- Email: [email protected]
L-dopa challenge test of negative schizophrenia
Treatment of Schizophrenia
49
BIOL PSYCHIATRY 1992~3! :61A-252A
83A
L-DOPA CHALLENGE TEST OF NEGATIVE SCHIZOPHRENIA Zhang Zong-sheng, Jin Wei-dong, Xiao Jia-hong First Affiliated Hospital, Hubei Medical College, Wuhan, Hubei, P.R. China 430060. The L-dopa Challenge Test (DCT) was carried out in 15 patients with negative schizophrenia according to Andreasen's criterion of negative-type schizophrenia. The patients were divided into two groups: eight cases with primary negative schizophrenia (PNS) and seven cases with secondary negative schizophrenia (SNS) according to the history of their disorders. The 750-1000 mg/day of L-dopa was used for all patients orally for 1 week. Positive DCT was an increasing score of 12 BPRS compared with baseline of BPRS or more, and negative DCT was no change or less of an increasing score of 12 BPRS. The result shows six cases of positive DCT consisting of five SNS and one PNS, and nine patients negative DCT, two SNS and seven PNS. In X 2 test, DCT was significance between NSN and PNS. This result suggests that negative schizophrenics may have various psychochemical bases according to their response to L-Dopa.
50
PSYCHOSIS SUPPRESSED BY THALAMIC STIMULATION Orlando J. Andy, Brian L. Crabtree, Cora Dearman University of Mississippi Medical Center, Jackson, MS 39216. Psychosis developed in a 35-year old woman 1 year after a right cerebral artery aneurysm had ruptured. First attack, "It was a dirty dog- smelled bad- was buruing- like fire. i shot him -admitted to psychiatry." There were 20 admissions in 12 years. She had urges to kill husband and others with rat poison. Once husband almost died. She read murder magazines, wrote murder stories, became suicidal, and had severe headaches. Seizures developed; medication was ineffective. EEG revealed right fronto/temporal and thalamic spikes. CT showed atrophy: right frontal, temporal, thalamic. After cortical resection, seizures and pain did not improve, but right thalamic stimulation has suppressed pain, seizures, and psychosis for 9 years (on dilantin, elavil, and trUafon). Frontal BAER P300 is significantly delayed without thalamic stimulation', it is normal with stimulation. The woman lives alone, has a car. We speculate that the psychosis is caused by a mesodiencephalic progressive gliosis that generates abnormal electrical discharges. The pathologic discharges disrupt mesodiencephalie dopamine cells that project to prefrontal areas. Consequently, the suppression of those abnormal discharges by therapeutic thalamic stimulation allows dopamine systems to function normally.
51
OLFACTORY SENSITIVITY CHANGES IN SCHIZOPHRENIC PATIENTS TREATED WITH NEUROLEPTIC DRUGS Pinkhas Sirota, lsrael Ben David, Ruth Gross Isseroff SUNY at Buffalo, Buffalo, NY 14215. Work was performed at the Abarbanel Mental Health Center, Sackler School of Medicine, Tel Aviv, and the Weizmann Institute of Science, Rehovot, Israel. Olfactory thresholds to adrostenone and isoamyl acetate before and during neuroleptic treatment were studied in 20 male schizophrenic patients. Increased threshold values to isoamyl acetate under neuroleptic treatment were demonstrated in 14 patients (p < 0.09). in nine patients, threshold values to adrostenone wel'e increased whereas 11 of them were anosmic to it (p < 0.02). Patients treated with phenothiazines exhibited a more prominent decrease in olfactory sensitivity to both substances than those treated with butyropbenones. A correlation between adrostenone and isoamyl acetate threshold values was uot established (borderline values) on the drug-free trial, but was established under neuroleptic treatment (p < 0.042).
49
BIOL PSYCHIATRY 1992~3! :61A-252A
83A
L-DOPA CHALLENGE TEST OF NEGATIVE SCHIZOPHRENIA Zhang Zong-sheng, Jin Wei-dong, Xiao Jia-hong First Affiliated Hospital, Hubei Medical College, Wuhan, Hubei, P.R. China 430060. The L-dopa Challenge Test (DCT) was carried out in 15 patients with negative schizophrenia according to Andreasen's criterion of negative-type schizophrenia. The patients were divided into two groups: eight cases with primary negative schizophrenia (PNS) and seven cases with secondary negative schizophrenia (SNS) according to the history of their disorders. The 750-1000 mg/day of L-dopa was used for all patients orally for 1 week. Positive DCT was an increasing score of 12 BPRS compared with baseline of BPRS or more, and negative DCT was no change or less of an increasing score of 12 BPRS. The result shows six cases of positive DCT consisting of five SNS and one PNS, and nine patients negative DCT, two SNS and seven PNS. In X 2 test, DCT was significance between NSN and PNS. This result suggests that negative schizophrenics may have various psychochemical bases according to their response to L-Dopa.
50
PSYCHOSIS SUPPRESSED BY THALAMIC STIMULATION Orlando J. Andy, Brian L. Crabtree, Cora Dearman University of Mississippi Medical Center, Jackson, MS 39216. Psychosis developed in a 35-year old woman 1 year after a right cerebral artery aneurysm had ruptured. First attack, "It was a dirty dog- smelled bad- was buruing- like fire. i shot him -admitted to psychiatry." There were 20 admissions in 12 years. She had urges to kill husband and others with rat poison. Once husband almost died. She read murder magazines, wrote murder stories, became suicidal, and had severe headaches. Seizures developed; medication was ineffective. EEG revealed right fronto/temporal and thalamic spikes. CT showed atrophy: right frontal, temporal, thalamic. After cortical resection, seizures and pain did not improve, but right thalamic stimulation has suppressed pain, seizures, and psychosis for 9 years (on dilantin, elavil, and trUafon). Frontal BAER P300 is significantly delayed without thalamic stimulation', it is normal with stimulation. The woman lives alone, has a car. We speculate that the psychosis is caused by a mesodiencephalic progressive gliosis that generates abnormal electrical discharges. The pathologic discharges disrupt mesodiencephalie dopamine cells that project to prefrontal areas. Consequently, the suppression of those abnormal discharges by therapeutic thalamic stimulation allows dopamine systems to function normally.
51
OLFACTORY SENSITIVITY CHANGES IN SCHIZOPHRENIC PATIENTS TREATED WITH NEUROLEPTIC DRUGS Pinkhas Sirota, lsrael Ben David, Ruth Gross Isseroff SUNY at Buffalo, Buffalo, NY 14215. Work was performed at the Abarbanel Mental Health Center, Sackler School of Medicine, Tel Aviv, and the Weizmann Institute of Science, Rehovot, Israel. Olfactory thresholds to adrostenone and isoamyl acetate before and during neuroleptic treatment were studied in 20 male schizophrenic patients. Increased threshold values to isoamyl acetate under neuroleptic treatment were demonstrated in 14 patients (p < 0.09). in nine patients, threshold values to adrostenone wel'e increased whereas 11 of them were anosmic to it (p < 0.02). Patients treated with phenothiazines exhibited a more prominent decrease in olfactory sensitivity to both substances than those treated with butyropbenones. A correlation between adrostenone and isoamyl acetate threshold values was uot established (borderline values) on the drug-free trial, but was established under neuroleptic treatment (p < 0.042).