- Email: [email protected]
New investigational clinical use of risperidone
poster session ill
DIOL. PSYCHIATRY 1997:42:1S-2975
16 5-1 OS I Effect of long-term clozaplne treatment In MK-801-lnduced dystonia In monkeys
J. 0hlenschlaeger, J. Gerlach. St. Hans Hospital•. Department P & The
Research Institute of Biological Psychiatry. Roskilde. Denmark
In eaJ1ier investigations It has been demonstrated that the glutamaterglc an· tagonist MK-801 administered to Cebus Apella monkeys produces a reaction Ihat Is indistinguishable from acute dystonia Induced by antipsycotics. We have examined the effect of chronic clozapine treatment in doses from 2 ~g to 10 mglkg and evaluated its effects In dystonia induced by MK·801. In Jingle dose administration (5 mglkg) clozapine alone induced sedation, sloW movements, mild ataxia and hypersallvation. In chronic administration toIeraIlC8 was seen to these clozapine effects. CIozaPlne (5 mglkg and 10 mglkg) partially reversed the MK 801-dystonia, aJIhOUgh sedation, slow movements and ataxia remained present for an extended period of time.
183S
roleptlcs. In this paper we report on our experience In using risperidone In the treat~ent of ~tients with neurological and no schizophrenic disorder. We descnbe 3 patients who suffered from hemiballism, senile chorea and tardive dyskinesia. They all were treated with risperidone in a dosage of 6 mg/day. Results: All patients Improved dramatically under treatment with risperi. done. No adverse effects occurred. Risperidone appears to have an an· tldyskinetlc effect with lower side effects than typical neuroleptlcs and should be considered In the treatment of different extrapyramidal disorders.
165-1121 Study of quantitative EMG In outpatients of psychiatry with the facial Involuntary movement M. Nakamura, H. Naitoh, Y. Ikeda. Dept. of Psychiatry. School of Medicine Fujita Health Univ.. Toyoake, Japan '
a1IecliVe and motivational areas, both because of their frequency. S8CC)nda1Y, psychiatric symptoms represent a precious model, suitable for tormuJation and verification of psychiatric disorders' pathogenetic hypothe• ses. This Is possible by means of HD characteristics: Ifs a neurodegeneratlve diS88S8 whOse anatomopathologlcal and genetic alterations are known and tor many different disciplines provide Instruments for Investigation. Such disciplines are neuroradiology, neuropathology, molecular genetics,
Previous studies have suggested that tardive dyskinesia Is usually un· treatable and often Irreversible. Therefore, patients receiving long·term antips~chotic medlc:ation should be regularly monitored for the development of tardive dyskineSia or treatable Involuntary movement, including tremor rigidity and hypokinesia. This study attempted to establish a simple physiC: logical examination to clarify the pathophysiology of drug Induced abnormal movement Methods: Psychiatric outpatients who had had constant oral Involuntary movements more than 1 month, were treated with a single Injection with biperiden 5 mg 1M. One pair of disc electrodes were placed on the center of the patlent~' chin. The EMG data obtained by a biomedical electric amplifier (NEC medical systems Co.) were recorded onto hard disk in the computer through the analog-digltal converter. The data were then subjected to the Fast Fourier Transform (FFT), and a power spectrum was computed from FFT. Results: From these FFT analyses, the treatable Involuntary movements was characterized by: the appearance of power peak ranged 4 to 10Hz before blperiden Injection; and/or the decrease of power values ranged 30 to 100 Hz after blperiden injection. This may be Important for differential diagnosis of tardive dyskinesia.
