Chemical aversion treatment of alcoholism: Lithium as the aversive agent

Animal work indicating flavour aversion produced by chemical aversion therapy (CAT) with lithium might be effective in the treatment of alcoholism led to this treatment being given to 25 patients. The abstinence rate six months later of 36% was significantly better than the 12% rate for an equivalent group of patients, treated with a disulfuram-like drinking deterrent, calcium carbimide. The rate for the CAT group improves to 47% if 8 patients are excluded who did not develop sickness reactions to lithium. CAT with lithium appears safe given proper medical precautions.     

Lymphadenopathy in phenytoin treatment]

The authors report on a 20-year-old patient who developed hydantoin lymphadenopathy during treatment with diphenylhydantoin. The problems associated with clinical and histological delimination from malignant lymphomata are described by reference to the literature. Hydantoin lymphadenopathy is regarded as a drug-induced allergic and toxic process.     

Out-patient treatment of psychoses using depot-fluphenazin]

43 courses of treatment in various psychoses are reported. Peculiarities of dosage and application, and the position of Depot-Fluphenazin as compared to other Depot-neuroliptics are considered in detail.     

Preliminary results of imurek treatment of multiple sclerosis]

The authors, after presenting a survey of the literature on the treatment of multiple sclerosis with immunosuppressants, report their experience with Imurek. Of 53 patients with a chronic and progressive course of the disease, objective improvement could be observed in 17. In 20 patients the symptomatology remained unchanged, although 4 of them reported subjective improvement. In 16 patients, progression of the disease could not be stopped. Better results of treatment could be obtained for those forms of the disease where the course was, first, in the form of what may be referred to as outbursts and, later, in a chronic and progressive form. -Possible side effects are pointed out.     

Psychotropic drugs for behavior disorder treatment in oligophrenic epileptics]

Forty-one patients were treated with promazine, a phenothiazine derivative, for an average of 266 days. The average daily dose was 200 mg. Thirty patients were treated with levomepromazine for an average of 115 days, the daily dose being about 130 mg. The two groups of patients were examined for their contactual, impulsive, and affective behavior before, during, and after treatment. The positive results obtained justify the use of the above-mentioned psychopharmaceuticals for the therapy of abnormal behavior of oligophrenic epileptics.     

Indications, contraindications and legal problems in antiandrogen treatment]

The author in his present paper gives an outline of the indications, contraindications, and legal problems of Androcur treatment. Androcur (cyproterone acetate) is an antiandrogen that is capable of competitively inhibiting androgens in the organism. Accordingly, the effects obtained by drug therapy, of which the purpose is to reduce the sexual desire or libido, are similar to those produced by operative castration. The use of such drugs makes it possible to control abnormal sex drives and desires and prevent sexual offenders from becoming recidivous. Since treatment with Androcur is an intervention in the deeply personal sphere and there is not yet availability any reliable data on the full reversibility of the phenomena involved (for example, alterations to the testicles) especially in the case of long-time treatment, such therapy should be carried out on the principle of absolute voluntariness and after suitable suggestions have been furnished as to the proper treatment of the respective subject.     

Clinical experience with Leponex]

Until now the "neuroleptic threshold" (Haase) was considered to be the efficiency criterion of the antipsychotic effect of a neuroleptic substance and it was thought therefore that the extrapyramidal symptoms were a necessary although undesired side effect. The benodiazepine derivative Leponex developed by Sandox - Basel upsets this view because it has an excellent antipsychotic effect without creating definite extrapyramidal symptoms. It is noted for its quick soporfic effect after only a few minutes, for subdueing psychopathological productivity in a very impressive way, for acting rapidly on the "plus"-symptomatology typical of psychosis, as early as in the first days of treatment, and for its equally visible effect on the "minus"-symptoms, typical of psychosis, in the last third of an average period of treatment lasting 40 days. The clinic using Leponex (Dresden, Halle, Brandenburg-G?rden) belonged to the clinical application programme of the Sandox - Basel firm. The article gives a summary of essential results and particulars about the treatment. A detailed evaluation of the case sheets which are at present being statistically reviewed will be given in the next paper.     

