[Changes in adipokines in the blood of patients with the first episode of schizophrenia during treatment with haloperidol and risperidone]. / Izmenenie soderzhaniya adipokinov krovi u bol'nykh s pervym epizodom shizofrenii v protsesse terapii galoperidolom i risperidonom.

OBJECTIVE: To study plasma adipokines (adiponectin, leptin, adipsin) in patients with the first episode of schizophrenia treated with haloperidol and risperidone. MATERIAL AND METHODS: Two hundred and twelve patients with the first episode of paranoid schizophrenia (F20.09) were examined. Patients were divided into the haloperidol group (n=107) and the risperidone group (n=105). The control group included 132 healthy people. Body mass index was recorded at baseline and in 2, 4, 6, 8 week of treatment. Adiponectin, adipsin and leptin were determined by the multiplex analysis. Blood test was conducted prior to therapy and after 8 weeks of treatment. RESULTS: An increase in body mass index is recorded in both clinical groups, with no statistically significant differences between groups. Before treatment with antipsychotics, the levels of adiponectin and adipsin increase in both clinical groups. In the course of therapy, the levels of adiponectin and adipsin significantly increase in the haloperidol group and the levels of adiponectin and leptin in the risperidone group. CONCLUSION: The increase in body weight is not the only mechanism of changes in adipokines in blood during treatment with antipsychotics. Further studies on the relationship between the levels of adipokines and pharmacogenic metabolic disorders are required.

NMDA receptor genotypes associated with the vulnerability to develop dyskinesia.

Dyskinesias are involuntary muscle movements that occur spontaneously in Huntington's disease (HD) and after long-term treatments for Parkinson's disease (levodopa-induced dyskinesia; LID) or for schizophrenia (tardive dyskinesia, TD). Previous studies suggested that dyskinesias in these three conditions originate from different neuronal pathways that converge on overstimulation of the motor cortex. We hypothesized that the same variants of the N-methyl-D-aspartate receptor gene that were previously associated with the age of dyskinesia onset in HD were also associated with the vulnerability for TD and not LID. Genotyping patients with LID and TD revealed, however, that these two variants were dose-dependently associated with susceptibility to LID, but not TD. This suggested that LID, TD and HD might arise from the same neuronal pathways, but TD results from a different mechanism.

[Effect of haloperidol and risperidone on neuromarkers and indices of endothelial dysfunction in patients with acute schizophrenia].

Effect of haloperidol and risperidone on positive, negative, neurocognitive disorders, biological parameters and neurodestruction-neuroreparation processes have been studied in 23 patients with the first episode of paranoid schizophrenia. Risperidone, along with high therapeutic effect towards positive, negative, neurocognitive disorders, is able to reduce brain neurodestruction markers as well as to improve protective-compensatory processes directed to the neuroplasticity restoration. There were correlations between biological parameters studied: the higher were levels of GFAP and antibodies to NR2 subunit of NMDA receptors, the higher were BDNF and NO values. The association between parameters studied and psychopathological disorders measured with the PANSS has been found in patients treated with risperidone. The mentioned correlations were not observed in patients treated with haloperidol.

[Electroencephalographic correlates of transpersonal psychotherapy efficacy in neurotic depressions].

Based on the results of examination of 157 patients with neurotic depression (ICD-10 items F43.20, F43.21, F43.22), electroencephalographic criteria of transpersonal psychotherapy efficacy have been specified as following: the increase of alpha-3 activity in the frontotemporal region and the decrease of a spectral index of theta-activity in parietal, central, occipital and prefrontal regions; some changes in beta-band (the increase of spectral index of beta-1 in frontotemporal and prefrontal regions and the decrease of beta-2 in parietal and occipital regions). The direction of these changes is objectively supported by the clinical dynamics, data of correlation analysis of neurophysiological parameters and psychometric scales used for assessment of the presence and severity of emotional and personality disorders.

[The pathophysiological analysis of cerebrolysin therapy of children with mental developmental delay caused by ecological factors].

The treatment with cerebrolysin combined with psychological correction was conducted in 24 children, aged 4-6 years, with mental developmental delay. The effect of this drug was compared to placebo (20 patients with mental development delay) and control groups (35 healthy children). After cerebrolysin therapy effect of cerebrolysin (0,1 mg/1kg of body mass during 42 day) was assessed using neuropsychological data and a set of different pathophysiological indices which reflected the biochemical, immunological and neurophysiological status of patients. After cerebrolysin therapy significant improvement of the mental state, including preconditions of intellect, and motor functions specific for mental development delay was found. These changes were correlated with the positive dynamics of some indices - lipid peroxidation, immune status, hormonal shifts and parameters of neurodegeneration-neuroprotection processes.

[Neuroimmune parameters as markers of therapeutic and rehabilitation efficacy in children with organic mental retardation].

A complex of therapeutic and rehabilitation measures including neurometabolics (brain cytomedine cortexin, pantogam and glycine), antioxidants and vascular medications, massage, physiotherapeutic procedures and special psychological and educational correction was administered to 40 children, aged 5-8 years, with organic mental retardation. A control group consisted of age-matched healthy children. The efficacy of rehabilitation was assessed after 3 months basing on a special coefficient and correlations between this coefficient and some neuroimmune parameters. This approach makes it possible to specify favorable prognostic markers, i.e. the decrease of serum level of neuron-specific enolase, myelin-associated glycoprotein antibodies and increase of brain-derived neurotrophic factor.

[Effect of psychopathological disorders in patients with unstable stenocardia on serum lipids and the indicators of lipid peroxidation]. / Vliianie psikhopatologicheskikh narushenii u bol'nykh nestabil'noi stenokardiei na syvorotochnye lipidy i pokazateli perekisnogo okisleniia lipidov.

