RESUMEN

A brief summary of the current treatment of Alzheimer disease (AD) (cholinergic replacement therapy, influence of glutamatergic neurotransmission, treatment based on the beta-amyloid cascade theory, antioxidants, anti-inflammatory drugs) clearly proves that the applied strategies are practically inefficient. We describe therefore the rationale and design of a reasonable clinical trial to test the validity of Knoll's concept that the administration of a synthetic mesencephalic enhancer substance prior to the precipitation of the symptoms is our only chance to significantly reduce the prevalence of the two main neurodegenerative disorders AD and Parkinson's disease (PD). Considering that in the population over 65 there are substantial sex (68% female, 32% male) and geographical (highest rate: 10% in USA) differences in the incidence of AD, we propose to perform the clinical trial in 75-85 year old females in the USA. Individuals without (Group 1) and with (Group 2) predisposition to AD should be selected. One third in each group should be treated daily with placebo, (-)-deprenyl (1 mg) and (-)-BPAP (1 mg), respectively. Series of studies proved already the protective effect of the synthetic mesencephalic enhancer substances against age-related neurodegenerative changes in the brain. We may therefore expect a significant difference in the placebo versus drug treated groups in the number of individuals who will precipitate with the passing of time the symptoms of AD or PD. The introduction of a safe and efficient prophylactic therapy that significantly decreases the prevalence of AD is a necessity which cannot be further postponed.

Asunto(s)

RESUMEN

BACKGROUND: This study compares prescription practices for acute inpatients with schizophrenia among six academic departments located in China, Japan, Hungary, and the U.S. METHODS: Prescription data for a sample of 429 inpatients from six academic departments were collected on a randomly chosen census day. All patients met criteria for schizophrenia according to DSM-IV and had a length of illness of at least two years. RESULTS: While patients at the different centers varied in their demographic and clinical characteristics, i. e., age, sex, and length of illness, a great variation in prescription patterns for antipsychotic and other psychotropic drugs among centers was observed even within the same country for all the variables studied (i. e., number and dose antipsychotics, atypical and depot antipsychotics, other psychotropic drugs, multiple antipsychotics, and daily dose) except antidepressant use. In most cases these differences persisted even after adjusting for demographic and clinical characteristics (age, sex, and length of illness) of the subjects. Antipsychotics were usually prescribed in divided daily doses in combination with one or more other psychotropic drugs, including anticholinergics, anticonvulsants, benzodiazepines, and non-benzodiazepine hypnotics. Anticholinergic use was more common with typical antipsychotics. Rates of atypical antipsychotic drug use were lowest in the Japanese center. The Japanese center had by far the highest mean daily dose of antipsychotics. CONCLUSIONS: The results indicate that prescription patterns in different centers do not follow any specific guidelines for the treatment of schizophrenia. The results also confirm previous findings that prescribing practices for schizophrenia vary greatly among centers and countries. A common prescribing pattern found was the use of atypical antipsychotic drugs in combination with psychotropic drugs, such as anticholinergics, hypnotics, anticonvulsants, and benzodiazepines, administered in multiple daily doses.

Asunto(s)

RESUMEN

The Fear Survey Schedule-III (FSS-III) was administered to a total of 5491 students in Australia, East Germany, Great Britain, Greece, Guatemala, Hungary, Italy, Japan, Spain, Sweden, and Venezuela, and submitted to the multiple group method of confirmatory analysis (MGM) in order to determine the cross-national dimensional constancy of the five-factor model of self-assessed fears originally established in Dutch, British, and Canadian samples. The model comprises fears of bodily injury-illness-death, agoraphobic fears, social fears, fears of sexual and aggressive scenes, and harmless animals fears. Close correspondence between the factors was demonstrated across national samples. In each country, the corresponding scales were internally consistent, were intercorrelated at magnitudes comparable to those yielded in the original samples, and yielded (in 93% of the total number of 55 comparisons) sex differences in line with the usual finding (higher scores for females). In each country, the relatively largest sex differences were obtained on harmless animals fears. The organization of self-assessed fears is sufficiently similar across nations to warrant the use of the same weight matrix (scoring key) for the FSS-III in the different countries and to make cross-national comparisons feasible. This opens the way to further studies that attempt to predict (on an a priori basis) cross-national variations in fear levels with dimensions of national cultures.

