Creation of Psychopharmacol III (VLSG 28-04-08)
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Transcript of Creation of Psychopharmacol III (VLSG 28-04-08)
Felix HaslerFelix HaslerKlinische ForschungKlinische Forschung
HRCHRC ZürichZürich
The Creation ofThe Creation ofPsychopharmacology IIIPsychopharmacology III
David Healy, Harvard University Press, 2002David Healy, Harvard University Press, 2002
Von den Neuroleptika zu den Antipsychotica
Pipamperone (Dipiperon®)
Risperidon (Risperdal®)1993
Von den Neuroleptika zu den Antipsychotica
Lundbeck: Sertindol (Serdolect® 1996)
Komplikation: Verlängerung des QT-Intervalls
Exkurs Herzphysiologie
Erstes EKG (1903)
Sertindol (Serdolect® 1996)
Komplikation: Verlängerung des QT-Intervalls
Rezeptorbindungs-Profil Sertindol
(Seroquel)
ECDEU: Empirische Wissenschaft
Max Fink Nathan Kline Leo Hollister
Positive symptoms Negative symptoms
Cognitive symptoms Behavioral symptoms
„EGO-DISORDER“
Positive and negative schizophrenia
Externe / Interne StimuliExterne / Interne Stimuli Externe / Interne StimuliExterne / Interne Stimuli
Filter intaktFilter intakt Filter „gestört“Filter „gestört“
Thalamus
Frontal Cortex
Striatum Pallidum
Prim.-sensori.Cortex
Extro-ceptive& intro-ceptive Stimuli
CSTC-Loop and Sensorimotor GatingCSTC-Loop and Sensorimotor Gating
Hippocampus
-Glu
RA
+5-HT +5-HT +5-HTVTA
+DA-DA
Parietal cortex
Temporal cortex
C. m.
Agid O, Mamo D, Ginovart N, Vitcu I, Wilson AA, Zipursky RB, Kapur S (2007) Agid O, Mamo D, Ginovart N, Vitcu I, Wilson AA, Zipursky RB, Kapur S (2007) Striatal vs extrastriatal dopamine D2 receptors in antipsychotic response - aStriatal vs extrastriatal dopamine D2 receptors in antipsychotic response - adouble-blind PET study in schizophrenia.double-blind PET study in schizophrenia. Neuropsychopharmacology 32: 1209-15Neuropsychopharmacology 32: 1209-15
D2-Besetzung durch Neuroleptika und D2-Besetzung durch Neuroleptika und klinische Wirksamkeit Iklinische Wirksamkeit I
D2-Besetzung durch Neuroleptika und D2-Besetzung durch Neuroleptika und klinische Wirksamkeit IIklinische Wirksamkeit II
Fluoxetin (Prozac®)Klassischer SSRI(Selektiver Serotonin-Wiederaufnahme-Hemmer)
„Symbol of the 90ies“
Figure 2. Mean Standardized Improvement as a Function of Initial Severity and Treatment Group.Drug improvement is portrayed as red triangles around their solid red regression line and placebo improvement as blue circles around their dashed blue regression line; the green shaded area indicates the point at which comparisons of drug versus placebo reach the NICE clinicalsignificance criterion of d ¼ 0.50. Plotted values are sized according to their weight in analyses.
Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug AdministrationKirsch I, Deacon BJ, Huedo-Medina TB, Scoboria A, Moore TJ, et al., PLoS Medicine Vol. 5, No. 2, e45 doi:10.1371/journal.pmed.0050045
Figure 3. Mean Standardized Improvement as a Function of Initial Severity and Treatment Group, Including Only Trials Whose Samples Had High Initial Severity Drug improvement is portrayed as red triangles around their solid red regression line and placebo improvement as blue circles around their dashed blue regression line; the green shaded area indicates the point at which comparisons of drug versus placebo reach the NICE clinical significance criterion of d ¼ 0.50. Plotted values are sized according to their weight in analyses.doi:10.1371/journal.pmed.0050045.g003
Neue Allianzen
„Management of behaviour“