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Biomedical subjects

W Kissling

Publications and source records attributed to W Kissling.

At least 55 records · Page 3Linked to original sources
PubMed1991

Efficacy and tolerability of a new antipsychotic compound (risperidone): results of a pilot study.

Risperidone is a new benzisoxazole derivative displaying a very potent serotonin antagonism and a potent dopamine antagonism in pharmacological studies. These properties suggest the hypothesis that risperidone may exert antipsychotic effects and be superior to classic neuroleptics in its beneficial effects on negative and affective symptoms and its low extrapyramidal side-effect propensity. In an open pilot study 13 patients suffering from acute schizophrenic psychosis were treated with risperidone within an individually adapted dose range from 1 to 10 mg per day. A good antipsychotic efficacy could be demonstrated in 6 of the 8 patients who completed the trial. Risperidone was very well tolerated. The substance possesses a low EPS-inducing profile. Future research has to test the suggested advantage of risperidone over other neuroleptic drugs and its performance in the treatment of chronic schizophrenic patients.

Acute Disease↗
PubMed1991

[Information-centered family groups for improving compliance in schizophrenic patients].

We tried to improve the compliance in the long-term treatment of schizophrenic patients by psychoeducational groups for relatives of 48 patients over the course of six months. More than 90% of the relatives requested mainly informations concerning the illness and its treatment both at the beginning and at the end of the group sessions. At the beginning only 33% of the relatives thought they could benefit from sharing their experiences with others, afterwards this rate rose to 67%. At first, 49% believed to understand the nature of schizophrenia, at the end this rate was 86%. The importance of medication implying certain side effects was accepted by about 85% before and afterwards. This good quota at the beginning of the group sessions can be explained of this high acceptance rate appears to be a direct result of the group meetings.

Adaptation, Psychological↗
PubMed1991

The current unsatisfactory state of relapse prevention in schizophrenic psychoses--suggestions for improvement.

The current state of relapse prevention in schizophrenic psychoses is very unsatisfactory. Although in the form of neuroleptics a very efficient means of relapse prevention has been available for almost 40 years, approximately 50% of the schizophrenic patients still suffer a relapse within the first year after their most recent episode. Seventy percent of the hospitalized schizophrenic patients are readmissions, and the noncompliance rate for neuroleptic relapse prevention is 75%. An important factor contributing to these high rates of noncompliance and relapse seems to be the fact that, 40 years after the introduction of neuroleptics, there is still no consensus on how these drugs are to be used in relapse prevention. An inquiry among Austrian and German psychiatrists revealed unacceptably high discrepancies concerning their recommendations for indication and duration of neuroleptic relapse prevention. To overcome this unsatisfactory situation, an international consensus meeting on guidelines for neuroleptic relapse prevention was organized by the author in April 1989. Precise guidelines on indication, duration, and dosage of neuroleptic for relapse prevention that resulted from that meeting are presented.

Antipsychotic Agents↗
PubMed1989

Doubleblind evaluation of the antimanic properties of carbamazepine as a comedication to haloperidol.

1. Today carbamazepine is the most important alternative to neuroleptic drugs for the treatment of manic psychoses. Often carbamazepine is administered as a comedication to a neuroleptic. 2. A doubleblind study with 20 patients suffering from manic or schizomanic psychoses was performed to determine whether carbamazepine and haloperidol in comedication are more effective than haloperidol alone. 3. Under the tested conditions (24 mg haloperidol p.d.) only the smaller amount of additional medication with levomepromazine in the experimental group gave evidence for the antimanic effect of carbamazepine in combination with haloperidol. 4. Especially the patients with pure manic psychoses seem to benefit from carbamazepine as an adjunct to haloperidol.

Adult↗
PubMed1989

Efficacy and tolerability of a new antipsychotic compound (savoxepine): results of a pilot-study.

Savoxepine is a new tetracyclic compound displaying potent neurolepticlike effects in pharmacological studies. Of particular interest is its preferential binding to dopamine-2 receptors in the hippocampus, which leads to the hypothesis that savoxepine may exert antipsychotic effects at doses not inducing extrapyramidal side-effects. In an open pilot-study 18 patients suffering from acute schizophrenic psychoses or paranoid syndromes were treated with savoxepine in an individually adapted dose range from 0.50 to 10 mg per day. A good antipsychotic efficacy could be demonstrated in 10 of 16 patients. Savoxepine was found to be generally well tolerated. Contrary to expectations, mild or moderate extrapyramidal side-effects, especially of the parkinsonian type, were registered. Future research has to test the suggested advantage of savoxepine in comparison with other neuroleptic drugs.

Adult↗
PubMed1986

The dexamethasone suppression test in depressive and schizophrenic patients under controlled treatment conditions.

