Fluoxetine in the treatment of borderline and schizotypal personality disorders

Article Abstract:

Patients with borderline or schizotypal personality disorders, and obsessive-compulsive disorder share many common symptoms such as depression, bulimia, suicidal tendencies, and hostility. It is thought the three disorders may be related. Fluoxetine is a drug useful in treating some of the impulse control problems associated with obsessive-compulsive disorder. This study examined if fluoxetine might also be useful in treating patients with borderline or schizotypal personality disorders. The drug was given to 22 patients. Of these patients, eight were diagnosed with borderline personality disorder, four were diagnosed with schizotypal disorder, and 10 had both types of disorders. A self-mutilation questionnaire and the Hopkins Symptom Checklist (HSCL), a test of psychiatric well-being, were given at the beginning of the study and at follow-up visits over a 12-week period. Twelve patients reported self-mutilating behavior at the beginning of the study with an average 4.1 incidents per week. After nine weeks, the number of patients reporting these episodes dropped to six. By week 12 of the study, two patients were experiencing episodes of self-mutilation, with the total number of episodes reduced to less than one per week. HSCL scores averaged 22 at the beginning of the study and decreased significantly by the week 12, indicating an increase in psychiatric well-being. These results demonstrate that fluoxetine may be useful in treating borderline and schizotypal personality disorders. Further studies using control groups and different clinical trial methodologies are required. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy, Fluoxetine, Borderline personality disorder, Schizotypal personality disorder

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Serotonergic measures in the brains of suicide victims: 5-HT(subscript 2) binding sites in the frontal cortex of suicide victims and control subjects

Article Abstract:

Serotonin (5-HT) is one of the major neurotransmitter chemicals found in the brain and other nerve tissue. Neurotransmitters are necessary for the transmission of nerve signals to and from the brain. Higher levels of this chemical have been found in the brain tissues of suicide victims and patients with major affective disorders (such as depression) than normal individuals. Also, 5-HIAA (5-hydroxyindoleacetic acid), the major breakdown product of 5-HT, has been reported to be low in the CSF (cerebral spinal fluid) and various brain areas of suicide victims. The authors determined the number of serotonin binding sites in the frontal cortex of 32 suicide victims and 37 subjects who died from nonpsychiatric causes. The results indicate that the maximum number of serotonin binding sites in the frontal cortex of suicide victims is significantly greater than that in control subjects. One explanation offered is that a general decrease in neurotransmitter activity may cause the receptor sites to increase. Further studies using larger sample sizes are needed to help determine possible causes for the greater density of serotonin receptors observed in this study. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Physiological aspects, Suicide, Affective disorders, Mood disorders, Neurotransmitters, Serotonin

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Clozapine: is another view valid?

Article Abstract:

Physicians started subscribing clozapine for schizophrenics in 1989. Research has shown that clozapine is effective for schizophrenics who are resistant to drug treatments and intolerant of traditional neuroleptics. Furthermore, it has been shown that clozapine's ability to decrease suicidality more than compensates for the increased risk of agranulocytosis in patients who took the drug. A recent study erred in discouraging the use of clozapine to treat schizophrenics.

Care and treatment, Antipsychotic drugs, Antipsychotic agents, Schizophrenics, Clozapine

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