Psychopharmacologic Study of Schizophrenia and Depressions

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Abstract
Sodium amytal followed by benzedrine sulfate was admd. intraven. on 5 consecutive days and again once on the 5th day after a course of electric convulsive therapy to 20 patients with depression and 20 patients with schizophrenia. Each patient was evaluated on a rating scale for quantity of affect, quality of affect, motor activity, and speech productivity, before and after each administration of the drugs. (1) For depressed patients: (a) There was considerable individual variability in psychologic response to the drugs. The initial mean responses to the daily injns. of the drugs were a small increase in the quantity of affect above the normal level; lessening of the degree of depression (but not to the normal level); and improvement to the normal level in motor activity and speech productivity. (b) The mean daily drug responses for all 4 variables throughout the exptl. period remained at the same level on the 1st and subsequent days. (c) The trends of the day-to-day mean ratings before the admn. of the drugs indicated symptomatic improvement in motor activity and speech productivity. (d) Electric convulsive therapy led to remission of symptoms and then the drugs produced no change in the variables. (e) Two correlations among the variables were significant[long dash]the less the motor activity, the less the volume of speech, and the greater the depth of depression, the greater the quantity of affect. (f) The further the symptoms deviated from the norm, the greater the response to the drugs. (2) For schizophrenic patients: (a) There was considerable individual variability in the psychologic response to the drugs. The initial mean responses for this group of patients to the daily injns. of the drugs were: slight improvement in the quantity of affect; improvement to near the normal level for the slightly diminished quality of affect; improvement to the normal level in motor activity and speech productivity. (b) The initial mean responses were the greatest, subsequent ones becoming progressively less for quantity of affect, motor activity, and speech productivity throughout the 5-day exptl. period. (c) There was no symptomatic improvement in any of the variables throughout the 5-day period. (d) Electric convulsive therapy did not lead to symptomatic improvement and the drug responses continued to be similar to what they had been previous to the treatment. (e) Only motor activity and speech productivity were correlated; the less the motor activity, the less the volume of speech. (f) The further the symptoms deviated from the norm, the greater the response to the drugs. (3) The differences in response to Na amytal and benzedrine sulfate between patients with depression and those with schizophrenia suggested further areas of study. Failure to maintain the same degree of psychologic response from day to day in schizophrenic patients suggested the possibility of a pathophysiological defect in carbohydrate metabolism in these patients; the improvement in certain symptoms from day to day in depressed patients suggested that these drugs may have limited value for giving symptomatic relief and that other related drugs may be more effective; the lack of drug response in depressed patients after electric convulsive therapy suggested that the pathophysiology was restored to normal function by the convulsive therapy; and the striking contrast in responses of patients with depression to those with schizophrenia suggested the use of these drugs in defining the phenomenological aspects of the psycho-pathology of these disorders.

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