- Email: [email protected]
Schizophrenia as initial manifestation in multiple sclerosis
S256
I?2 Psychotic disorders and antipsychotics
retroactively examined the effects of co-administration of Olanzapine with ECT, specifically examining the effect of co-administration on seizure duration. This retrospective study focused on the safety of coadministration of Olanzapine with ECT. We present six patients (five schizophrenic, one bipolar) who received co-administration of Olanzapine with ECT. EEG, ECT, blood pressure, heart rate and blood oxygensaturation was monitored for a total of 45 treatments. No significant adverse events were noted, and the clinical status of three of the patients improved. Conclusion: This retrospective, open-labeled sample indicates that Olanzapine can be co-administered with ECT, with no significant adverse events, and may lead to clinical improvement.
-1
Abnormal patients
heart rate variability in clozapine treated
U. Loewenthal, H. Cohen, Z. Kaplan, M. Kotler. Mental Health Center Anxiety & Stress Research Unit, Faculty of Health Sciences, Ben Gurion University of the Negeu, Beer-Sheua, Ismel Power spectral analysis (PSA) of heart rate variability (HRV) offers a reliable means of assessment of cardiovascular autonomic responses, providing a “window” onto the interaction of sympathetic and parasympathetic tone. Alterations in HRV are associated with various physiological and pathophysiological processes and may contribute to morbidity and mortality. Standardized heart rate analysis was carried out in twenty schizophrenic patients treated with 30&600 mgday of clozapine as monotherapy, twenty schizophrenic patients treated with 5-10 mgday haloperidol as monotherapy and twenty schizophrenic patients treated with S-10 mgday Olanzapine as monotherapy. Our preliminary results show that schizophrenic patients treated with clozapine had significantly lower HR\! lower high frequency (HF) and higher low frequency (LF) components compared to the patients treated with haloperidol. Prolonged QTc intervals were more common in the clozapine treated patient sample. Patients treated with 300 mg of clozapine per day showed significant change of HR\! fulfilling the criteria of cardiovascular autonomic neuropathy. Probably, the autonomic dysfunction is caused by the dose-dependent anticholinergic side effect of clozapine. The clinical application of these preliminary findings will be discussed.
Ip.2.0081
Clinical efficacy and safety of the sigma receptor ligand panamesine in schizophrenic patients
M.T. Huber, U. Gotthardt, W. Schreiber’, J.-C. Krieg. Department Psychiatry and Psychotherapy,
Philipps-University
of Marburg, Germany
Study Purpose: Alterations of sigma receptor function have been supposed to be involved in the pathogenesis of schizophrenia. Therefore, respective ligands may offer new treatment options. Panamesine (EMD 57455) is a new sigma receptor ligand with known antipsychotic effects (1). Animal studies have demonstrated that panamesine has a functional antidopaminergic activity without extrapyramidal side-effects and a c-fos expression pattern similar to that obtained with atypical neuroleptics. We here report on an exploratory open clinical trial to determine the appropriate dose range for clinical efficacy and safety of panamesine in patients with an acute episode of schizophrenia, paranoid or undifferentiated
Results: The intent-to-treat analysis of the complete sample exhibited an improvement of psychometric variables. Seven patients completed the study and demonstrated significant changes in their psychometric variables: BPRS x = 20.75, p = 0.0004; CGI x2 = 20.04, p = 0.0005; PANSS pos. x = 17.03, p = 0.0019; PANSS neg. x2 = 18.86, p = 0.0008; PANSS tot. x2 = 19.83, p = 0.0005. Pairwise comparisons versus day 0 showed an improvement of all psychometric variables, starting already at day 7. Among the seven completers, four were responders according to the protocol definition, two patients improved slightly and one remained unimproved. Responders were characterized by the following changes in their psychometric variables: BPRS x2 = 4.60, p = 0.0056; CGI x2 = 14.25, p = 0.0065; PANSS pos. x2 = 15.28, p = 0.0042; PANSS neg. x2 = 14.91, p = 0.0049; PANSS tot. x2 = 13.60, p = 0.0087. Nonresponders showed no significant changes at all. Two of the nonresponders were of the undifferentiated type. Panamesine was well tolerated and did not have any major side-effects except for two patients, who experienced extrapyramidal symptoms; due to these side-effects, one of the patients had to be taken out of the study. Conclusions: Concerning clinical efficacy and safety, our data confirm and underline the previous study by Frieboes et al. (2) with the only exception, that in our study panamesine was not found to be totally free of extrapyramidal side-effects. References [l] Bartoszyk, G.D., Bender, H.M., Hellmann, J., Schnorr, C., Seyfried, C.A., 1996. CNS Drug Rev. 2, 175-194 [2] Friebocs, R.M., Murck, H., Wiedemann, K., Holsboer, E, Steiger, S., 1997. Psychopharmacology 132, 82-88.
