Neuroleptic malignant syndrome (NMS): challenge with zuclopenthixol and follow-up--a case report.

In view of its receptor-binding profile, zuclopenthixol was used for NMS-challenge in the past 2 years. In 2 patients uneventful challenge took place. One patient showed recurrence of NMS. This occurrence may have been due to challenge shortly after the first episode had abated, and to use of a relatively high dose of zuclopenthixol. Differences in results of challenge showed no relationship with findings on follow-up: the patients who suffered recurrence had an uneventful recovery. One of the others showed a persisting organic amnestic syndrome, lasting now for more than 1.5 year, with EEG disturbances. The last patient rapidly developed tardive dyskinesia, despite the fact that he was treated with neuroleptics for a relatively short time. A hypothesis concerning these effects is presented.

Pseudohallucinations in diabetic eye disease: a natural Rorschach test?

In diabetic eye disease, worsening vision may lead to the phenomenon of pseudohallucinations. Illustrated by a case history, a hypothesis is proposed which views this phenomenon as a kind of deprivation. This deprivation has implications for treatment, since reassurance and explanation seem more appropriate than pharmacological action. Other forms of sensory deprivation may occur in which one might expect the same situation, for example in polyneuropathy or impending deafness.

Zuclopenthixol-induced neuroleptic malignant syndrome at rechallenge and its extrapyramidal effects.

This is the first report of a zuclopenthixol-induced NMS. The lack of previous reports may be because the receptor-binding profile of thioxanthenes give rise to fewer extrapyramidal effects than comparable neuroleptics. It is important to know more of the relationship between the potential for induction of extrapyramidal effects and success in NMS rechallenge.

A retrospective and explorative study of hypokalemia in psychiatric disorders: a beta 2-receptor related phenomenon.

Since the serum potassium level is under beta 2-adrenergic influence, we studied serum potassium values on admission in psychiatric patients. Data are reported on 683 patients from nine major diagnostic groups. Among these nine groups significant differences were found concerning the mean serum potassium level and incidence of hypokalemia. Significant differences existed between the alcohol withdrawal and attempted suicide groups compared to the dysthymic, bipolar manic, schizophrenic and nonschizophrenic psychosis groups. Like alcohol withdrawal, attempted suicide is assumed to be a hyper-adrenergic state. Although the relative contribution of factors like nutritional state, aldosterone, insulin, and beta 2-receptor density or sensitivity is unclear, the catecholamine-potassium relationship deserves further study.