Antiaggressive effect of adjunctive clonazepam in schizophrenia associated with seizure disorder.

A case of schizophrenia associated with complex partial seizure disorder and postictal violence, both refractory to conventional treatment, is presented. Adjunctive treatment with clonazepam resulted in the cessation of the seizures and of persistent, violent hallucinations. The theoretical implications for possible mechanisms underlying at least some types of aggressive behavior are discussed.

Elevation of thioridazine plasma levels by propranolol.

As part of a pilot study to assess the efficacy of propranolol in the treatment of aggression in psychiatric patients, drug interactions of propranolol with other agents were estimated by blood level monitoring. In the two patients taking a standard oral dose of thioridazine, the addition of propranolol caused a threefold and fivefold increase of plasma thioridazine levels, which placed them in a potentially toxic range. Although neither patient exhibited a toxic effect, these levels may be associated with an increased risk of thioridazine-induced irreversible pigmentary retinopathy, cardiac arrhythmias, and tardive dyskinesia. The authors suggest precautionary monitoring of thioridazine plasma and other relevant levels and clinical assessments when thioridazine and propranolol are used in combination.

Severe lithium intoxication in a child.

A mentally retarded six-year-old child became severely intoxicated with lithium carbonate whilst on maintenance lithio-therapy for control of aggressive behaviour in an institutional setting. His lithium level of 5.15 mmol/l returned to normal after two weeks. Treatment consisted of an initial saline infusion but was otherwise supportive. Although lithium toxicity is rare in children this may be because it had been used infrequently and cautiously. We feel his young age and situation accounted for some of the severity of his intoxication, and wish to stress the potential toxicity of lithium when used under these circumstances.

The management of chronic behavior disorders in mentally retarded adults with lithium carbonate.

The authors review the medical literature and present two case histories regarding the efficacy of lithium carbonate in the treatment of chronic behavior disorders in mentally retarded adults. They conclude that the available data lend tentative support for the use of lithium to manage behavior disorders in retarded individuals which are characterized by lifelong hyperactivity, aggressiveness, and/or self-mutilation. They recommend that, when lithium is used for this indication, a blood level of approximately 1.0 mEq/1 is necessary, and that all patients be given a drug-free trial once a therapeutic effect has been achieved in order to assess the continued need for treatment. Etiological issues, a possible mechanism of action involving lithium's effect on CNS serotonergic activity, and areas for future research are discussed.

[O2 multistep method as a supplement to therapy of standard brain energy balance disorders]. / Die O2-Meherschritt-Methodik als Ergänzung der Standard-Therapie gegen Energiebilanzstörungen des Gehirns

The possibility of improving the brain's energy state by the O2 multistep method is discussed. An outline is given of several variations of the O2 multistep method, and this is followed by a discussion of the results of studies of the increase and decrease in concentration of high-energy phosphates in the brains of rats during and after the O2 multistep process. In conclusion, the author reports a twin series of tests where psychic irritations lasting for a short time only were triggered and in which such irritations were suppressed through using the O2 multistep procedure.