~~~·of this review Is to provide a critical analysis of literature conceming psychiatriC aspects of HD and a clinlcal-epldemlologlcal and pathogenetic
165-1131 Does smoking cause dyskinesia? - A study of
[65-109J psychiatric symptoms In huntington's disease: An analysis of literature and etlopathogenetic hypotheses L sarzaghl'. L Barina " R. Alberti' , C. Nespolo', M.L. Manzone 1, U. M8ntero 1,2, G. Penatl'. , Institute of Psychiatry- University of Milan· IRCCS Ospedale Maggiore. Milan. Italy. 2 A. USSL 38. Milan. Italy. 3/nstitute d psychiatry- University of Modena, Italy psyct1OP8thOloglcal symptoms during Huntington'S Disease (HD) are par•
tIcUIaI1Y remar1
wtUch
men born In 1933
&.¢ating.
f65-11 Q] ~
A. Nilsson', L. Waller, A. Rosengren, A. Adlerberth, l. Wilhelmsen.
Treatment of the neuroleptic malignant syndrome by electroconvulsive therapy
Dagmar Seifertova.
psychiatric Center Prague. Czech RepUblic
NeuroleptiC Malignant Syndrome (NMS) Is life-threatening complication of neuroI8¢JC treatment Mortality rate of cases without specific treatment was reported to reach 21%. Suggestions were made on the probable safety and of electroCOnvulsive treatment (ECT). ~Is a report on the treatment of NMS patients at the Intensive Care . (~CU) During the last three years ECT was used as the main treatment Unit . I~ 14 patients that had been referred to ICU because of their ~ emergent NMS. They represented 78.6% of all NMS cases treated
at ltl8 unit. ECT were administered after discontinuation of neuroleptic treatment and IdeqUS non-speciflc support for somatic condition of our patients was te ~ We observed improvement In all patients and there did not occur fatality among them. We also observed an Improvement In the psychotic ~ of these patients. The duration of their stay at the ICU was 17 In average. The range of the EeT applied was between 2-12. We daysidef' fCT. If properly indicated and applied. to be a safe and efficacious ~ modality in NMS patients.
[!5-11
TI New Investigational clinical use of rlsperldone
'nemann• H.J. Assion. Department of Neurology. St..Josef-Hospital.
~. Germany, Department of Neurology, St..Josef-Hospital.
()/)(JftJausen, Germany al of the report is to examine the effectiveness of risperidone in ~ mwith extrapyramidal disorders. ~od.' Risperidone has shown to be effective In the treatment 01 ~... r~ic patients with lower EPS side effects than conventional an• ~. Extrapyramidal disorders are often treated with typical neu-
, Department of Clinical Neurosciences. G6teborg University. Sweden. Departmenl of Medicine. G6teborg University. Sweden
It has been postulated that dyskinesia may be attributable to the schizophrenic disease process rather than to Its treatment. This is In line with the hypothesis that a putative organic vulnerability may cause dyskinesia to emerge even without exposure to neuroleptlcs. In the present general population survey of dyskinetic phenomena, no 'a priori' assumption was made of their cause. Spontaneous and tardive dyskinesia were studied In a random population sample of 559 men, aged 59 years. The Research Diagnostic Criteria for dyskinesia were fulfilled by 8.2% (n .. 46). Dyskinetic men had higher cigarette consumption and higher scores for Parkinsonian symptoms, as well as higher frequency of psychiatric morbidity, exposure to neuroleptics, and alcohol dependence. Logistic regression showed ex• posure to neuroleptics (p < 0.05) and dally cigarette consumption (p < 0.0005) to be Independently associated with dyskinesia. The probability of dyskinesia was 19% in a person smoking a pack a day or more, whereas the probability associated with exposure to neuroleptlcs was 30%.
