Search PubMed⌕ Search

Biomedical subjects

W Kissling

Publications and source records attributed to W Kissling.

66 records · Page 4Linked to original sources

Effect of sodium valproate on mania. The GABA-hypothesis of affective disorders.

A possible antimanic property of the GABA-ergic anticonvulsant valproate was examined by use of a double-blind placebo-controlled ABA design in 5 acutely ill manic patients. In 4 cases a marked improvement was observed after valproate medication whereas one patient showed no response. Seven further patients with frequently recurrent episodes of a manic or maniform schizoaffective psychosis, irresponsive to lithium prophylaxis, were chronically treated with valproate in combination with low doses of lithium (one case only with valproate). Over an observation period of 1 1/2-3 years none of the patients exhibited a relapse. It is proposed that, in general, GABA-ergic anticonvulsants possess antimanic properties and that the specific antimanic effect of lithium is due to a GABA-ergic mode of action. The possible role of GABA-systems in affective disorders and in organic types of psychoses (e.g.,porphyria-psychosis, delirium tremens) is discussed on the basis of pharmacopsychiatric considerations.

Adolescent↗

[Hemodialysis in patients with chronic schizophrenia (author's transl)].

In an open study three chronically schizophrenic patients with normal kidney function were treated by hemodialysis in an attempt to ameliorate their psychotic symptoms. Neuroleptic treatment was stopped at least four weeks prior to hemodialysis. The patients were dialysed once weekly for twelve (in one case eleven) weeks. Psychopathology was evaluated using the IMPS, BPRS and NOSIE. No patient showed any improvement during the course of dialysis, one patient showed a marked detrioration. These observations raise doubts about whether schizophrenic psychoses can be improved by means of hemodialysis as previously published by Wagemaker (1977).

Adult↗

Des-tyrosyl-gamma-endorphin in schizophrenia: a double-blind trial in 13 patients.

A double-blind placebo-controlled cross-over investigation of the possible antipsychotic action of [des-Tyr1]-gamma-endorphin (DT gamma E) was undertaken in schizophrenic patients. This non-opiod derivative of gamma-endorphin has recently been shown to exert both neuroleptic-like effects in animals and an antipsychotic action in schizophrenic patients failing to respond to conventional neuroleptic therapy. 13 patients undergoing continuous neuroleptic therapy, and suffering from either chronic or acute, frequently-relapsing schizophrenia and displaying persistent productive symptoms (hallucinations, acute delusions) were selected for the trial. After one day of single-blind injection of placebo, two successive double-blind treatment periods of 4 days each followed, viz 4 days with i.m. injections of 2 mg DT gamma E preceding 4 days of placebo injections or vice versa. Psychopathological evaluation was performed twice daily by use of the IMPS and an eight-point-scale appropriate for the estimation of special target symptoms (VBS). The mean data obtained from the whole sample of 13 patients show that placebo and DT gamma E produce a reduction in symptomatology of an appoximately equal magnitude. The results provide no support for the hypothesis of an antipsychotic efficacy of DT gamma E in the treatment of chronic schizophrenic patients. In the subgroup of acute cases, however, a therapeutic action of DT gamma E appears possible

Adult↗

Action of d-propranolol in manic psychoses.

Six manic patients were treated with high doses of d-propranolol or d- and dl-propranolol in a double-blind, placebo controlled study. The following variables were measured: propranolol dosage, propranolol serum concentration, pulse frequency, blood pressure, and psychotic behavior. In all cases an improvement was noticed. High dosages were necessary to obtain sufficient effect. The antimanic property of d-propranolol was approximately 50% smaller than the antimanic property of dl-propranolol. We conclude that at least some part of the antimanic action of beta-blockers is independent from the beta-blocking property.

Adult↗

Hemodialysis in schizophrenia. Results in three chronic cases.

Therapeutic trials with hemodialysis have been performed in three cases of chronic schizophrenia. The severely ill patients had been hospitalized for more than ten years and had not responded to different types of conventional somatic treatment. Psychopathology was evaluated by use of the IMPS, BPRS, and NOSIE scales. No improvement could be observed as a consequence of 12 (11 in one case) hemodialysis treatments. Rather, some deterioration occurred in two of the patients. This result is not in accord with the markedly positive findings of Wagemaker and Cade (1977). However, further studies appear necessary to render final conclusions.

Adult↗

beta-Endorphin-like immunoreactivity in cerebrospinal fluid and plasma of patients with schizophrenia and other neuropsychiatric disorders.

Measurements of beta-endorphin-like immunoreactivity have been performed in CSF and plasma of patients with schizophrenia and other neuropsychiatric disorders. The detection limit of the RIA was between 20--50 pg/ml (6--15 fmole/ml). In CSF the quantity of beta-endorphin-like immunoreactivity ranges up to 65 pg/ml. The data from schizophrenics and other neuropsychiatric patients show no obvious deviation from the results in a control group of medical patients with normal CSF findings. In plasma the immunoreactive beta-endorphin-like material ranges up to 250 pg/ml. There is only a small tendency to higher values in schizophrenic patients, if compared with different types of neuroses and affective and organic psychoses. In a second series of experiments also this tendency could not be reproduced. In 9 electroconvulsive treatments an increase of blood beta-endorphin-like immunoreactivity was observed 7 times. A possible endorphinergic mechanism in the mode of action of electroconvulsion is hypothesized.

Adolescent↗

Action of propranolol in mania: comparison of effects of the d- and the l-stereoisomer.

The antimanic action of high doses of the beta-receptor blocking agent propranolol was investigated by the use of a double-blind placebo controlled ABA design. For comparison, the d-stereoisomer (which is practically devoid of beta-blocking activity) was used. 6 trials were performed with d-propranolol, 6 trials with the racemic mixture. From dose-effect relations one can conclude that the d-stereoisomer is about half as effective against manic syndromes as the racemic mixture. From this finding it can be concluded that the antimanic action of propranolol is at least partially due to a mechanism independent of its beta-blocking action.

Adult↗