[Clinical pharmacokinetics of haloperidol decanoate. Comparison with other prolonged-action neuroleptics]. / Pharmacocinétique clinique du décanoate d'halopéridol. Comparison avec celles des autres neuroleptiques d'action prolongée.

Precise pharmacokinetic data of long-acting neuroleptics: apparent half life (T 1/2), time of peak plasma concentration (Tmax), bioavailability, has been a major contribution to determine optimal dosage of the drug. If the aim of the depot neuroleptic is to obtain a stable plasma concentration of the neuroleptic after I.M. injection of the ester form equivalent to that following oral administration, it is logical to obtain the same pharmacological effect; this is true for haloperidol decanoate. Mean value of T 1/2 of clopenthixol decanoate and haloperidol decanoate are 19 and 21 days, respectively, they thereby justify monthly administration. Flupenthixol decanoate and fluphenazine enanthate should be injected with dosing intervals of 3 and 1 weeks, respectively in respect with their half-lives: 17 and 4 days. Fluphenazine decanoate have a half-life of 14 days, however, the longer time the treatment, the longer the apparent half-life, suggesting to reduce the dose or to enlarge the dosing interval. Optimal dose has been determined from the bioavailability of the oral formulation and the interval between two injections, it averages 15, 20 times the oral daily dose for haloperidol decanoate. A lower conversion factor is frequently used (0.5 to 5 times) for other depot-neuroleptics such as pipotiazine palmitate, fluphenazine enanthate or decanoate; these low factors are not entirely explainable by the low bioavailability of the oral forms and produces more lower plasma concentration than after oral administration.

[Open preliminary study of new antidepressive compound: citalopram]. / Etude préliminaire en ouvert d'un nouveau composé antidépresseur: le citalopram.

The antidepressant effect of citalopram, a specific inhibitor of the reuptake of serotonin, was explored in an open phase II study involving twenty-one patients hospitalized for depression. Fourteen patients responded, six did not and one was excluded from the study. These preliminary results suggest that citalopram is an effective, well tolerated antidepressant.

[Efficacy and tolerance of alprazolam and bromazepam in flexible doses. Double-blind study in 119 ambulatory anxious patients]. / Efficacité et tolérance de l'alprazolam et du bromazépam à doses ajustables. Etude en double aveugle chez 119 sujets anxieux ambulatoires.

Double-blind study comparing efficacy and safety of alprazolam and bromazepam in 119 ambulatory anxious patients receiving flexible dosage. 119 ambulatory anxious patients (global score on the Hamilton anxiety rating scale between 18 and 35) have been included in this double-blind trial (duration 4 weeks) comparing alprazolam and bromazepam given at flexible dosage. The global score on the Hamilton anxiety rating scale improved by 57.8% and 55.3% for alprazolam and bromazepam respectively. The percentage of therapeutic success according to the psychiatrist and the patient were respectively 82.7% and 79.3% for alprazolam compared to 74.1% and 71.9% for bromazepam. Fewer side-effects were recorded in the alprazolam group (97) than in the bromazepam group (120) and global safety of alprazolam seemed superior (p = 0.07). At trial-end, mean dosage reached 1.70 mg/day for alprazolam and 10.35 mg for bromazepam, but no correlation was found between anxiety intensity and optimal daily dosage used; however, a correlation has been found between the improvement of the overall Hamilton rating scale score and the dosage given (p = 0.02). The overall results suggest that the efficacy/safety ratio is better for alprazolam.

[Effects of thymo-analeptics and acceptability of amineptin compared to those of imipramine]. / Etude des effets thymo-analeptiques et de l'acceptabilité de l'amineptine comparés à ceux de l'imipramine.

Amineptine and imipramine were compared in a double-blind controlled trial carried out in 52 depressed patients over a period of 30 days, with daily doses of amineptine ranging from 100 to 300 mg or of imipramine ranging from 50 to 150 mg. Global assessment of response to treatment and Hamilton rating scale scores showed no significant difference between amineptine and imipramine. Both drugs were effective as soon as the 7th day of treatment, and their efficacy constantly increased during the 30 days of the observation. The clinical acceptability of amineptine is superior to that of imipramine: in the amineptine group acceptability was considered excellent in 67% of the cases; in the imipramine group acceptability was considered excellent in 48%. 8% of the patients in the imipramine group were withdrawn from the trial because of intolerance.

[Perphenazine enanthate. Results of a 1-year open multicenter study]. / Enanthate de perphénazine. Résultats d'une étude ouverte multicentrique d'un an.

