Spectrofluorimetric and isotachophoretic determination of maprotiline in human blood serum.

Maprotiline determination in blood serum samples was investigated by the use of both capillary isotachophoresis and spectrofluorimetric techniques. The analyte had to be enriched before determination and extraction with n-heptane was used for this purpose. The preliminary separation enabled the determination of maprotiline in blood serum at therapeutic concentration levels.

ADAS-cog (Alzheimer's Disease Assessment Scale-cognitive subscale)--validation of the Slovak version.

BACKGROUND: ADAS was designed to measure the severity of the most important symptoms of Alzheimer's disease (AD). Its subscale ADAS-cog is the most popular cognitive testing instrument used in clinical trials of nootropics. It consists of 11 tasks measuring the disturbances of memory, language, praxis, attention and other cognitive abilities which are often referred to as the core symptoms of AD. AIM: The aim of the study is to verify the Slovak adaptation of ADAS-cog and its ability to distinguish patients with AD from those with depressive disorders (DD). SUBJECTS AND METHODS: The study sample consists of 29 psychiatric inpatients divided into 2 groups: the AD group of 14 patients (4 males, 10 females, mean age 73.9 +/- 7.3 yrs) fulfilling NINCDS-ADRDA criteria of probable AD and the DD group of 15 subjects (6 males, 9 females, mean age 74.3 +/- 6.5 yrs) without any cognitive impairment. In all patients the ADAS-cog and SMMSE were administered. We compared the group in: total scores in both scales, task scores in the ADAS-cog and the scores of 3 ADAS-cog factors--memory, language and praxis. RESULTS: Both methods distinguished the patients with the AD from DD (p < 0.001 for both scales). Also other variables (task and factor scores of ADAS-cog) reflect the worse results of the AD group. The most evident differences between the diagnostic groups were found in the orientation and constructive praxis. The education level did not affect the scores of the ADAS-cog in the AD patients but it did in SMMSE scores in the DD group (p < 0.05). CONCLUSIONS: The Slovak version of ADAS-cog has distinguished the patients with the AD from those with DD. The most evident differences between the groups were found in orientation and visuo-constructive praxis. In DD patients, the risk of false positive findings in subjects with lower education is higher than in the AD patients. In comparison with the SMMSE, ADAS-cog seems to be more helpful in early diagnostics of AD. (Tab. 6, Fig. 3, Ref. 14.)

[Adverse effects of antidepressive agents in hospitalized geriatric patients]. / Neziadúce úcinky antidepresív u hospitalizovaných gerontopsychiatrických pacientov.

The frequency, intensity and profile of adverse effects of antidepressants was studied in elderly patients. The series consisted of 102 patients with depression admitted to hospitals in Bratislava and Moscow. The adverse effects of amitriptyline (Amitriptylin Spofa) and maprotiline (Ludiomil Ciba-Geigy) were compared. The assessment done on days 0, 7, and 28 of treatment showed that xerostomia had the highest occurrence rate with both preparations studied. In patients treated with amitriptyline adverse effects were more severe and were recorded more frequently, requiring treatment withdrawal in 3 patients. The overall intensity of adverse effects was significantly higher with amitriptyline (p < 0.05). In the group of patients treated with amitriptyline the adverse effects were more marked in those with severe somatic pathology. The risk of amitriptyline treatment in elderly patients is being emphasized along with the need for monitoring and correcting adverse effects of the treatment. Although maprotiline exhibited a lower occurrence rate of adverse effects, cardiac functions should be regularly checked in patients with preexisting cardiac pathology. (Tab. 2, Fig. 3, Ref. 6.).

[Maintenance therapy in schizophrenia using clozapine]. / Udrziavacia liecba schizofrénie klozapínom.

Most of the experience with the atypical neuroleptic of Clozapine (Leponex, Sandoz) pertains to active treatment. In conjunction with possible risks, at present its administration in selected groups of patients is recommended. The authors describe the results of an intraindividual comparison of Clozapine in 11 patients with the diagnosis of schizophrenia (according to ICD-9), 7 men, mean age 30.5 years with previous neuroleptic treatment. The average period for comparison was 2.3 years (1.5-4 years), the mean daily dose of Clozapine was 200 mg (50-400 mg). During Clozapine treatment the hospitalization period was significantly shorter and the number of hospital admissions was lower. The frequency of undesirable effects was equal during both periods. During Clozapine treatment morning sleepiness and hypersalivation were more frequent and during treatment with neuroleptics extrapyramidal undesirable effects. In none of the patients they caused discontinuation of treatment. Transient leukopenia after Clozapine in one patient was improved after reduction of the dose. The paper is supplemented by the case-history of female patient treated by Clozapine monotherapy during 17 years.

Clozapine in the treatment of schizophrenic patients: an international multicenter trial.

One hundred twenty schizophrenic patients were treated with clozapine for two months in accordance with a standard trial protocol at ten research centers in the USSR, Czechoslovakia, Hungary, Poland, Bulgaria, and in the GDR. The daily dose ranged from 50 mg to 550 mg (mean: 272.1 mg for responders; 298 mg for nonresponders). In 94 patients (78%) the disease was clearly progressive; in 57 (47.5%) it was continuous; in 63 (52.5%) it was episodic. Before the start of clozapine treatment, 95 of the patients (79%) had been receiving other neuroleptics. There was a positive therapeutic response in 80% of the responding patients. The effect of clozapine was closely related to the dominant syndrome structure of the psychosis: a positive response was noted in 89% of patients with delusional, hallucinatory-delusional, and catatonic states and in 60% of patients with affective-delusional syndromes. Moderate side effects were noted in 87 patients (73%). The incidence of side effects reached a peak during the first four weeks of treatment and then declined despite maintenance of or even an increase in the daily clozapine dose. Hematological changes (moderate leukocytosis and thrombocytopenia) were noted in eight patients (6.7%).