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Biomedical subjects

E Lehmann

Publications and source records attributed to E Lehmann.

At least 55 records · Page 3Linked to original sources
PubMed1995

[Differential pharmacologic therapy of generalized anxiety disorders--results of a study with 30 individual case experiments].

In pharmacotherapy of generalized anxiety disorders (GAD) different psychopharmacological agents (neuroleptics, diazepines, antidepressants) proved to be effective. However, there is a lack of predictors of therapeutic response. The present study was designed to address this question in 30 patients with treatment refractory GAD (12 male, 18 female). Amitriptyline 30 mg/d, flupentixol 1.5 mg/d, clotiazepam 15 mg/d, and placebo were administered double-blind and randomly. Each agent was given 4 times for one week. To avoid carry-over effects, all treatment weeks were interrupted by one week's wash-out periods. Thus each single-case experiment comprised 31 weeks. Primary efficacy criterion was Hamilton total score at the end of each treatment week. Statistical analysis (U-test) showed that in 19 patients one agent was significantly (p < 0.05) superior to the other substances (clotiazepam n = 11, flupentixol n = 3, amitriptyline n = 5). Placebo was not superior in any of these 30 patients. There was no significant difference between the drugs in 11 patients. However, metaanalysis showed that in chronic GAD, by means of single-case experiments, differences in efficacy between different drugs can be found (p < 0.01). ANOVA showed no drug x time interaction.

Adult↗
PubMed1995

Hot spots of recombination in fission yeast: inactivation of the M26 hot spot by deletion of the ade6 promoter and the novel hotspot ura4-aim.

The M26 mutation in the ade6 gene of Schizosaccharomyces pombe creates a hot spot of meiotic recombination. A single base substitution, the M26 mutation is situated within the open reading frame, near the 5' end. It has previously been shown that the heptanucleotide sequence 5' ATGACGT 3', which includes the M26 mutation, is required for hot spot activity. The 510-bp ade6-delXB deletion encompasses the promoter and the first 23 bp of the open reading frame, ending 112 bp upstream of M26. Deletion of the promoter in cis to M26 abolishes hot spot activity, while deletion in trans to M26 has no effect. Homozygous deletion of the promoter also eliminates M26 hot spot activity, indicating that the heterology created through deletion of the promoter per se is not responsible for the loss of hot spot activity. Thus, DNA sequences other than the heptanucleotide 5' ATGACGT 3', which must be located at the 5' end of the ade6 gene, appear to be required for hot spot activity. While the M26 hotspot stimulates crossovers associated with M26 conversion, it does not affect the crossover frequency in the intervals adjacent to ade6. The flanking marker ura4-aim, a heterology created by insertion of the ura4+ gene upstream of ade6, turned out to be a hot spot itself. It shows disparity of conversion with preferential loss of the insertion. The frequency of conversion at ura4-aim is reduced when the M26 hot spot is active 15 kb away, indicating competition for recombination factors by hot spots in close proximity.

Base Sequence↗
PubMed1995

Randomized, double-blind, controlled trial of risperidone versus clozapine in patients with chronic schizophrenia.

This study compares the antipsychotic efficacy and the tolerability of risperidone and clozapine in patients with schizophrenia. Patients were randomized to double-blind treatment with risperidone, 4 mg (N = 20), risperidone, 8 mg (N = 19), or clozapine, 400 mg (N = 20), daily for 28 days. Efficacy was assessed by improvement of psychotic symptoms, measured on the Brief Psychiatric Rating Scale, and Clinical Global Impression. The tolerability was assessed by the Simpson and Angus scale for extrapyramidal side effects (EPS), the Association for Methodology and Documentation in Psychiatry (AMDP) scale for somatic side effects, spontaneous reports of adverse events, clinical laboratory assessments, and vital signs. All treatments reduced psychotic symptoms. The global tolerability was significantly better in the risperidone than in the clozapine-treated patients (p < 0.01). There were no differences between treatments on the AMDP scale. The most frequent spontaneously reported adverse effects were dizziness, fatigue, accommodation disturbance, and EPS in all treatment groups and increased salivation, mainly in the clozapine-treated patients. Although there were no changes in vital signs during risperidone treatment, clozapine was associated with a mean reduction in heart rate of 10 beats/minute. Risperidone tolerability at endpoint was classified as "very good" by 60 and 47% of patients treated with risperidone, 4 and 8 mg daily, respectively; the corresponding figure in clozapine-treated patients was 30%. The results suggest that risperidone is at least as effective as an antipsychotic as clozapine, providing a valuable new approach for the treatment of schizophrenia.