Asunto(s)

RESUMEN

A noninvasive DNA sampling method has been implemented collecting buccal mucosa cells by cotton wool swabs. An amount of 0.2 2 microg DNA per patient was obtained after the phenol-extraction procedure and 0.2 2 ng DNA template was sufficient for PCR amplification of the polymorphic 48 basepair repeat region of dopamine receptor D4 (DRD4) gene. PCR products were visualized during microfabricated electrophoretic separation by laser-induced fluorescent detection and automatic data registration. Initial data of genotyping drug-dependent subjects shows a relatively high ratio of heterozygotes, possessing either longer or shorter variants beside the common 4-repeat DRD4 allele.

Asunto(s)

RESUMEN

BACKGROUND: The long-term efficacy and tolerability of the antidepressant reboxetine, a unique selective norepinephrine reuptake inhibitor (selective NRI), were assessed in an international study. METHOD: Two hundred eighty-three patients with recurrent DSM-III-R major depression who responded to 6 weeks of reboxetine treatment (> or =50% decrease in Hamilton Rating Scale for Depression [HAM-D] total score) were randomly assigned to receive reboxetine or placebo for 46 weeks in a double-blind phase. Relapse (> or =50% increase in HAM-D total score and/or a HAM-D total score > or =18) rate was the principal assessment criterion and included patients who experienced relapse or recurrence. Only patients who remained relapse-free at the end of the first 6-month treatment period were included in the relapse rate assessment at the end of the second 6-month treatment period. RESULTS: Reboxetine was associated with a markedly lower relapse rate than placebo (22% vs. 56%; p<.001) and a greater cumulative probability of a maintained response (p = .0001) during long-term treatment. Patients in remission (HAM-D total score < or =10) at the time of random assignment were less likely to relapse (16% reboxetine, 48% placebo; p<.001). The proportion of patients who were relapse-free and therefore remained in the study was significantly (p< or =.001) higher among those on reboxetine treatment than on placebo at the end of the first (61% vs. 40%) and second (88% vs. 59%) 6 months of treatment. Additional efficacy measures supported these findings. The incidence of adverse events with reboxetine was low and comparable with that for placebo. Discontinuation due to adverse events occurred infrequently. CONCLUSION: Reboxetine treatment over 1 year is more effective than placebo in the prevention of relapse in patients with recurrent depression. The low relapse rates at the end of the second 6 months of treatment further suggest that reboxetine effectively prevents recurrence of depressive symptoms following episode resolution. Reboxetine is well tolerated in long-term treatment of depression, a finding that bodes well for long-term patient compliance.

Asunto(s)

Asunto(s)

RESUMEN

In a previous study, an attempt was undertaken to examine whether dimensions of parental rearing style as measured with the Egna Minnen Beträffande Uppfostran (EMBU) on dimensions of Rejection, Emotional Warmth, Overprotection, and Favoring Subject can be generalized from Dutch adult samples, for whom they were originally interpreted from factor analyses, to an Hungarian adult sample. The findings suggested either differences in the meaning of the constructs between Hungarians and the Dutch or the presence of errors of translation in the Hungarian version. To rule out the possibility of inadequate translation, the Hungarian item-content was cross-checked by our Hungarian coworkers and, after reformulating several items, used for obtaining new data with a sample of adolescents. On the whole, negative findings with the old version disappeared with the new; clear evidence was found here for qualitative similarity/identity of the Rejection, Emotional Warmth, and Overprotection dimensions across the Dutch and Hungarian samples. Further studies with Hungarian persons are needed to examine whether these dimensions generalize from (nonpatient) adolescent to adult samples.

