Myotoxicity and neurotoxicity during clozapine treatment.

Some recent studies have shown that clozapine (CLZ) has myopathic side effects and causes alterations in motor force control. The aim of this study was to evaluate the neurologic and electrophysiologic characteristics of patients with schizophrenia who are undergoing long-term CLZ treatment. Ninety-four patients with schizophrenia treated with CLZ for 18.

Prospective evaluation of circulatory levels of catecholamines and serotonin in neuroleptic malignant syndrome.

Objective: Neuroleptic malignant syndrome (NMS) may be associated with a dysregulation of the catecholaminergic and serotonergic systems. The objective of the present study was to evaluate prospectively the circulatory levels of serotonin (5-HT), epinephrine (E) and dopa in patients suffering from NMS.

Method: Platelet-poor plasma (PPP) levels of serotonin, epinephrine and dopa in eight NMS patients were measured twice: in the acute state and in the state of remission.

The patient's right to know, in the 1996 Israel law for the rights of the patient: the pains of progress.

The 1996 Israel Law for Patients' Rights, Sections 21 and 22, introduces to the field of health legislation two new entities: internal examination committees and quality-control committees. The former are to be established when there is a need to investigate unusual, irregular or exceptional events related to diagnosis and/or treatment. Furthermore, the 1996 Law directs the internal examination committee to reveal its findings to the patient or to his representatives.

Frequency of neuroleptic malignant syndrome in a large psychiatric hospital in Moscow.

A ten-year prospective survey of neuroleptic malignant syndrome (NMS) was performed in a major psychiatric hospital (1,510 beds) in Moscow. All inpatients who developed a persistent and severe extrapyramidal rigidity accompanied by fever after exposure to neuroleptic medication were screened for NMS. The diagnosis of NMS was established according to Levenson's criteria and at a later stage all NMS cases were reevaluated using the DSM-IV research criteria.

[Cyclic vomiting syndrome in children].

Cyclic vomiting syndrome in children is a manifestation of various etiologies, including gastroenterological and renal disorders, central and autonomic nervous system abnormalities, as well as metabolic and endocrine dysfunction. Frequently no organic cause is found. Personality profiles of children with cyclic vomiting reveal perfectionism, competitiveness, and aggressive behavior.

Combined electroconvulsive-clozapine therapy.

We reviewed 36 reported psychiatric patients who were treated with a combination of electroconvulsive therapy (ECT) and clozapine. The indication of the ECT-clozapine treatment was resistance to classical antipsychotic agents, clozapine, or ECT alone. Sixty-seven percent of the patients benefited from the combined treatment.

The effect of long-term antipsychotic treatment on the body weight of patients suffering from chronic schizophrenia: clozapine versus classical antipsychotic agents.

The aim of this study was to evaluate the effect of long-term clozapine treatment on body weight changes in neuroleptic-resistant chronic schizophrenic patients and to compare it with that of classical antipsychotic agents. The body mass index (BMI) of 96 neuroleptic-resistant chronic schizophrenic patients was calculated before the beginning and after long-term (mean +/- SD 1.7 +/- 1.

Circulatory levels of catecholamines, serotonin and lipids in attention deficit hyperactivity disorder.

Attention deficit hyperactivity disorder (ADHD) may be associated with a dysregulation of the catecholaminergic and serotonergic systems. Furthermore, ADHD is frequently complicated by aggressive impulsive behaviour, which is suggested to be related to low serum cholesterol levels. We examined the relationship between blood serotonin, norepinephrine, dopa and lipid levels and the degree of hyperactivity, impulsiveness, lack of concentration, and aggressiveness in boys with ADHD of low and high severity as determined by a specially designed formulated scale based on the DSM-IV criteria for ADHD.

Low platelet-poor plasma concentrations of serotonin in patients with combat-related posttraumatic stress disorder.

Background: Combat-related posttraumatic stress disorder (CR-PTSD) is associated with a dysregulation of various neurotransmitter systems.

Methods: We assessed levels of platelet-poor plasma (PPP) norepinephrine (NE), and serotonin (5-HT), and 24-hour urinary excretion of NE, dopamine (DA), and homovanillic acid (HVA) in 17 male outpatients with untreated chronic CR-PTSD (age, 33.1 +/- 7.

Lateral preference in post-traumatic stress disorder.

Background: We assessed lateral preference in 80 male patients with combat-related post-traumatic stress disorder (PTSD) and in 100 healthy age-matched male controls.

Methods: Hand, foot, eye and ear preferences were examined, using the Edinburgh Handedness Inventory-Modified and the Coren Inventory of Lateral Preference.

Results: Mixed lateral preference was noted in significantly more PTSD patients than controls (65 v.

