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Prediction of psychotropic properties of lisuride hydrogen maleate by quantitative pharmaco-electroencephalogram.

Based on "quantitative pharmaco-EEG" using computer-analyzed EEG (CEEG) measurements, unknown CNS effects of lisuride hydrogen maleate (LHM) were established. CEEG profiles of LHM in low dosages (less than or equal to 10 mcg) are similar to CNS "inhibitory" compounds, while in higher dosages (25 mcg to 100 mcg) they resemble "psychostimulant" compounds. By measuring the brain function using computer period analysis of cerebral biopotentials, dose-efficacy relations were found (in the range of 25-75 mcg) which suggest the bioavailability of LHM at the CNS level. By comparing the CEEG profiles of LHM with the previously studied compounds, five different clinical uses of LHM were predicted. The pilot trials suggest that LHM may have therapeutic potentials in patients with "aging" and/or organic brain syndromes, and in children with behavioral disturbances.

Adolescent↗

Monoamine oxidase. Its inhibition.

Some 50 years ago the enzyme MAO was discovered by Hare and in the early 1930s Blaschko suggested that MAO may play an important role in the catabolism of monoamines in the central nervous system. With the discovery of iproniazid as an inhibitor of MAO and its introduction as an anti-depressant, many aspects of MAO activity and biogenic amine metabolism in experimental animals and man were examined. Although many other inhibitors of MAO were discovered and used therapeutically as anti-depressants, these drugs fell into disrepute largely because of their side-effects. Furthermore, their anti-depressant properties were questioned. After some years of relative inactivity there is now a revival of interest in the functional role of MAO in the central nervous system and drugs that inhibit or stimulate its activity "specifically". The basic reason for the upsurge of interest is that the enzyme from many tissues, including the brain of animals as well as man, has been purified and characterised. The evidence that neuronal MAO exist with different substrate and inhibitor specificities has led to the suggestion that they have physiological function and that deamination of non-methylated biogenic monoamines can take place in neurons. These findings have led to the advent of new drugs (clorgyline and depranil) with "selective" inhibition of enzyme forms. Their possible usage in the chemotherapy of depressive illness should be considered seriously. Fluctuation in peripheral organs as well as brain MAO is well documented. Recently they have been associated with changes in naturally occurring steroids. Although a decrease in platelet and brain MAO activity has been reported in a number of affect disorders (schizophrenia and bipolar depression) the results of these findings have recently been questioned (20, 141). Obviously further study in this area of research discussed is badly needed.

Bipolar Disorder↗

A neglected modality in psychiatric treatment--the monoamine oxidase inhibitors.

The monoamine oxidase inhibitors are at present being used relatively infrequently in my opinion because of reports of severe and dangerous side effects such as toxic hepatocellular damage and hypertensive crises and also on account of several studies which have not given a very encouraging picture regarding the efficacy of this group of drugs. The purpose of this article is to demonstrate that this group of antidepressant drugs is very useful when the proper indications for their employment are observed and are relatively safe provided that appropriate precautions such as the avoidance of cheese and other foods high in tyramine content are taken by the patients being treated with these compounds. The history, pharmacology, side effects, and indications for their use are reviewed, and it is indicated that the MAO inhibitors are the therapeutic agents of choice in atypical depressions associated with anxiety, phobic and hysterical symptoms, and depressive illnesses (including endogenous depressions) which have failed to respond satisfactorily to tricyclic antidepressants. It is then demonstrated both from a review of the literature relating to these drugs and also from my own clinical experience that these compounds are very effective when used in the treatment of the psychiatric conditions for which they are indicated and are also relatively safe when the appropriate precautions are conscienciously observed.

Depression↗