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Biomedical subjects

W M Verhoeven

Publications and source records attributed to W M Verhoeven.

At least 37 records · Page 2Linked to original sources
PubMed1990

Naltrexone attenuates self-injurious behavior in mentally retarded subjects.

The effect of naltrexone on the frequency of self-injurious behavior (SIB) was investigated in 6 male subjects with profound mental retardation. Following a double-blind placebo-controlled crossover design, naltrexone was administered in a dose of 50 mg once daily for 3 consecutive weeks. In 2 of 5 subjects, a significant decrease of SIB frequency could be demonstrated, and in 1, a tendency to a reduction was found. No effect on duration of restrain time was found in 3 subjects. These data suggest that disturbances of the endogenous opioid systems may be involved in the pathophysiology of SIB of certain patients.

Administration, Oral↗
PubMed1990

Double blind comparative study of remoxipride and haloperidol in acute schizophrenic patients.

In the present 6-week double-blind, randomised, multicentre study, the atypical neuroleptic remoxipride was compared to haloperidol in acute schizophrenic patients (DSM-III). Seventy-one patients entered the study, 36 in the remoxipride group and 35 in the haloperidol group. There were ten early withdrawals, four in the remoxipride group and six patients in the haloperidol group. The Present State Examination (PSE) profile revealed a similar reduction in the symptom clusters of psychosis in both treatment groups. Forty-seven per cent of the patients in the remoxipride group and 34% of the patients in the haloperidol group showed clinically relevant improvement (reduction of BPRS total score greater than or equal to 50%). All extrapyramidal symptoms except "glabella tap" occurred significantly less frequently in the remoxipride group as compared to the haloperidol group. Substantially lower incidences of EPS were found by active questioning in the remoxipride group compared to the haloperidol group. In addition, considerably lower incidences were observed in the remoxipride group with respect to drowsiness/somnolence, tiredness/fatigue and concentrating difficulty. At the end of treatment 66% of the patients in the haloperidol group and 22% in the remoxipride group were using anticholinergics. No consistent changes were found in the mean plasma HVA level in either treatment group. In responders (reduction of BPRS total score greater than or equal to 50%) lower baseline HVA levels were observed in both treatment groups. This study indicates that the newly developed neuroleptic remoxipride is an effective antipsychotic compound, which is clinically safe and well tolerated. In particular, few EPS were induced by remoxipride, as compared to haloperidol.

Acute Disease↗
PubMed1990

Anhedonia, suicide ideation and dexamethasone nonsuppression in depressed patients.

In the search for a valid analysis of a number of operationalised symptoms common to depressive behaviour, a study was performed comprising 46 patients showing depressive symptoms, according to operationalised criteria and as part of which all agreed to undergo the following tests: (a) psychiatric: Present State Examination; (b) psychological: Hamilton Rating Scale, Montgomery-Asberg Rating Scale, State-Trait Anxiety Inventory, Beck Suicide Ideation Scale, Chapman Anhedonia Scale, Mood Scale, Sleep Quality Scale, Activities Scale, Social Support Scale, Questionnaire on Recently Experienced Events and the Paykel Life Events Interview; and (c) biochemical: Dexamethasone Suppression (DEX) Test. After gathering different depressive subgroups, based on operationalised symptoms, a dichotomy was made in the distributions of the (an)hedonia, suicide ideation and DEX-(non) suppression scores. This study may indicate that anhedonia, suicide ideation and DEX-nonsuppression are the opening to the identification of a subgroup of depressed patients. This symptom complex could not definitely be identified on the basis of existing DSM-III diagnostic entities, because of the known fact that this method of classification is not appropriate for our purposes in revealing pathophysiological processes. It is suggested, therefore, that these symptoms might prove to be the anchor-point from which to reach a better insight into the aetiology and pathogenesis (i.e. the final common pathway) of depression.

Adult↗
PubMed1990

A double-blind comparative study of remoxipride and haloperidol in acute schizophrenia.

Seventy-one patients were entered into a multicentre, double-blind randomized study to compare the efficacy and safety of remoxipride with those of haloperidol in the acute treatment of schizophrenia or schizophreniform disorder. The patients, who were well-matched regarding demographic characteristics, were aged 18-64 years. Four patients in the remoxipride group and 6 in the haloperidol group discontinued treatment prematurely. The mean daily doses during the last week of treatment were 363 mg remoxipride and 9 mg haloperidol. At this time 22% of patients on remoxipride and 66% of those on haloperidol were taking anticholinergics (p less than 0.001). The clinical efficacy was similar in both groups as judged by Present State Examination (PSE) profile and Brief Psychiatric Rating Scale (BPRS) ratings. Several adverse symptoms occurred significantly more frequently during treatment with haloperidol than with remoxipride, particularly where extrapyramidal symptoms were concerned. No clinically relevant changes occurred in the laboratory tests in either group.