Endogenous depressive and schizophrenic patients demonstrated the same frequency of pathological DST results after admission. After 3 weeks of psychopharmacological treatment the percentage of abnormal DST results was significantly reduced in both groups, although the treatment conditions were different. A correlation between the DST non-suppression and intensity of depression was observed only in the depressive group, not in the schizophrenic group. Normalization of DST results in depressive patients was mostly associated with an improvement of depressive scores. Other course patterns of DST results did not seem to be combined with psychopathological changes. From this data it has to be concluded that DST non-suppression is in some part related to depressive symptoms, but is not characteristic or specific for endogenous depression or for depressivity.

Adult↗
PubMed1986

Controlled trial on the possible advantages of a combined therapy with maprotiline and haloperidol in endogenous depression.

There is some clinical evidence that neuroleptics are able to increase the therapeutic effect of antidepressant drugs. From a theoretical viewpoint this could be due to influences on pharmacokinetics or receptor sensitivity. In a controlled three-week trial in 28 patients with endogenous depression the potential advantages of a combined medication of 150 mg maprotiline and 9 mg haloperidol per day (given for the first six days) in comparison with monotherapy with maprotiline were tested. Neither during the time of combined medication nor following withdrawal of haloperidol did this treatment regimen show better clinical results in comparison with controls. In keeping with results described elsewhere, the serum levels of the antidepressant, but not of its desmethyl metabolite, were higher in the experimental group.

Adult↗
PubMed1985

Double-blind comparison of haloperidol decanoate and fluphenazine decanoate effectiveness, side-effects, dosage and serum levels during a six months' treatment for relapse prevention.

In this present study 31 schizophrenic patients were treated for six months for relapse prevention under double-blind conditions with either haloperidol decanoate (22) or fluphenazine decanoate (9). In respect of the prophylactic action, both depot neuroleptics proved to be equal during the comparatively short period of observation. In both groups a psychotic relapse occurred that could not be managed by increasing the depot dosage. No side-effects worth mentioning appeared in either group of patients; patients under haloperidol decanoate, however, only required half the quantity of anti-parkinson medication as compared with patients treated with fluphenazine decanoate, and also displayed extrapyramidal motor symptoms (EPMS) to a lesser degree. Patients received a mean monthly injection of 80 mg of Haloperidol, reaching steady-state serum levels of about 3 ng/ml in the third injection interval. Fluphenazine serum levels known so far for seven patients amount to 0.8 ng/ml after fluphenazine injections of 21 mg every 14 days.

Adult↗
PubMed1984

[Controlled study on the possible benefits of combination therapy with chlorimipramine and haloperidol inpatients with endogenous depression].

Ther is some clinical evidence that neuroleptics are able to increase the therapeutic effect of antidepressive drugs. From a theoretical viewpoint this could be due to influences on pharmacokinetic or receptor sensibility. In a controlled trial on 20 endogenous depressives the advantage of a combined medication of 150 mg Chlorimipramine and 9 mg p.d. Haloperidol (given over six days) were tested. Neither during the combined medication, nor after discontinuation of haloperidol, this treatment regimen proved better clinical results. According to the literature serum levels of chlorimipramine were higher in the experimental group, not the levels of desmethyl-chlorimipramine.

Adolescent↗
PubMed1984

Serial application of clonidine tests during antidepressive treatment with chlorimipramine.

In a controlled 3 week trial on 20 endogenous depressive inpatients refractory to outpatient treatment and treated with two different types of antidepressive medication (chlorimipramine vs. chlorimipramine combined with haloperidol in the first six days), the clonidine test was performed repetitiously to analyse changes of the functional state of central noradrenergic synapses. In nearly all cases the GH response after clonidine was blunted at the beginning and at the end of the trial; in a few cases a response was observed after 8 days of treatment. The data are discussed under the hypothesis of a hyposensitivity of central alpha-receptors in endogenous depressives and under the aspect of drug induced changes: at first inhibition of noradrenaline reuptake, later on adaptive down-regulation of alpha-receptors. There was no evidence for the expected haloperidol-induced supersensity of central adrenergic receptors.

Adult↗
PubMed1983

[Prognostic value of the early response of psychiatric patients to neuroleptics for the subsequent course of treatment].

There is some evidence that the early response of schizophrenic patients to neuroleptic treatment is of prognostic value for the subsequent course of treatment. This hypothesis was confirmed in a prospective study. It was demonstrated that already the therapeutic effect on the first day of treatment is of prognostic value, especially with a standardized drug regimen.

Adolescent↗
PubMed1982

Efficacy and side effects of haloperidol in psychotic patients: oral versus intravenous administration.

It is a commonly held view among clinicians that intravenously administered haloperidol has a greater antipsychotic effect than oral haloperidol. To test this hypothesis, the authors carried out a double-blind study on patients with acute schizophrenia and patients with schizophreniform or schizoaffective (with manic features) psychoses. Using biologically equivalent doses, they found that intravenously administered haloperidol was slightly more effective during the first 3 hours; thereafter the route of administration did not make a difference in effectiveness.

Administration, Oral↗