Mood-altering effects of biperiden in healthy volunteers

There has been considerable evidence that, aside from various other effects, synthetic anticholinergics also possess a significant euphoriant property. A double-blind placebo-controlled study was conducted in an attempt to answer the following questions: Can euphoria be induced by experimental intravenous administration of biperiden in therapeutic dosages? Is the individual's psychic response to anticholinergics associated with particular personality traits? In a study with a double-blind placebo cross-over design 28 healthy volunteers were given biperiden intravenously. The evaluation of their reaction to the drug using the Bech-Rafaelsen Mania Scale (MRS) revealed two groups of about the same numerical size demonstrating a considerable difference in their reaction to the drug.

Low-dose zotepine in the maintenance treatment of schizophrenia

Zotepine is new tricyclic neuroleptic with a pharmacological profile comparable to substances such as thioridazine and chlorpromazine. Its chemical structure is related to clozapine and fluperlapine. Ten patients (8 men and 2 women) fulfilling DSM III criteria for residual schizophrenia participated in an open clinical trial that lasted 8 months. The effects of low-dose maintenance therapy with Zotepine were evaluated using the Brief Psychiatric Rating Scale and the Scale for the Assessment of Negative Symptoms. Eight patients dropped out of the study within the first 6 months, 5 because of acute psychotic relapse, 3 due to compliance problems. Psychotic relapse appeared to be indicated by increasing BPRS and SANS scores recorded 1 month before relapse. Apart from minor sedation, no side effects, especially none of the extrapyramidal motor type, were observed. Even though Zotepine does not seem to possess sufficient prophylactic properties against psychotic relapse, preliminary results suggest that it might play an important role as a supplement to conventional neuroleptics in the near future.

Zotepine in the treatment of negative symptoms in chronic schizophrenia

Zotepine is a new tricyclic neuroleptic with a pharmacological profile comparable to substances like Thioridazine and Chlorpromazine. In an open pilot study, 10 patients suffering from negative symptoms in the course of chronic schizophrenia were treated with Zotepine. The efficacy of Zotepine in this indication was evaluated by means of the BPRS and the Andreasen Scale for the Assessment of Negative Symptoms. Significant improvement could be demonstrated after 3 weeks of treatment. No side effects were observed within the dosage range of 50 to 200 mg per die. These results suggest that Zotepine is useful in the treatment of residual schizophrenia.

Results of an open phase II study with zotepine--a new neuroleptic compound

Zotepine is a new tricyclic neuroleptic with a pharmacological profile comparable to substances such as thioridazine and chlorpromazine. Ten patients fulfilling DSM-III criteria of paranoid schizophrenia were included in an open pilot study at the Department of Psychiatry in Innsbruck. Neuroleptic efficacy, optimal dose, side effects, and the influence on serum prolactin levels were evaluated. Definite onset of antipsychotic action could be demonstrated between days 5-10, and approximately 400 mg/die seems to be an optimal dose. Four patients showed side effects of a minor degree that had no influence on the course of therapy. These results suggest that Zotepine is a rapidly acting neuroleptic with a high benefit-risk ratio. Further double-blind studies will be needed to reinforce these preliminary data.

Treatment of alcohol organic mental disorder with piracetam

1. The paper presents an investigation of the efficiency of piracetam in alcohol organic mental disorder. 2. A double blind placebo controlled study design was used to compare two dosages of the substance (2 x 3g versus 2 x 12g). 3. The cognitive functions of the patients, especially short term memory and concentration, were assessed on the days 0, 7, 14, 28 and 42 using various psychological instruments. 4. An analysis of 39 patients showed an improvement of cognitive functions in all three groups. 5. Patients receiving drug treatment showed earlier responses than patients receiving placebo; differences between the three investigational groups were not statistically significant. 6. The results achieved make the effect of piracetam appear somewhat questionable.