Acute Disease↗
PubMed1988

CSF monoamine metabolites in patients and controls: support for a bimodal distribution in major affective disorders.

The monoamine metabolites 5-hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA) in cerebrospinal fluid (CSF) were measured in 38 patients with major affective disorder and 48 age- and sex-matched controls by means of liquid chromatography. Statistical analysis using maximum likelihood normal mixture computations provided evidence for a subgroup of patients characterized by low CSF levels of both 5-HIAA and HVA. In controls, CSF 5-HIAA and HVA levels appeared to be normally distributed when fitted separately, whereas a subgroup of controls characterized by higher values of 5-HIAA and HVA could be discerned when metabolite data were fitted simultaneously. No relationship was found between monoamine levels and suicidal behaviour in patients. A statistically significant relationship was found between CSF 5-HIAA and HVA levels in patients and controls. These data provide supportive evidence for the existence of a subgroup of patients with an abnormal serotonin metabolism as reflected by 5-HIAA, and probably HVA, in CSF.

Adult↗
PubMed1987

Effect of serotonin uptake inhibitors in anxiety disorders; a double-blind comparison of clomipramine and fluvoxamine.

A double-blind comparative study of clomipramine and fluvoxamine was performed in 50 patients suffering from anxiety disorders (DSM-III). Patients were treated for 6 weeks with either 150 mg of clomipramine or 100 mg of fluvoxamine. The results show that both drugs at the dosages used are equipotent in reducing anxiety symptoms as assessed with the Hamilton Anxiety Scale and the Spielberger State-Trait Anxiety Inventory. Clomipramine differed from fluvoxamine in its efficacy with respect to associated depressive symptomatology in that it had a more pronounced effect on the Self Rating Depression Scale. The results support the hypothesis that brain serotonergic pathways are implicated in the pathophysiology of anxiety disorders, particularly in agoraphobia and panic disorders.

Adult↗
PubMed1987

Effect of a serotonin precursor and uptake inhibitor in anxiety disorders; a double-blind comparison of 5-hydroxytryptophan, clomipramine and placebo.

A double-blind placebo-controlled study of 5-HTP and clomipramine was carried out on 45 patients suffering from anxiety disorders (DSM-III). Clomipramine has shown to be effective in that it induced significant improvement on all rating scales as compared to placebo. 5-HTP showed a moderate reduction of the symptomatology on the 90-item symptoms checklist (SCL-90) and the State Scale of the Spielberger State-Trait Anxiety Inventory. Clomipramine and 5-HTP differed in their efficacy in that 5-HTP did not affect the associated depressive symptomatology. The results support the hypothesis that brain serotonergic pathways are involved in the pathogenesis of anxiety disorders, particularly in agoraphobia and panic disorders.

5-Hydroxytryptophan↗
PubMed1986

The interaction between gamma-type endorphins and HLA class I antigens.

The clinical response of schizophrenic patients to treatment with gamma-type endorphins was found to be associated with certain HLA class I antigens (Bw22, B15, B13). Moreover, pretreatment of lymphocytes from healthy donors with des-Tyr1-gamma-endorphin (DT gamma E) inhibits the complement-dependent cytotoxicity between alloantisera and those HLA antigens, of which the frequency was increased among schizophrenic patients, who respond well to the gamma-endorphin therapy. Also for the opiate antagonist, naloxon interactions with HLA class I antigens could be demonstrated. Using the inhibition assay with DT gamma E it was possible to detect a subtype of HLA-A2, which, until now, was only defined by cytotoxic T lymphocytes and biochemistry. These data suggest an interaction between the HLA class I antigens and the receptor(s) for DT gamma E and naloxon, which may support the hypothesis that HLA class I antigens play a role in many recognition processes. Their role in immunological recognition would then be only a specialized form of a more general function.

Antigen-Antibody Reactions↗
PubMed1986

A comparative study on the antipsychotic properties of desenkephalin-gamma-endorphin and ceruletide in schizophrenic patients.

