Steven L. Mahorney

Preliminary study of carbamazepine in post-traumatic stress disorder

Ten patients meeting DSM-III criteria for post-traumatic stress disorder (PTSD) participated in a five-week open trial of carbamazepine. Seven patients manifested moderate to very much improvement, as shown on the Clinical Global Impression scale. Among the multiple symptoms associated with PTSD, nightmares, flashbacks, and intrusive recollections were selectively reduced in intensity and frequency. The results suggest that a kindling model or a model of a paroxysmal disorder may be applicable to PTSD.

The response of depressed inpatients to isocarboxazid.

Fifty-six inpatients with unipolar depression completed treatment with isocarboxazid. In comparing the differences between responders and nonresponders, it was found that psychomotor retardation, pathological guilt, daily persistence of unremitting symptoms, phobic anxiety, dexamethasone suppression test nonsuppression, and neuroticism were significantly more common among nonresponders. Reactivity of mood, blaming others, and extraversion were more common in responders. Total endogenous depression scores on the Newcastle 1, Newcastle 2, and Michigan scales were also significantly higher in nonresponders. Attained platelet monoamine oxidase inhibition was similar in both groups.

Dynamics of lip dyskinesia associated with neuroleptic withdrawal.

The lip movements associated with dyskinesia in adults with mental retardation were investigated through a dynamic analysis at medication baseline, at the points of the highest level of withdrawal dyskinesia as indexed by the DISCUS rating scale, and at the lowest level of dyskinesia following complete withdrawal of the medication. Results showed that the changes in the amount of lip oscillations following medication reduction and eventual withdrawal were strongly linked to changes in the structural complexity of the dynamics of lip motions. These findings provide evidence that neuroleptic medication reduces the df of the dynamics of the movement output and that this change is inversely related to the level of tardive dyskinetic motion observed in the clinical setting.

Onset of Dyskinesia and Changes in Postural Task Performance during the Course of Neuroleptic Withdrawal.

The effect of neuroleptic withdrawal on postural task performance of 20 adults with mental retardation was examined. Dyskinesia was measured using the DISCUS rating scale and postural stability using a force platform during a prospective longitudinal neuroleptic medication withdrawal protocol. Assessments were conducted at baseline and monthly intervals, extending to approximately one year following complete medication withdrawal, when significant changes in amount of postural motion and sequential pattern of postural movement complexity were observed. Postural task performance tended to return to near baseline levels at periods of up to 1 year following medication withdrawal, although one third of the subjects continued to display atypical postural motion profiles at follow-up. Results provide within-subject evidence that tardive dyskinesia is associated with generalized changes in motor control and not simply peripheral disturbances of movement.