Clinical Neuroscience - 1960;13(07)

Clinical Neuroscience

JULY 01, 1960

[Clinical experiences with Tofranil]

ANGYAL Lajos, FENYVESI Tamás

[1. The study reports 135 cases treated with Tofranil, 119 of them in the depression group and 16 in the schizophrenia group. 2. In endogenous depression, the treatment led to a complete cure in 68% of patients and to a substantial improvement in a further 12%. In psychoreactive depression, the cure was 45% and the substantial improvement 19%. In one case of suicide with lethal outcome, we emphasise the need for increased surveillance and careful selection of cases for outpatient treatment. 3. With the help of a timely initiated T. cure, the incipient depressive phases of several patients were reduced. One hypertensive patient's severe depression induced by chronic reserpine treatment was completely relieved by T. in four weeks. 4. The only psychiatric basis of endogenous depression, the pathological depressive state, T. - treated in about 4/5 of cases - is cured. The resolution of the pathological depressive state is accompanied not only by the disappearance of the vital depressive symptoms, but also by the disappearance of the secondary psychiatric symptoms of depression, often "abruptly", without any psychiatric intervention. 5. The results are considerably less favourable in cases where the depressive syndrome develops on the basis of organic disorders. 6. In 19 schizophrenic patients, T has been shown to be ineffective, with severe psychiatric complications including the onset of agitation. 7. Apart from the insignificant vegetative side-effects already described in other publications and the moderate eosinophilia observed in 37% of cases, the authors found no adverse somatic side-effects of T. and, in their opinion, no contraindication to the use of T. in depressive cases. In patients of the affective form, overdosage, or normal dosage in the case of special personal disposition, may lead to the occurrence of maniform agitation of varying degrees. In the case of a depressive syndrome or schizophrenic inhibition developing on an organic basis, the underlying disorder may be triggered by T. ]

HUN 1960;13(07)

Clinical Neuroscience

JULY 01, 1960

[On extrapyramidal side effects of neuroleptic treatments and their prevention with promethazine]

ORTHMAYR Alajos, SZILÁGYI Katalin

[We have discussed the common brainstem origin of extrapyramidal movement poverty and dyskinesias during neuroleptic treatments based on literature and our own observations. We found correlations between these phenomena and the structure of the compounds, dose size, duration of administration and familial or acquired weakness of extrapyramidal cells. Co-administration of chlorpromazine and reserpine reduces such side effects through their antagonistic effects on pulsus and peristaltica, and their synergistic effects enhance the psychic effect by eliminating turbulent phasis and promoting reintegratio. Extrapyramidal side-effects are more frequent, but with a small dose of promethazine it has been possible to prevent or eliminate extrapyramidal movement disorders induced by the combined or single administration of different neuroleptics, and even dyskinesias, in addition to the usual antiparkinsonian agents, and, as a phenothiazine derivative, to enhance the effect of neuroleptics on the psycho.]

HUN 1960;13(07)

Clinical Neuroscience

JULY 01, 1960

[Ossified subdural haematomas ]

ÁFRA Dénes

[The author reports on two subdural haematomas of chronic, calcified and ossified subdural haematomas diagnosed alive and successfully operated. After a literature review, he emphasizes the extreme rarity of the findings, while at the same time drawing attention to the importance of clinical and pathological observations that can be of value in the pathogenesis of subdural haematoma. After a detailed description of the pathological course of the two patients and the surgical and pathological findings, the cases are analysed from a clinical and pathological point of view in comparison with the literature. Histopathological examination of ossified subdural haematomas reveals a progressive degenerative phenomena based on connective tissue organization, which requires many years of both our own and literature experience. There is no specific, particular theory or explanation for the process of calcification and ossification, but the author classifies the process as dystrophic calcifications or metaplastic ossifications. This only shows the persistence of the haematoma over many years - but with balanced intracranial dynamics. The true subdural location of the haematoma and the secondary organisation of the haematoma are supported by the macro- and microscopic independence of the intact dura and bony haematoma from its immediate environment. These observations are valid against rather than for the inflammatory, pachymeningitis theory. ]

HUN 1960;13(07)