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Biomedical subjects

M Schmauss

Publications and source records attributed to M Schmauss.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Perspectives on the therapy of neuropsychiatric diseases with adenosinergic substances].

The function of the neuromodulator, adenosine, has been thoroughly examined during the last two decades. Adenosine inhibits the release of several neurotransmitters and endogenous adenosine is supposed to have sedative and anticonvulsive properties. Lately, it has been discussed whether neuropsychiatric disorders could be treated with adenosynergic drugs. In patients with anxiety disorder a first clinical trial with the reuptake inhibitor dipyridamole was not successful. Disorders of the basal ganglia and schizophrenia might be positively influenced by newly developed A2-receptor ligands. A1-receptor agonists might prove to be neuroprotective; they also could be of importance in the treatment of epilepsy. Selective A1-receptor antagonists might be used in the treatment of depressive disorders and of neurodegenerative disorders such as Alzheimer's disease. The adenosine receptor antagonist, caffeine, is widely used in the treatment of migraine; more selective antagonists would provide a more powerful treatment.

Adenosine↗
PubMed1993

[Predicting antidepressive treatment success--critical review and perspectives].

Although antidepressants have been available for over 35 years, it is not possible to accurately predict the response to this kind of treatment. This article reviews both clinical and biological predictors of treatment response. Among the clinical predictors chronicity of depression, high neuroticism and psychotic features are associated with poor response. Tricyclic antidepressants remain the drugs of choice in "endogenous" depression, whereas monoamine oxidase inhibitors play an important role in the treatment of atypical depression. Biological predictors of response, despite a lot of interesting findings that may be important for the future, are not yet sufficiently established for clinical practicability.

Antidepressive Agents↗
PubMed1993

[Group psychotherapy in patients with panic disorder and agoraphobia].

The one-year supportive group-psychotherapy (3 groups with 8-9 patients) was carried out once-weekly by two therapists in 26 patients who met the DSM-III-R criteria for panic disorder and agoraphobia. Patients filled in various ratings at the beginning and at the end of the therapy and a visual analog scale before as well as after each session. Twelve months after the end of the group-therapy the Longitudinal Interval Follow-up Evaluation (LIFE) was carried out. During the group-psychotherapy panic sensations, anxiety, nervousness and fears as well as psychosocial disability decreased. Duration of illness affected the reduction of panic sensations, anxiety, nervousness and fears during the first 6 months of the group-psychotherapy. Phobic fears and avoidance behavior mostly improved in patients with a duration of illness of more than 5 years and an additional depressive disorder. At the one-year follow-up 80% of panic patients without depressive disorder were symptom-free and reported better partner-relationships, more satisfaction, and a better social adjustment compared with panic patients with concomitant depressive disorders.

Adult↗
PubMed1990

[Adenosine and methylxanthines in the central nervous system--on their significance for psychiatry and neurology].

In the last 15 years the central effects of adenosine and its importance for neurology and psychiatry have increasingly become an object of investigation. Physiology and metabolism of adenosine have been examined by different research groups. The effects of adenosine in the central nervous system and the various mechanisms of these effects have been described by electrophysiologic methods. The inhibition of the release of several neurotransmitters through adenosine has already been described 10 years ago. In this review studies on binding sites for adenosine receptor ligands are discussed thoroughly. The properties and the highly specific distribution of the distinct receptor subtypes are described. For the functioning of the adenosinergic system the different interactions with other centrally active substances such as benzodiazepines, barbiturates, neuroleptics, anti-depressants, opiates, alcohol and carbamazepine have turned out to be of interest. The results of neuropsychiatric investigations on methylxanthines, which are antagonists at the adenosine receptor, are widely considered. Finally the discussion on the importance of the adenosinergic system in different neurological and psychiatric diseases is summed up. The particular significance of adenosine in the modulation of dopaminergic functions is emphasised.

Adenosine↗
PubMed1989

Tolerability of long term clozapine treatment.

Tolerability of long term clozapine treatment (7-8 years) was investigated in 27 female patients (age 34-77 years). Diagnosis according to ICD 9 was schizophrenia in 21 patients, severe psychomotor agitation with mental deficiency in 4 patients and an "endogenous" depression in 2 patients. All patients had previously been treated with different neuroleptics but with inadequate response or distressing side effects. The duration of the disorder was 10-36 years, duration of hospitalisation 10-36 years. At the day of investigation the total dose of clozapine ranged from 52-826 g, the average total dose being 385 g. The daily dose of clozapine ranged from 75 to 600 mg, the average daily dose being 225 mg. Only 2 patients were treated exclusively with clozapine, the other 25 patients were also receiving other neuroleptics. Seventy eight per cent of the investigated patients complained about hypersalivation and 63% showed overweight. In 37% of the patients the EEG demonstrated abnormalities. Mild parkinsonism was reported in 15% and akathisia in 11% of the patients, all these patients being on combined treatment. Clozapine did not induce tardive dysakinesia (TD) in any of the patients within a treatment period of 7-8 years. It is concluded that a potential benefit of clozapine includes a low incidence of neurological side effects even after long term administration.

