The authors discuss the historical aspects, as well as the various etiological and clinical factors which contribute to the so-called pharmacogenically induced depressions during treatment by means of neuroleptics generally, and long-term neuroleptics especially. An open study on 161 schizophrenic patients treated by means of fluspirilene and 123 patients treated by means of penfluridol is described. A single blind trial on 48 patients, by means of fluphenazine-decanoate and flupenthixol-decanoate, which compares the possible depression-inducing or antidepressant activity of the above drugs, is presented. The criteria for evaluating drug-induced depressions and their two clinical types are discussed.

The paper describes the theoretical and experimental basis of lithium action, tremor as the main side effect, and the attempt of treating tremor in Parkinson’s disease by administration of β-receptor blockers. A review is presented of β-receptor and propanolol action, as well as its relation to lithium-induced tremor. 15 of own cases, 10 of which were affected by lithium-induced tremor and the other 5 by psychogenic tremor, were treated by 2 X 40 mg (or 4 X 20 mg) propanolol over a period of 7-28 days under permanent supervision of lithium blood level. The ten lithium-treated patients belong to the following diagnostic groups: manic-depressive psychosis, endogenous depression, ‘vitalised’ neurotic depression and schizo-affective psychosis. Out of the 8 positive results obtained, 3 were satisfactory and 5 excellent. No side effects were observed. Tremor modifications were objectivated by writing and drawing tests. Further possibilities for more detailed studies are discussed.

The paper reports on 26 acute, first time or repeatedly diseased schizophrenic patients, who were treated by Sulpiride in a psychiatric ward. The method used was a variant of the single-blind technique of administration and evaluation, the basic conception being that of the ‘neuroleptic threshold’ of Haase. The substance proved to be an intermediary drug between feeble and middle-potent neuroleptics. In doses about 200 mg/ day, it showed a mood-clearing and stimulating effect. The average dosis necessary to reach the neuroleptic threshold was 399 mg Sulpiride, the average time being 6 days. An average dosis of 593.3 mg daily produced in an average time of 11.5 days, dependent from the initial dose, an evident antipsychotic effect. A good indication for Sulpiride therapy seemed to be the inhibited and withdrawn patients, but also the restless, highly productive psychoses, of which 17 from 23 cases showed good results. Extrapyramidal side effects were not important and could easily be kept under control. Only a certain drowsiness after very high doses was registered. The indication of Sulpiride in the ambulatory treatment and in post-psychotic depressions are discussed.

This paper discusses the present state of investigations concerning the concepts of ‘neuroleptic threshold’ and fine motor extrapyramidal inhibition. The publication also includes reports on studies carried out by thirty-one collaborators from the Haase work-team based on over 50,000 handwriting tests. The main results of the following studies are presented and discussed: Investigations effected by fourteen authors on 328 cases of schizophrenia proving the close relationship between crossing the neuroleptic threshold and onset of the anti-psychotic effect. By a gradual increase of dosage a neuroleptic-anti-psychotic action was obtained in the days following the crossing of the neuroleptic threshold for a total of 87% of cases, 52% of which took place in the first three days, another 16% within the following three days and the rest after a longer interval. In another series of investigations the actions of a neuroleptic drug above and under the neuroleptic threshold were systematically compared in twenty-four cases of chronic schizophrenia. Concerning the action of anti-parkinson drugs on motor and psychic neuroleptic efficiency, results are reported on two series of investigations. Furthermore, the concepts of ‘neuroleptic-therapeutic range’ and ‘neuroleptic potency’ are defined and the problem of different individual predispositions to the neuroleptic threshold is discussed. Fine motor extrapyramidal handwriting symptomatology was quantified by means of Haase's handwriting test and evaluated according to the following degrees: mild, moderate and severe. The relevancy of determining the impressive character of handwriting was proved by the work of three different independent investigators, each separately assessing the samples resulting from the same 300 handwriting tests. Two measuring procedures were evolved for the planimetric evaluation of handwriting. The application of handwriting tests in the therapy of long-term neuroleptics is discussed, viz. in determining duration of activity, in controlling cumulative tendency and in studies on under-threshold neuroleptic action. This paper stresses the clinical and practical importance of these results.