Amisulpride is a selective D2-like dopamine receptor antagonist with a high affinity for the cloned D2 and D3 receptors. At low doses it may improve depressive and negative schizophrenic symptoms whereas antipsychotic effects on positive schizophrenic symptomatology require higher dosages. Acute endocrine effects were studied for two doses of amisulpride with regard to the daytime secretion of prolactin, thyroidea stimulating hormone (TSH), growth hormone (GH), luteinizing hormone (LH) and cortisol. Amisulpride was administered i.v. to eight healthy male volunteers in a single-blind trial under a randomized cross-over, placebo-controlled design using doses of 20 mg or 100 mg, or saline. The drug was injected at 09:00 h, and plasma samples were withdrawn from 08:30 h to 16:00 h at intervals of 15 and 30 min, respectively. At both dosages, prolactin was significantly elevated to the eight- to ten-fold of baseline levels. Likewise, a significant 50% elevation of TSH concentrations with a trend to a greater increase under the 100 mg dose was observed. Plasma levels of LH and cortisol were not significantly affected by amisulpride. With regard to GH secretion, there was a trend to a decrease only with the 20 mg dose. These results indicate that the neuroendocrinological side-effect profile of acute amisulpride administration may be similar to conventional neuroleptics, and that there are only minor dose-dependent differential effects on hormone secretion in the dose range investigated.

Adult↗

PubMedDate not supplied

Primary enduring negative symptoms in schizophrenia and major depression.

Primary enduring negative symptoms (PENS) were studied in 26 patients with DSM-III-R schizophrenia and in 94 patients with unipolar major depressive episodes 5 years after the index episode. PENS were assessed with the Schedule for Deficit Syndrome (SDS). Negative symptoms were also assessed with the Scale for Assessment of Negative Symptoms (SANS) and subclassified into primary and secondary according to the SDS. The frequency of PENS did not differ significantly between schizophrenics and non-schizophrenic patients. Enduring negative symptoms (regardless of whether primary or not) were more frequently observed in schizophrenia (65% according to the SDS, and 88% according to the SANS) than in patients who had major depressive episodes (29% according to the SDS and 32% according to the SANS). By applying the SDS criteria for PENS, their frequency decreased in a manner which would probably affect the availability of patients samples for testing antinegative drugs. The results suggest that neither the negative symptomatology nor the primary enduring subtype ("deficit") is specific for schizophrenia. This finding might imply potential advantages of non-nosological, functional approaches for research into PENS.

Adult↗

PubMedDate not supplied

Clinical subtypes in panic disorder: their descriptive and prospective validity.

In a sample of 97 patients with panic attacks, presence of agoraphobia was associated with a more severe syndrome of panic anxiety both at index assessment and during one-year follow-up but was not associated with increased incidence of major depression. Groups with a history of depression--primary or secondary to the onset of panic--did not differ from the group without depression when severity of anxiety was concerned but were more severely impaired and had a higher incidence of further depressive episodes during follow-up. For future classification of panic disorder, subtypes defined according to associated syndromes of agoraphobia or depression are proposed, since these conditions appear constant through follow-up.

Adult↗

PubMedDate not supplied

Sources of disagreement between clinical (ICD-9) and operational (RDC, DSM-III) diagnosis of endogenous depression (melancholia).

In a sample of 173 depressed in-patients, the sources of disagreement between the clinical ICD-9 diagnosis of endogenous depression (ED) and the corresponding operational definitions of RDC and DSM-III were analyzed. The RDC definition of ED gave a significantly higher degree of concordance with the ICD-9 diagnosis of ED, than that of DSM-III. This difference was mainly due to the algorithm used in DSM-III. When empirically derived algorithms were applied to the diagnostic criteria of DSM-III and RDC, both criteria lists reached a higher degree of concordance with the ICD-9 diagnosis of ED. When the criteria lists of RDC and DSM-III were supplemented with cross-sectional criteria (psychotic features, incapacitation) and by course-related criteria (recurrence, bipolarity, primary episode, adequate personality, no precipitating stress), this did not result in significant enhancement of the degree of concordance.

Adjustment Disorders↗