tropisetron and Chronic-Disease

A growing body of evidence illustrates that 5-HT3 receptor antagonist drugs may be of benefit in the treatment of negative symptoms in schizophrenia.. The objective of this study was to assess the efficacy and tolerability of tropisetron add-on to risperidone on negative symptoms in patients with chronic stable schizophrenia.. In a double-blind, placebo-controlled 8-week trial, 40 patients with chronic schizophrenia who were stabilized on risperidone were randomized into tropisetron or placebo add-on groups. Psychotic symptoms were measured using the Positive and Negative Syndrome Scale (PANSS) every 2 weeks. Furthermore, extrapyramidal and depressive symptoms as well as side effects were assessed. The primary outcome measure was the difference in change from baseline of negative subscale scores between the two groups at week 8.. Tropisetron resulted in greater improvement of the total PANSS scores [F(1.860,70.699) = 37.366, p < 0.001] as well as negative scores [F(2.439,92.675) = 16.623, p < 0.001] and general psychopathology [F(1.767,67.158) = 4.602, p = 0.017], but not positive subscale scores [F(1.348, 51.218) = 0.048, p = 0.893] compared to placebo. In a multiple regression analysis controlling for positive, extrapyramidal, and depressive symptoms, treatment group (standardized β = -0.640) significantly predicted changes in primary negative symptoms. The side effect profile did not differ significantly between the two groups.. Tropisetron add-on to risperidone improves the primary negative symptoms of patients with chronic stable schizophrenia.

Topics: Adult; Antipsychotic Agents; Chronic Disease; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Indoles; Male; Regression Analysis; Risperidone; Schizophrenia; Schizophrenic Psychology; Serotonin Antagonists; Severity of Illness Index; Treatment Outcome; Tropisetron

Various pathophysiological processes can lead to chronic back pain, which necessitates a differentiated therapeutic approach. In addition, psychic and psychosocial processes may influence the clinical picture.. Twenty-five patients with chronic back pain were enrolled in the study. Patients suffering from psychosocial stresses and depressions were excluded from the study. The patients with painful tendinopathies and myofascial pain syndromes were treated with local injections of 5-10 mg tropisetron, and patients with degenerative processes were treated for 5 days with an intravenous (i.v.) bolus injection of 5 mg tropisetron (Navoban). Before treatment and 7 and 14 days later, the visual analog pain scale was filled in. The long-term drug therapy could be continued.. There was a highly significant pain reduction with a very potent effect both in the locally treated group and in the intravenously treated group. Most of the patients could discontinue or reduce their long-term therapy with non-steroidal anti-inflammatory drugs or analgesics.. A marked improvement in pain could be achieved in an open study by treating back pain of a primarily somatic nature with the 5-HT3 receptor antagonist tropisetron. A reduction in pain of > or =50% was reported by 76% of the patients. These results should be substantiated by the corresponding randomized, placebo-controlled, double blind studies that are needed to investigate the true benefit of treating back pain with 5-HT3 receptor antagonists.

Topics: Adult; Aged; Chronic Disease; Female; Humans; Indoles; Low Back Pain; Male; Middle Aged; Serotonin Antagonists; Tropisetron

To characterize the immune modulatory effects of 5-HT3 receptor antagonist treatment in patients with fibromyalgia, autoimmune disorders, and chronic pain.. Multiplex-assisted cytokine measurements were performed before and during treatment. Whole blood stimulation with TNF-alpha was carried out to determine the proinflammatory response induced by exogenous TNF-alpha.. Five of nine patients clinically responded to treatment, and two had a moderate response. All patients had significantly elevated levels of T-H1 cytokines more prominent than TNF-alpha, IL-1beta, and IL-6. Treatment resulted in transient effects on peripheral monocyte counts in all but one patient, a plasma IL-1beta increase in two responder patients, and decreased T-H1 cytokines in two responder patients. Ex vivo TNF-alpha stimulation was transiently reconstituted in three responder patients to a significant level. Three patients showed a marginal reconstitutive response.. 5-HT3 receptor blockade transiently affects monocyte tissue infiltration, modulates T-H1 cytokines in clinical responders as well as MIP-1beta in moderate responders, and transiently affects the ex vivo response to exogenous TNF-alpha.

Topics: Adult; Aged; Autoimmune Diseases; Chronic Disease; Fibromyalgia; Humans; Immune System; Indoles; Middle Aged; Pain; Serotonin 5-HT3 Receptor Antagonists; Serotonin Antagonists; Tropisetron

Intraplantar administration of serotonin 5-HT3 receptor antagonists ICS 205-930 and MDL 72222 (1-100 micrograms; 50 microliters) produced dose-related analgesia against formalin-induced acute- and Freunds adjuvant-induced chronic-inflammatory pain in rats. 5-HT3 receptor antagonists had greater effect in the chronic pain test than in the acute paradigm. In both tests, ICS 205-930 was more potent than MDL 72222. These data further support the involvement of peripheral 5-HT3 sites in inflammatory pain, and suggest the utility of selective 5-HT3 receptor antagonists as peripheral analgesics.

Topics: Acute Disease; Analgesics; Animals; Anti-Inflammatory Agents, Non-Steroidal; Chronic Disease; Indoles; Male; Nociceptors; Pain Measurement; Rats; Serotonin Antagonists; Tropanes; Tropisetron