Suicide attempts with drugs]

A sample of 352 subjects, who had made a suicide attempt by ingesting pills examined in the aspects of age and sex, number and origin of used tablets and combination of pill ingestion with alcohol or other methods. Younger people under 20, took nearly exclusively tablets, which they accidentally found at home. Elder patients over 50, used nearly exclusively prescribed drugs. The typical patients attitudes to this suicidal method gives us the right to speak about such suicide attempts as "attempts by tablets". The pharmacological substance is unimportant and plays a secondary role. The seriousness of suicide attempts depends on topical situation of person, biological and social factors; it does'nt dependent on number or pharmacological substance of tablets.     

Psychosis associated with anti-N-methyl-D-aspartate receptor antibodies

We describe the eighth case study of a female diagnosed with anti-N-methyl-D-aspartate receptor encephalitis without an identified tumor who presented with floridly psychotic symptoms following a 2-week prodromal phase with new-onset headaches and presyncopal episodes. While hospitalized, the patient had seizures, autonomic dysfunction, involuntary movements, and a decline in mental status. A subsequent assay was positive for anti-N-methyl-D-aspartate receptor receptor antibodies. In contrast to most reported cases, an initial trial with corticosteroids was therapeutically unsuccessful. Subsequent treatment with intravenous immunoglobulins, however, resulted in a prompt, robust clinical response and enabled the patient to be rapidly discharged from the hospital, with minimal neuropsychiatric sequelae.     

Antidepressant treatment of psychotic major depression: potential role of the sigma receptor

Psychotic major depression is a severe condition that frequently proves difficult-to-treat. The most effective traditional treatments (electroconvulsive therapy and combinations of antipsychotics with tricyclic antidepressants) are associated with significant side effects, and the use of tricyclic antidepressants alone is largely ineffective. Recent evidence has indicated that the selective serotonin reuptake inhibitors, either alone or in combination with antipsychotics, may provide a desirable alternative to traditional treatments. Among selective serotonin reuptake inhibitors, fluvoxamine has been the best studied and, somewhat surprisingly, has proven effective in several studies as a monotherapy without the need to combine with an antipsychotic. It is proposed that the apparent efficacy of fluvoxamine in psychotic major depression may be related to its unique property of high affinity for the sigma 1 receptor, which is thought to play a role in psychosis and in the action of some antipsychotic drugs.     

Examinations with the modified VNPI]

The revised design of a psychometric procedure (VNPI) is described. Additional factors were extracted by intercorrelations and factor analysis: increased perseveration, inhibited contact, defective flexibility, instability of moods. They provide information, additionally to the evaluation of the factors of vegetative lability, neuroticism, and introversion. A random test in 360 persons from a screening series is used for the presentation of the relations between VNPI values and findings of social and internal medicine. The possibilities of individual diagnosis of the procedure are demonstrated by VNPI profiles of patients.     

Attitude changes in alcoholics - demonstrated in phasic course of treatment]

The constant change in attitude to personal "alcohol problems" of patients treated on an inpatient or out patient basis is described with reference to the phasic course of treatment and the deviations therefrom. It is essential that this be taken into account in both group and individual therapy, more especially as this will lead to favorable psychagogic and psychotherapeutic approaches.     

