The Hillside Akathisia Scale: a new rating instrument for neuroleptic-induced akathisia.
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Biomedical subjects
Publications and source records attributed to W W Fleischhacker.
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1. The paper presents an investigation of the efficiency of piracetam in alcohol organic mental disorder. 2. A double blind placebo controlled study design was used to compare two dosages of the substance (2 x 3g versus 2 x 12g). 3. The cognitive functions of the patients, especially short term memory and concentration, were assessed on the days 0, 7, 14, 28 and 42 using various psychological instruments. 4. An analysis of 39 patients showed an improvement of cognitive functions in all three groups. 5. Patients receiving drug treatment showed earlier responses than patients receiving placebo; differences between the three investigational groups were not statistically significant. 6. The results achieved make the effect of piracetam appear somewhat questionable.
Zotepine is a new tricyclic neuroleptic with a pharmacological profile comparable to substances like Thioridazine and Chlorpromazine. In an open pilot study, 10 patients suffering from negative symptoms in the course of chronic schizophrenia were treated with Zotepine. The efficacy of Zotepine in this indication was evaluated by means of the BPRS and the Andreasen Scale for the Assessment of Negative Symptoms. Significant improvement could be demonstrated after 3 weeks of treatment. No side effects were observed within the dosage range of 50 to 200 mg per die. These results suggest that Zotepine is useful in the treatment of residual schizophrenia.
Zotepine is new tricyclic neuroleptic with a pharmacological profile comparable to substances such as thioridazine and chlorpromazine. Its chemical structure is related to clozapine and fluperlapine. Ten patients (8 men and 2 women) fulfilling DSM III criteria for residual schizophrenia participated in an open clinical trial that lasted 8 months. The effects of low-dose maintenance therapy with Zotepine were evaluated using the Brief Psychiatric Rating Scale and the Scale for the Assessment of Negative Symptoms. Eight patients dropped out of the study within the first 6 months, 5 because of acute psychotic relapse, 3 due to compliance problems. Psychotic relapse appeared to be indicated by increasing BPRS and SANS scores recorded 1 month before relapse. Apart from minor sedation, no side effects, especially none of the extrapyramidal motor type, were observed. Even though Zotepine does not seem to possess sufficient prophylactic properties against psychotic relapse, preliminary results suggest that it might play an important role as a supplement to conventional neuroleptics in the near future.
Zotepine is a new tricyclic neuroleptic with a pharmacological profile comparable to substances such as thioridazine and chlorpromazine. Ten patients fulfilling DSM-III criteria of paranoid schizophrenia were included in an open pilot study at the Department of Psychiatry in Innsbruck. Neuroleptic efficacy, optimal dose, side effects, and the influence on serum prolactin levels were evaluated. Definite onset of antipsychotic action could be demonstrated between days 5-10, and approximately 400 mg/die seems to be an optimal dose. Four patients showed side effects of a minor degree that had no influence on the course of therapy. These results suggest that Zotepine is a rapidly acting neuroleptic with a high benefit-risk ratio. Further double-blind studies will be needed to reinforce these preliminary data.
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The efficacy of the dopaminergic substance Memantine was studied in severe cases of senile dementia of the Alzheimer type using a randomized single blind trial. Following 20 days of a basis therapy, consisting mainly of the proper therapy of medical disorders, 10 patients received 20-30mg Memantine pro die intravenously, 10 other patients were given placebo infusions. Patients were evaluated using the Syndrom Kurztest, the Funktionspsychose-Skala, the Plutchik Geriatric Rating Scale as well as the Sandoz Clinical Assessment Geriatric 5 times following the baseline period. Statistical evaluation showed no significant differences between the two groups. Mild amelioration of sleep-wakefulness cycles and impulse and drive functions could be observed clinically in both groups. Side effects (deterioration of psychopathology in two patients of the Memantine group) disappeared after withdrawal of the substance.
The psychopathological symptoms occurring in the course of alcohol addiction, which probably have a very complex pathogenesis, call for a thorough examination. Jellinek's description of the autonomous course of this disease includes various mechanisms and behaviour abnormalities which do not only refer to the psychopathology of alcoholism, but which do also include reactive and environmental elements and personality-specific factors. The psychopathology of 'uncomplicated' alcoholism develops in the course of dependence and lasts for a shorter or longer period of time and persists even during abstinence. Symptoms appearing under the acute influence of alcohol may be totally different when observed in sober periods. On the whole the psychopathology of alcohol addiction contributes to a great extent to personality changes in alcoholics which play an important role in the perpetuation of the process. This study deals with the appearance of cognitive deficits, amnestic episodes, and affective and paranoid syndromes, leaving psychiatric complications of alcoholism, e.g. alcoholic psychoses, out of consideration.