Arthur Rifkin

Low dose fluphenazine decanoate in maintenance treatment of schizophrenia

To test the clinical efficacy of low dose fluphenazine decanoate (1.25 mg to 5.0 mg biweekly), we carried out two separate experiments: (1) an open trial in 57 schizophrenic outpatients, lasting 6 months; (2) a double-blind, placebo-controlled discontinuation study in a subgroup of patients who maintained good remission throughout the entire 6-month open trial. The results suggest that lower doses of fluphenazine decanoate than those usually used may be effective in preventing psychotic relapse while keeping total cumulative dosage to a minimum.

Can schizophrenia with premorbid asociality be genetically distinguished from the other forms of schizophrenia

Sufficient data exist to establish a genetic basis for some forms of schizophrenia. However, genetic factors may not account for all the variance, and subtle forms of central nervous system (CNS) damage may have etiological significance for some schizophrenic subtypes. One such subtype may be chronic schizophrenia with premorbid asociality (SPA). To test this hypothesis, the risk of schizophrenia among relatives of probands who did or did not meet the criteria for SPA was examined. The incidence of schizophrenia in the relatives of SPA probands was lower than that in the relatives of non-SPA probands. This difference approached but did not reach statistical significance. Because most studies have found a higher familial genetic loading in chronic forms of schizophrenia, the apparently lower incidence of disorder in relatives of chronic schizophrenics with premorbid asociality seems to be a heuristic lead worth pursuing.

Panic disorder: response to sodium lactate and treatment with antidepressants

Effective drugs for mental disorders have been found by serendipitous findings not supported by knowledge of psychopharmacology. Drug are assigned labels, such as antidepressant without knowledge that such a label delimits the utility of such agents. Many double-blind controlled studies have shown that imipramine effectively ameliorates panic attacks and agoraphobia. Epidemiological data show a relationship between Panic Disorder and Depression. Relatives of probands with Major Depression plus an Anxiety Disorder were at greater risk for both Major Depression and for an Anxiety Disorder. Panic Disorder, as a subcategory of Anxiety Disorder was associated with the greatest increased risk. Intravenous sodium lactate reliably produces anxiety attacks clinically indistinguishable from those occurring in Panic Disorder, in subjects with that disorder. Panic Disorder is characterized by response to imipramine, an epidemiological link to Affective Disorder, and is similar to panic induced by infusion of sodium lactate.

Sodium lactate response as a model for panic disorders

An important advance in our understanding of panic disorder is the use of an infusion of sodium lactate as a biological stimulus of an attack, which should enable researchers to investigate such attacks under laboratory conditions.