The relative utility of steady-state (SS), plasma (Pl), and red blood cell (RBC) haloperidol levels for predicting clinical response was evaluated in a fixed-dose study in schizophrenic inpatients. There were significant curvilinear relationships between the decrease in BPRS Psychosis Factor Scores by day 24 of haloperidol treatment and both Pl (R2 = 0.34) and RBC (R2 = 0.38) haloperidol levels. Although SS RBC haloperidol levels consistently showed a slightly stronger relationship to clinical response than Pl levels in several comparisons, the differences in R2s between Pl and RBC haloperidol were not statistically significant. Ninety percent confidence intervals for the blood level ranges associated with optimal clinical response in our sample of patients were: 6.5-16.5 ng/ml Pl haloperidol and 2.2-6.8 ng/ml RBC haloperidol.
Ten patients diagnosed clinically as having Alzheimer's disease (age range 54 to 73 years) were given 35 g/day of a 53% lecithin mixture for two weeks, in a double-blind crossover design. Patients received memory training during the lecithin condition and "placebo training" during the placebo drug condition. Repeated assessment with Buschke's Selective Reminding Procedure provided no evidence of a therapeutic lecithin effect either during the two week clinical trial or during longer follow-up trials. Noninvasive measurement of regional cerebral blood flow (nr CBF) by the 133Xe-inhalation method, and repeated EEG's also failed to demonstrate a therapeutic effect. These latter indices reflected a decline in cerebral function over the course of the study, a finding which paralleled clinical impressions in four of the patients. Follow-up trials of memory training under placebo and lecithin conditions provided some suggestion that memory training may lead to some immediate improvement in list-learning ability, but the improvement was not well maintained overtime.
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