Clinical study on the psychotropic effects of caerulein. An open clinical trial in chronic schizophrenic patients.

Abstract

An open clinical trial of caerulein diethylamine, a cholecystokinin analogue, was performed in a total of 58 chronic schizophrenic patients maintained on drugs such as antipsychotic agents without dosage modification. The neuro peptide medication by intramuscular route produced a clinical improvement in 20 cases and was eventually assessed to have been of therapeutic value in 23 cases. Clinical responses to the medication observed in the present series in cluded: subjective changes in mood mostly to become feeling "fine" or "re freshed in the head", improvement in contact, increased spontaneity and objective behavioral changes such as restlessness and excitement. These features of clinical responses observed in respect of mental condition seem to indicate that the drug affects emotion and exerts an analeptic effect as its principal clinical effects. The clinical effects were remarkably long sustained for 1-2 weeks after a single i.m. dose in most responders. Feeling of facial warmth and lassitude as well as symptoms of the gastrointestinal system were encountered as attendant symptoms in 6 cases.

The use of cholecystokinin in schizophrenia: a review

“…The authors drew the conclusion that caerulein had a long-acting antipsychotic effect in chronic schizophrenia. Similar findings have been reported in seven other open studies (Moroji et al 1985;Itoh et al 1982;Kudo, 1983;Albus et al 1984;van Ree et al 1984;Boza & Retondo, 1985;Yamagani et al 1986) which all found some therapeutic benefit when caerulein was administered in dosages ranging from 0-3 to 20/ig per kg bodyweight (see Table 1). In these studies, most of the patients were suffering from chronic schizophrenia, and all were maintained on neuroleptics.…”

“…It is commercially available as a drug for testing biliary and pancreatic function; it is reported to produce fewer gastro-intestinal side effects than CCK (Hommer et al 1985). There is a suggestion that it may have more potent CNS effects than CCK-8 (Itoh et al 1982). However, there have been no studies which were specifically designed to compare the efficacy of caerulein and CCK fragments in the treatment of schizophrenia, and a review of the double blind studies in chronic schizophrenia reveal little evidence of efficacy for any of the CCK preparations.…”

Treatment of the Neuroleptic-Nonresponsive Schizophrenic Patient

“…The evidence suggests no consistent benefit from this regimen. The alpha 2 -agonist clonidine (Freedman et al 1980, 1982), the alpha 1 antagonist prazosin (Hommer et al 1984 b ), GABAergic drugs such as di-n-propyl-acetate (Linnoila et al 1976), baclofen (Simpson et al 1976), gamma-acetylenic acid (Casey et al 1980), gamma-vinyl-GABA (Korsgaard et al 1983; Stahl et al 1985), thyrotropin-releasing hormone (Wilson et al 1973), lysine-8-vasopressin (Korsgaard et al 1981), cholecystokinin (Itoh et al 1982; Nair et al 1982, 1985; Bloom et al 1983; Hommer et al 1984 a ; Mattes et al 1985 a , 1985 b ), beta-endorphin (Gerner et al 1980; Pickar et al 1981) have also been tried. These studies have been reviewed by us elsewhere (Meltzer 1986).…”

Novel approaches to the pharmacotherapy of schizophrenia

“…Nair and colleagues [1982] reported CCK-33 and CCK-8 [Bloom et al, 19831 were effective in an open trial in neuroleptictreated but resistant schizophrenics. Itoh et al [1982] reported results of an open clinical trial with caerulein (CCK-8 sulfate) and claimed benefit in 23 of 58 neuroleptic-treated chronic schizophrenia patients. The dose of caerulein was 20 or 40 mg and the route was intramuscular.…”