165-1141 Low arachidonic acid levels In dyskinesia A study of men born In 1933 A. Nilsson, D.F. Horrobln', A. Rosengren. L. Walier, A. Adlerberth,
L. Wilhelmsen. G"teborg University. Sweden, ' Scotia Pharmaceuticals. UK We have studied the relationship between Essential Fatty Acids (EFAs) and spontaneous and tardive dyskineslas In a random population sample of 446 men, aged 59 years. Dyskinesia (AIMSscore of ~2 in any body part) was seen In 15.1% (n .. 74). Dyskinetic men had higher cigarette consumptlo~, more psychi~tric morbidity and they were more often exposed to neuroleptlcs. DyskineSia was associated with several abnormalities In EFA concentrations In plasma, but the most consistent finding was low arachidonic acid (AA) levels In phospholipids, trlglycerides and cholesterol esters. In a logistic regression model, cigarette consumption (p < 0.02),
DIOL. PSYCHIATRY 1997:42:1S-2975
16 5-1 OS I Effect of long-term clozaplne treatment In MK-801-lnduced dystonia In monkeys
J. 0hlenschlaeger, J. Gerlach. St. Hans Hospital•. Department P & The
Research Institute of Biological Psychiatry. Roskilde. Denmark
In eaJ1ier investigations It has been demonstrated that the glutamaterglc an· tagonist MK-801 administered to Cebus Apella monkeys produces a reaction Ihat Is indistinguishable from acute dystonia Induced by antipsycotics. We have examined the effect of chronic clozapine treatment in doses from 2 ~g to 10 mglkg and evaluated its effects In dystonia induced by MK·801. In Jingle dose administration (5 mglkg) clozapine alone induced sedation, sloW movements, mild ataxia and hypersallvation. In chronic administration toIeraIlC8 was seen to these clozapine effects. CIozaPlne (5 mglkg and 10 mglkg) partially reversed the MK 801-dystonia, aJIhOUgh sedation, slow movements and ataxia remained present for an extended period of time.
183S
roleptlcs. In this paper we report on our experience In using risperidone In the treat~ent of ~tients with neurological and no schizophrenic disorder. We descnbe 3 patients who suffered from hemiballism, senile chorea and tardive dyskinesia. They all were treated with risperidone in a dosage of 6 mg/day. Results: All patients Improved dramatically under treatment with risperi. done. No adverse effects occurred. Risperidone appears to have an an· tldyskinetlc effect with lower side effects than typical neuroleptlcs and should be considered In the treatment of different extrapyramidal disorders.
165-1121 Study of quantitative EMG In outpatients of psychiatry with the facial Involuntary movement M. Nakamura, H. Naitoh, Y. Ikeda. Dept. of Psychiatry. School of Medicine Fujita Health Univ.. Toyoake, Japan '
a1IecliVe and motivational areas, both because of their frequency. S8CC)nda1Y, psychiatric symptoms represent a precious model, suitable for tormuJation and verification of psychiatric disorders' pathogenetic hypothe• ses. This Is possible by means of HD characteristics: Ifs a neurodegeneratlve diS88S8 whOse anatomopathologlcal and genetic alterations are known and tor many different disciplines provide Instruments for Investigation. Such disciplines are neuroradiology, neuropathology, molecular genetics,
Previous studies have suggested that tardive dyskinesia Is usually un· treatable and often Irreversible. Therefore, patients receiving long·term antips~chotic medlc:ation should be regularly monitored for the development of tardive dyskineSia or treatable Involuntary movement, including tremor rigidity and hypokinesia. This study attempted to establish a simple physiC: logical examination to clarify the pathophysiology of drug Induced abnormal movement Methods: Psychiatric outpatients who had had constant oral Involuntary movements more than 1 month, were treated with a single Injection with biperiden 5 mg 1M. One pair of disc electrodes were placed on the center of the patlent~' chin. The EMG data obtained by a biomedical electric amplifier (NEC medical systems Co.) were recorded onto hard disk in the computer through the analog-digltal converter. The data were then subjected to the Fast Fourier Transform (FFT), and a power spectrum was computed from FFT. Results: From these FFT analyses, the treatable Involuntary movements was characterized by: the appearance of power peak ranged 4 to 10Hz before blperiden Injection; and/or the decrease of power values ranged 30 to 100 Hz after blperiden injection. This may be Important for differential diagnosis of tardive dyskinesia.
