Effects of citalopram and fluoxetine on the corticocerebral blood flow in conscious rabbits.

Depression, which is associated with an increased incidence of vascular events, frequently occurs following stroke. Selective serotonin reuptake inhibitory drugs (SSRIs) as antidepressants, are well tolerated, and also seem to be effective in post-stroke depression. The aim of this study was to investigate the effects of the SSRIs citalopram and fluoxetine, on the corticocerebral blood flow (cCBF) in rabbits with unilateral carotid occlusion induced cerebral ischemia. The cCBF was measured by the hydrogen clearance technique. After determination of the mean baseline cCBF, the effects of individual doses (0.1, 0.3 and I mg/kg) of citalopram or fluoxetine on the cCBF were investigated. Following the induction of an impaired cCBF, the changes in cCBF after drug treatments in this condition were likewise measured. The mean arterial blood pressure (MABP) and the heart rate (HR) from the electrocardiogram (ECG) were also determined. Neither citalopram nor fluoxetine influenced the cCBF in the control group. Fluoxetine improved the cCBF only very slightly in the ischemic animals. In contrast, all the doses of citalopram exerted pronounced and dose-dependent cCBF-increasing effects in the animals with unilateral carotid occlusion (maximal mean ACBF: 10, 16 and 27 ml/min/100 g tissue). The HR was decreased in both groups. Only citalopram treatment led to a slight MABP-decreasing effect. Besides enhancement of the serotonergic transmission in the brain, the cCBF-increasing effect of citalopram under ischemic conditions may be of benefit in post-stroke and vascular depression.

Comparison of regional vasomotor responses to acetazolamide and CO2 in rabbit cerebrum and cerebellum, measured by a hydrogen clearance method.

AIM: Many investigators have proved the usefulness of acetazolamide provocation and the carbon dioxide test for assessment of the local cerebrovascular reactivity by measurement of the regional cerebral blood flow in patients with occlusive cerebrovascular disease. Data originating from a comparison of these two different vasomotor stimuli as concerns the differences in sensitivity to them in various parts of the central nervous system are scarce. Our aim was to compare the cerebral blood flow responses to hypercapnic and acetazolamide stimuli in different brain regions. METHODS: The cerebral blood flow was measured in the cerebrum (cortex and caudate nucleus) and cerebellum (cortex), as measured by a hydrogen clearance method in anaesthetized, artificially ventilated rabbits. RESULTS: In normocapnia, the cerebral blood flow values in the cerebrum and the cerebellum differed significantly. The cerebral blood flow responses to both vasodilatory stimuli were to be significantly higher in the cerebrum than in the cerebellum, but the relative increases, i.e. the mean relative reactivities, were similar in the different regions measured. CONCLUSION: The regional dissimilarity might explain to some extent the different sensitivities of the various brain areas to sudden blood pressure changes (infarction or haemorrhage). The results further suggest that heterogeneity in cerebrovascular reactivity should be considered in the assessment of vasoreactivity in patients with occlusive cerebrovascular disease. Since the comparison of the carbon dioxide and acetazolamide-induced cerebrovascular reactivities revealed a strong linear relationship, it was concluded that acetazolamide provocation is equivalent to the carbon dioxide test in the evaluation of cerebrovascular reactivity.

Comparative two-phase clinicopharmacological trial of a new antihistaminic, EGYT-2062, setastine.

During the two-phase clinicopharmacological trial in humans of a new antihistaminic compound EGYT-2062, setastine developed by EGIS Pharmaceutical Company, Budapest, was tested the tolerance to the drug, its pharmacodynamic effect by i. c. histamine and acetylcholine tests, and its effect on the CNS by neuropsychiatric examination on eight healthy volunteers. The side-effects appearing during treatment were recorded. A self-controlled blind study was performed. The reference compound was clemastine. Based on the results, for prolonged use a dose of 2 mg three times/day (t.i.d.) is recommended. The antihistaminic effect of setastine almost equalled that of clemastine given in a dose of 1 mg t.i.d., while its antiacetylcholine effect exceeded it, and in view of its few psychic side-effects, might be tolerated better than clemastine.

Efficacy testing of beta-galactosidase with H2 breath test in patients with carbohydrate malabsorption.

The clinical efficacy and the potential side-effects of beta-galactosidase were studied in adult lactose intolerance. Various randomized oral tolerance tests were performed using lactose solution (35 g), glucose + galactose solution (17.5 + 17.5 g), native, skimmed milk and milk pretreated with beta-galactosidase. In each case, simultaneous examinations were made of the glucose concentration of capillary blood by an instrument constructed by the authors, of the H2 content of expired air as also of the subjective complaints and of the number of stools and their pH. It was established that pretreatment of milk with beta-galactosidase has a beneficial effect in adult lactose maldigestion, since it stops dyspeptic complaints and diarrhoea due to milk, it reduces the H2 content of expired air increases blood glucose concentration. Measuring the H2 content of the breath by using and instrument constructed by the authors, exact data can be obtained noninvasively, and rapidly on the degree of carbohydrate malabsorption in patients with lactose-intolerance.