Adult↗
PubMed1989

[Therapy refractory depression--causes and treatment possibilities].

Despite the advances in the treatment of depression, 10 to 30% of all depressions remain--depending on the definition of the term--refractory to treatment. Having clarified possible causes such as wrong diagnosis, poor compliance, inadequate treatment, drug interactions and psychological factors, various treatment methods can be applied. However it is necessary to know not only the efficacy but also the side effects and contraindications of these methods.

Antidepressive Agents↗
PubMed1989

[Indications for therapy using MAO inhibitors].

The MAOIs have been an underutilized and overly feared class of medical compounds potentially useful for a wide spectrum of disorders. At one end of the spectrum they have been found effective for several anxiety disorders, especially when phobic or panic reactions are part of the symptoms. At the other end of the spectrum, they are effective in patients with melancholic depressions, especially outpatients who have lack of energy, a history of bipolar disorder, or a nonresponse to conventional treatment with TCAs. However, their major role for psychiatric patients appears to be in the large heterogeneous group of ambulatory depressives who have symptoms of both anxiety and depression. The danger of side effects or toxicity associated with MAOIs has been exaggerated. Most side effects are relatively mild and are controllable by dose reduction or other supportive measures. The adverse reaction of most concern, hypertensive crisis, is great extent preventable with appropriate dietary restrictions. Selective and reversible MAOI's may have a better safety profile compared to classical MAOI's.

Anxiety Disorders↗
PubMed1988

Combined MAO-inhibitor and tri- (tetra) cyclic antidepressant treatment in therapy resistant depression.

1. One aspect of using MAO-inhibitors - combining them with tricyclic antidepressants in the treatment of therapy resistant depression - has always been controversely discussed in regard to its unusual toxicity and efficacy. 2. To obtain detailled information about safety and efficacy of such a combined treatment, the charts of 94 inpatients treated with a tranylcypromine - tri- (tetra) cyclic antidepressant combination were reviewed. 3. Within a mean treatment period of 21.9 days, 68% of the patients demonstrated a very good or good improvement to combined treatment, the most effective combination being tranylcypromine + amitriptyline. 4. The incidence of side effects among the patients on the combined regimen was slightly, but not significantly lower as compared to the patients on single tri- (tetra) cyclic antidepressant treatment. 5. Our retrospective study supports the general safety and efficacy of combined MAOI-TCA treatment and suggests that combined treatment, if properly administered, leads to neither serious complications nor an inordinate number of side effects.

Antidepressive Agents↗
PubMed1988

Effects of alpha 2-receptor blockade in addition to tricyclic antidepressants in therapy-resistant depression.

It was investigated whether yohimbine, a primarily alpha 2-receptor blocking agent, may have an antidepressant effect when given in addition to tricyclic antidepressants. After at least two unsuccessful preliminary antidepressant treatments for a minimum of 4 weeks each, patients received, in addition to tricyclics, yohimbine in increasing doses for 7 days. None of the five patients investigated demonstrated any improvement in depressive symptomatology and four of the five suffered from such side effects as severe anxiety, inner restlessness, psychomotor agitation, and tremor. During intravenous administration of 2.5 and 20 mg yohimbine, significant increases in norepinephrine values and systolic blood pressure were observed. It was concluded that a combination of yohimbine and tricyclic antidepressants seems to have little indication due to yohimbine's lack of efficacy and the high incidence of side effects in the treatment of severely depressed inpatients.

Adult↗
PubMed1985

Oxaprotiline in the treatment of endogenous depressed inpatients an early clinical trial.

Oxaprotiline (C 49/802 BA), a further development and structural analogue of maprotiline, is characterized by a very potent and extremely specific inhibitory effect on the re-uptake of norepinephrine. In an open early phase II study oxaprotiline was investigated in 10 inpatients with endogenous depression with regard to its antidepressive efficacy and occurrence of adverse effects. Oxaprotiline was given in a dosage up to 225 mg over a period of 28 days. 9 out of 10 patients completed the study, and, of these, 5 were found to be either very much improved or much improved. Standardized rating scales (HAMD, Bf-S, EWL-K) indicated significant improvement after 4 weeks of treatment. Except dry mouth, generally mild, there were no remarkable side effects; there was no influence of oxaprotiline on heart, cardiovascular and routine laboratory parameters. The results of this study indicate that oxaprotiline is an effective antidepressant without significant adverse effects.

Adult↗
PubMed1984

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↗