ABSTRACT
The effect of adjunctive fluoxetine on negative schizophrenic symptoms was evaluated in 34 chronic schizophrenic in-patients on maintenance therapy with neuroleptics. They received randomly, on a double-blind basis, fluoxetine (20 mg/day) or placebo for 12 weeks. In the fluoxetine group, three patients dropped out because of side effects. Negative symptoms, as measured by change on the Scale for Assessment of Negative Symptoms at the end point compared to baseline values, were significantly improved in fluoxetine-treated patients (p < 0.001), but not in the placebo group. Fluoxetine treatment did not influence positive schizophrenic symptoms, while it induced a slight, but statistically significant, decrease (p < 0.05) in depressive symptoms, as measured by the Hamilton Rating Scale for Depression. Unwanted effects were more common among patients receiving fluoxetine. These data suggest that the addition of fluoxetine to neuroleptic treatment may be beneficial in some schizophrenic patients with negative symptoms.
Subject(s)
Fluoxetine/therapeutic use , Schizophrenia/drug therapy , Adult , Antipsychotic Agents/therapeutic use , Chronic Disease , Double-Blind Method , Drug Therapy, Combination , Female , Humans , Male , Middle Aged , Placebos , Psychiatric Status Rating Scales , Schizophrenia/diagnosis , Schizophrenia/prevention & control , Schizophrenic PsychologyABSTRACT
Eighty patients affected by ischemic cerebrovascular disease (ICVD) in stable conditions were studied: brain CT scan was performed in all patients to evaluate site/extension of brain injury, while urodynamic tests were employed in those patients who showed urinary bladder symptomatology (n = 30). Twenty-six complained of urgency and urge incontinence, only 4 patients showed urinary retention. Micturition abnormalities seem to occur mostly in patients with multiple infarcts and cerebral atrophy and particularly among those with bilateral lesions.
Subject(s)
Brain Ischemia/complications , Urination Disorders/etiology , Aged , Brain Ischemia/physiopathology , Cerebral Cortex/physiopathology , Cerebral Infarction/complications , Cerebral Infarction/physiopathology , Dominance, Cerebral/physiology , Female , Humans , Male , Middle Aged , Urinary Bladder/innervation , Urinary Incontinence/etiology , Urinary Incontinence/physiopathology , Urinary Retention/etiology , Urinary Retention/physiopathology , Urination Disorders/physiopathology , Urodynamics/physiologyABSTRACT
Six epileptic women, showing a clear increase in seizure frequency in the perimenstrual period, were studied during three consecutive menstrual cycles. At each control seizure occurrence, EEG recordings, endocrine profile and antiepileptic drug plasma levels were evaluated. The only pathological finding was the progesterone deficiency with a relative hyperestrogenism during the late luteal phase. Our data agree with other reports suggesting that catamenial epilepsy may result from a sex hormone disregulation.
Subject(s)
Electroencephalography , Epilepsies, Partial/blood , Epilepsy, Temporal Lobe/blood , Gonadal Steroid Hormones/blood , Menstruation Disturbances/blood , Adolescent , Adult , Estrogens/blood , Female , Humans , Luteal Phase/physiology , Progesterone/bloodABSTRACT
"Enuresis risoria" or "giggle incontinence" is a particular condition characterized by a sudden, involuntary, uncontrollable and complete emptying of the bladder during giggling or hearty laughter. We had under observation a 15-year-old girl affected by this condition. The tests she underwent did not reveal anatomic or functional alterations. We were able to control her symptoms with Imipramine. We can thus assume that laughter reacts as a trigger that activates micturition reflex through the intermediation of the limbic system.
Subject(s)
Enuresis/etiology , Laughter , Adolescent , Desipramine/blood , Enuresis/drug therapy , Female , Humans , Imipramine/blood , Imipramine/therapeutic useABSTRACT
To evaluate the comparative effects of valproic acid (VPA) and valpromide (VPM) on plasma levels and protein binding of carbamazepine (CBZ) and CBZ-10,11-epoxide (CBZ-E), 12 adult epileptic patients stabilized on CBZ monotherapy were divided into two groups. One group (n = 6) received sodium valproate (1,100 mg/day) for 2 weeks, while the other group (n = 6) was given, for the same period, a dosage of VPM (1,200 mg/day) expected to produce VPA levels equivalent to those achieved with valproate. Plasma CBZ levels were not affected by either treatment. In the valproate-treated group, plasma CBZ-E levels increased by 101% (range, 29-238%) within 1 week of combined therapy (p less than 0.02) and returned to baseline values after VPA treatment was stopped. In the VPM-treated patients, the elevation of plasma CBZ-E levels was much greater. In this group, plasma CBZ-E increased by 330% (range, 110-864%), and this was associated in two patients with the appearance of adverse effects which subsided after reducing the VPM dosage. The plasma protein binding of CBZ and CBZ-E was not affected significantly by VPM or valproate therapy. Plasma VPA levels were similar in the two groups. It is concluded that VPM is not simply a prodrug of VPA. Although both VPA and VPM increase CBZ-E levels--probably by inhibiting the enzyme epoxide hydrolase--the interaction caused by VPM is of much greater magnitude and potential clinical significance.