The neuropeptides desenkephalin-gamma-endorphin (DE gamma E) and ceruletide were administered intramuscularly to patients with schizophrenic psychoses following a double-blind placebo-controlled design, including a total of 44 subjects. Neuroleptic medication was continued during the experimental period, which was started with one placebo injection for all patients. One week later subjects received a single intramuscular injection with 3 mg DE gamma E, 40 micrograms ceruletide or placebo. After an interval of 10 days, the patients received six similar injections over a period of 2 weeks. Treatment with either peptides resulted in a decrease of psychotic symptomatology as compared to placebo treatment. The beneficial effect of the peptides lasted at least 2 weeks after the experimental treatment period. Of the 14 patients treated with placebo only, three showed a slight response. Of the 30 patients treated with the neuropeptides, eight did not respond (DE gamma E: 3; ceruletide: 5), eight had a slight response (DE gamma E: 6; ceruletide: 2) and 14 responded moderately or markedly (DE gamma E: 6; ceruletide: 8). No obvious difference between the effects of the two neuropeptides was found, besides a somewhat earlier onset of the effect of ceruletide. Patients presenting relatively less negative psychotic symptoms were particularly susceptible to treatment with either peptide. Apart from slight and short-lasting gastrointestinal complaints after the first injections with ceruletide in some patients, no side effects were observed.

Adult↗
PubMed1986

Remoxipride in schizophrenia. A preliminary report.

Remoxipride, a substituted benzamide with preferential action on mesolimbic dopaminergic brain functions, was investigated in an open study in 10 schizophrenic patients. After 1 week with placebo, patients received remoxipride in a increasing doses from 150 to maximal 450 mg daily for 6 weeks. In six patients a clinically relevant reduction of psychotic symptomatology as assessed with the BPRS was observed. Few adverse effects were noted; extrapyramidal symptoms, if present, decreased during treatment, while the reported side effects were only mild. No consistent changes in plasma levels of prolactin and HVA were found.

Adult↗
PubMed1985

Gamma-type endorphins: neurolepticum-like and antipsychotic action.

The hypothesis implicating the gamma-type endorphins in schizophrenia was initially based on animal data showing commonalities between the behavioral effects of these peptides and neuroleptics. Clinical studies have shown that these peptides have an antipsychotic action in a number of patients suffering from schizophrenic psychosis. The patients responding to the peptides are characterized by features at least partly resembling those characterizing type I schizophrenia. This may be consistent with the animal data showing that gamma-type endorphins may directly or indirectly control certain dopaminergic systems present in the nucleus accumbens. Genetical differences may exist between patients susceptible to and not susceptible to gamma-type endorphins, as has been concluded from studies concerning antigens of the HLA system.

Antipsychotic Agents↗
PubMed1984

Clinical, biochemical, and hormonal aspects of treatment with Des-tyr1-gamma-endorphin in schizophrenia.

Des-tyr1-gamma-endorphin (DT gamma E) was administered intramuscularly in a dose of 1 mg/day for 10 days to 18 neuroleptic-free schizophrenic patients in a double-blind crossover design. Six patients showed either a slight or no antipsychotic response; seven patients showed a moderate antipsychotic response; and the remaining five patients showed a marked antipsychotic response. DT gamma E led to a decrease of plasma prolactin levels in patients treated with DT gamma E in the first period of experimental treatment as compared to those treated with placebo. Neither plasma levels of growth hormone and cortisol nor cerebrospinal fluid concentrations of homovanillic acid, 5-hydroxyindoleacetic acid, and 3-methoxy-4-hydroxyphenylglycol were affected by DT gamma E. Patients suffering from a hebephrenic or paranoid type of schizophrenia and those presenting relatively fewer negative symptoms were most susceptible to treatment with DT gamma E. These data confirm and extend previous findings that DT gamma E has antipsychotic properties in a number of schizophrenic patients.

Adolescent↗
PubMed1984

Repeated naloxone administration in schizophrenia.

A double-blind study of repeated subcutaneous administrations of 20 mg naloxone was performed in 10 schizophrenic patients as part of a World Health Organization collaborative project. No clinically obvious treatment effects were observed. None of the analyzed psychopathological symptoms, including hallucinations and unusual thought content, showed a distinct improvement during the 4 consecutive days of naloxone treatment. A slight but statistically significant decrease of symptomatology was found shortly after placebo injection on the first 2 days of treatment. This effect was not present following naloxone treatment. These findings are discussed in view of the hypothesis that increased endorphin activity contributes to the symptomatology of schizophrenic syndromes.

Adult↗