0000000000007259
AUTHOR
O. Benkert
Psychological distress and psychiatric disorders in primary health care patients in East and West Germany 1 year after the fall of the Berlin Wall
The reunification of Germany confronted citizens in East and West Germany with many changes in their lives. These changes may be considered as critical life events. Especially for those in East Germany, life circumstances drastically changed, and individuals were increasingly required to adopt and develop coping capabilities. In addition to new opportunities and freedom, there was threatening uncertainty about the future. Theories of life events and stress postulate that threat events have an impact on human well-being. It was expected that there would be an increased rate of psychiatric morbidity after unification, especially in the eastern part of Germany.An international study by the WHO…
Neuroleptika: Neue Substanzen — Neue Indikationen
Seit den Untersuchungen von Carlsson u. Lindqvist (1963) weis man, das klinisch wirksame Neuroleptika Dopaminrezeptoren blockieren, und Mitte der 70er Jahre konnte dies erstmals anhand von Rezeptorbindungsstudien direkt nachgewiesen werden (Burt etal. 1975; Seeman etal. 1975). Obwohl man von der antidopaminergen Wirkung der Neuroleptika nicht zwingend auf einen der Schizophrenie zugrundeliegenden Pathomechanismus Ruckschlusse ziehen kann, stellt doch die antipsychotische Wirksamkeit von Dopaminantagonisten eine der wichtigsten Stutzen der mittlerweile weiterentwickelten Dopaminhypothese der Schizophrenie (Crow 1987; McKenna 1987) dar.
Zotepin versus Perazin bei Patienten mit paranoider Schizophrenie: eine doppelblind-kontrollierte Wirksamkeitsprüfung
The dibenzothiepine zotepine is a new potential "atypical" neuroleptic exhibiting powerful antiserotonergic and antidopaminergic properties. The efficacy of zotepine was evaluated in a double-blind controlled trial versus the tricyclic neuroleptic perazine in 41 patients suffering mainly from the paranoid-hallucinatory type of schizophrenia. The key outcome variable was the extent of mental disturbance as defined by the total score of the BPRS. Additional outcome variables were GAS and CGI. In addition, adverse reactions and extrapyramidal side effects were assessed according to the FSUCL scale and the Gerlach and AIMS rating scale, respectively. Additional variables recorded were blood pre…
Psychopharmakotherapie in Schwangerschaft und Stillzeit
The primary purpose of this article is to review critically the literature on the use of psychotropic medications in pregnancy and during breast feeding in order to suggest strategies for the clinical management of these periods. Use of psychotropic medications during pregnancy may cause three complications: 1. teratogenicity, 2. perinatal syndromes (neonatal toxicity), and 3. postnatal behavioural sequelae (behavioural toxicity). The literature features few well-controlled studies concerning these points, so that the available information allows only few conclusions. Exposure to certain psychotropic drugs in utero may increase the risk for some specific congenital anomalies; there is mostl…
Psychotropic Effect of Combined Estrogen-Vit B6 Treatment in Endogenously Depressed Females
Estrogens are among the most commonly prescribed substances in females. Also endogenous estrogen levels change dramatically throughout life and this biological variable has been associated with several psychological signs like premenstrual tension syndrome and depression in older age. Along with clinical practice there is increasing evidence from neuropharmacology suggesting a psychotropic action of estrogens (review: Holsboer, 1982). The most prominent findings are: 1. Reduction of monoamine-oxidase (MAO)-activity by estrogens (McEwen et al., 1978); 2. Competitive inhibition of catechol-o-methyltransferase by 2-hydroxyestrogens, which are major metabolites of estrogens in the CNS (Breuer e…
Role of Testosterone in Male Sexual Impotent Patients
The role of biological factors contributing to development of sexual dysfunction (SD) has given rise to controversy over many years. Whereas a broad consensus is achieved that schizophrenia and affective psychoses have a biological etiology, such mechanisms receive less acceptance for SD. Conversely, the observation that SD is frequently a concomitant factor in affective illness is subject of current interest in research. For both diseases SD and affective disorder impaired gonadal function is documented (Rubin et al., 1981; Benkert and Holsboer, 1984), whereas both disorders may well occur independantly from each other. In the following section we outline briefly some of the presently avai…
Effect of sulpiride in endogenous depression.
Clinical practice and pharmacological data suggest a possible antidepressive action of sulpiride given in low dosages. To further explore the therapeutic efficacy of sulpiride 11 patients with an endogenous type of depression were studied during treatment with an oral daily dose of 150 mg sulpiride. The present data allows the conclusion that (A) low dosed sulpiride seems to act as an antidepressant in severe and milder forms of depression, (B) a clinical progress is seen earlier than is common during treatment with tricyclics and (C) a significant increase of drive is observable. However, sulpiride maintenance therapy did not prevent early relapse into depression. The preliminary nature of…
Effects of Trimipramine on Sleep EEG, Penile Tumescence and Nocturnal Hormonal Secretion
Sleep EEG, nocturnal penile tumescence (NPT) and nocturnal endocrine activity were studied in 3 male control subjects during placebo, under trimipramine (TR) and after withdrawal. TR did not change the sleep structure. NPT activity tended to increase under TR. Nocturnal plasma cortisol levels decreased markedly while the early morning rise of cortisol appeared delayed under 200 mg TR. After withdrawal the changes of the cortisol secretion rebounded. Nocturnal secretion of GH, testosterone, LH and FSH remained unaffected, but plasma prolactin levels increased under TR and returned to normalcy after cessation. Our data illustrate that the neurobiological effects of TR are different from those…
Functional Classification and Response to Psychotropic Drugs
Psychopathologically defined diagnoses represent guidelines for the application of drugs and serve as selection criteria for the evaluation of potentially useful psychopharmacological agents. Therefore, the success of research in drug evaluation strongly depends on the conceptual frameworks of diagnostic classification and how these change. For instance, at the beginning of the era of antidepressants 30 years ago, the efficacy of antidepressants was thought to be restricted to patients with endogenous depression, but since then their therapeutic spectrum has broadened: first to the “depressive syndrome” and then, due to the growing acceptance of DSM-III, to the major depressive episode. Now…
Rezeptoren für Neurotransmitter und psychiatrische Erkrankungen
Effect of Repetition and Inspection Times on Picture Recall in Patients with Dementia of Alzheimer Type
The present study is part of a series of systematic studies intended to identify simple strategies of picture presentation to improve recall performance in demented subjects. The aims of this design were to examine the effects of elaboration by naming, 4-fold repetition and different inspection times on memory performance. 19 patients with senile dementia of Alzheimer type and 21 control subjects with remitted depression were included. Picture recall was examined using different presentation conditions on 5 consecutive days. The presentation conditions significantly influenced recall performance depending on the diagnosis and on the delay of recall. Naming of pictures did not improve later …