Antipsychotic profile of alstonine: ethnopharmacology of a traditional Nigerian botanical remedy

Although recently developed drugs have brought significant improvement, the treatment of psychotic disorders still presents serious drawbacks. Since inherent complexity and lack of satisfactory understanding of the underlying pathophysiology impose limits for rational drug design, resourceful approaches in the search for antipsychotics are pertinent. This paper reports pharmacological properties of alstonine, a heteroyohimbine type alkaloid, Which exbitited an antipsychotic-like profile, inhibiting amphetamine-induced lethaly, apomorphine-induced steotypy and potentiating barbiturate-induced slleping time. Atypical features of alstonine were the prevention of haloperidol-induced catalepsy and lack of direct interaction with D1, D2 and 5-HT2A receptors, classically linked to antipsychotic mechanism of action.

The use of flumazenil in reversing the midazolam and diazepam sedation in outpatients undergoing gastroscopy.

A prospective double blind randomized study was conducted to assess the efficacy and safety of flumazenil in patients for upper gastrointestinal endoscopy, sedated with midazolam or diazepam. Flumazenil significantly reduced the degree of sedation in both treatment groups without significant intergroup differences. There was no evidence of rebound sedation during the observation period of 4 hours. Anterograde amnesia was effectively antagonized in both groups. Flumazenil was a well tolerated safe and effective benzodiazepine antagonist. The combination of benzodiazepine with flumazenil makes it possible to reduce the recovery period and may be useful in outpatients undergoing endoscopy.