Nine double‐blind studies comparing remoxipride to haloperidol in the treatment of acute schizophrenia formed the basis of this analysis. All studies followed a basic protocol with the main assessments performed regularly during the 4–6 week trial period according to the same methodology, thus allowing the data to be pooled. The results showed that remoxipride in a daily dose of 150–600 mg had a therapeutic effect comparable to that of haloperidol (5–45 mg/day), both on positive and negative symptoms. There was a clear advantage for remoxipride over haloperidol with regard to adverse events/symptoms, particularly extrapyramidal symptoms, but also drowsiness/somnolence and tiredness/fatigue. Anticholinergic drugs were used consistently less frequently as concomitant medication to alleviate extrapyramidal symptoms in the remoxipride group; the use of sedatives/hypnotics was approximately the same in both groups. Based on these and supportive clinical data, remoxipride seems to have a clinical profile characterized by antipsychotic efficacy in acute schizophrenia, apparently equal to that of haloperidol, and good tolerability in being non‐sedative (in terms of drowsiness/somnolence) and with low incidences of extrapyramidal, autonomic, and endocrine symptoms.

A visual analogue scale has been constructed to allow relatives and professionals to rate the behaviour of elderly patients. The scale has been shown to have good inter-rater reliability, test-retest reliability and validity. It is suggested that the scale can provide a quick and convenient initial assessment of the patient either at home or in hospital, and possibly also a measure of change.

The prevalence of abnormal perceptual experiences as symptoms of migraine attacks was determined in a consecutive series of 46 new female referrals to a migraine clinic. All patients met the diagnostic criteria of the International Headache Society for migraine with aura or migraine without aura and had no other serious physical illness. Seven patients (15%) reported abnormal perceptions (olfactory and/or gustatory hallucinations and distortions of body image) as part of most migraine attacks. A statistically significant association was found between these abnormal perceptual experiences and complaints of mood change, particularly increased depression and irritability, as part of most migraine attacks. It is suggested that spreading depression of cortical electrical activity may be responsible for the manifestations of temporal lobe and limbic system dysfunction.

SYNOPSISIn a consecutive series of 46 female new referrals to a migraine clinic, 17 patients (37%)complained of increased irritability and/or depression in association with more than 50% of their migraine attacks. This was not related to the attack frequency or duration. Sixteen patients (33 %) met DSM-III criteria for a current diagnosis of an affective syndrome and when present this was significantly associated with these complaints.

In view of the evidence for the role of the central cholinergic pathways in memory and preliminary studies suggesting alteration of neurotransmitters after severe head injury, we completed a double-blind, placebo-controlled study of combined oral physostigmine and lecithin. Sixteen survivors of moderate to severe closed head injury who had unequivocal memory deficit were studied during the course of inpatient rehabilitation. Although the results generally indicated no difference in the effects of the physostigmine-lecithin combination as compared to lecithin alone, sustained attention on the continuous performance test was more efficient under physostigmine than placebo when the drug condition occurred first in the crossover design. Further investigation of neurotransmitter manipulation is warranted in patients with traumatic brain injury.