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Seasonal influence on platelet serotonin function in healthy volunteers
P6 Other topics effect in 3 risperidone- and 4 placebo-treated patients. At week 10, the improvement in RAAPP scores was significantly greater in patients receiving risperidone than placebo (-1.7 vs -0.2, p < 0.05); improvement in CGI severity scores was also significantly greater in patients receiving risperidone than placebo (-2.59 vs -0.22, p = 0.001). Risperidone was well tolerated and not associated with extrapyramidal symptoms with this dosing regimen. Conclusions: Risperidone at doses of 1.5-3.0 mg/day was safe and efficacious in the treatment of aggression in children diagnosed with conduct disorder.
References [1] Kemph, JP, DeVane, CL, Levin, GM, et al: Treatment of aggressive children with clonidine: results of an open pilot study. J Am Aead Child Adolesc Psychiatry 32: 577-581, 1993 [2] Vanden Borre R, Vermote R, et al: Risperidone as add-on therapy in behavioural disturbances in mental retardation: a double-blindplacebo-controlled cross-over study. Acta Psychiatr Scand. 897: 167-71, 1993
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Seasonal influence on platelet serotonin function in healthy volunteers
$359
treated in a 6 week cross-over trial with 0.15 mg pergolide or with placebo. We measured: Computer-assisted digital imaging processing (Gattaz & Biichel, 1993) with the average power index (API) for severity of oral dyskinesia, Abnormal Involuntary Movements Scale (AIMS), Brief Psychiatric Rating Scale (BPRS), Negative Symptoms Rating Scale (NSRS). Statistical analysis was done using t-test procedure for crossover design, Wilcoxon-test and Kruskal-Wallis test, Results: 7 female and 3 male patients were included, 9 patients completed the study, 1 female discontinued. No serious adverse events occurred. None of the statistical tests showed a carry-over- or a periodeffect, Calculated with the AIMS-scores and with the API-scores, pergolide had no significant treatment effect, although the raw data implicated an improvement. When correlating abnormal movements in facial muscles, lips, jaw and tongue measured by AIMS with the API by digital imaging processing a significant correlation (p < 0.05) was found. Conclusion: We confirmed the correlation between clinical scales and digital imaging processing. Although the results for the pergolide treatment did not reach statistical significance, as the study population was to small, the raw data implicated an improvement in the pergnlide treated group. A follow up study with a population of at least 25 should be done.
J. Neuger, A. Aberg-Wistedt, R. Stain-Malmgren. Karolinska Institute,
Institution of Clinical Neuroscience, Department of Psychiatry, St. G6ran's Hospital Stockholm, Sweden Seasonal changes in platelet ~4C-serotonin uptake, platelet [3H]LSDand [3H]paroxetine-binding and whole blood serotonin was studied longitudinally both intra- and inter-individually for 3 years in 199 healthy volunteers. The relationships between the biochemical parameters and climatic variables, such as ambient temperature, relative humidity, air pressure and sunlight duration was investigated. Preliminary results show that platelet serotonin uptake, Vmax and Kin, the affinity of the platelet serotonin uptake site for its substrate, was lower in spring and fall than in summer and winter. Bmax for [3H]LSD-binding, showed seasonal variation, thus Bmax was higher during the summer than during the winter. Bmax for [3H]paroxetine-binding, showed a seasonal variation, with maximum in November and minimum in August. The affinity constant Ko -¢- showed sesonal variation for [3H]LSD-binding but not for [3H]paroxetine-binding. Also blood serotonin showed seasonal variation with maxima in spring and fall and minima in summer and winter. Statistical analyses of the impact of enviromental factors are ongoing and will be presented. The present study demonstrates seasonal variations in several serotonergic parameters and indicates the necessity to match patients with regard to the season of sampling.