The results of a one-year, open multicenter trial of perphenazine enanthate, a sustained-release neuroleptic drug, are reported. 240 patients (62% suffering from schizophrenia) were included in the study and 144 were followed during the 12-month period. The usual adverse reactions associated with sustained-release neuroleptic drugs were observed. Total and partial BPRS ratings showed that improvement (expressed as a percentage) after 12 months' treatment was similar for systematized chronic delusions, paranoid schizophrenia and hebephrenia. However, the onset of therapeutic activity was different in these three groups of patients. Maximum therapeutic activity, as defined by the BPRS rating, was obtained within 4 months in chronic delusions whereas schizophrenia improved more progressively. Such patients therefore require prolonged treatment before the therapeutic activity of a sustained-release neuroleptic drug can be assessed.

[Treatment of anxiety with prazepam, 40 mg. A controlled study versus lorazepam]. / Traitement de l'anxiété par le prazépam 40 mg. Une étude contrôlée contre le lorazépam.

Anxiolytic effects and tolerance of a four weeks treatment with prazepam (single dose of 40 mg in the evening) and with lorazepam (3 daily doses of 1.25 mg) are compared in a double blind study. Patients were treated by psychiatrists and were suffering from neurotic anxiety. Evaluation for therapeutic efficacy used a clinical global improvement scale and the Hamilton Anxiety Scale. Evaluation for side effects used the side effects symptoms check list. Anxiolytic effects of prazepam and lorazepam are not significantly different. Tolerance of the two treatments is comparable. The side effects are essentially an undesirable sedative action.

[Haloperidol decanoate. Results of an open-ended multicentric study in chronic psychotic states]. / Décanoate d'halopéridol. Résultats d'une étude ouverte multicentrique dans les états psychotiques chroniques.

UNLABELLED: An open multicentric study of 196 in-patients was carried out in 9 centres. After an initial stabilization (min. 15 days) with oral haloperidol, patients received haloperidol decanoate IM for at least 24 weeks (or a minimum of 9 injections). RESULTS: - esterification of haloperidol increased the duration of its efficacy (interval between 2 injections: average 4 weeks) without interfering with its therapeutic activity (global appreciation scale, BPRS at each injection and at the end of the treatment); - equivalent quantities of haloperidol injected at a time were 15 to 20 times those administered daily during the initial stabilisation period; - side-effects were not different with haloperidol decanoate as compared to those of the previous period (haloperidol).

[Psychiatric aspects in Papua New Guinea]. / Aspects psychiatriques de la Papouasie Nouvelle-Guinée.

The author presents the historical, legal, administrative and clinical aspects of psychiatry in Papua New Guinea. He also outlines the traditional psychiatry of Baruya tribe (Eastern Highlands province). He concludes on the adaptation of psychiatry system concerning the characteristics of this country. Finally, the author sets the problem of psychiatric diagnosis and epidemiology for the countries engaged into an acculturation process.

[Non-psychotic impairment and neurotic impairment (thoughts on the place of this pathology in the long-term outcome of civil servants)]. / L'invalidité non psychotique et la névrose invalidante (réflexions sur la place de cette pathologie dans les congés de longue durée des fonctionnaires).

UNLABELLED: The purpose of the authors was an attempt to draw a frame of non psychotic patients in a invalidating process. METHOD: they analysed a population of 144 employees from the city of Paris who had been put out of work for a long period of time on the basis of psychiatric impairement criteria were sociological, professional, life events and medical. RESULTS: the profile of this type of patient is likely to be a women rather than a man, she is in her forties, comes from a below average background, has been working for about fifteen years; the illness has been going on for some five years has been off work for two years, two out of three cases the reason is depressive pathology. The authors concluded neurosis invalidated more through secondary depression than through neurosis mechanisms.

[Neurotropic anisamides (author's transl)]. / Les anisamides neurotropes.

Evolution of the opinion of the french clinicians, during the 10 last years, towards the chemical group of the neurotropic anisamides : metoclopramide, sulpiride, sultopride, and tiapride. The good tolerance of these neuroleptic compounds, their low degree of activity on vigilance, are original characteristics of this new group of psychotropic drugs : polyvalent, or "multiple potential" neuroleptic agents.

Dimensionality, responsiveness and standardization of the Bech-Rafaelsen Mania Scale in the ultra-short therapy with antipsychotics in patients with severe manic episodes.

OBJECTIVE: Typical antipsychotics have their indication in the ultra-short (first week) treatment of severe episodes of mania. In this setting the Bech-Rafaelsen Mania Scale (MAS) was psychometrically compared with the Clinical Global Impression scale (CGI) to assess its ability to measure response. METHOD: Ratings on patients with marked to severe mania (n = 80) who participated in the clinical trials to evaluate the ultra-short antimanic effect of zuclopenthixol acetate were assessed. The MAS was analysed for internal validity (total score a sufficient statistic) and for external validity. RESULTS: The MAS was shown to have a high internal validity showing onset of action already after days of treatment. After 6 days of treatment 53% of the patients responded according to the MAS but only 30% according to the CGI. The difference was statistically significant. CONCLUSION: The MAS has been found to be a valid scale to measure early onset of action and response in the ultra-short antimanic treatment with typical antipsychotics.