dihydroergotoxine and Chronic-Disease

Topics: Adult; Aged; Caffeine; Cerebrovascular Disorders; Chronic Disease; Dihydroergotoxine; Drug Combinations; Female; Humans; Male; Middle Aged; Treatment Outcome

Chronic cerebrovascular disturbances of the aged are characterized by a decline of attention. When these patients undergo pharmacological treatment, it is very difficult to distinguish between a direct benefit and/or a secondary effect on memory resulting from attention improvement. In our study we have proposed and evaluated a new method for identifying the different components of therapeutic efficacy on memory and attention in chronic cerebrovascular patients. This method is based on the use of the Randt Memory Test, traditional scores of memory efficiency (Acquisition, Recall, and a combined index), and the RMT three-factor scores derived from a structural model of memory functioning. The three scores have been called Encoding and Organization, Cognitive Efficiency, and Attention Efficiency. Participants were 96 selected chronic cerebrovascular patients treated in a double-blind study for 12 weeks with dihydroergocristine versus placebo. While changes in both acquisition and recall scores were related to the treatment, only changes of the Encoding and Organization factor scores were systematically related to therapy. Changes in Attention Efficiency were positively related to therapy only in proportion to the degree of cerebrovascular impairment.

Topics: Attention; Cerebrovascular Disorders; Chronic Disease; Dihydroergotoxine; Double-Blind Method; Effect Modifier, Epidemiologic; Female; Geriatric Assessment; Humans; Male; Memory; Middle Aged; Models, Neurological; Sensitivity and Specificity

An example of multidimensional assessment procedure applied to the study of treatment effects in a type of pathological aging is presented in this paper. Data discussed here come from a clinical trial performed to evaluate the effects of an ergot derivate, dihydroergocristine, in CCVD memory deficits. The multidimensional assessment procedure consisted of behavioral, clinical, and psychometric measures aimed to identify both the results related to drug activity (experimental validity), and the implications that these eventual drug-induced changes have on the everyday life patients' competence (clinical validity). 97 out-patients (both sexes were represented), with a mean age of 61.21 y (SD 7.29), who suffered from mild to moderate chronic cerebro-vascular disturbances were included in this double-blind study only when they met rigid inclusion criteria. The experimental period was 12 weeks. Results indicate a pattern of convergent, statistically significant, changes which evidence how treatment-associated memory changes are accompanied by an improvement of emotional and physical well being and by a modification of behavioral structure which is characterized by greater efficiency and greater responsiveness to stimuli.

Topics: Aged; Cerebrovascular Disorders; Chronic Disease; Clinical Trials as Topic; Dihydroergotoxine; Double-Blind Method; Female; Humans; Male; Memory Disorders; Mental Processes; Middle Aged; Psychiatric Status Rating Scales

Five-year results are reported of a controlled long-term comparative study to assess the effects of ergoloid mesylates (1.5 mg 3-times daily) and placebo on medical, psychological and electrophysiological variables. Initially, 148 healthy elderly volunteers of both sexes were included. Eighty-nine subjects (48 on ergoloid mesylates and 41 on placebo) are still in the double-blind study; 39 subjects have left the trial for various reasons (6 deaths, 25 drop-outs due to disease, and 8 withdrawals) and 20 subjects are participating under 'open' conditions. Formal statistical comparison of the two groups in terms of 10 medical and psychometric outcome variables did not produce significant differences. However, a number of relevant findings and trends with regard to the effects of ergoloid mesylates were established: the drug was well tolerated objectively and subjectively; subjective complaints such as frequent dizziness, cardiac symptoms and leg cramps were improved; there was less increase than on placebo in the number of subjects with pathological ECG findings; there was less increase than on placebo in the number of subjects taking digitalis; fewer subjects than in the placebo group had an increase in the number of major diagnoses; the decrease in some lipid fractions was more pronounced than on placebo; and performance in some psychometric tests (WAIS Vocabulary, WAIS Performance) was better in the ergoloid mesylates group. None of these findings, by itself, would be evidence of a dramatic effect of ergoloid mesylates on the participants in the double-blind trial. Taken together, however, they fall into a pattern, suggesting that ergoloid mesylates was partly effective in maintaining physical and mental health in these healthy elderly individuals. The finding of more disease-related and symptom-related drop-outs in the placebo group (25 vs. 20 in the ergoloid mesylates group) supports this assumption. Furthermore, the fact that a number of subjects who had left the double-blind trial for medical reasons improved on subsequent ergoloid mesylates administration may be seen as a further argument in favour of a prophylactic effect of ergoloid mesylates on pathological concomitants of ageing.

Topics: Aged; Aging; Blood Pressure; Chronic Disease; Dihydroergotoxine; Double-Blind Method; Drug Administration Schedule; Drug Evaluation; Drug Utilization; Electrocardiography; Female; Habits; Humans; Male; Mental Disorders; Middle Aged; Nervous System Diseases; Office Visits; Psychological Tests; Psychophysiologic Disorders

