Pharmacopsychiatria最新文献

From October 1977 until March 1978 a prospective study was performed on 30 depressive patients of both sexes, age 20 to 60 years. In a double-blind design patients received either amitriptyline or trazodone for 28 days. The course of therapy was controlled six times by means of the Hamilton Rating Scale for Depression (HRS) and the Zerssen-Contentment Scale (BS). The following results were obtained: By the statistical analysis of the HRs scores no difference in the antidepressant properties of trazodone and amitriptyline can be demonstrated. The same result is obtained by use of the BS scores. Therefore the antidepressant efficacy of the two medications can be called equal. When comparing day 10 to day 0, a correlation between the two data pools of RSp = 0.719 (p less than 0.01) according to Spearmen was found. Upon comparing the 28th day with the pre-treatment day, RSp comes out to be 0.809. When applying Anova no significant correlation for the pre-treatment day can be demonstrated (RL = 0.260); yet at the end of the study the correlation comes out to be extremely high (RL = 0.940, p less than 0.1). When considering each day of the study, RL results to be 0.808 (p less than 0.001). Thus, a high correlation can be demonstrated for the HRS and BS.

Reliability, validity and sensibility to variations over time were investigated for a German version of the Visual Analogue Mood Scale (VAS) Re-test reliability was high with r = .98. The correlation with the self-rating "Befindlichkeits-Skala" (Bf-S) was food with r = .79 whereas the correlation with the Hamilton-Depression-Rating-Scale only was r = .49. Sensitivity to mood changes over time was a good as with the Bf-S. According to these results the German version of the VAS can be used for the assessment of actual depressive mood. The main advantage of the scale is it's simplicity.

This article describes a controlled clinical trial comparing nomifensine and amitriptyline in endogenously depressed inpatients. It is also the first trial of the ICPP-BLIPS, a computer based clinical trial data documentation system. Using strict methodological criteria, careful quality control and comprehensive and systematic data display and data analysis, we have been able to show clearcut efficacy differences between nomifensine and amitriptyline (favouring the later) and clearcut differences in the profile of side effects between these drugs. Future studies utilizing this methodology are recommended were definitive and documented results of clinical trials are desired.

10 patients suffering from endogenomorphic depression on the basic of organic brain lesion were treated with 40 mg bromocriptin daily. Therapeutical efficacy was evaluated by various psychometric methods and by clinical impression. A negative correlation between performance and the depressive syndrome could be shown. Amelioration proved to be short lived, only 2 patients showed satisfactory response over a longer period of time. nausea and vomiting were the most common side effects, one patient showed a fully reversible manic syndrome. Reasons for the application of bromocriptin on the basis of a "dopamine-deficit hypothesis", and the results of the study are discussed.

Twenty-three patients who completed a four-week, double-blind, clinical trial of bromperidol versus haloperidol were treated with bromperidol for eight additional weeks in a continuation study. Over 87 percent of patients maintained their improved status or showed further improvement. Extrapyramidal signs were frequent, but required discontinuation of treatment in only two patients.

The physical and psychophysiological effects of an orally administered single dose of 3 mg cloxazolam as compared to 5 mg diazepam and a placebo were investigated for 144 healthy male subjects using a double blind technique. In a pre-experimental test, the Ss were classified as either emotional stabiles or labiles, and in the experimental program of one four and half hour period were tested under either stress or control conditions. In order to create appropriate conditions for testing the tranquilizers, three stress situations that would induce anxiety were used: anticipation of an electric shock, preparation of a public speech and one due to failure in an achievement test. By combining these methods it was possible to sustain for 30 minutes in healthy Ss a state of anxiety or emotional activation which seemed suitable as a model for clinical anxiety. Under 5 mg diazepam rather week, but tranquilizer-typical effects were registered in both subjective and objective measures: an increase in self-confidence in emotional labiles, mood improvement, lower electrodermal responses and tranquilizer-typical EEG-pattern, but also subjective deactivating effects. The HR-increase elicited by anxiety induction was not influenced by Diazepam. Under 3 mg cloxazolam very similar effects to those under diazepam were apparent in the subjective measures; there was however, no mood improvement. Cloxazolam was judged as more strongly deactivating and fatigue inducing than diazepam. Cloxazolam was clearly different from diazepam with respect to its physiological effects, especially showing an obvious heart rate increase in the control group, which requires further investigation.