Adult↗
PubMed1995

[Homicide crimes as irrational responses to existential crises exemplified by separation dates].

It is investigated whether killing delicts as a "solution" of conflicts between partners are the expression of a fateful situative restraint, or whether it is the personal disposition of the committer which entails killing. The fundamentals of the discussion are examinations of 98 criminals with killing delicts, 36 of whom "solved" a conflict in partnership by killing the partner. The 36 separation crimes can be subdivided into four groups according to the prevailing causes. 16 happened due to the partner's intention to leave, 14 due to humiliation and severe offence, 3 due to material self-interest, and 3 in states of delusion. For each of the four groups a typical representative in his constellation of situation and personality is described. Generalized, it will be questioned under which circumstances someone develops the will to kill the partner, and who possesses the capability to realize this will. It can be shown by systematical exploration of their personality by means of objective personality testing procedures that almost all criminals who have committed murder show a conspicuous structure of personality. Hysterical and/or sociopathic properties predispose a person to acts of personally-impertinent or personally-short-sighted violence.

Adult↗
PubMed1994

[Therapy of depression].

Somatic treatment and psychotherapy are available for the treatment of depressive episodes. Regarding the side-effect profile, tetrazyclic antidepressants, selective serotonin reuptake inhibitors and selective MAO inhibitors are recommended as therapy of first choice. In less severe cases phytopharmaca and major tranquilizers in low dosage are possible alternatives. In case of resistance to therapy with high subjective strain electroconvulsive therapy may be indicated. Psychotherapy can also be applied as treatment of first choice. The cognitive behavioural therapy intends a normalization of activity rate, cognitive attitude and social competence, which are characteristically changed in depressives. The combination of drug therapy with psychotherapy has no clear advantage over monotherapy, but it possibly reduces the relapse rate.

Antidepressive Agents↗
PubMed1994

Risperidone versus clozapine in the treatment of schizophrenic patients with acute symptoms: a double blind, randomized trial.

1. In order to verify the hypothesis that risperidone is a useful therapeutic alternative to clozapine the authors carried out a randomized double blind trial in 59 patients with paranoid hallucinatory psychoses. 2. In a treatment lasting 28 days three groups of patients received either 4 mg risperidone (N = 20), 8 mg risperidone (N = 19), or 400 mg clozapine (N = 20) daily. 3. The tolerance of 4 mg risperidone was globally assessed as being better than that of 400 mg clozapine. Drop-outs under clozapine were mostly caused by side effects, whereas under risperidone they tended to occur for therapeutic inefficacy. 4. The antipsychotic effect was highly significant and clinically relevant under both risperidone and clozapine.

Acute Disease↗
PubMed1993

Initial improvement as a criterion for drug choice in acute schizophrenia.

Several investigators have found that the initial improvement of acute schizophrenia after some days of neuroleptic treatment is correlated in a statistically significant way to the outcome after four weeks. In all these studies the question arises as to whether the correlation between early response and subsequent outcome is due to a specific response to a certain neuroleptic, or whether patients who respond early simply have a better prognosis. In order to isolate the specific drug effect from prognostic influences we performed a controlled double-blind study in 50 newly admitted schizophrenic inpatients. All patients were treated over three days with 15 mg haloperidol i.v., following which they were classified as 'early responders (ER)' (markedly improved or improved) or as 'early nonresponders (EN)' and then randomly assigned to group 1 (3 x 5 mg haloperidol p.o./d) or to group 2 (3 x 100 mg perazin p.o./d). If there was a specific drug effect on the correlation between early response and subsequent outcome a therapeutic superiority of perazin in EN and no superiority in ER was expected. Independently of the treatment condition the mean BPRS score had decreased from 61.2 (Sx = 12.1) to 38.1 (Sx = 13.9) at the end of the study. ER and EN were evenly distributed in the haloperidol and perazin group. The analysis of variance revealed no significant interactions of the factors 'treatment condition' x 'duration' x 'early response' (p = 0.27) and 'treatment condition' x 'early response' (p = 0.88) on the outcome (BPRS, CGI). This means that the initial hypothesis of this study has to be rejected.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Drug monitoring study (phase IV) of xantinolnicotinate (Complamin) in general practice.

