Differential effect of serum from bipolar versus schizophrenic patients on spontaneous acetylcholine release at mammalian neuromuscular junction.

OBJECTIVE: The diagnosis of bipolar disease frequently requires a long time since the age of onset, especially because the disease is misdiagnosed with schizophrenia. The aim of the present work was to investigate whether sera from bipolar patients have an active substance that allows making a fast identification of the disease. METHODS: Sera from healthy volunteers, euthymic and non-stabilized bipolar patients, and schizophrenic patients were passively transferred into CF1 mice and after 2 day injections, MEPP frequency from diaphragm muscles was recorded. The same procedure was performed with sera fraction of high and low MW (cut-off 3000). RESULTS: Sera from non-stabilized bipolar patients induced a decreased MEPP frequency and occluded the presynaptic inhibitory effect of the specific adenosine A(1) receptor agonist 2-chloro-N(6)-cyclopentyl-adenosine (CCPA) in the recipient mice, while in the euthymic bipolar group spontaneous secretion reached control values although the action of CCPA was still prevented. Similar results were obtained with low MW sera fraction from euthymic and non-stabilized bipolar patients. The addition of adenosine deaminase to the sera fraction prevented the modification of spontaneous ACh release. In mice injected with sera from schizophrenic patients, MEPP frequency was within control values and CCPA induced its typical inhibitory action. CONCLUSIONS: These results indicate that bipolar patients contain in their blood an active substance compatible with adenosine, which was able to modify spontaneous ACh release in the recipient mice. This effect was not observed with sera from healthy volunteers and schizophrenic patients. The increase of adenosine concentration may result from synaptic hyperactivity that presumably plays a role in the symptoms of bipolar disorder and/or may derive from peripheral cells through a more general mechanism. SIGNIFICANCE: The different results obtained with bipolar and schizophrenic sera raise the possibility that the passive transfer model could be used as a diagnostic test in the future.

Lack of extrapyramidal side effects predicts quality of life in outpatients treated with clozapine or with typical antipsychotics.

We compared symptom severity and quality of life (QOL) in schizophrenic patients adequately treated with typical antipsychotics (TAP) or clozapine (CZP). Groups did not differ in symptom severity or QOL. Clozapine caused fewer extrapyramidal symptoms. Negative and extrapyramidal symptoms predicted QOL. Similar outcome in both groups suggests a common ceiling to antipsychotic efficacy.

[Mental Health Residents: Knowledge on prices and availability of drugs they prescribe]. / Conocimiento de residentes de Salud Mental sobre precios y disponibilidad de los fármacos que prescriben.

OBJECTIVES: The cost and availability of psychiatric drugs is an important aspect for patient adherence to treatment. Therefore, Psychiatry Residents were interviewed about what drugs were most usually prescribed by them, their estimated price, free availability in their hospitals and access to literature about drug costs in the services. MATERIALS AND METHODS: During the VI Congress of Residents in Mental Health of the Metropolitan Area of Buenos Aires, a structured interview was administered to Psychiatry Residents. A form was used containing open and close questions. The questionnaire was not self administered. Sixty eight Psychiatry Residents of fourteen Public Hospitals of the Capital and Province of Buenos Aires were interviewed. RESULTS: The drugs most frequently chosen in each pharmacological group were: haloperidol 24 percent, fluoxetine 43 per cent, clonazepan 39 percent and carbamazepine 34 per cent 82 percent of the questions regarding the knowledge about prescribed drug costs were incorrect. 57 per cent of the drugs chosen were not available at the Hospitals whereas 69 per cent of the drugs that were never selected were available. CONCLUSIONS: In this descriptive study, we found an important lack of knowledge on drug costs, little access to literature about this subject and availability of drugs not adequated to the Residents choices.