The effect of a single dose of beta-blocker (5 or 10 mg mepindolol) during a written examination was investigated in two double-blind studies (N : 49 and 55 students, respectively). The question was whether the beta-blocker would in comparison to placebo diminish examination anxiety and improve the performance of highly complex tasks, while leaving the performance of less complex tasks unchanged. A reduction in examination anxiety after beta-blocker intake could not be demonstrated with a multi-level test model (which included the parameters self-rated anxiety, motor behaviour, task performance and physiology), although pulse rates were lowered significantly. An improvement in performance could not be observed, while - by the same token - the performance was not impaired by the beta-blocker. A hypothesis according to which a beta-blocker has an anxiolytic effect and improves performance, dependent on the level of habitual examination anxiety, was tested post hoc, but could not be confirmed. Ten of the subjects treated with 10 mg mepindolol, complained of different side effects, including dizziness, fatigue and headache.

Several neurochemical parameters were estimated in plasma and urine of patients with affective disorders in the depressive phase and later in normothymia, after successful drug treatment. Significant increases were found for the activity of the enzyme dopamine-beta-hydroxylase in plasma and the concentrations of cyclic AMP in plasma and urine. No consistent changes were found for prolactin or cyclic GMP in plasma, and for methoxyhydroxyphenylgkyglycol, homovanillic acid, 5-hydroxyindoleacetic acid and cyclic GMP in urine. The major change we observed in the clinical state of the patients is thus not reflected in change in the urinary biogenic amine metabolites. Their changes were found to correlate inversely to their pretreatment values. In normothymia, high values decrease and low values increase for all three amine metabolites, indicating that antidepressives act towards a normalization of the amine turnover mechanisms.

Chronic psychiatric patients (N = 42) predominantly diagnosed as schizophrenics, who had been hospitalized for the mean of 9 years were treated in a double-blind study with a neurotropic drug (tamitinol dihydrochloride coated tablets of 300 mg t.i.d.) and placebo. Test drugs were administered concomitantly to the existing drug therapy during two treatment periods of 6 weeks each with an interval of two months free of test medication. In the second treatment period patients moved to a new building. It was expected that neurotropic drug effects can be made clearer after the transfer requiring patient's reorientation in a new environment than before the transfer. Assessment of efficacy was made using observer ratings (Psychic and Somatic Findings of the A.M.P. System, WING Behaviour Rating Scale) and patient's self ratings (Adjective Check List. List of Somatic Symptoms) and clinical laboratory parameters. Results show that neurotropic co-medication reduced the "neurological syndrome" and the "psychoorganic syndrome" (A.M.P. System). An amelioration of the "neurological syndrome" was observed at the end of the first and at the end of the second medication phase (p less than or equal to 0.10) whilst the improvement of the "psychoorganic syndrome" was particularly evident as expected after the transfer to the new building (p less than or equal to 0.001) Patients receiving placebo described themselves as more active than patients receiving the test drug. (Adjective Check List: p less than or equal to 0.10). No subjective or objective side effects (List of somatic symptoms and laboratory parameters) were evident due to the test medication which was tolerated by all patients.

Thirty acutely hospitalized schizophrenic patients were treated under double blind condition with either haloperidol (40-60 mg/day) or pimozide (40-60 mg/day) for 30 days. Ten patients in the pimozide and eleven in the haloperidol group showed a very good or good clinical response. There were no definite differences of treatment results as assessed by the Global Clinical Impression. Both groups showed a statistically significant decrease of the global scores of the Brief Psychiatric Rating Scale (p less than 0.01). There was a significant decrease of affective bluntedness and anergia in the pimozide but not in the haloperidol group. Extrapyramidal side effects were more pronounced in patients on pimozide who therefore needed more anticholinergic drugs. There was no consistent correlation between drug serum levels and global scores or single factors of the BPRS in either treatment group. It is concluded that pimozide in dose ranges from 40-60 mg has powerful antipsychotic properties indistinguishable from those of haloperidol but exerts stronger extrapyramidal side effects.