Asunto(s)

RESUMEN

In a series of fifty depressed patients and 258 controls possible differences in the early family situation as concerns parental rearing practices have been investigated by means of the Swedish EMBU inventory. The results show that the depressive experienced their parents as more "rejecting", more "overprotecting" and less "emotionally warm" as compared to their normal counterparts.

Asunto(s)

RESUMEN

Within the framework of an ongoing cross-national study of hospitalized depressed patients the symptomatology of age, sex and diagnosis matched depressives consecutively admitted to a University Department of Psychiatry in Budapest, Hungary and in Umeå, Sweden has been compared. Only minor differences in symptomatology were detected between the two groups.

Asunto(s)

RESUMEN

Mydriatic responses of the pupil were evoked by locally instilled noradrenaline and methoxamine in eight healthy volunteers. The effects of three single oral doses (25 mg, 50 mg and 100 mg) of amitriptyline and desipramine were compared on the mydriatic responses. Both antidepressants potentiated the mydriasis evoked by noradrenaline; desipramine appeared to be approximately four times more potent than amitriptyline. Both antidepressants antagonised the mydriasis evoked by noradrenaline; desipramine appeared to be approximately four times more potent than amitriptyline. Both antidepressants antagonised the mydriasis evoked by methoxamine, amitriptyline being approximately twice as potent as desipramine. It is suggested that the potentiation of the response to noradrenaline may reflect the blockade of the uptake of noradrenaline into adrenergic nerve terminals, whereas the antagonism of the response to methoxamine may reflect the blockade of postsynaptic alpha-adrenoceptors by the antidepressants. It is argued that the interaction of the antidepressants with adrenergic mechanisms could explain why amitriptyline, a potent anticholinergic agent, causes no significant change in resting pupil diameter, while desipramine, a relatively weaker anticholinergic agent, produces a significant mydriasis.

Asunto(s)

RESUMEN

The effects of three single oral doses (25 mg, 50 mg and 100 mg) of amitriptyline and desipramine, and of placebo, were compared on a range of cholinergic functions (resting pupil diameter, pilocarpine-evoked miosis, baseline-sweating, carbachol-evoked sweating, salivation, heart rate) in eight healthy volunteers. Three measures (pilocarpine-evoked miosis, carbachol-evoked sweating and salivation) reflected the antimuscarinic property of the antidepressants; in two tests (pilocarpine-evoked miosis and salivation) amitriptyline appeared to be more potent than desipramine. Resting pupil diameter was not affected by amitriptyline, whereas desipramine caused mydriasis, indicating that pupil size is not a reliable measure of anticholinergic activity in the case of drugs which also affect adrenergic mechanisms. Baseline-sweating and heart rate were not affected by the antidepressants.

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

Eight healthy male volunteers participated in four experimental sessions in which they ingested either DL-308 (10 mg), DL-308 (20 mg), thioridazine (50 mg) or placebo. Drugs were allocated to subjects and sessions in a double-blind fashion according to a balanced cross-over design. Both DL-308 and thioridazine displayed sedative properties, as indicated by the sedated appearance of the subjects, by a decrease in subjectively rated alertness and by an impairment of performance on psychomotor tests. DL-308 appeared to be a more potent sedative than thioridazine. DL-308 (10 mg) caused an increase in subjectivey rated sweating and objectively measured heart rate, suggesting a sympathomimetic property for the drug. DL-308, similarly to thioridazine, had effects consistent with an alpha-adrenolytic action; both drugs caused miosis, hypotension and a decrease in salivation. The decrease in salivation may also be consistent with an anticholinergic effect. When equisedative doses of the two drugs were compared, DL-308 had a much smaller influence on autonomic functions than thioridazine. DL-308 had a faster time-course of action than thioridazine. Peak effects were attained 1-3 h post-drug and the effects almost completely dissipated within 5 h. DL-308, similarly to thioridazine, had little effect on the motor system, as indicated by conventional clinical neurological examination.

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)