How to Examine Patients Using the Abnormal Involuntary Movement Scale

Munetz, Mark R.; Benjamin, Sheldon

doi:10.1176/ps.39.11.1172

Cited by 176 publications

(151 citation statements)

References 16 publications

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“…Acute EPS were evaluated using a modification of the Simpson Angus Extrapyramidal Symptoms Scale (SAEPS) (Simpson and Angus, 1970). Tardive dyskinesia was assessed at baseline and termination using the Abnormal Involuntary Movement Scale (AIMS-NIMH) (Munetz and Benjamin, 1988). Vital signs were obtained at each visit.…”

Section: Evaluation Of Adverse Effectsmentioning

confidence: 99%

A Pilot Study of Risperidone, Olanzapine, and Haloperidol in Psychotic Youth: A Double-Blind, Randomized, 8-Week Trial

Sikich

Hamer

Bashford

et al. 2003

Neuropsychopharmacol

283

148

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This pilot study was undertaken to estimate the acute antipsychotic effect size and side effect propensity of risperidone and olanzapine in the pediatric population, in comparison to haloperidol, a conventional antipsychotic with established efficacy. Risperidone and olanzapine are widely used as first-line treatments to ameliorate psychotic symptoms in youth, but their abilities to specifically treat children and adolescents presenting due to psychotic symptoms have not been rigorously studied. Subjects, selected because of prominent positive psychotic symptoms, were randomly assigned to double-blind, parallel treatment with risperidone, olanzapine, or haloperidol for 8 weeks. The primary outcome was reduction in the Brief Psychiatric Rating Scale for Children total score from baseline to termination. An exploratory, descriptive analysis was done to compare the three treatments. A total of 50 patients, 8-19 years, participated. All treatments reduced symptoms significantly with p-values (corrected for multiple comparisons) of 0.0018 for each of the atypical agents and 0.012 for haloperidol. In all, 88% of subjects treated with olanzapine, 74% treated with risperidone, and 53% treated with haloperidol met response criteria. The primary side effects observed in all patients were mild to moderate sedation, extrapyramidal symptoms, and weight gain. Risperidone and olanzapine acutely reduced psychotic symptoms in this pediatric sample. Exploratory comparisons indicate the magnitude of the antipsychotic response with these atypical agents is comparable to that observed with haloperidol. However, youth treated with risperidone and olanzapine experienced weight gain and extrapyramidal effects that appear more prevalent and severe than reported in adults.

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Section: Evaluation Of Adverse Effectsmentioning

confidence: 99%

A Pilot Study of Risperidone, Olanzapine, and Haloperidol in Psychotic Youth: A Double-Blind, Randomized, 8-Week Trial

Sikich

Hamer

Bashford

et al. 2003

Neuropsychopharmacol

283

148

View full text Add to dashboard Cite

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“…Ratings of psychiatric symptoms and medication side effects were assessed using: Brief Psychiatric Rating Munetz and Benjamin 1988). The majority of the ratings were carried out by one of us (LB).…”

Section: Behavioral Ratingsmentioning

confidence: 99%

Nicotine Withdrawal and Psychiatric Symptoms in Cigarette Smokers with Schizophrenia

Dalack

1999

Neuropsychopharmacology

116

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It is well known that the prevalence of smoking among those with schizophrenia is two to three times higher than that in the general population and considerably higher than that among those with other psychiatric illnesses de Leon et al. 1995). Crosssectional studies have suggested that smoking may be a marker of more severe schizophrenic illness and may affect treatment by modulating side effects of antipsychotic medication (Sandyk and Kay 1991;Goff et al. 1992). For example, neuroleptic-induced parkinsonism (NIP) is often found to be less prevalent among schizophrenics who smoke (Decina et al. 1990), whereas, the rate of tardive dyskinesia had been variably reported to be higher or lower (Yassa et al. 1987;Menza et al. 1991). The suggested effects of smoking on NIP may be accounted for by the faster metabolic clearance of neuroleptics attributable to hepatic microsomal enzyme upregulation caused by the products of tobacco combustion (Benowitz 1988), although some studies sug- et al. 1985;Jann et al. 1986). A number of explanations for the extensive cooccurrence of smoking with schizophrenia have been forwarded (Freedman et al. 1997;Glassman 1993). Some have focused on the ameliorating effects of nicotine on attentional abnormalities found in schizophrenia (Freedman et al. 1997;Adler et al. 1993), whereas, others have posited that the effects of nicotine on reward reinforcement and negative symptoms of schizophrenia are important (Glassman 1993;Nisell et al. 1995). Systematic studies of the effects of nicotine withdrawal have not been reported.The available cessation data suggest that smoking cessation rates among smokers with schizophrenia are quite low (Covey et al. 1994;Addington et al. 1997;Ziedonis and George 1997). In part, this may relate to lower motivation to quit (Ziedonis and George 1997). We have reported cases that suggested that attempts to cut down or quit smoking led to an exacerbation of psychiatric symptoms and a return to smoking (Dalack and Meador-Woodruff 1996).The very high prevalence of smoking among those with schizophrenia, coupled with our clinical impression that smoking abstinence may to lead to an exacerbation of psychiatric symptoms, led us to consider whether smoking in schizophrenia might be an attempt to self-medicate symptoms of the illness or side effects of treatment. Accordingly, we used an experimental paradigm that most closely paralleled our clinical observations. We conducted a randomized, double-blind, placebo-controlled crossover study to examine the effect of acute nicotine withdrawal on psychiatric symptoms and medication side effects in smokers with schizophrenia. Our goal was to examine the following hypotheses.1. Acute nicotine withdrawal will exacerbate psychiatric symptoms in heavy smokers with schizophrenia. 2. Treatment of acute withdrawal by transdermal nicotine patch will mitigate both the increase in withdrawal symptoms and psychiatric symptoms. 3. Neuroleptic-induced parkinsonism will worsen during acute nicotine withdrawal; tardive dyskinesia will not ch...

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“…Study criteria for patients with schizophrenia were as follows: 1) diagnosis of schizophrenia according to Diagnostic and Statistical Manual (DSM-IV); 2) no other DSM-IV axis I diagnosis; 3) no history of alcohol or substance abuse or dependence; 4) absence of benzodiazepine administration for at least 21 days; 5) no concomitant or past severe medical conditions; 6) no pregnancy; 7) no metallic objects in the body; and 8) ability to provide informed consent. Patient clinical evaluation at intake included the Positive and Negative Symptoms Scales (PANS) (Kay et al 1987), a scale that includes the Brief Psychiatric Rating Scale (BPRS) (Overall and Gorham 1962), and the AIMS (Munetz and Benjamin 1988). Since BDZ receptor density is not consistently affected by chronic antipsychotic administration (Gavish et al 1988;Giardino et al 1991), neuroleptic withdrawal was not required for this study.…”

Section: Subjectsmentioning

confidence: 99%