Effects of beta blockade with metoprolol on simple and complex task performance

The effect of treatment with the beta-blocker metoprolol on several indicants of task performance was investigated. Twenty-five male hypertensives were treated for 2 weeks each with drug and placebo in a double-blind crossover design. Comparisons to 25 matched untreated normotensives were made. Participants responded twice to a Mood Adjective Check List (MACL) and the Stroop Color-Word Test. In addition, they participated in two parallel decision-making simulations. Normotensives and hypertensives on drug or placebo did not differ on MACL and Stroop scores. Comparisons on 12 validated simulation measures showed that drug treatment with metoprolol aided complex task performance. Drug treatment improved strategic capacity and the ability to deal effectively with emergencies. Preliminary evidence that treatment with metoprolol might help restore performance capacity that may have been lost due to hypertensive disease was also obtained.     

A modified beta binomial model with applications to multiple choice and taste tests

A modified beta binomial model is presented for use in analyzing ramdom guessing multiple choice tests and certain forms of taste tests. Detection probabilities for each item are distributed beta across the population subjects. Properties for the observable distribution of correct responses are derived. Two concepts of true score estimates are presented. One, analogous to Duncan's empirical Bayes posterior mean score, is appropriate for assessing the subject's performance on that particular test. The second is more suitable for predicting outcomes on similar tests.This research was made possible by a grant from the Center for Food Policy Research, Graduate School of Business, Columbia University.     

Resting-state theta/beta EEG ratio is associated with reward- and punishment-related reversal learning

Prior research has shown that the ratio between resting-state theta (4–7 Hz)-beta (13–30 Hz) oscillations in the electroencephalogram (EEG) is associated with reward- and punishment-related feedback learning and risky decision making. However, it remains unclear whether the theta/beta EEG ratio is also an electrophysiological index for poorer behavioral adaptation when reward and punishment contingencies change over time. The aim of the present study was to investigate whether resting-state theta (4–7 Hz)-beta (13–30 Hz) EEG ratio correlated with reversal learning. A 4-min resting-state EEG was recorded and a gambling task with changing reward-punishment contingencies was administered in 128 healthy volunteers. Results showed an inverse relationship between theta/beta EEG ratio and reversal learning. Our findings replicate and extend previous findings by showing that higher midfrontal theta/beta EEG ratios are associated with poorer reversal learning and behavioral adaptive responses under changing environmental demands.     

Mitral cell beta1 and 5-HT2A receptor colocalization and cAMP coregulation: a new model of norepinephrine-induced learning in the olfactory bulb

In the present study we assess a new model for classical conditioning of odor preference learning in rat pups. In preference learning beta(1)-adrenoceptors activated by the locus coeruleus mediate the unconditioned stimulus, whereas olfactory nerve input mediates the conditioned stimulus, odor. Serotonin (5-HT) depletion prevents odor learning, with 5-HT(2A/2C) agonists correcting the deficit. Our new model proposes that the interaction of noradrenergic and serotonergic input with odor occurs in the mitral cells of the olfactory bulb through activation of cyclic adenosine monophosphate (cAMP). Here, using selective antibodies and immunofluorescence examined with confocal microscopy, we demonstrate that beta(1)-adrenoceptors and 5-HT(2A) receptors colocalize primarily on mitral cells. Using a cAMP assay and cAMP immunocytochemistry, we find that beta-adrenoceptor activation by isoproterenol, at learning-effective and higher doses, significantly increases bulbar cAMP, as does stroking. As predicted by our model, the cAMP increases are localized to mitral cells. 5-HT depletion of the olfactory bulb does not affect basal levels of cAMP but prevents isoproterenol-induced cAMP elevation. These results support the model. We suggest the mitral-cell cAMP cascade converges with a Ca(2+) pathway activated by odor to recruit CREB phosphorylation and memory-associated changes in the olfactory bulb. The dose-related increase in cAMP with isoproterenol implies a critical cAMP window because the highest dose of isoproterenol does not produce learning.     

Pattern-sensitive epilepsy with an unusual triggering mechanism]

A case of pattern-sensitive epilepsy is reported which is characterized in that the pattern is formed from images of human faces with clearly recognizable eyes. Similarities to previously reported cases of pattern-sensitive epilepsy as well as dissimilarities from those cases are discussed.