spontaneous and evoked cortical and subcortical activities were evaluated in cats during chronic alcohol administration and following alcohol withdrawal. In the normal and epileptic animals, alcohol was administered through a gastric cannula (Pavlov type) chronically inserted in each cat in the upper quadrant of the greater curvature of the stomach. Chronic alcohol administration produced: (a) an increase of EEG fast activity in cortical and subcortical structures associated with suppression of epileptiform discharges ; and (b) a decrease in the amplitude of the local evoked potentials recorded from cortical and subcortical structures. In contrast, withdrawal from alcohol produced: (a) an increase in EEG slow wave background activity associated with activation of epileptiform discharges; and (b) an increase in the amplitude of the local evoked potentials recorded from cortical and subcortical strucstures. In addition, an evaluation of the effects of intravenous and intraperitoneal administration of diazepam was presented. It was concluded that diazepam is an effective drug in the prevention and control of the withdrawal syndrome. Electrical and behavioral studies suggest that chronic alcohol administration has an inhibitory effect upon the integrative action of the CNS, and a reversal of this effect (excitation) occurs during the withdrawal syndrome. Possible mechanisms for two such inverse neurophysiological actions are discussed.

Patterns of substance use on a college campus: a 14-year comparison study.

In 1972, a drug incidence survey was conducted at a private southern university. Pooled results of this random survey of 1,032 students revealed that on at least one occasion, 90% of the students had tried alcohol, 70% had used tobacco, and 61% had experimented with marijuana. Use of amphetamines (38%), hallucinogens (28%), barbiturates (19%), and cocaine (10%) was much lower. To evaluate the apparent change in trends of drug usage, a follow-up study was undertaken in 1986 at the same school. The results showed a decline in amphetamine and barbiturate use. The greatest differences were seen in the nearly fourfold increase in one-time use of cocaine between 1972 and 1986 and the sixteenfold increase in students who used cocaine more than 10 times. It was noteworthy that one-third of the students who used marijuana had done so by the 9th grade. Similar early experimentation was noted with a majority of the other drugs.

Effects of yohimbine on CNS structures: Neurophysiological and behavioral correlations

Yohimbine (by intravenous and/or intraperitoneal routes at doses between 0.5 to 3 mg/kg) produces behavioral changes (in freely moving cats and dogs) characterized by: a) an increase in alertness, extreme agitation, and nervousness; b) an increase in motor reaction to a variety of sensory stimuli; and c) an appearance of muscular shaking and tremors. These behavioral changes are associated with electrographic alterations characterized by: a) an increase in the amplitude of the local evoked potentials (LEP) recorded from the mesencephalic reticular formation, posterior hypothalamus and intralaminar thalamic system; b) a decrease in the amplitude of the LEP recorded from preoptic area, lateral hypothalamus and septal region; c) a slight diminution in the LEP amplitudes of the amygdala and hippocampus; d) an initial increase (15 to 25 min) followed by a long period of strong diminution in the amplitude of the cortical LEP; e) an increase in the percent time of fast cortical activity and in the amplitude of all frequencies; f) an appearance of subcortical and cortical epileptiform discharges in the normal animals during administration of the compound at doses of 2 to 3 mg/kg; and g) a marked activation of epileptiform discharges in the subcortical or cortical epileptic animals in association with occasional clinical seizures. These results were discussed from the point of view of neuronal excitability changes in CNS structures.

Further observations on trifluperidol: a butyrophenone derivative

SummaryThe experimental butyrophenone compound, trifluperidol, was compared with trifluoperazine and phenobarbital under double-blind conditions in a group of 60 hospitalized chronic schizophrenic patients. Therapeutic response was evaluated by means of 15 quantitative psychiatric, psychologic, and ward behavior measures. Both trifluperidol and trifluoperazine were clearly superior to phenobarbital, which failed to effect notable improvement in any of the 20 treated subjects. Trifluperidol had a greater and more rapid therapeutic effect than trifluoperazine as measured in the global ratings of improvement, and there was also suggestion in the psychologic data of greater improvement in immediate memory and greater reduction of symptoms reflecting chronicity and deterioration. The results of this study, as well as a review of three recent controlled comparative studies of trifluperidol, suggest that trifluperidol may well be the drug of choice for schizophrenic patients.

Antidepressant Overdose: Symptoms and Treatment

In recent years, an increased use of antidepressant medications has resulted in a heightened incidence of drug overdose. Because of this increased use, more types of antidepressant agents have become available. Therefore, emergency-room physicians not only have to recognize the overdose patient (often unwilling or unable to communicate with the physician), but also, identify the overdose agents if possible, and initiate early and appropriate treatment. Recognizing overdose signs and symptoms associated with various antidepressant agents is essential in choosing the appropriate treatment. Tricyclic agent overdoses account for most of the hospital admissions and deaths due to antidepressant therapy; a majority of these deaths are attributable to cardiac complications. In contrast, trazodone, one of the safest drugs when taken in overdose, is not associated with cardiac arrhythmias. Thus, trazodone-overdose patients generally require only emesis and/or gastric lavage, and minimal supportive therapy, whereas tricyclic antidepressant overdoses often require more aggressive intervention.

Psychiatric Aspects of Alcohol Intoxication, Withdrawal, and Organic Brain Syndromes

When a patient arrives in a physician’s office or an emergency room with symptoms of slurred speech, difficulty with coordination, ataxia, loquaciousness, and difficulty with attention, there may be a natural tendency by the physician to attribute the patient’s symptoms to alcohol intoxication. However, similar symptoms may be caused by certain neurological diseases such as multiple sclerosis, cerebellar dysfunction, or intoxication due to other sedative substances such as barbiturates or benzodiazepines. Metabolic diseases such as diabetes mellitus may also be associated with impairment of central nervous system function and subsequent development of the above signs and symptoms. Even if the diagnostic impression is supported by a relatively high blood level of alcohol, it would be wise for the physician to follow the patient carefully in order to be sure that these symptoms clear as the alcohol disappears from the blood. It should be emphasized that the alcohol intoxication may be masking underlying physical sequelae of alcoholism. A careful history and physical examination should evaluate the possibility of trauma.