Many controlled double-blind clinical trials against placebo and other drugs have clearly demonstrated the activity of dihydroergotoxine mesylate (DHT) on some symptoms of chronic senile cerebral insufficiency (CSCI). In spite of this, there is still some controversy about the usefulness of DHT for treatment of CSCI, as it seems to be hard to transpose the results of these studies to treatment of a population with DHT. Trying to overcome this criticism, a multicenter double-blind, placebo-controlled long-term (1 year) clinical trial has been planned, using very simple criteria for patient selection and easy to use assessment devices. Fifty two centres distributed throughout Italy were invited and 40 took active part in the study. The present report deals with data collected for analysis on Aug. 31, 1982. On this date 559 patients entered the study and 458 were under treatment (229 on DHT 1.5 mg t.i.d. and 229 on placebo). 101 patients dropped out (48 on DHT and 53 on placebo). 388 patients (195 on DHT and 193 on placebo) had completed 6 months and 204 (111 on DHT and 93 on placebo) had completed 1 year of treatment. The data from patients who completed 6 and 12 months of treatment period were analyzed statistically using Student t tests for paired and unpaired data, the large number of patients being adequate protection against any non normality in the distribution of the data. Differences with 2P values of 0.01 or less were considered significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Aged; Cerebrovascular Disorders; Chronic Disease; Clinical Trials as Topic; Dihydroergotoxine; Double-Blind Method; Female; Humans; Male; Middle Aged; Placebos; Psychological Tests

A study is presented of 67 patients with hypertensive disease (stage II) at the age from 35 to 60 years. Three types of central hemodynamics were singled out: hyperkinetic, hypokinetic and eukinetic. The optimal effect was observed with associated use of Kristepin and obsidan in patients with the hyperkinetic type of hemodynamics. Concentrations of plasma renin and aldosterone cannot be used as criteria for the choice of hypotensive treatment in the above categories of patients.

Topics: Adult; Antihypertensive Agents; Chronic Disease; Clopamide; Dihydroergotoxine; Drug Combinations; Drug Evaluation; Drug Therapy, Combination; Hemodynamics; Humans; Hypertension; Middle Aged; Propranolol; Reserpine

Catecholamine therapy is often ineffective in reversing the peripheral vasodilatation and hypotension of septic shock. This suggests that catecholamines might not be able to activate alpha 1-adrenergic receptors to cause vasoconstriction. Despite elevations in endogenous catecholamines, hypoglycemia is also a complication of human sepsis, suggesting that among many other causes, hepatic alpha 1-receptors might be altered. To better understand the pathophysiologic basis for this pharmacologic dilemma, we studied the effect of experimental sepsis on alpha 1-adrenergic receptors in hepatic tissue, a rich source of alpha 1-receptors, from septic and control Sprague-Dawley rats. alpha 1-adrenergic receptors were measured with [3H]-prazosin and data analyzed by a computerized nonlinear least-square regression algorithm. Twenty-four hours following cecal ligation with puncture, a decreased number of alpha 1-adrenergic receptors was noted in crude and purified plasma membrane fractions (23 and 40% reductions respectively) from septic animals. No changes in either agonist or antagonist affinity for receptors from septic animals were noted. These data indicate that the catecholamine refractoriness seen in septic shock may be a result of alterations in alpha 1-adrenergic receptor number or receptor-effector coupling.

Topics: Animals; Bacterial Infections; Chronic Disease; Dihydroergotoxine; Disease Models, Animal; Glucose; Guanylyl Imidodiphosphate; In Vitro Techniques; Kinetics; Liver; Male; Prazosin; Rats; Rats, Inbred Strains; Receptors, Adrenergic, alpha; Shock, Septic; Tritium

Topics: Aged; Cerebrovascular Disorders; Chronic Disease; Dihydroergotoxine; Drug Evaluation; Female; Humans; Male; Middle Aged; Nicotinic Acids; Nimodipine; Vasodilator Agents

Topics: Aged; Cerebrovascular Disorders; Chronic Disease; Dihydroergotoxine; Electroencephalography; Humans; Middle Aged

After setting up a catalogue of complaints and signs for the most frequent disturbances of feeling tone of the patients suffering from cerebral arteriosclerosis, consisting of somatically subjective head pain and mental disturbances, treatment was given to 33 patients with cerebrovascular disturbances and 7 patients with similar, although non-vascular, disturbances (4 patients with presenile dementia, 3 patients with tinnitus in otosclerosis), the treatment consisting of eutergin 3 X 1 tablets to 3 X 2 tablets daily, the concomitant cardio-internistic medication remaining the same throughout the treatment course. The type and severity of the symptoms prevailing in each case were determined at the beginning, after 3 weeks and after 6 weeks of the medication with eutergin. It was found that improvement of the somatic-subjective head pain was more pronounced than that of the mental disturbances. Generally speaking, the disturbing somatic or mental signs were those which could be influenced better than the others. As far as the head pain was concerned, the feeling of giddiness, congestion in the head, rapid exhaustion, above all, tinnitus, responded best to the medication (the improvement amounting to approximately 40%), whereas of the mental complaints, a feeling of being "lost" or "abandoned" and a morose mood were most amenable to improvement (degree of improvement approximately 30%). The prevention of the delirogenic effect of antidepressives in senile depression was a remarkable effect; this means that effective antidepressive medication is made possible with the help of eutergin, EEG controls did not reveal any significant effects. There were no side effects. Elevated blood pressure levels showed a tendency to become normal without any dramatic drops. Hence, eutergin is recommended in all kinds of chronic cerebrovascular lesions, provided it is associated with concomitant cardiac and internistic treatment.

Topics: Aged; Antidepressive Agents; Cerebrovascular Disorders; Chronic Disease; Dementia; Dihydroergotoxine; Drug Combinations; Electroencephalography; Headache; Humans; Mental Disorders; Middle Aged; Neurocognitive Disorders; Otosclerosis; Papaverine; Sparteine; Tinnitus