Psychoanalysis of psychoses

Psychiatric Quarterly -     

Psychoanalysis of psychoses

Psychiatric Quarterly -     

Psychoanalysis of psychoses

Psychiatric Quarterly -     

Eglonyl in the treatment of schizoaffective psychoses

The author investigated in an open clinical study the neuroleptic and antidepressive action of Eglonyl in 17 patients who met the criteria (diagnosis of psychoaffective psychosis, symptoms in the sphere of schizophrenia, depressive pathic moods). Eglonyl was administered by injection during the first four days and in tablet form on the subsequent 24 days in individual daily doses of 300-800 mg. At the onset and after 7-day intervals the patients were followed up, by clinical and psychiatric tests, along with the evaluation of the therapeutic effect by means of the clinical global impression scale, CGI, by the BPRS scale, and side-effects by means of the SARS scale. For statistical analysis Wilcoxon's test was used. The expected neuroleptic and antidepressive action of Eglonyl was confirmed in the clinical trials in patients with schizoaffective psychosis--depressive type: marked improvement was recorded in 58.9% of patients, medium improvement in 29.4% and slight improvement in 11.7% of patients. The decline of the global score in BPRS is highly significant (T1 - Tpop = 76.5, P less than 1%).     

Epileptic psychoses and their drug treatment

This paper is concerned with classification, clinical-electroencephalographic correlation, principles of treatment, and pharmaceutic therapy of epileptic psychoses. Based on the system of the physically founded reversible psychoses, classification of epileptic psychoses is developed, which is easy to apply for clinical and research purposes. Its principles are the criteria of disturbance of consciousness and of connexion to epileptic seizures. Epileptic psychoses without disturbance of consciousness frequently go along with a forced normalization of epileptic EEG-changes. This clinical-electroencephalographic correlation is documented by the cases of a depressive-paranoid and a cenesthetic alternative-psychosis. Epileptic psychoses connected to seizures, going along with disturbances of consciousness, however, show, without any exception, a pathological changed EEG. Also in the cases of the often iatrogenically produced epileptic psychoses with disturbances of consciousness yet not connected to seizures, the EEG-results are of decisive diagnostic importance. Each of these three clinical-electroencephalographically defined groups of psychoses calls for concentration on particular pathogenetical aspects concerning a specific pharmaceutic therapy. The respective principles of treatment are developed in subtly differentiated ways and they are provided with suggestion as to medicamental treatment. Schizophrenia-like epileptic psychoses are a model for idiopathic schizophrenias and so important perspective opens up for research.     

Epileptic psychoses and anticonvulsant drug treatment

Forty four consecutive patients with epilepsy and psychoses were studied retrospectively for psychotic episodes associated with changes in antiepileptic drug therapy. Twenty seven patients (61%) developed their first episode of psychosis unrelated to changes in their antiepileptic drug regimen. Twenty three of these patients developed psychoses with temporally unrelated changes in seizure frequency. Many patients had chronic schizophrenia-like psychotic symptoms. Seventeen patients (39%) developed their first episode of psychosis in association with changes in their antiepileptic drug regimen. Twelve patients developed psychoses temporally related to seizure attenuation or aggravation. Many of their psychotic symptoms were polymorphic with a single episode or recurrent episodes. No marked differences were found in the various clinical backgrounds between the two groups. In the drug-related group, seven patients developed psychoses after starting add-on therapy with a new antiepileptic drug, six after abruptly discontinuing their drugs, and four after taking an overdose of antiepileptic drugs. Based on the present findings, drug regimens should be changed gradually and compliance should be maintained to prevent epileptic psychoses.