~~~·of this review Is to provide a critical analysis of literature conceming psychiatriC aspects of HD and a clinlcal-epldemlologlcal and pathogenetic
165-1131 Does smoking cause dyskinesia? - A study of
[65-109J psychiatric symptoms In huntington's disease: An analysis of literature and etlopathogenetic hypotheses L sarzaghl'. L Barina " R. Alberti' , C. Nespolo', M.L. Manzone 1, U. M8ntero 1,2, G. Penatl'. , Institute of Psychiatry- University of Milan· IRCCS Ospedale Maggiore. Milan. Italy. 2 A. USSL 38. Milan. Italy. 3/nstitute d psychiatry- University of Modena, Italy psyct1OP8thOloglcal symptoms during Huntington'S Disease (HD) are par•
tIcUIaI1Y remar1
wtUch
men born In 1933
&.¢ating.
f65-11 Q] ~
A. Nilsson', L. Waller, A. Rosengren, A. Adlerberth, l. Wilhelmsen.
Treatment of the neuroleptic malignant syndrome by electroconvulsive therapy
Dagmar Seifertova.
psychiatric Center Prague. Czech RepUblic
NeuroleptiC Malignant Syndrome (NMS) Is life-threatening complication of neuroI8¢JC treatment Mortality rate of cases without specific treatment was reported to reach 21%. Suggestions were made on the probable safety and of electroCOnvulsive treatment (ECT). ~Is a report on the treatment of NMS patients at the Intensive Care . (~CU) During the last three years ECT was used as the main treatment Unit . I~ 14 patients that had been referred to ICU because of their ~ emergent NMS. They represented 78.6% of all NMS cases treated
at ltl8 unit. ECT were administered after discontinuation of neuroleptic treatment and IdeqUS non-speciflc support for somatic condition of our patients was te ~ We observed improvement In all patients and there did not occur fatality among them. We also observed an Improvement In the psychotic ~ of these patients. The duration of their stay at the ICU was 17 In average. The range of the EeT applied was between 2-12. We daysidef' fCT. If properly indicated and applied. to be a safe and efficacious ~ modality in NMS patients.
[!5-11
TI New Investigational clinical use of rlsperldone
'nemann• H.J. Assion. Department of Neurology. St..Josef-Hospital.
~. Germany, Department of Neurology, St..Josef-Hospital.
()/)(JftJausen, Germany al of the report is to examine the effectiveness of risperidone in ~ mwith extrapyramidal disorders. ~od.' Risperidone has shown to be effective In the treatment 01 ~... r~ic patients with lower EPS side effects than conventional an• ~. Extrapyramidal disorders are often treated with typical neu-
, Department of Clinical Neurosciences. G6teborg University. Sweden. Departmenl of Medicine. G6teborg University. Sweden
It has been postulated that dyskinesia may be attributable to the schizophrenic disease process rather than to Its treatment. This is In line with the hypothesis that a putative organic vulnerability may cause dyskinesia to emerge even without exposure to neuroleptlcs. In the present general population survey of dyskinetic phenomena, no 'a priori' assumption was made of their cause. Spontaneous and tardive dyskinesia were studied In a random population sample of 559 men, aged 59 years. The Research Diagnostic Criteria for dyskinesia were fulfilled by 8.2% (n .. 46). Dyskinetic men had higher cigarette consumption and higher scores for Parkinsonian symptoms, as well as higher frequency of psychiatric morbidity, exposure to neuroleptics, and alcohol dependence. Logistic regression showed ex• posure to neuroleptics (p < 0.05) and dally cigarette consumption (p < 0.0005) to be Independently associated with dyskinesia. The probability of dyskinesia was 19% in a person smoking a pack a day or more, whereas the probability associated with exposure to neuroleptlcs was 30%.
165-1141 Low arachidonic acid levels In dyskinesia A study of men born In 1933 A. Nilsson, D.F. Horrobln', A. Rosengren. L. Walier, A. Adlerberth,
L. Wilhelmsen. G"teborg University. Sweden, ' Scotia Pharmaceuticals. UK We have studied the relationship between Essential Fatty Acids (EFAs) and spontaneous and tardive dyskineslas In a random population sample of 446 men, aged 59 years. Dyskinesia (AIMSscore of ~2 in any body part) was seen In 15.1% (n .. 74). Dyskinetic men had higher cigarette consumptlo~, more psychi~tric morbidity and they were more often exposed to neuroleptlcs. DyskineSia was associated with several abnormalities In EFA concentrations In plasma, but the most consistent finding was low arachidonic acid (AA) levels In phospholipids, trlglycerides and cholesterol esters. In a logistic regression model, cigarette consumption (p < 0.02),