Repeated dexamethasone suppression test during depressive illness. Normalisation of test result compared with clinical improvement.

The use of cardiovascular medications can have a variety of neuropsychiatric consequences. Many cardiovascular agents cause higher rates of fatigue and sedation than placebo, and case reports of medication-induced mood syndromes, psychosis, and cognitive disturbances exist for many cardiovascular drugs. Depression has been associated with P3-blockers, methyldopa, and reserpine, but more recent syntheses of the data have suggested that these associations are much weaker than originally believed. Though low cholesterol levels have been associated with depression and suicide, lipid-lowering agents have not been associated with these adverse effects. Finally, cardiovascular medications may have beneficial neuropsychiatric consequences; for example, the use of clonidine in patients with attention deficit-hyperactivity disorder, the use of prazosin for patients with post-traumatic stress disorder; and the use of propranolol for performance anxiety and akathisia.

Neuropsychiatric consequences of cardiovascular medications

Levels of protein and several enzymes involved with neurotransmitters Were determined in 15 brain areas of subjects diagnosed as chronic schizophrenics (CS), organic brain syndrome (OBS, an older age group), or mentally normal (N) prior to death. Enzymes studied were total cholinesterase (TChE), acetylcholinesterase (AChE), pseudocholinesterase (ChE), choline acetyltransferase (ChAc), monoamine oxidase (MAO), and N-methyltransferase (NMT). The only significant decrease in protein was in the temporal cortex of the OBS group. The septal area of CS patients ( [ill] The majority of brain areas sampled showed no significant differences in enzyme activity among the three groups. The differences that were observed must be considered preliminary and subject to further validation under better controlled conditions.

https://jamanetwork.com/HttpHandlers/ArticlePdfHandler.ashx?journal=PSYCH&articleId=490954&pdfFileName=archpsyc_29_2_004.pdf

Various Enzymes Involved With Putative Neurotransmitters: Regional Distribution in the Brain of Deceased Mentally Normal, Chronic Schizophrenics or Organic Brain Syndrome Patients

Man kann nicht behaupten, die psychiatrische „Gegenwart“ habe das Problem der sog. symptomatischen Psychosen wesentlich gefordert. Entsinnt man sich heute der klassischen Darstellung des Gegenstandes durch Bonhoeffer (1912), seines Bruches mit der uberlieferten, bis dahin feststehenden Uberzeugung von der symptomatologischen Trennbarkeit von Fieberdelirien, Infektionsdelirien, Vergiftungs- und Erschopfungspsychosen usw., betrachtet man seine klare Herausarbeitung der 5 grosen Syndrome des Delirs, der epileptischen Erregung, des Dammerzustandes, der Amentia und der Halluzinose, seine erstaunlich weitsichtige Erkenntnis, das auch maniforme, katatone und paranoide Erscheinungen durchaus zum Bilde des exogenen psychischen Reaktionstypus gehoren konnen, und endlich seine Vermutung eines atiologischen „Zwischengliedes“ zwischen der Noxe und dem Syndrom, dessen Entstehung im Organismus selbst zu suchen sei — dann will es scheinen, als ware die Psychiatrie der „Gegenwart“ nicht allzu weit uber diejenige der Vergangenheit hinausgewachsen.

Die symptomatischen Psychosen

Pharmacology of serotonin as related to anesthesia.

Considerable publicity has recently been given to the newer hypotensive agents. The most promising of these drugs, hexamethonium, a ganglionic blocking agent, and hydralazine (Apresoline) hydrochloride, a sympathetic blocking agent with other complex actions, are now being used extensively in treatment of patients with essential hypertension.1A third compound, Dibenzyline (N-phenoxyisopropyl-N-benzyl-β-chloroethylamine) hydrochloride is an orally effective, sympathetic blocking agent that produces a fall in blood pressure when the patient is in an upright position, and is capable of preventing wide fluctuations in pressure as well as relieving symptoms.2All of these drugs may produce severe reactions if they are not used under controlled conditions. Grimson and his associates3and Schroeder4have recently published reports advising caution in the use of these drugs. We have encountered numerous side-reactions of these three drugs, used either alone or in combination, in a group of carefully selected patients being treated

Acute psychosis as a complication of hydralazine therapy in essential hypertension

Reading this book is a frustrating experience. It is probably the best source of authoritative knowledge about the biochemistry of mental illness. It is encyclopedic in scope. Yet it leaves the clinician feeling dissatisfied. Why should this be? The editor, Dr. Himwich, has admirably described the present status of indoleamines in schizophrenia and depression. Drs. Snezhevsky and Vartanyan have reviewed the role of erythrocyte permeability in schizophrenia and given us the Russian approach to classification. Dr. Schildkraut has made an exhaustive, scholarly review of catecholamine metabolism and affective illness. Dr. Gottlieb and his co-workers have reviewed their provocative hypothesis about the role of γ2 globulin in schizophrenia and have suggested that this substance is out of control in the schizophrenic just as glucose is out of control in the diabetic. Dr. Heath has brought up to date his immunological theory of the etiology of schizophrenia and the possibility of an

Biochemistry, Schizophrenias, and Affective Illness

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Acute psychosis as a complication of hydralazine therapy in essential hypertension

Biochemistry, Schizophrenias, and Affective Illness