A. James Giannini

Bromocriptine Therapy in Cocaine Withdrawal

Twenty‐four cocaine addicts who experienced withdrawal symptoms were studied for six weeks in a double‐blind design. Half of the group received daily treatment with bromocriptine and the other half with placebo. Significant relief with bromocriptine was seen almost immediately and continued throughout the detoxification period. The authors speculate that the results are consistent with the “dopamine‐depletion model” of cocaine withdrawal.

Comparison of antimanic efficacy of clonidine and verapamil

The standard treatment for mania has been lithium carbonate, alone or in combination with neuroleptics. Unfortunately, lithium is refractory in some patients and may possess potential thyroid and renal toxicity.1 Neuroleptics also are not without risks and can cause extrapyramidal symptoms as well as tardive dyskinesia.2 As a result, other less potentially troubling agents have been sought to control the symptoms of mania. Two such drugs are the antihypertensive agent, clonidine, and the antianginal drug, verapamil.

Neurotoxicity Caused by Lithium‐Verapamil Synergism

A test of significance of the effects of placebo indicated that placebo had no effect at any time on the treatment of phencyclidine (time 0-60-U = 48.5, P> .05; time 60-120U = 43.5, P> .05; time 0-120-U = 40.5, P> .05). Terfenadine also did not produce any significant change at any time during the trial (time 0-60-U = 40, P> .05; time 60-120-U = 43, P> .05; time 0-120-U = 38, P> .05.) Initially, chlorpromazine did not produce any benefit (time 0-60-U = 30, P> .05). Also, there was no significant improvement in the latter phase of the experiment, although a tendency for improvement was seen (U = 28, P> .05). However, when results of the BPRS were compared from initial evaluation and the final evaluation (time 0-120), significant improvement was seen (U = 125, P < .01).

Effects of naloxone, metenkephalin, and morphine on phencyclidine-induced behavior in the rat

The effects of naloxone, metenkephalin, and morphine were tested on phencyclidine(PCP)-induced stereotyped behaviors, ataxia, and hyperactivity in the rat. Naloxone (8 mg/kg) significantly decreased stereotypy, ataxia, and hyperactivity across all PCP doses tested (2.0, 4.0, and 6.0 mg/kg). Metenkephalin (40 μg/kg) and morphine (5 and 10 mg/kg) increased ataxia at the 4.0 and 6.0 mg/kg PCP doses. Stereotypy was altered by the opiates in a dose-dependent manner; enhanced by metenkephalin (40 μg/kg) at 2.0 mg/kg and inhibited by metenkephalin (40 μg/kg) and morphine (10 mg/kg) at 4.0 and 6.0 mg/kg PCP. Locomotor activity was increased by morphine (5 mg/kg) at 2 mg/kg PCP. These results suggest an involvement of central opiate receptor mechanisms in the mediation of PCP-induced behaviors in the rat.

Phencyclidine Intoxication: Assessment of Possible Antidotes

Phencyclidine (PCP), a widely abused drug currently, has multiple pharmacological actions, including psychotomimetic [1], anesthetic [2], sympathomimetic [2], anticholinergic [3-7], and dopaminergic [8-10]. Similarly, PCP intoxication in man can present with diverse symptoms: schizophrenia-like delusions and hallucinations; mania; violence, dyskinetic, catatonic, or stereotyped movements; hypertension; and coma [11, 12]. There is general agreement that the treatment of PCP intoxication includes support of vital functions and acidification of the urine [13]. However, there is no known specific antidote for PCP toxicity. Although diazepam [13], haloperidol [14, 15], and chlorpromazine [16] have been reported to improve the agitation and psychotic symptoms caused by PCP, the therapeutic efficacy of these agents has rarely been documented with objective clinical measures. Recently we found that intramuscular physostigmine and haloperidol [17, 18] improved several symptoms of acute PCP intoxication as measured by the Brief Psychiatric Rating Scale (BPRS) [19].

Visual Symbolization as a Learning Tool: Teaching Pharmacology to International Audiences

Medieval and Renaissance teaching techniques used linkage between course content and tangentially related visual symbols to reinforce lectures. This technique was adopted in teaching pharmacologic principles of addiction to international audiences. It produced significant results with non‐English‐speaking audiences using concurrent or consecutive translation. This technique may be useful for non‐English‐speaking audiences because of enhancement of all three areas of memory: attention, storage, and retrieval.

Decreased reception of nonverbal cues in heroin addicts

ABSTRACT The ability to interpret nonverbal cues was tested in 15 young, white American male heroin addicts who were not intoxicated. When their responses were compared with those of age-matched controls, addicts were found to be significantly less accurate in reading nonverbal communications.

Antidotal Strategies in Phencyclidine Intoxication

The authors present different antidotal strategies in treating phencyclidine (PCP) intoxication based upon specific symptomatic presentation. Evidence exists for dopaminergic, cholinergic and opiate-like activity of PCP in both laboratory and clinical studies. Reviewing these studies, clinical interventions are recommended according to various symptom clusters.

TREATMENT OF PHENYLCYCLOHEXYLPYRROLIDINE (PHP) PSYCHOSIS WITH HALOPERIDOL

Twenty white males who presented with psychosis were later found to have ingested PHP. Treatment with haloperidol 5 mg IM caused significant improvement while placebo treatment did not. Results of haloperidol treatment of PHP psychosis were similar to previously published reports with phencyclidine (PCP) psychosis.

Drug Abuse and Depression: Possible Models for Geriatric Anorexia

The central biochemical pathology of anorexia and the natural aging of the brain is similar. Biochemical models for drug withdrawal and depression may also assist in understanding geriatric anorexia. Norepinephrine, corticotropin releasing factor and beta-endorphin may key neurotransmitters in all of these conditions.