Gastric microbleeding measurements during one day treatment with indomethacin and indomethacin plus sodium salicylate (1 : 10) in patients.

A double-blind, prospective, randomized clinical study was carried out. Gastric microbleeding was provoked in informed patients without gastrointestinal disorders by the administration of indomethacin (4 X 25 mg, orally), sodium salicylate (4 X 250 mg, orally) or indomethacin (25 mg) plus sodium salicylate (250 mg) (Pelsonin, 4 X 1 capsules). The rate of gastric bleeding was estimated on the basis of haemoglobin losses into the gastric juice according to a rapid and sensitive chemical method (Fisher and Hunt, 1976). The observations were done before and after the day of treatment. The basic gastric bleeding was practically the same in the three groups (indomethacin, 0.91 +/- 0.12 ml/day: sodium salicylate, 0.72 +/- 0.20 ml/day: Pelsonin, 0.99 +/- +/- 0.18 ml/day: p less than 0.05). Contrary to this, the increases of gastric bleeding were found to be considerably different after a one-day application of these drugs (indomethacin, 7.3 +/- 1.2 ml/day: sodium salicylate, 1.92 +/- 0.45 ml/day, Pelsonin, 2.1 +/- 0.8 ml/day). It has been concluded that sodium salicylate can reduce the indomethacin-induced gastric microbleeding in patients.

Human tolerance of flumecinol (Zixoryn, RGH-3332), its regime and dosage in healthy volunteers.

The enzyme inductive effect of flumecinol (Zixoryn, RGH-3332), a new hepatic enzyme inducer, was studied in healthy volunteers. The dosages employed were as follows: 25, 50, 100, 200, 400, 600 and 800 mg single doses; and during a 7-day period single doses of 50 mg daily, and doses of 200, 300 and 400 mg three times daily. The intensity of enzyme induction was measured by the following parameters: antipyrine metabolic clearance, D-glucaric acid excretion, menthol loading, and total serum bilirubin. The minimal and optimal inductive doses of flumecinol were determined. A single dose of 600 mg of flumecinol is recommended at intervals of 7 days. This dosage also induces the first and the second phases of reactions. The induction effect becomes manifest after 24 hours. Its peak is reached between 48 and 96 hours, and the inductive activity ceases between 216 and 408 hours.

Effects of drugs on the production of stress ulcer in the rat.

The authors studied the effect of drugs with different mechanisms of action on the prevention of stress ulcer production in the rat. Stress ulcer was induced by a method developed by the authors: intact, starved rats were swum in water at 23 degrees C for 5 hours. Atropine (0.1-0.5 and 1.0 mg/kg i.m.), cimetidine (1.0-5.0 and 25 mg/kg i.p.), prostacyclin (PGI2) (5.0-25.0 and 100 micrograms/kg i.p.) and phentolamine (0.35-1.75-3.5 and 7.0 mg/kg i.m.) were shown to decrease the production of stress ulcers significantly, in a dose-dependent fashion. Propranolol (0.35-1.75-3.5 and 7.0 mg/kg i.m.) did not influence the production of stress ulcers. The finding that drugs with different actions could considerably reduce or prevent the production of stress ulcer appears to indicate the complexity of the neural, hormonal and biochemical processes involved in the pathogenesis. On the basis of the present results the authors suggest the use of a preventive therapeutic regimen in clinical practice with an appropriate combination of drugs.

Enzyme-inductive effect of a hypolipidemic compound N-bis-(p-chlorophenoxy)-acetyl-urea in man and rat.

Besides its antilipidaemic effect, the new clofibric acid derivative (N-bis-(p-chlorohenoxy)-acetyl-urea) has an enzyme-inductive effect. The drug was administered (100 mg/kg orally) to male, Wistar rats for three days. The treatment raised the weight of the liver, the content of liver microsomal protein and cytochrome p-450 and shortened the hexobarbital sleeping time. The increase of cytochrome p-450 dependent biotransformation was found by in vitro methods in 9000-g supernatant of liver homogenate. There was a growth in biotransformation of substrates of type I (ethylmorphine, aminopyrine) and an extreme increase in reduction of nitrobenzene. We did not find any change in biotransformation of the type-II substrate aniline. In 16 patients suffering from Gilbert's syndrome, there was a decrease in the level of serum bilirubin, and increase of D-glucuric-acid output in urine and bromsulphophthalein transport maximum following the treatment of this drug given in 150 mg/day orally for three weeks. After this treatment, the level of gamma-glutamyl-transpeptides did not change. The authors highly recommend the serious consideration of metabolic interaction during the clinical application.