Peptide-containing fractions in depression.

A mixture of peptides and glycoproteins has been found in benzoic acid-precipitable material from urines of psychomotorically agitated and retarded endogenous depressive patients. This complex mixture of compounds is fractionated on a Sephadex G-25 gel, from which the different peaks are further separated on Biogel P2. The G-25 elution profiles ultraviolet absorbance, 280 nm) from depressive patients deviated from the normal pattern. The increase in hydrolyzable ninhydrin-colorable material of the P2 fractionation step encountered in psychotic depression was several-fold that of the normal population. Neurochemically active peptide-containing fractions were found. As explanation of these findings, it is probable that a genetically determined peptidase insufficiency is present, causing a peptide overflow when the secretion outstrips the breakdown. This model could easily combine more psychodynamic models with the genetic-biological models. The variability of the peptide patterns could possibly reflect the considerable clinical variability of the syndrome. Furthermore, the presence of a group of active compounds with different neuropharmacological activities might reflect the composite nature of the depressive syndrome.

A double-blind comparison of zimelidine and desipramine in endogenous depression.

Zimelidine, a specific 5HT uptake inhibitor (final dose 225 mg), and desipramine, mainly a noradrenaline uptake inhibitor (final dose 150 mg), were given in random order to 24 in- and out-patients fulfilling the Research Diagnostic Criteria for Major Depressive Disorder, definite or probable endogenous type, for a 3-week treatment period. Nonresponders were crossed over to the other drug for another 3 weeks. There was a nonsignificant trend towards more overall improvement on desipramine. Some patients in both groups showed very little change during 3 weeks, indicating a bimodal distribution of response to either drug. Several nonresponders improved markedly upon direct crossing over to the other drug. There were few and mild side effects on both drugs, with no significant difference between them. No significant correlation was found between improvement and plasma concentrations of zimelidine, norzimelidine, or desipramine, whereas a significant positive correlation was found between improvement and platelet serotonin uptake inhibition (measured in fresh platelets incubated in diluted plasma from the patients) in zimelidine-treated patients.

Pneumoencephalographic evidence of brain atrophy in acute and chronic schizophrenic patients.

Pneumoencephalography (PEG) was carried out in 50 patients of both sexes consecutively discharged from a psychiatric department with a diagnosis of acute schizophrenia. At clinical follow-up with a mean observation time of 8 years the diagnosis was verified in 38 patients, while 12 were considered to have had a reactive psychosis. The PEG findings and clinical findings in these two groups are compared, and compared to corresponding findings in 101 chronic schizophrenics previously studied with the same method. Linear measurements were used in estimating the size of the ventricular system, which was safely within normal limits in all but three of the 50 patients. Mean ventricular size did not differ significantly in the two groups of acute psychoses. No case of cortical atrophy was found. More than half of the chronic schizophrenics had abnormal PEG's, the typical finding being a bilateral enlargement of the ventricular system. The mean size of all parts of the ventricular system was significantly higher than in the acute schizophrenics. A close correlation was found between mental deterioration and ventricular enlargement. The most reasonable explanation of these findings is that schizophrenia is an inborn error of metabolism, disturbing normal brain function and in the long run leading to degenerative changes of the nervous tissue.

Comparison of sulpiride and chlorpromazine in psychoses. A double-blind multicentre study.

In a material of 71 patients admitted because of acute or chronic psychoses, 32 were treated with sulpiride (up to 1,800 mg per day) and 39 with chlorpromazine (up to 675 mg). Duration of treatment was from 4 to 8 weeks. The effect of the two preparations was very similar as were the type and frequency of side effects, except that sulpiride did not cause sunrash.