For 30 years, xantinolnicotinate has been on the market for the treatment of impaired brain function, i.e., organic brain syndromes of various etiologies. Controlled double-blind phase-III clinical trials have shown that xantinol-nicotinate is an effective drug in the treatment of dementia. Nevertheless, it is also important to assess xantinolnicotinate under routine treatment conditions in order to learn what type of patient is preferably treated, which ADRs can be observed how often, and whether the efficacy claimed by phase III studies can still be seen under routine treatment conditions. Theoretically, the more complex treatment situation in routine practice could lead to major changes in the selection of patients, the type and frequency of ADRs, or efficacy. The treatment of 10,134 patients was monitored in a treatment observation study. Results show that target illnesses are not cases of 'pure dementia', but more complex cases, in which multimorbidity plays an important role, so that the older term 'cerebrovascular insufficiency' seems more appropriate to describe this group of patients. Another interesting group is made up of younger patients suffering from a variety of psycho-organic syndromes. The assessment of therapeutic efficacy, e.g., with the SCAG, shows highly significant improvements during treatment, which are well comparable to those reported in controlled studies. The success of treatment was most expressed in the target symptoms "dizziness", "fatigue", "disturbance of concentration", "affective disorders", and "disturbance of vigilance and vitality". In 87% of these cases, no adverse drug reactions were reported.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

Low dose neuroleptanxiolysis in anxiety states.

1. In order to prove that neuroleptanxiolysis represents a therapeutical alternative in the treatment of patients suffering from anxiety we conducted four investigations. 2. In the first study it was experimentally proved with 45 outpatients suffering from anxiety that fluspirilene (1.5 mg per week) is superior to bromazepam (6 mg/day), especially in patients with a high degree of somatic anxiety. 3. In the second study the tolerance of fluspirilene (1.5 mg per week) was investigated in 1261 patients with anxiety states and psychoreactive disorders under controlled and open conditions for a period of six weeks. Side effects were found in 11.5% of the patients. All side effects had in common that they occurred already within the first few weeks of treatment. 4. In the third study investigating the dose-effect relationship 106 patients received either 0.5, 1.0, or 1.5 mg fluspirilene per week for a period of 6 weeks. The main result of this study was the verification of a clear dose-effect relationship. 5. The fourth study compared 155 patients who had received long-term treatment with fluspirilene (max 1.5 mg/week) and 121 patients with long-term benzodiazepine treatment. No differences were found with regard to the frequency and intensity of extra-pyramidal disturbances. 6. The therapeutical relevance of the findings was emphasized in the general discussion.

Adult↗
PubMed1992

[Disagreement in standardized haloperidol treatment in comparison with "adequate individual dosage" of acutely schizophrenic patients].

Experimental double-blind trials were performed to establish whether individual neuroleptic treatment of acute schizophrenic disorders is more effective and has fewer side effects than standard therapy. For this purpose, a group of 30 patients was treated with 10 mg haloperidol/day for 14 days, while a further group of 30 patients receined 20 mg haloperidol/day for the same period. Thirty patients in a third group were treated for 14 days with an individual haloperidol dose that was matched to the psychopathological findings. Allocation of the patients to the treatment groups was done on a random basis. In the individually treated group the dosage was determined by a senior psychiatrist at the hospital who was not involved in collecting the data of the investigation; neither the nursing staff nor the physicians involved in thus study were informed of the dosages. The psychological findings were recorded by means of the BPRS and the global assessment of the physician (CGI) on days 0, 7, and 14. The extrapyramidal side effects were established with the aid of the Simpson scale on days 0, 7, and 14. No superiority of the individually matched treatment over standardized treatment was demonstrated, either for the therapeutic target parameters or for the side effects. On the contrary, the groups treated with fixed doses were found to exhibit somewhat better results. These findings are discussed with respect to their significance for treatment.

Acute Disease↗
PubMed1991

[Double-blind comparison of 3 x 75 mg zotepine und 3 x 4 mg haloperidol in acute schizophrenic patients].

To assess the efficiency/risk ratio, fixed doses of zotepine and haloperidol were compared by means of a double-blind study in acute schizophrenics over a 4-week period. The assessment tools were BPRS, CGI, and the Simpson-Angus scale for the extrapyramidal disturbances, and a free report on side effects. No differences between the groups were found in respect of efficacy. According to the Simpson-Angus scale, the patients who had been treated with zotepine achieved better values, this being a general trend. There were significant differences according to the free report on side effects. Especially at onset of treatment, the patients treated with zotepine complained of tiredness. Partly marked extrapyramidal disturbances were seen in the patients who had been treated with haloperidol.

