Verapamil is not an antidepressant in patients resistant to tricyclic antidepressants.

The effects of a calcium channel blocker (verapamil, 160-320 mg/day for 4 weeks) were studied in seven unipolar major-depressed patients resistant to treatment with tricyclic antidepressants. This regimen of verapamil did not alter either the Hamilton rating scales for depression and anxiety or the Beck depression inventory score in these patients. Thus, verapamil appears devoid of antidepressant properties in patients resistant to tricyclic antidepressants.

Chronicle of an announced death (thoughts on mid-adulthood).

Middle age can be considered not as the onset of decline, but as a stage of expansion. There has been very little written in the literature on the developmental stages man can expect to experience during his adult life. The criteria and parameters for identifying the level of maturity have relied on terms extracted from developmental theories of childhood.

Seizures induced by combined levomepromazine-fluvoxamine treatment.

We report a case of combined levomepromazine-fluvoxamine treatment-induced seizures. It seems that combined treatment of fluvoxamine with phenothiazines may possess proconvulsive activity.

Survey of smoking habits and attitudes of patients and staff in psychiatric hospitals.

One hundred and six staff members and 150 patients of three psychiatric hospitals in Israel were administered a smoking habit and attitudes questionnaire. Upon analyzing the data, staff members and patients made up a very high percentage of smokers, 48.1 and 76%, respectively.

The velvet reform of the British medical services: implications for Israeli psychiatry.

Since 1990, the United Kingdom has been reforming its public medical services aiming at decentralization and more competition among the providers of services. To achieve these aims two major administrative changes are being introduced: a) increased direct cooperation between providers and consumers; b) the creation of self-government trusts (similar to the Israeli "taagidim"). Israel is also modifying the structure of its medical services in ways which have some basic similarities to the U.

The psychiatric patient as consumer.

The rocketing cost of good standard modern medicine and the constant strengthening of the consumers' voice are powerful factors behind the world-wide reorganization of medical services with the aim of improving cost-efficiency, quality and accessibility. The assumption of this article is that financial waste, redundancy and obsolence of medical systems are related to the non-participation of patients in the evaluation of the services they consume. These problems are demonstrated and analysed using examples from psychiatry, where the patients and their families constitute a relatively silent consumer group.

Delayed amnesia and disorientation after electroconvulsive treatment.

Memory-related effects of electroconvulsive therapy (ECT) are known to appear immediately after the treatment. The case of a 39-year-old woman who underwent a course of ECT because of a recurrent major depressive disorder is described. After a symptom-free period of 48 hours, transient amnesia developed.