The aim of this study was to evaluate the effects of a new antipsychotic compound on negative symptoms and cognitive deficit in schizophrenia. Psychiatric symptoms and cognition were assessed in 25 patients with schizophrenia, at baseline and after they had taken risperidone for 4 weeks. The Positive and Negative Symptoms Scale (PANSS), the Wisconsin Card Sorting Test (WCST) and two WAIS sub-tests were used to assess the patients. After the study period, both negative and positive symptoms and also measures of cognitive performance improved significantly. The WCST results correlated with negative symptom scores before and after treatment. This suggests that negative symptoms and cognitive deficit have a common underlying substrate which is the target of the risperidone treatment. Our data show that risperidone may have a substantial effect on complex cognitive functions in schizophrenia, and they suggest that certain cognitive deficits are relatively dependent on the negative symptoms of this disorder.

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Thirty patients suffering from dysthymic disorder participated in a 6-week double-blind trial comparing ritanserin 10 mg and placebo. After a single-blind placebo wash-out period of one week, the test medication was administered during 5 weeks on a double-blind basis. Twenty-three patients completed the study. At the end of the trial, ritanserin was significantly superior to placebo in its effect as manifested on the 19-item Hamilton Rating Scale for Depression, the Hamilton Rating Scale for Anxiety and the State Trait Anxiety Inventory X-1 and X-2. At the end of the study, the therapeutic effect was rated marked or moderate in 75% of the ritanserin-treated patients, but only in 18% of the controls. These data are consistent with the hypothesis of serotonin abnormalities in dysthymic disorder and suggest a therapeutic role of 5-HT2 antagonists. Ritanserin treatment was very well tolerated; no serious adverse experiences were reported.

Previous studies suggested a therapeutic action of the selective serotonin 5-HT2-antagonist ritanserin on negative symptoms of schizophrenia and on neuroleptic-induced parkinsonism. In this open trial the effect of risperidone, a combined serotonin-5-HT2-and dopamine-D,-antagonist, was studied on a sample of 31 schizophrenic outpatients with an unsatisfactory response to conventional neuroleptic treatment, predominance of negative symptoms, together with troublesome extrapyramidal side-effects. After 28 days of oral treatment (2-6 mg daily) the patients showed a significant improvement as measured by means of the Brief Psychiatric Rating Scale and the Scale for the Assessment of Negative Symptoms. It is possible that the 5-HT2 receptor antagonist properties of risperidone may improve negative symptoms. In addition, confirming previous studies, extrapyramidal symptoms showed a reduced incidence compared to previous neuroleptic treatment, suggesting a serotonin4opamine interaction in the basal ganglia. No electrocardiographic, cardiovascular or laboratory abnormalities were observed.

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Prevalence and severity of erectile dysfunction (ED) increase with aging and are often associated with illnesses, like diabetes mellitus, heart disease, and hypertension, pathologically characterized by endothelial dysfunction and whose prevalence increases with age. The assumption that ED is mainly a neurovascular disease is supported by the evidence that specific phosphodiesterase type 5 (PDE5) inhibition produces an efficient erection in a wide range of ages and conditions. The availability of specific PDE5 inhibitors has enabled the development of effective treatment strategies, in this contest, tadalafil may be considered as the least “typical” PDE5 inhibitor. In clinical trials, tadalafil significantly enhanced, in patients of different ages, all efficacy outcomes across disease etiologies and severities. With an effectiveness lasting up to 36h, tadalafil allows patients to choose when to have sexual activities without the need to time it, showing positive feedback in terms of quality of life related to the treatment. Headache and dyspepsia were the most frequent side-effects of tadalafil, followed by back pain, nasal congestion, myalgia, and flushing, but the impact that long time action could have on effectiveness and safety is not yet entirely defined. The aim of this article is to critically review the available evidence from the tadalafil clinical research program and give the physician a rational approach for intervention in the treatment of ED and related diseases.

1,25-dihydroxy vitamin D (vitamin D), a steroid hormone essential for calcium metabolism and various extra skeletal functions, is an in vitro inducer of Nerve Growth Factor (NGF) and modulates Brain-Derived Neurotrophic Factor (BDNF) in neurons, while its receptor is expressed in central nervous system. Due to restricted sunlight exposure and/or dietary intake many people are vitamin D-deficient and need supplementation. Vitamin D status has been associated with impairment in cognitive functions, but up to now no clinical studies have been conducted to verify its effect on neurotrophins and memory in humans. 20 postmenopausal women with low vitamin D levels were treated by calcifediol (25-OH D3) and followed in open for three months. At baseline and after three months NGF and BDNF together with Wechsler Memory Scale (WMS) were assessed. Mean plasma vitamin D levels were 14.52 (+/-5.65 SD) ng/ml at baseline and 47.58 (+/-15.05 SD) ng/ml after three months of supplementation. At the end of the study a statistical significant decrease in both neurotrophins was observed. NGF plasma levels were respectively: 451.13 (+/-243.20 SD) pg/ml and 323.68 (+/-195.60 SD) pg/ml (p=0.05); BDNF levels were 431.10 (+/-182.21 SD) pg/ml and 366.25 (+/-142.75 SD) pg/ml (p=0.02). WMS scored meanly 97.00 (+/-13.54 SD) at baseline and 107.82 (+/-16.19 SD) after three months (p=0.003). Considering the role of vitamin D in calcium metabolism and neurotrophic factors regulation, it seems indispensable in brain function and its deficiency must be considered in cognitive diseases.