Doubleblind evaluation of the antimanic properties of carbamazepine as a comedication to haloperidol.

1. Today carbamazepine is the most important alternative to neuroleptic drugs for the treatment of manic psychoses. Often carbamazepine is administered as a comedication to a neuroleptic. 2. A doubleblind study with 20 patients suffering from manic or schizomanic psychoses was performed to determine whether carbamazepine and haloperidol in comedication are more effective than haloperidol alone. 3. Under the tested conditions (24 mg haloperidol p.d.) only the smaller amount of additional medication with levomepromazine in the experimental group gave evidence for the antimanic effect of carbamazepine in combination with haloperidol. 4. Especially the patients with pure manic psychoses seem to benefit from carbamazepine as an adjunct to haloperidol.

Controlled trial on the possible advantages of a combined therapy with maprotiline and haloperidol in endogenous depression.

There is some clinical evidence that neuroleptics are able to increase the therapeutic effect of antidepressant drugs. From a theoretical viewpoint this could be due to influences on pharmacokinetics or receptor sensitivity. In a controlled three-week trial in 28 patients with endogenous depression the potential advantages of a combined medication of 150 mg maprotiline and 9 mg haloperidol per day (given for the first six days) in comparison with monotherapy with maprotiline were tested. Neither during the time of combined medication nor following withdrawal of haloperidol did this treatment regimen show better clinical results in comparison with controls. In keeping with results described elsewhere, the serum levels of the antidepressant, but not of its desmethyl metabolite, were higher in the experimental group.

[The anxiolytic action of phenoxypropanolamine derivatives in comparison with propranolol, diazepam and placebo]. / Zur anxiolytischen Wirkung eines Phenoxypropanolamin-Derivates im Vergleich zu Propranolol, Diazepam und Plazebo.

The hypothesis that the phenoxypropanolamine derivative CGP 361 A possesses anxiolytic activity was examined in 80 female healthy volunteers. Each volunteer received the treatment under double-blind conditions as part of a 1-way analysis of variance design. The medication factor had 4 levels (CGP 361 A, propranolol, diazepam and placebo). Stress was induced by asking subjects to deliver a free speech in front of a video camera. The anxiety was measured using adjectives list, state-trait-anxiety inventory and visual analogue scales. The physiological equivalents observed were pulse rate and skin resistance. The results support the hypothesis that a single dose of 10 mg CGP 361 A has a higher anxiolytic effect than 10 mg propranolol, 5 mg diazepam and placebo, with the peripheral beta-blocking effects (established by pulse rate) being no stronger than with propranolol. No subjective or objective sedation has been determined under the different drug conditions.

Double-blind study of oxaprotiline versus clomipramine in the treatment of depressive inpatients.

In a double-blind study on 38 unselected depressive inpatients (19 per group) suffering from endogenous and psychogenic depression, oxaprotiline, a new tetracyclic compound, a hydroxylized maprotiline with a highly selective norepinephrine reuptake inhibition, was compared with clomipramine over a period of 28 days in a daily dosage of 150 mg. Both drugs were found to be approximately equivalent and with no significant differences due to the overall assessment of the reduction of depression severity and amelioration of goal symptoms. This was also reflected in the results of the Hamilton Depression Scale and the self-rating scales for depression (SDS, Bf-S, ESTA).

CGP 12.103 A versus clomipramine in the treatment of depressed inpatients--results of a double-blind study.

In a double-blind study, which was conducted as an interindividual comparison, 41 depressed inpatients were divided into two test groups according to a randomized list and received either the test substance CGP 12.103 A (19 patients) or the comparative substance clomipramine (22 patients). The study was conducted over a period of 28 days and the dosage of each substance, after being gradually increased, was stabilized at 150 mg. Except for a significantly varied distribution of syndrome patterns, the two treatment groups were comparable with regard to relevant criteria. Both treatment groups showed a significant improvement as assessed by both the degree of severity of depression and the Hamilton Depression Rating Scale; on each scale, however, the clomipramine treatment group exhibited a tendency toward better antidepressive efficacy. According to the self-evaluations of the patients, which were conducted with the help of v. Zerssen's Self-Rating Scale, this tendency was not significant. The Kusta activation parameter indicated a tendentially stronger manifestation in the case of clomipramine. In the final evaluation the onset of efficacy for the CGP 12.103 A group lay in the mean on treatment day 6, for the clomipramine group on treatment day 10. The physician's overall assessment of therapeutic effect found no differences between the two treatment groups on day 14 and on day 28. Expected side effects were observed in the CGP 12.103 A group in nine patients, in the clomipramine group in 14. All in all, the test substance CGP 12.103 A, the (-) or R-enantiomer of the antidepressant oxaprotiline, which itself is derived from maprotiline, showed no essential differences in its antidepressive efficacy compared with clomipramine.