A total of 193 males suffering from unstable angina pectoris (UAP) were examined against 20 control subjects with stable angina pectoris (SAP) for the serum levels of lipids and activity of lipid peroxidation. The parameters studied varied between the groups. 152 UAP patients exhibited psychopathological disturbances, mainly agitated melancholia. These patients (78.8%) were noticed to have atherogenic shifts in serum lipids and lipid peroxidation products levels increased as compared to those without psychoemotional problems. It was found that in UAP psychopathologic disturbances contribute to the progress of coronary insufficiency this justifying the use of psychotherapy in combination with drugs in UAP patients.

[HLA immunogenetic markers in predicting therapeutic resistance in paranoid schizophrenia]. / Immunogeneticheskie markery HLA v prognozirovanii terapevticheskoi rezistentnosti pri paranoidnoi shizofrenii.

A study was made of the incidence of HLA histocompatibility antigens of A, B and C loci in 100 male patients suffering from paranoid continuous schizophrenia associated with hallucinatory paranoid symptomatology during the formation in them of therapeutic resistance. In accordance with the clinico-pathogenetic philosophy, 2 groups of resistant patients were formed: an "endogenous" one (because of rapid progression) and a "pharmacogenous" one (secondary, formed by the mechanisms of "adaptation" to neuroleptics). In addition, a group of "nonresistant" patients (a reference one) was also distinguished. The data were compared to those obtained in normal subjects (50 men) and to those derived within the distinguished groups, employing mathematic computation of the risk coefficient. It has been shown that in contrast to the group of normal subjects, the general group of patients suffering from paranoid schizophrenia manifested the accumulation of the HLA antigens A2, A9, W7 and B15. The accumulation of the HLA antigens A2 and A11 was characteristic of the patients suffering from "endogenous" resistance, which distinguished those patients from normal subjects, from "nonresistant" patients and those with "pharmacogenous" resistance. The HLA phenotype A2,11 can be regarded as a potential marker of progression (risk grades 9.8). Besides, it has been demonstrated that the HLA antigens B7 may attest to risk of tolerance to psychopharmacotherapy and formation of "pharmacogenous" resistance (risk grades 4.3).

[Significance of disorders of the processes of lipid peroxidation in patients with persistent paranoid schizophrenia resistant to the treatment]. / Znachenie narushenii protsessov perekisnogo okisleniia lipidov u bol'nykh nepreryvnoi paranoidnoi shizofreniei s terapevticheskoi rezistentnost'iu.

Lipid peroxidation (LPO) processes and the status of the ++bio-antioxidant defence system were studied in 133 male patients with continuous paranoid schizophrenia associated with hallucinatory and paranoid symptomatology, refractory to treatment. According to the ++clinico-pathogenetic principle, 3 groups of resistant patients were made up: an "endogenous" one (because of high progression), a "pharmacogenous" one (secondary, formed in accordance with the mechanisms of "adaptation" to neuroleptics, and a "resistant" one formed on the "pathological ground". The data were compared both to the normal patients (control) and to those in patients with acute paranoid schizophrenia and in a state of a remission. All the examined patients showed activation of LPO while the patients with acute schizophrenia were marked by a dramatic increase (by 2.5 to 3 times) of the intensity of LPO as compared to normals. During formation of therapeutic resistance, all the groups, in addition to the high values of the LPO intensity, demonstrated remarkable signs of depletion of the ++bio-antioxidant defence system, particularly in the group with resistance on the "pathological ground".

[Antibodies to neuroleptics and their role in the mechanisms of the development of drug resistance in psychopharmacotherapy of patients with paranoid schizophrenia]. / Antitela k neiroleptikam i ikh rol' v mekhanizmakh formirovaniia terapevticheskoi rezistentnosti pri psikhofarmakoterapii bol'nykh paranoidnoi shizofreniei.

A study was made of the content of drug antibodies (DAT) to chlorpromazine, triphthazine and haloperidol in the blood sera of 112 patients with paranoid schizophrenia (acute period, curable exacerbation associated with the chronic course, and a group of therapeutically resistant subjects). Antibodies to neuroleptics were demonstrable in all the patients' groups. However, the rate of positive reactions and the content of DAT in the therapeutically resistant patients differed significantly from the characteristics in "acute" patients and in the group of "nonresistant" ones. The maximum "antigenicity" was shown by chlorpromazine, the minimum by haloperidol. The appearance and the content of DAT agree well with the duration of the drug intake, especially if the treatment is repeated. In acute conditions, the content of DAT was found to depend on the increment of the daily dose (with the exception of haloperidol). In chronic conditions and repeated treatments, the rise of the content of DAT was feasible with the low daily doses, particularly to chlorpromazine.

[Use of thymic peptide thymalin in the complex treatment of therapy-resistant schizophrenia]. / Primenenie peptida vilochkovoi zhelezy timalina v kompleksnoi terapii bol'nykh shizofreniei s terapevticheskoiezistent-nost'iu.

The thymic peptide thymaline combined with psychotropic drugs was used in the treatment of 36 therapeutically resistant patients with pronounced immune abnormalities. Such a policy favoured considerable enhancement of the treatment efficacy which manifested itself by the elimination or amelioration of psychic disorders, appreciable activation of patients and reduction of neuroleptic complications. The positive dynamics in the patients' status always correlated with the normalization of immune abnormalities, with this being seen to a greater degree in cases of the secondary "pharmacogenic" resistance and resistance because of the "pathological ground". On the one hand, the studies demonstrated wide potentialities of the use of thymaline in the treatment of the resistant patterns of schizophrenia. On the other hand, they showed the heterogeneity of immune abnormalities in patients with different varieties of resistance.