Ip.2.0091
Schizophrenia sclerosis
as initial manifestation
In multiple
D. Kountouris. Center for Neurological Diagnosis, 45 Michalakopoulou Street, Gr-I I528 Athens, Greece Background: The hypothesis that schizophrenia may be caused by organic reasons goes back a century. The possibility of the coexistence or unified nature of Multiple Sclerosis (MS) and schizophrenia should be explored. In an effort to investigate the possible relationship between the two illnesses, 10 patients were clinically and psychiatrically studied, for a two-year period, after they were diagnosed with simultaneously MS and schizophrenia. Method: Specifically, the EDSS- Kurtzke scale was used for the clinical evaluation and the psychiatric symptoms were recorded before the patients were put on a Mitoxandrone therapy 80-100 mg total dose, which lasted one year. Results: A year after the end of treatment the patients’ clinical and psychological profiles were reevaluated. It was found that 2 years after the beginning of the treatment the symptoms of both illnesses subsided. The frequency of the symptoms was reduced for both illness at the same time approximately at an 80% rate. Conclusion: In general, it was found that beyond the proven benefits of Mitoxandrone in MS patients it also have a positive effect on patients with schizophrenia which leads to the question of whether the two illnesses may coexist and whether schizophrenia may be the initial manifestation of MS. We should also examined the possibility that low dose immunosuppression comprises a new treatment option for schizophrenia.
type.
Methods: 12 patients received panamesine up to 60 mgday for 4 weeks. Psychometric measures as well as extrapyramidal side effects were assessed by rating scales (BPRS, CGI, PANSS as well as ESRS and AIMS) obtained at days 0, 7, 14, 21 and 28. Responders were defined as having at least a 50% decrease in the BPRS total score at the end of the treatment period. Overall treatment effects were determined by nonparametric analysis of variance (Friedman Test) and pairwise comparisons of all successive assessment days with day 0 were performed using the Wilcoxon Matched Pairs Signed Ranks Test.
I-]
Blockade of glucose transporters drugs
by antipsychotic
D.S. Dwyer, R.J. Bradley, A.S. Kablinger, A.M. Freeman State University Medical Center: Dept. of Psychiahy. Shreveport, Louisiana, 71130, USA
Louisiana PO Box 33932, l
Introduction: It is suggested that on the basis of older literature certain antipsychotic drugs may interfere with glucose metabolism in the brain
I?2 Psychotic disorders and antipsychotics
retroactively examined the effects of co-administration of Olanzapine with ECT, specifically examining the effect of co-administration on seizure duration. This retrospective study focused on the safety of coadministration of Olanzapine with ECT. We present six patients (five schizophrenic, one bipolar) who received co-administration of Olanzapine with ECT. EEG, ECT, blood pressure, heart rate and blood oxygensaturation was monitored for a total of 45 treatments. No significant adverse events were noted, and the clinical status of three of the patients improved. Conclusion: This retrospective, open-labeled sample indicates that Olanzapine can be co-administered with ECT, with no significant adverse events, and may lead to clinical improvement.
-1
Abnormal patients
heart rate variability in clozapine treated
U. Loewenthal, H. Cohen, Z. Kaplan, M. Kotler. Mental Health Center Anxiety & Stress Research Unit, Faculty of Health Sciences, Ben Gurion University of the Negeu, Beer-Sheua, Ismel Power spectral analysis (PSA) of heart rate variability (HRV) offers a reliable means of assessment of cardiovascular autonomic responses, providing a “window” onto the interaction of sympathetic and parasympathetic tone. Alterations in HRV are associated with various physiological and pathophysiological processes and may contribute to morbidity and mortality. Standardized heart rate analysis was carried out in twenty schizophrenic patients treated with 30&600 mgday of clozapine as monotherapy, twenty schizophrenic patients treated with 5-10 mgday haloperidol as monotherapy and twenty schizophrenic patients treated with S-10 mgday Olanzapine as monotherapy. Our preliminary results show that schizophrenic patients treated with clozapine had significantly lower HR\! lower high frequency (HF) and higher low frequency (LF) components compared to the patients treated with haloperidol. Prolonged QTc intervals were more common in the clozapine treated patient sample. Patients treated with 300 mg of clozapine per day showed significant change of HR\! fulfilling the criteria of cardiovascular autonomic neuropathy. Probably, the autonomic dysfunction is caused by the dose-dependent anticholinergic side effect of clozapine. The clinical application of these preliminary findings will be discussed.