Acute Disease↗
PubMed1991

[Effect of a special kava extract in patients with anxiety-, tension-, and excitation states of non-psychotic genesis. Double blind study with placebos over 4 weeks].

Clinical Efficacy of a Kava Extract in Patients with Anxiety Syndrome/Double-blind placebo controlled study over 4 weeks. In a randomized, placebo-controlled double-blind study two groups each containing 29 patients with anxiety syndrome not caused by psychotic disorders were treated for a period of 4 weeks with kava extract WS 1490 (Laitan) 3 x 100 mg/day or a placebo preparation. Therapeutic efficacy was assessed by the Hamilton-Anxiety-Scale (main target variable), the Adjectives-List and the Clinical-Global-Impression-Scale (secondary target variables) after 1, 2 and 4 weeks of treatment. The HAMA overall score of anxiety symptomatology revealed a significant reduction in the drug receiving group already after one week of treatment. This difference between the two groups of patients increased in the course of the study. The results of the secondary target variables were in agreement with the HAMA-score and demonstrate the efficacy of WS 1490 in patients with anxiety disorders. No adverse experiences caused by the medication were noted during the 4 week administration of WS 1490.

Adolescent↗
PubMed1990

Vasopressin mRNA in the neurolobe of the rat pituitary.

Pro-vasopressin-neurophysin mRNA (AVP mRNA) was assayed in the pituitary gland of rats from different strains, using a specific cRNA probe corresponding to exon C of the vasopressin gene. Northern blot analysis revealed the presence of an about 650 base pair (bp) AVP mRNA in the neurolobe of all strains. No signal was found in the anterior or intermediate lobes. Partial nucleotide sequence analysis suggested identity with the genuine AVP mRNA. Osmotic stimulation with 2% saline or water deprivation increased AVP mRNA levels in a fashion that paralleled changes seen in the hypothalamus. The origin of the AVP mRNA in the neurolobe is uncertain but is likely to be the pituicytes. Transport of the mRNA into the nerve endings of hypothalamic supraoptic and paraventricular neurons is an alternative possibility.

Animals↗
PubMed1990

Detection of vasopressin mRNA in the neurointermediate lobe of the rat pituitary.

A messenger ribonucleic acid (mRNA) homologous to the transcript that encodes vasopressin (VP) was detected in the neurointermediate lobe (NIL) of the rat pituitary. The abundance of this transcript is approximately 1/100th the amount detected in the hypothalamus. In rats drinking 2% NaCl-water for 0,2,4, or 10 days, or for 10 days and then tap water for 14 days, the levels of VP mRNA in the NIL were altered in a fashion that paralleled changes in the hypothalamus.

Animals↗
PubMed1990

Double-blind study of the therapeutic efficacy and tolerability of amitriptylinoxide in comparison with amitriptyline.

In a double-blind trial, 32 patients with endogenous or neurotic depression requiring drug treatment in hospital were randomly allocated to a four-week treatment with amitriptylinoxide or amitriptyline. The initial dosage was, in most cases, 60 mg b.i.d. for both drugs. During the first week of treatment, the dose was increased to a maximum of 300 mg/day with amitriptylinoxide and to 240 mg/day with amitriptyline, depending on tolerability and clinical impression. This dose was then maintained, if possible, throughout the following three weeks. During this period the mean dose of amitriptylinoxide was 167 +/- 8 mg/day, that of amitriptyline 166 +/- 8 mg/day. Seven of the 32 patients (three in the amitriptylinoxide and four in the amitriptyline group) discontinued the trial. Therapeutic efficacy was assessed by means of the AMDP system (scale 4), HAMD total scale, 4 HAMD subscales, and DSI and Bf-S scales. Tolerability was assessed using the AMDP system (scale 5) and a list of side-effects often associated with antidepressive drug treatment. With regard to therapeutic efficacy, no differences were noted between the two drugs except on the DSI scale. In contrast, there was a significant difference in tolerability--both in terms of the vegetative syndrome (AMDP) and the sum of side-effects--in favour of amitriptylinoxide.

Adult↗