ABSTRACT
Negative and cognitive symptoms of schizophrenia are associated with a hypodopaminergic state in the frontal cortex and do not respond to neuroleptics equally well as positive symptoms. Therefore pharmacological strategies, which increase dopamine metabolism in the mesocortical pathways, may prove beneficial to ameliorate these symptoms. We report on a case of a patient with paranoid schizophrenia, who still presented negative and depressive symptoms during treatment with amisulpride for more than 6 weeks. We prescribed pergolide (a mixed D1/D2 agonist) as adjuvant therapy to treat these symptoms. The patient showed an improvement of global psychopathology, decrease of negative and depressive symptoms, while no changes in positive symptoms nor EPS were present. For this patient, the adjuvant therapy of pergolide to amisulpride constituted a valid pharmacological approach to treat negative and depressive symptoms of schizophrenia, without increasing positive symptoms.
Subject(s)
Antipsychotic Agents/administration & dosage , Depressive Disorder/drug therapy , Dopamine Agonists/administration & dosage , Hallucinations/drug therapy , Pergolide/administration & dosage , Schizophrenia, Paranoid/drug therapy , Sulpiride/analogs & derivatives , Adult , Amisulpride , Comorbidity , Depressive Disorder/diagnosis , Depressive Disorder/psychology , Drug Therapy, Combination , Frontal Lobe/drug effects , Hallucinations/diagnosis , Hallucinations/psychology , Humans , Male , Neural Pathways/drug effects , Psychiatric Status Rating Scales , Receptors, Dopamine D1/agonists , Receptors, Dopamine D2/agonists , Schizophrenia, Paranoid/diagnosis , Schizophrenia, Paranoid/psychology , Sulpiride/administration & dosage , Treatment OutcomeABSTRACT
The NB1 glycoprotein (CD177, HNA-2a antigen) is exclusively expressed on human neutrophils. As the clinical significance of CD177 expression is unknown, we investigated its expression in healthy individuals before and after stimulation with granulocyte colony-stimulating factor (G-CSF), in patients with rheumatoid arthritis, viral hepatitis, severe bacterial infections and polycythaemia vera. Expression was quantitatively determined by flow cytometry and by real time polymerase chain reaction. Only G-CSF-stimulated individuals and patients with severe bacterial infections and polycythaemia showed a significantly (P < 0.001) increased CD177 expression compared with healthy individuals, indicating that neutrophil CD177 expression can increase significantly in certain clinical conditions.