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Low-dose pergolide in the treatment of tardive dyskinesia (TD): a double-blind, placebo-controlled randomized cross-over trial
A. Diehl, H.P. Hundemer, M. Rubin, R.W. Dittmann, W. Gattaz. Psychi-
atric Department, University of Heidelberg, Germany Purpose: The therapy and pathophysiology of TD is not completely clear, an increased D-1 receptor function or an increased ratio between D-l/D-2 receptor functions may play a pathogenic role. A reduction in the dopaminergic function may be achieved by selective activation of presynaptic dopamine autoreceptors to decrease dopamine release. The dopamine agonist Pergolide activates both presynaptic and postsynaptic dopamine receptors with a degree of selective affinity for presynaptic dopamine autoreceptors. Low doses of pergolide should reduce dopaminergic transmission by activating presynaptic receptors that control dopamine release (Fuller et al, 1982). Aim of this study was to search for a new treatment of TD and to compare clinical scales for movement disorders with computer-assisted techniques. Methods: 10 patients with tardive oro-facial dyskinesia aged 1880, stable in psychopathology and antipsychotic pharmacotherapy were
References [1] Gattaz WF, Biichel C. Assessment of tardive dyskinesia by means of digital image processing. Psychopharmacology111: 278-284, 1993 [2] Fuller RW,Clemens JA, Heynes MD IlL Degree of selectivityof pergolide as an Antagonistat presynapticversus postsynapticdopamine receptors: implications for prevention or treatment of tardive dyskinesia. J Clin. Psychopharmacol.2: 371-375, 1982
~ H I V
and psychiatric disorders in general hospital
U. Becker. CentralInstitute of Mental Health, Mannheim, Germany Aim: 1. prevalence of mental disorders in HIV - patients compared to non-HIV patients both seen by the psychiatric Consultation and liaison (C/L) Service in a General Hospital, 2. Need for psychiatric co-treatment of HIV patients. Methods: Data from all HIV patients of the University Hospital Mannheim, that were co-treated by the Psychiatric/Psychosomatic C/L Service between 1986 and 1996 (n = 201) were compared to an ageand sex- matched controll group of somatic in-patients without HIV, who were also treated by the C/L service (n = 771). Results: a. 3.5 fold higher prevalence of organic disorders, (dementia, delirium) in the HIV group: 21% vs 6% in Non-HIM p < .001. b. 3 fold higher prevalence of illegal drug related disorders in HIV patients (33% vs 11%, p < .001). c. Same prevalence of suicide attempts in both groups (10% vs 12%, n.s.), but d. as underlying diagnosis in suicide at-tempters, drug related disorders and organic disorders were highly overrepresented in the HIV patients (drug disorders in suicide attempts: 29% HIV group vs 3% Non HIV, p < .001; organic disorders 14% vs 3%, p < .05). e. Significantly higher demand in HIV patients for psychiatric cotreatment: 33% of all HIV patients underwent a psychiatric consultation during their stay in General Hospital vs only 3% of Non HIV patients). Conclusions: 1. High prevalence of organic mental disorders in HIV patients underlies the necessity of intensive medical diagnostics whenever a mental disorder occurs. 2. In HIV patients organic and drug related disorders are high risk factors for suicide attempts. Under this point of view, programs treating addiction and abuse of illegal drugs are of great importance for HIV patients.
References [1] Kemph, JP, DeVane, CL, Levin, GM, et al: Treatment of aggressive children with clonidine: results of an open pilot study. J Am Aead Child Adolesc Psychiatry 32: 577-581, 1993 [2] Vanden Borre R, Vermote R, et al: Risperidone as add-on therapy in behavioural disturbances in mental retardation: a double-blindplacebo-controlled cross-over study. Acta Psychiatr Scand. 897: 167-71, 1993
•
Seasonal influence on platelet serotonin function in healthy volunteers
$359
treated in a 6 week cross-over trial with 0.15 mg pergolide or with placebo. We measured: Computer-assisted digital imaging processing (Gattaz & Biichel, 1993) with the average power index (API) for severity of oral dyskinesia, Abnormal Involuntary Movements Scale (AIMS), Brief Psychiatric Rating Scale (BPRS), Negative Symptoms Rating Scale (NSRS). Statistical analysis was done using t-test procedure for crossover design, Wilcoxon-test and Kruskal-Wallis test, Results: 7 female and 3 male patients were included, 9 patients completed the study, 1 female discontinued. No serious adverse events occurred. None of the statistical tests showed a carry-over- or a periodeffect, Calculated with the AIMS-scores and with the API-scores, pergolide had no significant treatment effect, although the raw data implicated an improvement. When correlating abnormal movements in facial muscles, lips, jaw and tongue measured by AIMS with the API by digital imaging processing a significant correlation (p < 0.05) was found. Conclusion: We confirmed the correlation between clinical scales and digital imaging processing. Although the results for the pergolide treatment did not reach statistical significance, as the study population was to small, the raw data implicated an improvement in the pergnlide treated group. A follow up study with a population of at least 25 should be done.
