Toxicology of Antidepressant Drugs

As many pharmacodynamic effects carry over from animals to man, many toxic effects may also be predicted from observations made in animals. However, some important toxic effects are not predictable from animal studies (WHO, 1966) and this limitation may apply particularly to drugs acting on the central nervous system, such as the antidepressants. Nevertheless, the recognition of species differences and similarities in responses is considered as an important means of predicting toxic effects in man. In the following, some degree of correlation is attempted by the comparison, whenever feasible, between toxicity in laboratory animals and adverse effects described in man, particularly in cases of acute intoxication. However, due to the differing amount of data that was available on various drugs and the widely varying experimental conditions employed, such a comparison may not always prove to be reliable. The following review has been restricted to antidepressants in clinical use and, as far as evidence was available from the literature, concentrated on two main categories of antidepressants, the monoamine oxidase (MAO) inhibitors and the tricyclics. The lithium salts are considered in a separate chapter of this volume. Read more […]

Drug Impairment Reviews: Anesthetics and Foreign Tranquilizers

STUDY: Doenicke, A., J. Kugler, M. Laub. Evaluation of Recovery “Street Fitness” by E.E.G. and Psychodiagnostic Tests After Anaesthesia. Can. Anaes. Soc. J., 14:567-583. 1967. (This study has been conducted in West Germany, but the address of the authors is not indicated in the reference.) Subjects: The total number of subjects is not evident but it must be above 200. Eighty-one subjects completed the psychomotor test battery. Demographic data on the subjects and descriptions of their health or drug use prior to the study are not given. They are, however, described as healthy volunteers. Method: This is an experimental study conducted in a clinical laboratory. The drugs administered as a single dose were thiobutabarbital (500 mg), methohexital (150 mg), and propanidid and C1-581 in doses which are not reported. Some subjects received repeated anesthesia but their number is not reported, nor is the order of or the interval between the anesthesias. Some subjects also received halothane, diethylether, or nitrous oxide after propanidid. Halothane was administered for 15 minutes. None of the concentrations of the inhalation anesthetics are reported in the text. EEG was continuously recorded for 12 or 24 hours Read more […]

Opioid-Related Disorders

Opioid abuse manifests in various ways in patients in medical settings. Psychiatrists are frequently consulted regarding opioid therapy for patients who are prescribed methadone, are thought or known to be dependent on prescription or illicit narcotics, engage in drug-seeking behavior, exhibit personality problems that interfere with medical care, or have overdosed. Suspicion is heightened by exaggerated pain complaints, by visits to multiple providers for multiple pain complaints requiring a narcotic prescription (e.g., migraine, back pain, dental pain, fibromyalgia, and endometriosis), and by claims to be “allergic” to every analgesic except for particular opioids (e.g., hydro-codone or oxycodone). Opioid-dependent patients often provoke angry reactions from staff, which can result in discharging a patient prematurely or underprescribing pain medications. Chronic pain patients who develop tolerance to opioids and experience opiate withdrawal on cessation of use are often misla-beled addicts (see “Pain”). Tolerance and withdrawal alone are not sufficient for the diagnosis of either substance abuse or dependence. For example, cancer patients with painful bone metastatic lesions may need high doses of narcotics and Read more […]

Meperidine: History notes

Meperidine: Composition, Therapeutic use, Usage trends. Treatment and rehabilitation. Meperidine effects. Reactions with other drugs.

Meperidine: Legal consequences

Meperidine: Composition, Therapeutic use, Usage trends. Treatment and rehabilitation. Meperidine effects. Reactions with other drugs.

Meperidine: Personal and social consequences

Meperidine: Composition, Therapeutic use, Usage trends. Treatment and rehabilitation. Meperidine effects. Reactions with other drugs.

Meperidine: Treatment and rehabilitation

Meperidine: Composition, Therapeutic use, Usage trends. Treatment and rehabilitation. Meperidine effects. Reactions with other drugs.

Meperidine: Reactions with other drugs or substances

Meperidine: Composition, Therapeutic use, Usage trends. Treatment and rehabilitation. Meperidine effects. Reactions with other drugs.

Meperidine: Physiological effects

Meperidine: Composition, Therapeutic use, Usage trends. Treatment and rehabilitation. Meperidine effects. Reactions with other drugs.

Meperidine: Mental effects

Meperidine: Composition, Therapeutic use, Usage trends. Treatment and rehabilitation. Meperidine effects. Reactions with other drugs.