Skin-testing with neurotransmitters in schizophrenic patients.

Pilot data are presented on a methodology to study a profile of simultaneous reactivity to intradermally injected norepinephrine, dopamine, serotonin, and histamine. The subject groups were young and old schizophrenics on medication and young control volunteers. Skin reactivity in terms of vasoconstriction, vasodilation, and whealing was measured over the course of 3 hours after the injections. Although interpretation of the results is limited by several sources of confounding error and the small number of subjects, the data suggest that skin-test profiles are sensitive enough to yield significant differences between the groups, particularly in the area of vasoconstriction. Further, abnormal skin reactivity may mirror the hypothesized alterations in CNS neurotransmitter physiology in schizophrenic patients.

Suicide after unilateral ECT in a patient previously responsive to bilateral ECT.

A 34-year-old schizophrenic committed suicide after his fourth unilateral electroconvulsive treatment. He previously responded successfully to seven bilateral treatments. The authors hypothesize that unilateral ECT may post a greater risk than bilateral ECT for the delusional suicidal patient. The rationale underlying this hypothesis states that the greater temporary disruption in cognition and memory associated with bilateral ECT is actually desirable in suicidal patients although it is an unwanted side effect in nonsuicidal patients. Since energy and mood often improve before delusions, bilateral ECT may neutralize delusions during the time of maximum suicidal risk as patients begin to improve.

Doxepin or diazepam for anxious and anxious-depressed outpatients?

A six-week double blind comparison of doxepin and diazepam in the treatment of 61 anxious outpatients showed few drug differences. Diazepam treated patients improved significantly more early in the trial, according to a few measures. They also had significantly fewer complaints of drowsiness. By six weeks, the medicines appeared roughly equal in efficacy. Practically no support was found for the position that doxepin may be more beneficial for anxious-depressive syndromes. In all patients, and also within the anxious-depressive subgroup, there were small mean differences on many criteria favoring doxepin at six weeks, but none reached significance. The doxepin group gained significantly more weight. Possible biasing influences were present requiring that the results be interpreted with particular caution.

Effects of chronic d-amphetamine on social behavior of the rat: implications for an animal model of paranoid schizophrenia.

Hooded rats in a social colony were given increasing daily doses of d-amphetamine up to 8 mg/kg. Time-lapse 16 mm cinematographically recorded behavior was analyzed for the following: grooming, feeding, sex, sleeping, resting, sterotypy, agonistic behavior, muricidal activity, and the location and movement of each rat. Subordiant rats receiving d-amphetamine actively withdrew from social interactions by retreating to strategically defensible locations in the environment. They remained hypervigilant of other rats and overreacted to their approaches by either fleeing or by defensively rearing and "boxing". On the other hand, when the dominant rat received the maximum dose, it seemed totally oblivious to the other rats. The responses to drug treatment in subordinant rats may provide a model for the social behavior of frightened paranoid schizophrenics.