Clinical Neuroscience

[Clinical use of Melipramine (Imipramine) ]


APRIL 01, 1963

Clinical Neuroscience - 1963;16(04)

[The authors analyze the clinical data of 45 patients treated with melipramine, describe the dosage, the course of the cure, the side effects, the other somatic treatments and psychotherapy applied during the cure. ]


  1. Debreceni Orvostudományi Egyetem Ideg- és Elmegyógyászati Klinikája



Further articles in this publication

Clinical Neuroscience

Über die Problematik der Neurosen im Kindesalter


Es wird vor der allzu starken Ausweitung des Begriffes ,,Neurose im Kindesalter“ gewarnt. Kinderfehler, phasenbedingte kindliche Fehlhaltungen, psychogene Reaktionen, psychogene Entwicklungen und auch einfache abnorme Erlebnisreaktionen sind nicht mit Neurosen gleichzusetzen. Für diese Diagnose ist eine abnorme psychogene Entwicklung zu fordern, die zu somatischen und psychischen Störungen führt, die das Kind nicht mehr kompensieren kann und die vom Kind selbst als fremdartig und störend empfunden werden. Näher eingegangen wird auf die besondere Umweltanfälligkeit und damit auch Neuroseanfälligkeit encephalopathischer Kinder, bei denen die Fähigkeit des Abstandnehmens und bestimmte Erlebnisse zum Abschluss zu bringen sowie die Hemmung und Eingrenzung intrapsychischer Reaktionen behindert sind. Es sind Kinder mit einem schwankenden Biotonus. Grundsätzliche Bedenken werden gegen die Verwendung des Begriffes „Psychopathie für das Kindesalter ventiliert, umso mehr, als damit die keineswegs bewiesene These von der Vererbung psychischer Eigenschaften allzu leicht dazu verführt, sich in seinem therapeutischen Handeln beeinflussen und lähmen zu lassen.

Clinical Neuroscience

[Enhancing insulin sensitivity with ganglion paralysers in insulin shock treatment ]


[1. With hexamethasone in IS treatment, the coma dose was reduced by 75-25% in 28 of our patients. 2. With this association, coma usually occurs sooner and the accompanying vegetative symptoms are milder. 3. Hexamethon combination has no complications. ]

Clinical Neuroscience

[Enhancing insulin sensitivity with ganglion paralysers in insulin shock treatment II.]


[1. Using Synapleg in IS treatment, the coma dose was reduced by 70.6% to 54%. 2. Coma with Synapleg was generally shorter than with hexamethasone. 3. There were no complications with the Synaplegic combination. ]

Clinical Neuroscience

[Some problems in clinical pharmacopsychology from an experiential perspective]

SIMKÓ Alfréd

[The practical relevance of pharmacopsychology as a clinical science is determined by its relationship to structural phenomenology and psychopathology. Only in this way is it able to approach the experiences that can be correlated with the dynamics of action of a psychotropic drug in question. (Psychopathological concepts that work with definitions that are abstracted from static mappings - with logical value - have not proved sufficient for this methodology.) After stressing the principle of target symptoms (Freyhan, Hippius) and syndromatics (M. Müller), which are important for the indications of pharmacopsychiatric treatments, the prophenomenal concept of "actual sensitivity" was elucidated, the latter being understood as the experiential dimension of the vital dispositions that can be influenced by medication. Following Friesewinkel's conception, we projected the effects of psychotropic drugs into the dimensions of "Aktualbefindlichkeit" changes. The basic law of pharmacopsychology was recognized in our experience that any pathological experience can only be influenced by medication to the extent that it is still mobile in relation to the variable intensional dynamics and the "Aktualbefindlichkeit". After presenting Hackstein's critical understanding of the issue of clinically relevant effect-disassociations (H. W. Janz), we addressed the issue and illustrated its essence with an example from our own case. We followed Ziolko in listing the most important subjective factors modifying the perception of impact. We have pointed out the phenomena of 'subjective intolerance', which we have mostly evaluated as oppositional. ]

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Fluoxetine use is associated with improved survival of patients with COVID-19 pneumonia: A retrospective case-control study

NÉMETH Klára Zsófia, SZÛCS Anna , VITRAI József , JUHÁSZ Dóra , NÉMETH Pál János , HOLLÓ András

We aimed to investigate the association between fluoxetine use and the survival of hospitalised coronavirus disease (COVID-19) pneumonia patients. This retrospective case-control study used data extracted from the medical records of adult patients hospitalised with moderate or severe COVID-19 pneumonia at the Uzsoki Teaching Hospital of the Semmelweis University in Budapest, Hungary between 17 March and 22 April 2021. As a part of standard medical treatment, patients received anti-COVID-19 therapies as favipiravir, remdesivir, baricitinib or a combination of these drugs; and 110 of them received 20 mg fluoxetine capsules once daily as an adjuvant medication. Multivariable logistic regression was used to evaluate the association between fluoxetine use and mortality. For excluding a fluoxetine-selection bias potentially influencing our results, we compared baseline prognostic markers in the two groups treated versus not treated with fluoxetine. Out of the 269 participants, 205 (76.2%) survived and 64 (23.8%) died between days 2 and 28 after hospitalisation. Greater age (OR [95% CI] 1.08 [1.05–1.11], p<0.001), radiographic severity based on chest X-ray (OR [95% CI] 2.03 [1.27–3.25], p=0.003) and higher score of shortened National Early Warning Score (sNEWS) (OR [95% CI] 1.20 [1.01-1.43], p=0.04) were associated with higher mortality. Fluoxetine use was associated with an important (70%) decrease of mortality (OR [95% CI] 0.33 [0.16–0.68], p=0.002) compared to the non-fluoxetine group. Age, gender, LDH, CRP, and D-dimer levels, sNEWS, Chest X-ray score did not show statistical difference between the fluoxetine and non-fluoxetine groups supporting the reliability of our finding. Provisional to confirmation in randomised controlled studies, fluoxetine may be a potent treatment increasing the survival for COVID-19 pneumonia.

