Colchicine reduces the activation of NLRP3 inflammasome in COVID-19 patients.

OBJECTIVE: To evaluate whether colchicine treatment was associated with the inhibition of NLRP3 inflammasome activation in patients with COVID-19. METHODS: We present a post hoc analysis from a double-blinded placebo-controlled randomized clinical trial (RCT) on the effect of colchicine for the treatment of COVID-19. Serum levels of NOD-like receptor protein 3 (NLRP3) inflammasome products-active caspase-1 (Casp1p20), IL-1ß, and IL-18-were assessed at enrollment and after 48-72 h of treatment in patients receiving standard-of-care (SOC) plus placebo vs. those receiving SOC plus colchicine. The colchicine regimen was 0.5 mg tid for 5 days, followed by 0.5 mg bid for another 5 days. RESULTS: Thirty-six patients received SOC plus colchicine, and thirty-six received SOC plus placebo. Colchicine reduced the need for supplemental oxygen and the length of hospitalization. On Days 2-3, colchicine lowered the serum levels of Casp1p20 and IL-18, but not IL-1ß. CONCLUSION: Treatment with colchicine inhibited the activation of the NLRP3 inflammasome, an event triggering the 'cytokine storm' in COVID-19. TRIAL REGISTRATION NUMBERS: RBR-8jyhxh.

Augmentation of haloperidol by ascorbic acid in phencyclidine intoxication.

The authors studied 40 white men with acute phencyclidine (PCP) intoxication. On a random basis, 10 were treated with ascorbic acid, 10 with placebo, 10 with haloperidol, and 10 with a combination of ascorbic acid and haloperidol. While haloperidol was significantly more effective than ascorbic acid, the combination was significantly more effective than either used alone. This combination may have a specific antipsychotic role in the emergency treatment of PCP psychosis.

Antimanic effects of verapamil.

When the authors compared the antimanic effects of verapamil, lithium carbonate, and placebo, no differences were seen between lithium and verapamil and both were more effective than placebo in reducing symptoms. No major side effects emerged during the study.

Comparison of clonidine and lithium in the treatment of mania.

The authors compared the antimanic effects of clonidine with lithium carbonate in a double-blind crossover design with 24 volunteers. Lithium was observed to be more effective than clonidine. Some patients reported experiencing hypotension (N=8) and depression (N=7) while taking clonidine.

Chlorpromazine vs. meperidine in the treatment of phencyclidine psychosis.

Patients with phencyclidine psychosis were treated with two 50 mg injections of either chlorpromazine (N = 10) or meperidine (N = 10). The chlorpromazine-treated group responded more rapidly, but the meperidine-treated group had greater overall improvement. It is suggested that meperidine may have a role in the emergency treatment of phencyclidine psychosis. These findings may provide support for the hypothesis that dopaminergic psychosis is mediated by opioids.

Hyperphagia in premenstrual tension syndrome.

The relationship between premenstrual tension syndrome and dietary intake was studied in a population of 20 young adult women. Caloric intake was measured during the 10 days preceding and following the menstrual cycle. Those women with more severe symptoms recorded a greater increase in caloric intake. Caloric intake during the premenstrual period also increased with age. It is hypothesized that this caloric intake may be due to increased beta-endorphin levels.

Pseudocholinesterase and trait anxiety in premenstrual tension syndrome.

Volunteers (N=71) with premenstrual syndrome (PMS) were given the Peck-Abraham PMS Questionnaire and separated by resulting scores into mild, moderate, and severe groups. Fourteen subjects were randomly selected from each group. Pseudocholinesterase serum levels were measured on the first day of menses for all group members. Trait anxiety was measured by the State Trait Anxiety Inventory (STAI). Pseudocholinesterase, a possible marker for trait anxiety, was found elevated in 6 of 14 (43%) of the severe PMS subjects, in 2 of the 14 (14%) moderate PMS subjects, and in none of the mild PMS subjects. Trait anxiety was found in 8 of these subjects. None of the subjects with mild PMS showed trait anxiety, while 25% of those with moderate PMS and 75% of those with severe PMS showed trait anxiety. No subject with mild PMS had trait anxiety. In this study PMS is treated as a trait-dependent form of anxiety.

Treatment of depression in chronic cocaine and phencyclidine abuse with desipramine.

An open field trial was conducted comparing desipramine and an active placebo in separate populations of chronic cocaine and phencyclidine (PCP) abusers, who discontinued their abuse. Subjects who received desipramine showed a decrease in depressive symptoms after a 20-40 day period regardless of whether they abused PCP or cocaine.

Comparison of haloperidol and chlorpromazine in the treatment of phencyclidine psychosis.

Phencyclidine (PCP) is a widely abused drug inducing a psychosis relieved by such dopamine antagonists as the neuroleptics. In the current study we compared two neuroleptics which act at different dopamine receptor sites. Haloperidol, a DA-2 receptor antagonist, and chlorpromazine, a DA-1 antagonist, were used to treat a total of 20 patients who experienced a phencyclidine psychosis. Ten patients each received two doses of one or the other neuroleptic on an alternating basis. Haloperidol 5 mg i.m. was shown to be superior to chlorpromazine 50 mg i.m. in relieving all signs of psychosis. The authors hypothesize that the DA-2 receptor is site-specific for PCP.

Depressed men's lower ability to interpret nonverbal cues: a preliminary study.

The ability to interpret nonverbal facial cues was tested with 20 depressed males prior to treatment. Each subject and matched control was asked to interpret videotaped facial cues of individuals engaged in a gambling task. Interpretive ability was significantly lower for the nontreated depressed white men than for their matched controls.

Reception of nonverbal communication in alcoholics.

The ability to interpret nonverbal facial cues was tested in 21 young male, primary alcoholics and a group of matched controls. All Ss were asked to view videotapes of individuals gambling and to determine only on the basis of facial cues the amount of monetary reward offered to videotaped individuals during a specific trial. On the basis of accuracy, the alcoholic group was determined to be significantly better than the control group at receiving the nonverbal cues.

Contemporary drugs of abuse.

The physician needs to know the signs, symptoms and recommended treatments of drug overdoses. Overdose of hallucinogens usually does not require drug therapy. Overdose of amphetamines ("uppers") may be complicated by the presence of PCP, a dissociative substance. It is important for the physician to be familiar with the street terminology for contemporary drugs of abuse and to be aware of how users obtain these drugs.

Space-based abstinence: alleviation of withdrawal symptoms in combinative cocaine-phencyclidine abuse.

Twenty male combinative cocaine free-base/phencyclidine (space-base) abusers were studied for forty-five days, in a double-blind design. Treatment with desipramine was significantly more effective than placebo in alleviating abstinence symptoms. This study tends to support the catecholamine-depletion hypothesis of cocaine and phencyclidine withdrawal.

Defective response to social cues in Möbius' syndrome.

A case of Möbius' syndrome is presented, with the mask-like facies and poor social relationships consistent with this diagnosis. Previous thought has implicated the inability to transmit facial cues as a cause for impoverished social functioning. The authors hypothesize that the inability to transmit is related to an inability to receive cues. They repeated a paradigm used previously to test ability to interpret facial cues. The otherwise intelligent patient could not perform a task previously performed by approximately 300 other subjects. These findings suggest that the rehabilitation of Möbius patients should include education in interpreting social cues.