A comparison of carbamazepine Divitabs and a normal carbamazepine preparation in psychiatric and oligophrenic patients.

Twenty patients who had become accustomed to a stable oral carbamazepine dose participated in an open, randomized, two-centre, cross-over study, in which ordinary tablets and Divitabs (a new sustained release preparation) were compared. Pharmacokinetic parameters, seizure control, effects on the behavioral state, and tolerability were considered. A smaller Area Under the Curve (AUC) during the Divitabs period was the only pharmacokinetic parameter with a significant difference (p less than 0.05). However, all patients with peak/trough carbamazepine serum level ratios of at least 1.30 after the intake of the normal tablet-form (n = 9) showed a smaller peak/trough ratio during the Divitabs period. No remarkable differences were found between the normal carbamazepine preparation and Divitabs regarding seizure frequency and tolerability. The behavioral state improved in four patients during the Divitabs period, whereas no enhancement was noticed during the normal-tablet period in any of the subjects. Although this study produced no evidence that carbamazepine Divitabs were at all advantageous for the trial population in general, some of the pharmacokinetic results suggest that a subgroup of the patients would benefit from changing from the normal tablet-form to Divitabs. However, even in this subgroup, the usage of Divitabs was not shown to result in obvious clinical benefits.

Is diltiazem effective in treating the symptoms of (tardive) dyskinesia in chronic psychiatric inpatients? A negative, double-blind, placebo-controlled trial.

Calcium channel blockers, antiarrhythmic drugs, such as verapamil and diltiazem, may decrease the symptoms of tardive dyskinesia. The efficacy and safety of administering 60 mg diltiazem hydrochloride, four times daily for a period of 3 weeks, was studied in a random, double-blind, crossover trial in which the drug was compared with placebo in 17 neuroleptic-treated, chronic psychiatric inpatients of both genders with (tardive) dyskinesia. The severity of the dyskinesia was assessed using the Abnormal Involuntary Movement Scale. Neither diltiazem nor placebo produced a significant decrease in the severity of the dyskinesia. Diltiazem did not influence the psychiatric state of the patients, nor did it have a significant effect on either the blood pressure or electrocardiographic parameters. No significant adverse drug reactions were elicited.

Psychomotor retardation in depression, a pilot study.

Several studies have demonstrated that psychomotor retardation is an important sign of the major depressive episode, both from a diagnostic point of view and as a predictor of treatment outcome. However, it is uncertain to what extent psychomotor retardation is specific for the major depressive episode. A heterogeneous group of psychiatric patients (n=26) was studied using a rating scale developed specifically to assess psychomotor retardation (RRS). The 13 patients suffering from a major depressive episode had a significantly higher RRS score than patients with another diagnosis. Furthermore, in the depressive subjects the severity of the depression (measured by means of Hamilton's depression rating scale) appeared to correlate with the severity of the psychomotor retardation. Cognitive features of psychomotor retardation were mainly responsible for the more severe psychomotor retardation in the depressive patients. Surprisingly. Hamilton's depression scale which was used in this study does not pay much attention to these aspects.