Pharmacopsychiatria最新文献

The effect of 4 weeks' treatment with lithium chloride on the central and peripheral nervous system of Wistar albino rats was studied. Normal activity values of some brain enzymes related to energy transduction (LDH, MDH, COX, NADH-ccRT) and neuro-transmission (ACHe), evaluated both in the homogenate in toto and in the crude mitochondrial fraction, were obtained. Fine changes in mitochondrial organelles and nerve processes of neurocytes were ultrastructurally observed. The peripheral nerve studies revealed in some treated rats a slight motor nerve conduction velocity impairment by electro-physiological methods, but no significant alterations in the sciatic nerve specimens examined by electron microscopy.

Improvement of acute psychotic exacerbations under neuroleptic therapy can depend on the time course of the disease itself, on the individual patient or on the specific neuroleptic applied. Previous studies demonstrated that neither the characteristics of the patients nor the disease qualities could predict the outcome of neuroleptic therapy (review by May and Goldberg 1978). In this study the initial improvement after the onset of neuroleptic treatment was tested for its predictive value. In 33 patients treated with constant doses of butyrophenones the decrease of psychotic symptomatology during the first 5 days of treatment not only accounted for the major part of the overall improvement, but was also a relatively reliable predictor for the further course of the therapy.

The effects of ACTH4-10 (Org O163) and of the ACTH4-9 analog (Org 2766) were tested in 20 male patients suffering from a mild to moderate cerebroorganic impairment. Patients were aged between 51-72 years (mean 60.9). Org 2766 was given in dosages of 0.05 mg, 0.5 mg and 5 mg, Org O163 in a dosage of 30 mg. The investigation was based on a randomized incomplete crossover design. By means of psychological tests the effects of the synthetic neuropeptides on memory, state of well-being, attention, vigilance and psychomotor function were investigated. The statistical analysis of the results did not reveal any effects of both substances on the functions tested. These results are in agreement with those of other studies in man using similar methods and acute administration of ACTH4-10 and/or Org 2766. In such studies only effects of reactive inhibition of attention and motivation could be demonstrated consistently.

70 schizophrenic outpatients have been treated continuously after index hospital discharge with neuroleptic drugs for an average of 14.3 years. In predicting their outcome in several dimensions (rehospitalization rate, symptoms, social and work adjustment, self ratings) differential predictor patterns could be confirmed, at most accounting for 65% of the outcome variance. In part work adjustment at follow-up cold be predicted by premorbid social and sexual adjustment as well as by working capability at index discharge. The most powerful predictor for the number of social relations was the former frequency of social contacts. Rehospitalization was related to higher neuroleptic equivalence dose at index discharge among other predictors, whereas presence of symptoms could be predicted e.g. by formerly longer hospital stays. Although at the beginning of the treatment our sample was classified as "process schizophrenic" on "classic" prognostic scales, 40-60% of our cases had a relative good outcome. This results and the considerable decrease of the rehospitalization rate from 0.57 before treatment to 0.11 during treatment stand for a clear treatment related improvement of the spontaneous prognosis. The partly mutually independence of the outcome criteria and predictor patterns underlines the importance of multiaxial diagnosis.

Trazodone (TZ), a 'new generation' antidepressant and amitriptyline (AMT) were administered in a double-blind controlled study to 43 depressed inpatients. The Hamilton Depression Rating Scale (HAM-D), the AMDP-system and the Bf-s self-rating questionnaire were used for documentation of psychopathological changes and autonomic side effects. The Newcastle-Scale for definition of a neurotic and an endogenous subgroup of depression was retrospectively applied. No significant improvement was noticed on the Bf-s self-rating questionnaire in the TZ group as compared to the AMT group (p less than 0.001). The global HAM-D score decreased significantly in the TZ group (p less than 0.05) as well as in the AMT group difference (p less than 0.01) emerged during the trial in favour of AMT. Core symptoms of depression were significantly improved in the AMT group but not in the TZ group: depressed mood (p less than 0.001), psychic anxiety (p less than 0.001) and retardation (p less than 0.05). TZ was faster actin than AMT in controlling agitation. Results of this clinical study demonstrate TZ to have sedative and some anxiolytic properties but only negligible antidepressant efficacy.

The influence of rolipram, a potential psychotropic drug, on the central serotoninergic system was studied. Rolipram was found to elicit the head twitch reaction in rats but not in mice. This effect was abolished by phenoxybenzamine, clonidine and morphine but not by cyproheptadine, metergoline and pizotifen. The antagonistic action of morphine was reversed by naloxone. Rolipram stimulated the flexor reflex of the hind limb in the spinal rat but this effect was blocked neither by cyproheptadine and pizotifen, nor by phenoxybenzamine. In rats kept at a high ambient temperature, rolipram induced slight hypothermia and did not affect the hyperthermia induced by fenfluramine. Rolipram produced also slight hypothermia in rabbits. Our results indicate that rolipram does not affect the central serotoninergic transmission but in some of its central effects (the head twitch reaction) the noradrenergic system and the opiate receptors seem to be involved.

The effect of acute ethanol administration on plasma levels of beta-endorphin-immunoreactivity and opioid activity was measured in 4 normal volunteers. 60 min following ethanol consumption opioid activity levels, measured by radioreceptorassay, increased significantly with peak rises of more than 400%; levels of beta-endorphin-immunoreactivity did not change significantly. These results are compatible with the effect of the opiate-antagonist naloxone, reversing ethanol-induced coma.

Thirteen patients with endogenous depression received an oral load of L-tryptophan (100 mg/kg) before and after a series of unilateral ECT. Age-matched and sex-matched controls also received the tryptophan load twice, at intervals corresponding to those used in the patients. After the loads the level of tryptophan in serum was lower in patients than in control subjects. ECT failed to influence either baseline or postload tryptophan levels. The results are consistent with the notion of disturbances in tryptophan metabolism in patients with endogenous depression, but they fail to clarify the mechanism responsible for the antidepressant effect of ECT.