Sixteen patients with neuroleptic-induced akathisia were treated with lorazepam. A marked improvement in symptoms was observed in 9 of the patient and moderate improvement in 5. Symptoms remained unchanged in 2 patients. The drop in the akathisia score from a pretreatment value of 1.81 to 0.5 after 7 days and to 0.32 after 14 days was statistically significant. Symptoms did not improve significantly during observation of the spontaneous course. No severe side effects were observed. The physiologic mechanisms of action of lorazepam on the akathisia syndrome are discussed.
In an open study of schizophrenic patients treated with perazine (Taxilan), a multidimensional approach comprising the following three areas was chosen: 1. psychopathology (AMDP, BPRS); 2. psychophysiology (habituation of skin resistance reaction, pulse rate); 3. pharmacokinetics (perazine-desmethylperazine plasma levels). Looking beyond the known global effect of the neuroleptic drug, interactions between these three areas were studied. Furthermore, methodological questions concerning possible predictor variables for treatment outcome were examined. Finally, an improved method for analyzing psychopathological data was employed. The methodological framework of the study, the examination techniques, and patient population are presented.
Skin conductance and heart rate of 19 drug-free acute schizophrenic patients were measured before neuroleptic therapy was started. The patients were divided into two groups according to therapeutic outcome. The Discriminant Analysis revealed a difference in the ANS activity pattern between the group with low improvement and the group with a more favorable outcome. The low improvement group showed a paradoxical ANS reactivity pattern: relatively lower activity in skin conductance level under demand (attention task) and relatively higher activity, as reflected by the cardiovascular response to neutral stimuli (orienting stimuli), which suggests poor adaptation of ANS arousal to the environment in these schizophrenics. This finding agrees with those reported in other short-term outcome studies that considered differences in ANS activity in a schizophrenic population. The authors' findings indicate that these differences in the ANS response in schizophrenics should be included in future biochemical and pharmacotherapeutic investigations on schizophrenia.
The fatty acid composition of plasma and red cell membranes was determined in alcoholics without liver dysfunction upon admission for withdrawal therapy and after a 4-week period of abstinence, and in normal subjects. Fatty acid analysis of plasma by capillary gas chromatography showed a higher proportion of saturated fatty acids in alcoholics on admission than in normal subjects. Other major differences in plasma fatty acids in alcoholics were the reduction of linoleic acid and the increase in palmitic acid. Similar abnormalities were measured in red cell membranes of alcoholics. Although there were less polyunsaturated fatty acids in red cells of alcoholics, the degree of hydrogen peroxide or phenylhydrazine-induced lipid peroxidation was the same as in controls. Membrane tolerance to ethanol was attributed to adaptive membrane alterations (increase of saturated fatty acids in membranes). However, the here reported changes in plasma and red cell lipids suggest that alterations in red cell membrane lipids reflect abnormalities in plasma lipids due to equilibrium exchanges rather than signify adaptive changes of the red cells to ethanol.
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