Reduction of aggressiveness and impulsiveness during clozapine treatment in chronic neuroleptic-resistant schizophrenic patients.

Aggressive and impulsive behavior is frequently observed in schizophrenic patients. Previous studies suggest that impulsive aggression may be the most common behavioral correlate of central serotonergic system dysfunction. This study was aimed to determine if clozapine, an atypical antipsychotic agent with potent serotonergic antagonistic properties, can reduce impulsiveness and aggression in neuroleptic-resistant chronic schizophrenic patients.

Elevated levels of serum interleukin-1 beta in combat-related posttraumatic stress disorder.

Levels of serum interleukin-1 beta (IL-1 beta) and soluble interleukin-2 receptor (sIL-2R) were assessed in 19 male patients with combat-related posttraumatic stress disorder (PTSD) in comparison to 19 age- and sex-matched healthy volunteers. Serum IL-1 beta levels (but not sIL-2R) were significantly higher (p < .001) in the PTSD patients than in the controls.

Trihexyphenidyl treatment of clozapine-induced hypersalivation.

The objective of this study was to investigate the efficacy of the anticholinergic agent trihexyphenidyl in the treatment of clozapine-induced hypersalivation. Fourteen chronic schizophrenic patients who exhibited nocturnal hypersalivation during clozapine treatment were coadministered trihexyphenidyl (5-15 mg/day, at bedtime) for 15 days. Salivation was assessed by a single-item 5-point scale.

Clozapine treatment for neuroleptic-induced tardive dyskinesia, parkinsonism, and chronic akathisia in schizophrenic patients.

Background: Previous studies on the use of clozapine in neuroleptic-resistant chronic schizophrenic patients have demonstrated positive effects on tardive dyskinesia but were less conclusive about chronic akathisia and parkinsonism. The aim of the present study was to investigate the short-term (18 weeks) efficacy of clozapine in neuroleptic-resistant chronic schizophrenic patients with coexisting tardive dyskinesia, chronic akathisia, and parkinsonism.

Method: Twenty chronic, neuroleptic-resistant schizophrenic patients with coexisting tardive dyskinesia, parkinsonism, and chronic akathisia were treated with clozapine.

An open trial of clozapine in neuroleptic-resistant childhood-onset schizophrenia.

Background: Studies performed with schizophrenic adults who were resistant to classical neuroleptics showed improvement in 30% of the patients when treated with clozapine. Very early onset schizophrenic patients benefit only partially from conventional antipsychotics and are at increased risk of developing extrapyramidal symptoms; clozapine may offer an alternative treatment for these patients.

Methods: Eleven neuroleptic-resistant children (< 13 years) with schizophrenia were treated with clozapine.

Psychopathology in dementia.

The purpose of this overview is to describe the psychological and behavioral symptoms of dementia reported in the professional literature in recent years. This subject, a relatively neglected one, is considered in order to focus attention on a number of the symptoms most troublesome to the demented person's surroundings which lead to his/her hospitalization, with all the implications this has on the patients, their families and the community's health budget. To carry out an early and effective intervention, professionals need to define and recognize these symptoms and gain experience in treating them, either by intervention in the environment or by medication.

Functional hemisphere imbalance in patients with paranoid or disorganized schizophrenia.

We assessed hemisphere function in right-handed male chronic schizophrenic patients using dichotic listening tests. We evaluated digit, tonic and transitional tests in patients with paranoid schizophrenia (n = 8), patients with disorganized schizophrenia (n = 8) and in control subjects (n = 8). The dichotic listening analysis discriminated between paranoid and disorganized schizophrenia.

Further insights into transsexualism.

Transsexualism is a challenging entity posing diagnostical, etiological, ethical and moral questions with no general consensus of opinion and a controversial management policy. The present article tries to deal with these questions by drawing a parallel with another psychiatric syndrome in which there is also a disturbance in body image, namely anorexia nervosa. The parallel is at the level of clinical presentation, psychodynamic etiology and their common socioepidemic dimension.

The use of non-mental health professionals volunteers in a psychiatric hospital.

Volunteers' activities in psychiatric institutions is becoming a widespread phenomenon in Israel with different modalities and approaches implemented in a variety of settings. This paper presents and discusses the historical roots of volunteering, its potentialities and also some of the characteristics of existing programs.

Problems in implementing the 1991 Treatment of Mental Patients Law in Israel.

The application of the new Treatment of Mental Patients Law, 1991, has been responsible for significant changes in the work of mental health workers, in particular those involved in the often complex process of civil commitment for examination/hospitalization. The experience of implementing this new law shows that some of the clauses related to this process contain controversial concepts. These concepts will be the focus of this paper.