Olanzapine versus flupenthixol in the treatment of inpatients with schizophrenia: a randomized double-blind trial.

OBJECTIVE: The atypical antipsychotic olanzapine has extensively been compared with haloperidol, whereas studies vs. other (conventional) neuroleptics are scarce. This exploratory double-blind 4-week study was designed to compare the efficacy and the safety of olanzapine (OLA) and flupenthixol (FLU) which have recently been considered as a "partially atypical" antipsychotics. METHODS: Twenty-eight inpatients with schizophrenia (DSM-IV) were randomly assigned for treatment with OLA (N = 15, 5-20 mg/d) or FLU (N = 13, 5-20 mg/d). The Brief Psychiatric Rating Scale (BPRS) and the Negative Symptoms Rating Scale (NSRS), plus the Patient Global Impression (PGI) and Clinical Global Impression (CGI) scales, were used to assess the efficacy of both compounds; safety was determined by using the Simpson Angus Scale (SAS) and the Abnormal Involuntary Movement Scale (AIMS) and by assessing treatment-emergent adverse events. Non-parametric statistics were applied. RESULTS: BPRS and NSRS scores improved in both groups (exploratory tests; all p < or = 0.02). Similar results were observed for CGI-Severity, CGI- and PGI-Improvement. There were no significant group differences. Responder rates (at least 40 % decrease in BPRS total) were 9/13 OLA patients (69 %) and 9/12 FLU patients (75 %). EPS events were reported only in the FLU group (p < 0.01); FLU patients needed significantly more anticholinergic medication. Weight gain was higher in OLA patients (p < 0.01). Overall, fewer patients with adverse events were observed in the OLA group (p = 0.04). No significant changes were noted on SAS and AIMS scores. CONCLUSION: Findings from this study suggest that overall and negative symptomatology improved in both treatment groups, while the safety and tolerability profiles differed for both substances.

Cocaína: bases biológicas da administraçäo, abstinência e tratamento / Cocaine: biological basis of administration, withdrawal and treatment

O aumento do consumo de cocaína nas últimas duas décadas foi acompanhado por uma melhora do conhecimento dos mecanismos biológicos relacionados ao uso, abuso e dependência desta droga. Entender esses mecanismos ajudará o clínico a compreender os comportamentos e sintomas dos usuários, bem como as possibilidades de tratamentos biológicos existentes. Os objetivos desta revisäo säo:1. Avaliar a neurobiologia da cocaína, as alteraçöes que provoca nos usos agudo e crônico, os possíveis mecanismos de dependência e da síndrome de abstinência, além das repercussöes neuroendócrinas do uso crônico. 2. Relacionar a farmacoterapia disponível, avaliando sua eficácia a partir de estudos já realizados e apontar novos estudos em andamento

Síntomas positivos y negativos de la esquizofrenia / Positive and negative symptoms of schizophrenia

Desde el siglo pasado se reconoce dos grupos de síntomas que se supone corresponden a dos tipos de procesos mórbidos en la esquizofrenia. El artículo presenta las ideas de los principales investigadores acerca de estos dos aspectos, junto con los hallazgos neuroquímicos y los estudios de imágenes cerebrales que las sustentan.

Síntomas positivos y negativos de la esquizofrenia / Positive and negative symptoms of schizophrenia

Desde el siglo pasado se reconoce dos grupos de síntomas que se supone corresponden a dos tipos de procesos mórbidos en la esquizofrenia. El artículo presenta las ideas de los principales investigadores acerca de estos dos aspectos, junto con los hallazgos neuroquímicos y los estudios de imágenes cerebrales que las sustentan. (AU)