No abstract

For this open study, we selected 21 chronic psychotic female in-patients (16 of them schizophrenics) who were being maintained on oral neuroleptics. After a wash-out period, they were treated by intramuscular depot injections of haloperidol decanoate, once a month for four months. The dose was calculated from the previous oral dosage, and the amount of the first injection was double that of the three following injections. Relatively stable plasma levels of haloperidol were achieved with the first injection, and corresponded to those observed with oral medication. A very significant correlation was found between plasma level and the dose administered, but not between plasma level and therapeutic effect. The clinical condition of about two-thirds of the patients remained unchanged or improved, compared with the period of oral treatment. During the first two months of treatment, there was more rigidity and tremor, but from the third month, the extrapyramidal symptoms were less pronounced than during the period of oral neuroleptics.

The resocializing and activating properties of halopemide were investigated in an open study and a double-blind study in 20 patients who had been hospitalized on account of various psychiatric disorders. The results of the open study showed a significant improvement in contact and activity, regardless of the nosological characteristics. There was no significant difference in therapeutic effect between the single (2 x 10 mg/day) and the double (2 × 20 mg/day) dose. The patients were more approachable, sought contact with their surroundings and showed a greater interest in their work. However, these results were not confirmed by the double-blind study, which for these target symptoms showed no significant difference between the placebo phase and halopemide phase. Two factors that might explain the discrepancy between the results of the open study and the double-blind study are postulated: the difference in experimental methods and the short duration of the study phases.

There is evidence that antidepressants may have an analgesic effect in chronic pain. To replicate this effect and to throw light on the processes involved, a 12-week cross-over double-blind trial of mianserin versus placebo was carried out in 4 diagnostic groups: A) depressive patients without pain complaints (n = 8), B) depressive patients with chronic organic pain (n = 8), C) patients with somatoform pain disorder and vital signs of depression (n = 11) and D) patients with chronic organic pain without depression (n = 8). Although a mianserin-induced antidepressant effect in group A was evident, no significant pain reduction was accomplished in any group. The reasons for this failure to replicate the antidepressant-induced analgesic effect are discussed.

The present study was designed to examine the premorbid 'action-proneness' of chronic pain patients without obvious organic etiology. Using a validated psychometric instrument (the HAB questionnaire), 3 clinical groups were compared: 30 patients with chronic 'non-organic' pain, 30 patients with chronic organic pathology and 30 hospitalized psychiatric patients without pain as a primary complaint. The results indicate that the chronic pain patients describe themselves retrospectively as more 'action-prone' than the patients of the two control groups. Using an analysis of covariance to have statistical control on age, occupational level and depression, the results were statistically significant on the 0.05 level. Although this study suggests that a strong tendency towards direct action may be a frequent and relatively specific premorbid feature of chronic pain patients, the pathogenic implications of these findings remain uncertain.