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.

Extrapyramidal Symptoms and their Relationship to Clinical Efficacy under Perphenazine Treatment*

In order to verify the hypothesis of a strict relationship between clinical improvement and extrapyramidal side-effects, especially micrographia, twenty-two acutely ill schizophrenics were treated with perphenazine in a controlled prospective 28-day trial. During the study period, psychopathometric data, prolactin plasma levels, and handwriting samples were collected. According to the remission criteria fixed before the study began (both BPRS ≤ 25 and GAS ≥ 80 points), 45.5% (10/22) of the total patient sample were classified as treatment responders. Handwriting tests were quantified in 21 patients. "Positive" handwriting results, i. e., a reduction of at least 13% in the overall area of 50…

Minimum effective dose for antidepressants - an obligatory requirement for antidepressant drug evaluation?

Extensive clinical trials are required for registration and approval of new antidepressants in most countries including the requirement that a minimal effective dose should be determined. The rationale for this requirement is to avoid the use of unnecessarily high doses. The implication is that for every antidepressant, a dose exists that serves as a threshold, below which all doses are not effective or are clearly less effective in treating a major depressive episode. Dose titration and fixed dose studies are used to determine the minimal effective dose, but both strategies have limitations and often do not allow definite establishment of a clear-cut minimal effective dose. The effort of e…

Rezeptoren für Neurotransmitter und psychiatrische Erkrankungen

Serotonin dysfunction syndromes: a functional common denominator for classification of depression, anxiety, and obsessive-compulsive disorder.