Piracetam in alcoholic organic mental disorder: a placebo controlled study comparing two dosages

The following paper presents an investigation of the efficacy of piracetam in alcoholic organic mental disorder. A double-blind placebo-controlled study design was used to compare 2 dosages of the substance (2 X 3 g vs. 2 X 12 g). Cognitive function was assessed on days 0, 7, 14, 28, 42. Analysis of the results from 24 patients showed a clear-cut amelioration of cognitive functions in all 3 treatment groups. No difference could be demonstrated between the administration of placebo and the lower dose of piracetam. Patients on the higher dose showed an earlier improvement on one of the tests, but the final scores were similar in all three treatment groups.

Epidemiology of benzodiazepine dependence

The charts of 10,861 patients of the Innsbruck University Department of Psychiatry were evaluated for this study. The patients were in- and outpatients admitted between January 1978 and September 1981. WHO criteria were used for the diagnosis of dependence. 1,743 inpatients and 2,130 outpatients were dependent on psychotropic substances (most of them being alcoholics). 57 (1.1%) resp. 73 (1.3%) suffered from polydrug abuse including benzodiazepines. Only nine inpatients and 21 outpatients were addicted to benzodiazepines only. Details of benzodiazepine dependence are discussed.

Fluperlapine vs haloperidol: a comparison of their neuroendocrinological profiles and the influence on serum lipids

Twelve male patients suffering from acute paranoid schizophrenia, randomly receiving fluperlapine - a new dibenzodiazepine very similar to clozapine - or haloperidol were included in a double blind study. Plasma levels of triglyceride, cholesterol and HDL-cholesterol, prolactin, thyroxine, triiodothyronine, ACTH and cortisol were determined. There was no evidence, that fluperlapine has any relevant influence on those hypothalamic-pituitary axis mediated hormones with the possible exception of plasma lipids. These findings, together with the clinical experiences, suggest that fluperlapine might have a different mode of action than conventional neuroleptics.

The psychopathology of alcoholism

The psychopathological symptoms occurring in the course of alcohol addiction, which probably have a very complex pathogenesis, call for a thorough examination. Jellinek's description of the autonomous course of this disease includes various mechanisms and behaviour abnormalities which do not only refer to the psychopathology of alcoholism, but which do also include reactive and environmental elements and personality-specific factors. The psychopathology of 'uncomplicated' alcoholism develops in the course of dependence and lasts for a shorter or longer period of time and persists even during abstinence. Symptoms appearing under the acute influence of alcohol may be totally different when observed in sober periods. On the whole the psychopathology of alcohol addiction contributes to a great extent to personality changes in alcoholics which play an important role in the perpetuation of the process. This study deals with the appearance of cognitive deficits, amnestic episodes, and affective and paranoid syndromes, leaving psychiatric complications of alcoholism, e.g. alcoholic psychoses, out of consideration.

Memantine in the treatment of senile dementia of the Alzheimer type

The efficacy of the dopaminergic substance Memantine was studied in severe cases of senile dementia of the Alzheimer type using a randomized single blind trial. Following 20 days of a basis therapy, consisting mainly of the proper therapy of medical disorders, 10 patients received 20-30mg Memantine pro die intravenously, 10 other patients were given placebo infusions. Patients were evaluated using the Syndrom Kurztest, the Funktionspsychose-Skala, the Plutchik Geriatric Rating Scale as well as the Sandoz Clinical Assessment Geriatric 5 times following the baseline period. Statistical evaluation showed no significant differences between the two groups. Mild amelioration of sleep-wakefulness cycles and impulse and drive functions could be observed clinically in both groups. Side effects (deterioration of psychopathology in two patients of the Memantine group) disappeared after withdrawal of the substance.

Preliminary results of guanfacine treatment of acute opiate withdrawal

Ten patients experiencing sudden opiate withdrawal received low doses of guanfacine. Improvement was noticeable within the first 4 days and was most evident in moderate to severe cases. The major effect was on autonomic symptoms. Tolerance to guanfacine was excellent.

[Bromocriptin in organic depression (author's transl)]

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.