Ketazolam (Solatran) an open study of once-a-day treatment in ambulatory patients with anxiety.

The efficacy of ketazolam (Solatran) in alleviating the symptoms of short-term reactive or neurotic anxiety in thirty-three patients was examined using a single 30 mg night-time dose in an open study. Patients were to receive treatment for up to 1 month and thereafter as necessary for several months. At the follow-up visits, at the end of the first, second and fourth weeks and then at the end of therapy if continued, the clinical condition was assessed by the Hamilton Anxiety Rating Scale and physician's and patients' subjective global assessments. A highly significant improvement was observed after a week's treatment in both somatic and psychic aspects of anxiety. A favourable response as measured by the two subjective assessments was observed in more than 80% of the patients by the third visit. There were two reports of morning tiredness, both dose-related, but no other adverse effects. Only four patients derived no benefit from the treatment.

Plasma levels of the cis- and trans-isomers of doxepin and desmethyldoxepin after administration of doxepin to patients.

In depressed patients treated with doxepin (Sinequan), a 15:85% mixture of cis- and trans-isomers, plasma levels of the cis- and trans-forms of doxepin and desmethyldoxepin were measured using a GLC-method with a capillary column and a nitrogen detector. A gradual increase of the concentration of the products in the plasma is seen in the first days of administration. There is a remarkable variation from patient to patient in the steady-state concentrations of trans-doxepin and of cis- and trans-desmethyldoxepin. cis-Doxepin levels are always very low. It is suggested that for studies of correlation between plasma levels and therapeutic and toxic effects of doxepin, the isomers of the parent compound and its metabolite should be measured separately.

Intramuscular haloperidol decanoate for neuroleptic maintenance therapy. Efficacy, dosage schedule and plasma levels. An open multicenter study.

Thirty-eight hospitalized chronic psychotic patients were injected (i.m.) every 4 weeks with haloperidol decanoate using different dosage schedules which were calculated from the previously prescribed daily oral dose of haloperidol multiplied by a factor of 30, 20 or 10. The 20-fold schedule appeared to be adequate in most of the patients. All patients were well stabilized on their optimal dose schedule and several symptoms improved even further during treatment. No increase of extrapyramidal or other side-effects was reported in any of the patients. Antiparkinson medication could be omitted in 37 patients without problems. There was neither pain nor irritation at the site of injection. Plasma levels of haloperidol reaching a steady state after the second injection of haloperidol decanoate were about two times higher than during the previous oral treatment with haloperidol. No accumulation was observed. Haloperidol decanoate injected every 4 weeks proved to be as safe and therapeutically reliable as orally administered haloperidol.

Compatibility of high doses of both oral domperidone and neuroleptics in chronic psychotics.

Twenty chronic schizophrenic inpatients who were being treated with high doses of neuroleptics and of whom seven had extra-pyramidal symptoms in spite of anti-Parkinsonian therapy, were given oral domperidone (50 mg t.d.s. for 2 weeks) for the relief of chronic dyspepsia. The dyspepsia symptoms were markedly improved, no side effects were seen and, even at high doses, domperidone did not intensify the existing extra-pyramidal side effects of the neuroleptics or produce new ones.

Oxazepam in the treatment of anxiety in children and the elderly.

The nature of anxiety, particularly in the young and the elderly, is described. The difficulty of treating anxiety occurring at the extremes of age is emphasized. Oxazepam is exceptionally well tolerated by these patients and is considered to be the benzodiazepine of choice for paediatric and geriatric anxiety. Metabolic and pharmacokinetic factors may account for this distinction.

Antinuclear factor-positive mental depression: a single disease entity?

Antinuclear factor (ANF) was present in the serum of about 30% of 53 patients newly admitted to the psychiatric hospital because of mental depression. Clinically, ANF-positive depression closely resembles manic-depressive psychosis but tends to be more resistant to treatment. It is suggested that ANF-positive depression may be a quite distinctive disease.

Pipamperone (Dipiperon) in the treatment of behaviour disorders. A large-scale multicentre evaluation.

Pipamperone solution or tablets were prescribed for four weeks to 188 patients (3-100 years) with behavior disorders. Fifty of these (group A) were mental retardates, the remaining 138 (group B) had a normal I.Q. Their doses were gradually increased until optimal effect was reached. Nearly all 17 items of a behaviour rating scale had improved very significantly by the end of the fourth week, while in 82% of the patients of group A and 76% of group B results were rated good to very good. Also, pipamperone proved to be far superior to previous psychotropic drugs in patients who had been treated before.