Clinical Neuroscience

Late simultaneous carcinomatous meningitis, temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting with mono-symptomatic vertigo – a clinico-pathological case reporT

JARABIN András János, KLIVÉNYI Péter, TISZLAVICZ László, MOLNÁR Anna Fiona, GION Katalin, FÖLDESI Imre, KISS Geza Jozsef, ROVÓ László, BELLA Zsolt

Although vertigo is one of the most common complaints, intracranial malignant tumors rarely cause sudden asymmetry between the tone of the vestibular peripheries masquerading as a peripheral-like disorder. Here we report a case of simultaneous temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting as acute unilateral vestibular syndrome, due to the reawakening of a primary gastric signet ring cell carcinoma. Purpose – Our objective was to identify those pathophysiological steps that may explain the complex process of tumor reawakening, dissemination. The possible causes of vestibular asymmetry were also traced. A 56-year-old male patient’s interdisciplinary medical data had been retrospectively analyzed. Original clinical and pathological results have been collected and thoroughly reevaluated, then new histological staining and immunohistochemistry methods have been added to the diagnostic pool. During the autopsy the cerebrum and cerebellum was edematous. The apex of the left petrous bone was infiltrated and destructed by a tumor mass of 2x2 cm in size. Histological reexamination of the original gastric resection specimen slides revealed focal submucosal tumorous infiltration with a vascular invasion. By immunohistochemistry mainly single infiltrating tumor cells were observed with Cytokeratin 7 and Vimentin positivity and partial loss of E-cadherin staining. The subsequent histological examination of necropsy tissue specimens confirmed the disseminated, multi-organ microscopic tumorous invasion. Discussion – It has been recently reported that the expression of Vimentin and the loss of E-cadherin is significantly associated with advanced stage, lymph node metastasis, vascular and neural invasion and undifferentiated type with p<0.05 significance. As our patient was middle aged and had no immune-deficiency, the promoting factor of the reawakening of the primary GC malignant disease after a 9-year-long period of dormancy remained undiscovered. The organ-specific tropism explained by the “seed and soil” theory was unexpected, due to rare occurrence of gastric cancer to metastasize in the meninges given that only a minority of these cells would be capable of crossing the blood brain barrier. Patients with past malignancies and new onset of neurological symptoms should alert the physician to central nervous system involvement, and the appropriate, targeted diagnostic and therapeutic work-up should be established immediately. Targeted staining with specific antibodies is recommended. Recent studies on cell lines indicate that metformin strongly inhibits epithelial-mesenchymal transition of gastric cancer cells. Therefore, further studies need to be performed on cases positive for epithelial-mesenchymal transition.

Clinical Neuroscience

Cholinesterase inhibitors and memantine for the treatment of Alzheimer and non-Alzheimer dementias


In aging societies, the morbidity and mortality of dementia is increasing at a significant rate, thereby imposing burden on healthcare, economy and the society as well. Patients’ and caregivers’ quality of life and life expectancy are greatly determined by the early diagnosis and the initiation of available symptomatic treatments. Cholinesterase inhibitors and memantine have been the cornerstones of Alzheimer’s therapy for approximately two decades and over the years, more and more experience has been gained on their use in non-Alzheimer’s dementias too. The aim of our work was to provide a comprehensive summary about the use of cholinesterase inhibitors and memantine for the treatment of Alzheimer’s and non-Alzheimers’s dementias.

Clinical Neuroscience

[The Comprehensive Aphasia Test in Hungarian]


[In this paper we present the Comprehensive Aphasia Test-Hungarian (CAT-H; Zakariás and Lukács, in preparation), an assessment tool newly adapted to Hungarian, currently under standardisation. The test is suitable for the assessment of an acquired language disorder, post-stroke aphasia. The aims of this paper are to present 1) the main characteristics of the test, its areas of application, and the process of the Hungarian adaptation and standardisation, 2) the first results from a sample of Hungarian people with aphasia and healthy controls. Ninety-nine people with aphasia, mostly with unilateral, left hemisphere stroke, and 19 neurologically intact control participants were administered the CAT-H. In addition, we developed a questionnaire assessing demographic and clinical information. The CAT-H consists of two parts, a Cognitive Screening Test and a Language Test. People with aphasia performed significantly worse than the control group in all language and almost all cognitive subtests of the CAT-H. Consistent with our expectations, the control group performed close to ceiling in all subtests, whereas people with aphasia exhibited great individual variability both in the language and the cognitive subtests. In addition, we found that age, time post-onset, and type of stroke were associated with cognitive and linguistic abilities measured by the CAT-H. Our results and our experiences clearly show that the CAT-H provides a comprehensive profile of a person’s impaired and intact language abilities and can be used to monitor language recovery as well as to screen for basic cognitive deficits in aphasia. We hope that the CAT-H will be a unique resource for rehabilitation professionals and aphasia researchers in aphasia assessment and diagnostics in Hungary. ]

Lege Artis Medicinae

[Vaccines against COVID-19 pandemic]


[The rapidly spreading SARS-CoV2 respiratory virus has evoked an epidemic with serious aftermath around the world. In addition to the health effects, the global economic damage is actually unpredictable. At the same time, the pandemic has launched a series of unprecedented collaborative scientific research, including the development of vaccines. This study summarizes up-to-date information on vaccines, immune memory, and some emerging clinical effects.]