Ip.2.0081
Clinical efficacy and safety of the sigma receptor ligand panamesine in schizophrenic patients
M.T. Huber, U. Gotthardt, W. Schreiber’, J.-C. Krieg. Department Psychiatry and Psychotherapy,
Philipps-University
of Marburg, Germany
Study Purpose: Alterations of sigma receptor function have been supposed to be involved in the pathogenesis of schizophrenia. Therefore, respective ligands may offer new treatment options. Panamesine (EMD 57455) is a new sigma receptor ligand with known antipsychotic effects (1). Animal studies have demonstrated that panamesine has a functional antidopaminergic activity without extrapyramidal side-effects and a c-fos expression pattern similar to that obtained with atypical neuroleptics. We here report on an exploratory open clinical trial to determine the appropriate dose range for clinical efficacy and safety of panamesine in patients with an acute episode of schizophrenia, paranoid or undifferentiated
Results: The intent-to-treat analysis of the complete sample exhibited an improvement of psychometric variables. Seven patients completed the study and demonstrated significant changes in their psychometric variables: BPRS x = 20.75, p = 0.0004; CGI x2 = 20.04, p = 0.0005; PANSS pos. x = 17.03, p = 0.0019; PANSS neg. x2 = 18.86, p = 0.0008; PANSS tot. x2 = 19.83, p = 0.0005. Pairwise comparisons versus day 0 showed an improvement of all psychometric variables, starting already at day 7. Among the seven completers, four were responders according to the protocol definition, two patients improved slightly and one remained unimproved. Responders were characterized by the following changes in their psychometric variables: BPRS x2 = 4.60, p = 0.0056; CGI x2 = 14.25, p = 0.0065; PANSS pos. x2 = 15.28, p = 0.0042; PANSS neg. x2 = 14.91, p = 0.0049; PANSS tot. x2 = 13.60, p = 0.0087. Nonresponders showed no significant changes at all. Two of the nonresponders were of the undifferentiated type. Panamesine was well tolerated and did not have any major side-effects except for two patients, who experienced extrapyramidal symptoms; due to these side-effects, one of the patients had to be taken out of the study. Conclusions: Concerning clinical efficacy and safety, our data confirm and underline the previous study by Frieboes et al. (2) with the only exception, that in our study panamesine was not found to be totally free of extrapyramidal side-effects. References [l] Bartoszyk, G.D., Bender, H.M., Hellmann, J., Schnorr, C., Seyfried, C.A., 1996. CNS Drug Rev. 2, 175-194 [2] Friebocs, R.M., Murck, H., Wiedemann, K., Holsboer, E, Steiger, S., 1997. Psychopharmacology 132, 82-88.
Ip.2.0091
Schizophrenia sclerosis
as initial manifestation
In multiple
D. Kountouris. Center for Neurological Diagnosis, 45 Michalakopoulou Street, Gr-I I528 Athens, Greece Background: The hypothesis that schizophrenia may be caused by organic reasons goes back a century. The possibility of the coexistence or unified nature of Multiple Sclerosis (MS) and schizophrenia should be explored. In an effort to investigate the possible relationship between the two illnesses, 10 patients were clinically and psychiatrically studied, for a two-year period, after they were diagnosed with simultaneously MS and schizophrenia. Method: Specifically, the EDSS- Kurtzke scale was used for the clinical evaluation and the psychiatric symptoms were recorded before the patients were put on a Mitoxandrone therapy 80-100 mg total dose, which lasted one year. Results: A year after the end of treatment the patients’ clinical and psychological profiles were reevaluated. It was found that 2 years after the beginning of the treatment the symptoms of both illnesses subsided. The frequency of the symptoms was reduced for both illness at the same time approximately at an 80% rate. Conclusion: In general, it was found that beyond the proven benefits of Mitoxandrone in MS patients it also have a positive effect on patients with schizophrenia which leads to the question of whether the two illnesses may coexist and whether schizophrenia may be the initial manifestation of MS. We should also examined the possibility that low dose immunosuppression comprises a new treatment option for schizophrenia.
type.
Methods: 12 patients received panamesine up to 60 mgday for 4 weeks. Psychometric measures as well as extrapyramidal side effects were assessed by rating scales (BPRS, CGI, PANSS as well as ESRS and AIMS) obtained at days 0, 7, 14, 21 and 28. Responders were defined as having at least a 50% decrease in the BPRS total score at the end of the treatment period. Overall treatment effects were determined by nonparametric analysis of variance (Friedman Test) and pairwise comparisons of all successive assessment days with day 0 were performed using the Wilcoxon Matched Pairs Signed Ranks Test.
I-]
Blockade of glucose transporters drugs
by antipsychotic
D.S. Dwyer, R.J. Bradley, A.S. Kablinger, A.M. Freeman State University Medical Center: Dept. of Psychiahy. Shreveport, Louisiana, 71130, USA
Louisiana PO Box 33932, l
Introduction: It is suggested that on the basis of older literature certain antipsychotic drugs may interfere with glucose metabolism in the brain