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Biomedical subjects

H Hippius

Publications and source records attributed to H Hippius.

At least 73 records · Page 4Linked to original sources

Pathological cerebral blood flow during motor function in schizophrenic and endogenous depressed patients.

In this investigation we examined eight Type I (positive symptoms without marked negative symptomatology), eight Type II (marked negative symptoms) schizophrenic patients of the disordered and paranoid diagnostic subgroups (DSM-III 295.1 and 295.3), eight severely (HAMD above 35) and eight less severely (HAMD below 20) endogenous depressed patients, and eight control persons using the 133Xe inhalation method in resting condition and during motor activity of the dominant right hand. In all patient groups we found flow activation patterns that were different from those observed in normal control persons. During motor activation in Type I schizophrenics and in less severely endogenous depressed patients, we found a bilateral hyperflow and a diffuse cortical flow increase, also involving deeper cerebral structures. In Type II schizophrenics and severely endogenous depressed patients, however, we found a widespread nonreactivity of the regional cerebral blood flow (rCBF) to motor activation, with no flow increase in the contralateral primary motor area. In normal control individuals, we reproduced a 25% flow increase that was strictly limited to the contralateral primary motor area, as already reported by other authors. As only the schizophrenic patients were not under antipsychotic medication (4 with a washout of at least 1 week prior to the investigation, 12 never treated with drugs before), contaminating effects of the medication cannot be ruled out for the endogenous depressed patient groups. However, in schizophrenic patients, these results suggest a diffuse disorganization and lack of laterality of motor functional systems. In addition, the change from hyperactivity to hyporeactivity might indicate cerebral functional correlates of the change from Type I to Type II symptomatology in schizophrenic patients, which could possible prove to be of clinical importance.

Adolescent↗

[Malignant neuroleptic syndrome and malignant hyperthermia--a comparison].

Malignant Hyperthermia is a specific potentially fatal condition which occurs in susceptible individuals in response to various triggering mechanisms, of which anesthetic agents have been found to be the most common offenders. Leading symptoms are generalized muscular rigidity and hyperpyrexia. The etiology seems to be associated with some inherited disturbance in muscle metabolism related to calcium regulation. This syndrome is known for 25 years, the mechanism of triggering, the genetics and the treatment have been able to get examined by animal model as malignant hyperthermia syndrome may occur in swine as well. Pharmacological in-vitro studies on biopsy specimen of muscle fragments are presently one of the most accepted means for pre-anesthetic diagnosis, the hydantoin derivate dantrolene sodium is the only known specific drug in treatment and prophylaxis. Neuroleptic Malignant Syndrome which occurs in patients treated with neuroleptics shows almost identical symptoms. Although the pathogenesis is still unknown, most authors believe a neuroleptic-induced alteration of central neuroregulatory mechanisms is involved. Alternative etiologic mechanisms are suggested by the striking similarities noted between the Neuroleptic Malignant Syndrome and Malignant Hyperthermia. Both disorders might be based on common pathophysiologic mechanisms and might be induced in susceptible patients by a variety of pharmacologic agents. The authors present and compare the actual knowledge concerning symptoms, course and therapy of both syndromes on the basis of 126 case studies of the Neuroleptic Malignant Syndrome from literature.

Adult↗

Remarks on the therapy of depressions with amine precursors.

The therapy of depressions with amine precursors is based on the hypothesis of an amine deficiency in depression. A brief review of different trials with these substances is given. However, the therapeutic effects achieved were not satisfactory, although treatment with 5-HT or with amine precursors combined with lithium or MAO-inhibitors seemed to be more successful. Furthermore, the difficulties in interpreting these somewhat disappointing results is pointed out.

5-Hydroxytryptophan↗

[Perspectives of psychiatric pharmacotherapy].

A review of the development of psychiatric pharmacotherapy often leads to the conclusion that the major discoveries were made in the years between 1952 and 1960; Since the psychiatric pharmacotherapy is said to stagnate. This opinion is wrong. Psychopharmacological research has attained continuous progress also in the last twenty years. In the future, further progress is to be expected, if clinical research expands to hitherto neglected (e.g. Alzheimer dementia, personality disorders, drug dependence) and at the same time abandons the unilateral tie to an up to now purely nosologically oriented concept of indications. This means that in the future psychopharmaca will be prescribed possibly no longer primarily according to etiological considerations, but also with particular consideration of the symptoms and the course of the disease.

Alzheimer Disease↗

Assessment of adverse drug reactions in psychiatric hospitals.

A system for monitoring adverse drug reactions (ADR) in psychiatric inpatients was introduced in psychiatric hospitals in the FRG in May 1979. It consists of intensive drug monitoring (IDM) and a so-called "organized spontaneous reporting system" (OSR). ADR are rated separately according to impact on therapy and probability of causal relationship. With IDM all ADR (Grades I-III) are assessed in a randomly selected sample of inpatients. With OSR only ADR leading to discontinuation of the drugs in question (= ADR Grade III) are assessed. In 406 drug-treated inpatients monitored by IDM in the psychiatric hospitals of Berlin and Munich from May 1979 to Dec. 1981, ADR were observed in 60,4%. In 15% of IDM-patients ADR led to discontinuation of the drugs in question; with OSR the relative frequency of these Grade III ADR was 9,0% in 5096 patients monitored throughout the entire period. Life-threatening events were observed in 1,2% of patients undergoing IDM as well as 1.2% of those undergoing OSR. The most frequently observed ADR by IDM were sedation, extrapyramidal signs, disturbances of the autonomic nervous system and increase in transaminases, and by OSR Parkinsonism, akathisia, sedation, toxic delirium and increased transaminases. The relative frequency of Grade III ADR was similar for neuroleptics and antidepressants (5,4% and 5,3% in OSR); a very low relative frequency of ADR Grade III was found for tranquilizers and hypnotics (0,7% and 0,2%). Methodological aspects of this drug monitoring system are discussed in the light of current literature.

Antidepressive Agents↗

The effect of fluperlapine in acute psychotic patients.

Fluperlapine (NB 106 689), a dibenzazepine chemically and pharmacologically similar to clozapine, was investigated in 28 patients with regard to antipsychotic efficacy and occurrence of adverse effects. In an open early phase II study patients were given fluperlapine over a period of 26 days. The average daily dosage was 300 mg. Five patients had to be withdrawn from the trial during the first week due to side effects or therapeutic inefficacy, 23 patients were examined during the period planned. The substance proved to have fast-acting antipsychotic effect with few adverse effects and no extrapyramidal motor disturbances.

Acute Disease↗

Antipsychotic efficacy of fluperlapine. An open multicenter trial.

In an open multicenter trial 46 schizophrenic patients were treated with fluperlapine for 20 days. A mean daily dosage of 300-400 mg appeared to be an effective antipsychotic treatment in most cases. The marked antipsychotic effect was accompanied by a good improvement of depressive symptoms. Extrapyramidal side effects were extremely rare.

Adult↗