RESUMO
Twenty hospitalized patients have been treated for acute mania with doses of 450-750 micrograms/day of clonidine (an alpha 2-adrenergic agonist), for one month. The tolerance to the given doses was excellent. A marked decrease of the manic symptoms was noted in 65% of the patients during the first 10 days of the treatment. The response was prompt and maintained for the whole period of the research, the clonidine being efficient on the whole scale of the manic syndrome. The sedating effect was much lower than in the case of neuroleptics; it is quite likely that the clonidine could represent an advance in the acute treatment of manic patients.
Assuntos
Transtorno Bipolar/tratamento farmacológico , Clonidina/administração & dosagem , Doença Aguda , Administração Oral , Adulto , Avaliação de Medicamentos , Quimioterapia Combinada , Tolerância a Medicamentos , Feminino , Haloperidol/uso terapêutico , Humanos , Lítio/uso terapêutico , Masculino , Pessoa de Meia-Idade , Fatores de TempoRESUMO
Twenty schizophrenia-like psychotic patients suspected of epilepsy were explored using EEG techniques (recordings in the 10-20 International System, source derivation, EEG mapping and EEG spectral reaction mapping by photic and somesthetic stimulation). In 16 of them, latent epileptic disorders were found. EEG spiking foci could be located either: (a) in temporal, (b) fronto-basal, or (3) in the sagittal-line leads. A corresponding associated dysrhythmia was clearly revealed by EEG mapping. On EEG spectral reaction mapping a suggestive aberrant displacement of the area of maximal sensory response was found. These EEG disorders were in significant relation with the psychotic syndrome observed in the respective group of patients: (a) patients with fronto-basal (temporal anterior) foci were prevalently paranoid; (b) patients with temporal lobe foci were prevalently depressive; (c) patients with sagittal line (singular) foci presented a predominantly expansive, hypomanic behaviour. The study shows the importance of normal fronto-limbic circuits for the preservation of mental health.
Assuntos
Mapeamento Encefálico , Encéfalo/fisiopatologia , Eletroencefalografia , Epilepsia/fisiopatologia , Transtornos Psicóticos/fisiopatologia , Adulto , Transtornos Psicóticos Afetivos/diagnóstico , Transtornos Psicóticos Afetivos/fisiopatologia , Mapeamento Encefálico/métodos , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/fisiopatologia , Eletroencefalografia/métodos , Epilepsia/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Paranoides/diagnóstico , Transtornos Paranoides/fisiopatologia , Transtornos Psicóticos/diagnósticoRESUMO
The authors have treated 20 patients hospitalized for acute manic disorders with 450-750 micrograms of clonidine per day for a period of one month. The tolerance to the drug was excellent. A marked decrease in manic symptoms was noted in 65% of the patients after the first ten days of therapy. The response was rapid and was maintained for the entire duration of the study, and clonidine was efficient for all the symptoms of the manic syndrome. The supra-sedation effect was much lower than with neuroleptics, and clonidine could be considered to represent a practical progress in the acute therapy of manic patients. Clonidine, usually employed as an anti-hypertensive drug, is an alpha-2-adrenergic agonist. It is believed that this property decreases the neural transmission by noradrenaline by stimulating pre-synapsis inhibitor receptors.