J. Neuger, A. Aberg-Wistedt, R. Stain-Malmgren. Karolinska Institute,
Institution of Clinical Neuroscience, Department of Psychiatry, St. G6ran's Hospital Stockholm, Sweden Seasonal changes in platelet ~4C-serotonin uptake, platelet [3H]LSDand [3H]paroxetine-binding and whole blood serotonin was studied longitudinally both intra- and inter-individually for 3 years in 199 healthy volunteers. The relationships between the biochemical parameters and climatic variables, such as ambient temperature, relative humidity, air pressure and sunlight duration was investigated. Preliminary results show that platelet serotonin uptake, Vmax and Kin, the affinity of the platelet serotonin uptake site for its substrate, was lower in spring and fall than in summer and winter. Bmax for [3H]LSD-binding, showed seasonal variation, thus Bmax was higher during the summer than during the winter. Bmax for [3H]paroxetine-binding, showed a seasonal variation, with maximum in November and minimum in August. The affinity constant Ko -¢- showed sesonal variation for [3H]LSD-binding but not for [3H]paroxetine-binding. Also blood serotonin showed seasonal variation with maxima in spring and fall and minima in summer and winter. Statistical analyses of the impact of enviromental factors are ongoing and will be presented. The present study demonstrates seasonal variations in several serotonergic parameters and indicates the necessity to match patients with regard to the season of sampling.
•
Low-dose pergolide in the treatment of tardive dyskinesia (TD): a double-blind, placebo-controlled randomized cross-over trial
A. Diehl, H.P. Hundemer, M. Rubin, R.W. Dittmann, W. Gattaz. Psychi-
atric Department, University of Heidelberg, Germany Purpose: The therapy and pathophysiology of TD is not completely clear, an increased D-1 receptor function or an increased ratio between D-l/D-2 receptor functions may play a pathogenic role. A reduction in the dopaminergic function may be achieved by selective activation of presynaptic dopamine autoreceptors to decrease dopamine release. The dopamine agonist Pergolide activates both presynaptic and postsynaptic dopamine receptors with a degree of selective affinity for presynaptic dopamine autoreceptors. Low doses of pergolide should reduce dopaminergic transmission by activating presynaptic receptors that control dopamine release (Fuller et al, 1982). Aim of this study was to search for a new treatment of TD and to compare clinical scales for movement disorders with computer-assisted techniques. Methods: 10 patients with tardive oro-facial dyskinesia aged 1880, stable in psychopathology and antipsychotic pharmacotherapy were
References [1] Gattaz WF, Biichel C. Assessment of tardive dyskinesia by means of digital image processing. Psychopharmacology111: 278-284, 1993 [2] Fuller RW,Clemens JA, Heynes MD IlL Degree of selectivityof pergolide as an Antagonistat presynapticversus postsynapticdopamine receptors: implications for prevention or treatment of tardive dyskinesia. J Clin. Psychopharmacol.2: 371-375, 1982
~ H I V
and psychiatric disorders in general hospital
U. Becker. CentralInstitute of Mental Health, Mannheim, Germany Aim: 1. prevalence of mental disorders in HIV - patients compared to non-HIV patients both seen by the psychiatric Consultation and liaison (C/L) Service in a General Hospital, 2. Need for psychiatric co-treatment of HIV patients. Methods: Data from all HIV patients of the University Hospital Mannheim, that were co-treated by the Psychiatric/Psychosomatic C/L Service between 1986 and 1996 (n = 201) were compared to an ageand sex- matched controll group of somatic in-patients without HIV, who were also treated by the C/L service (n = 771). Results: a. 3.5 fold higher prevalence of organic disorders, (dementia, delirium) in the HIV group: 21% vs 6% in Non-HIM p < .001. b. 3 fold higher prevalence of illegal drug related disorders in HIV patients (33% vs 11%, p < .001). c. Same prevalence of suicide attempts in both groups (10% vs 12%, n.s.), but d. as underlying diagnosis in suicide at-tempters, drug related disorders and organic disorders were highly overrepresented in the HIV patients (drug disorders in suicide attempts: 29% HIV group vs 3% Non HIV, p < .001; organic disorders 14% vs 3%, p < .05). e. Significantly higher demand in HIV patients for psychiatric cotreatment: 33% of all HIV patients underwent a psychiatric consultation during their stay in General Hospital vs only 3% of Non HIV patients). Conclusions: 1. High prevalence of organic mental disorders in HIV patients underlies the necessity of intensive medical diagnostics whenever a mental disorder occurs. 2. In HIV patients organic and drug related disorders are high risk factors for suicide attempts. Under this point of view, programs treating addiction and abuse of illegal drugs are of great importance for HIV patients.