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JEUTICA                                          I
                                                  I
                                                 l
                         Num. 1                 I
                                                             THE EFFEcr OF HYPOTHALAMlC PHOSPHOLIPID LIPOSOMES
                                                             IN PAT1ENTS TREATED WITH SmPJRIDE OR HALOPERlOOL
 . volume of distribution
                                    5.
                                                                          E. AGUGLIA, C. CALANDRA, V. RAPISARDA
 rnagement of hyperten-
 rdy.                           15              i
                                                I
                                                                    ltmittIJe of Ps~çhittt1'1 (Remi 01 Dsp4rlmenl: Pro/. ·V. Rapkaraa)J
                                                                                          Uni'V6'rfiJy of Catania (1141'1)

  potassfum conserving                          / ...                                        D.   MAUGERI
                               23                                   InJJituie o/ Gero1Jlolccy (Read of Departmento' p.rot. L. Motta),
:>SEI, G. ROMAN8!:LI,                                                                 UnitJt1rsity o/ Cd/anta (1ta1:y)
IESAN, M. MOTOLESE,

otory heart fa/lure •          31
                                                        Summary
 of cyprohepladlne and
                               43                             We evaluated the effieacy of treatment with hypothalamic phospholipid
                                                        Iiposomes in depressed patieots treated with sulpiride and io schizophrenie
ERICHETII,                                  ":i '.
                                                        patients !reated with haloperidol in comp,arison with patients having the
'JJlnical trla! of dihydro·
                               53
                                            J
                                           . --1.
                                                        same disorders and !reated with· the same psychotlopic ~ alone. The
                                                        results were assessed nsing the tests of Hamilton, CassllJl(>, Zoog and Witten·
ZAGUI~~k'
      ,                                                 homo Plasma prolactin Ievels were monitored iJr order to detect aetivity of
                                                        hypothalamic phospholipids on drng-induced hyperprolactinaemia.
~èute   appendlcltls wlth                                     The resu!ts obtained showed not only that the therapeutic association
n of cfif}damycin   phos~
                                                        of hypotbalamic phospholipid Iiposomes did not negatively inJIuence the
                               69                       therapeutie potentiai of the two. psychotropic drngs, but indeed eohauced
H                                                       their efficacy.
mQdul® 200                     79
                                                               The increase of plasma proIactin levels produced· by sulpiride was not
nog/ycate pressurlsoo                                   modified by treatment with hypothaIamic phospholipid Iiposomes, whereas
                               89          .~
                                                        this increase was conside,ably blunted in patients receiviog haioperid.ol.

'o dlsorders and post-
                               97                       !NTRODUcrION
JOMANGE
'l/meni In tha trt'8tment                                     During Iecent yeaIs pharmacologica1 pIOgICSS has peImitted an improved
                                          ..~ .
                              107                       symptomarie ·appIoaeh co mental illnesses. Drugs sueh as haloperidol have
                                                        made the control of halincinatory phenomena possible [l}, while drugs sueh
nad/ne In varlous skin
                              119                       a, sulpiride have pIoved to have a good therapeurle effeef in depression, psy.
                                                        chosomatic diseases and psychomoror inhibition [2, 3]. Howevèr, tbe pIoblem
                                                        of undesiIable side effeets hils remained.

                                                        Acta Therapeutica lO (1984)                                                       133
-•..•., - - - - - - - -                            .
                                     -----:;:te---'-.                      '
i
                                                                           "'--"--+:.,-
                                                                                     .._.... __.-....._ _. _ - -
                                                                                                                               J



 B. AGUGLIA, C. CALANDRA,   n.   MAUGERI. V. RAPISAR:OA                                                                        i
                                                                                                                               I



     Morot side effecrs can be largely controlled by the use cri anrlcholinergic              phtenia. The 15 depressed :
                                                                                                                               !
                                                                                                                               !
druga, but these do nOt have the same acrion on othet side effeets which                      to diffetent therapeutic proI
depend on a neuro·endoctine mechanism [4, 5). Recent data in the literarure
have shown that phospholipids can interiere witli this mechanism [61.
                                                                                                . Group A, including      i
                                                                                                                          l(
                                                                                              sulpitide Im. (400 mg pet d I
     Mter only seven days of trealment with sulpidde, plasma prolaetin levels
undergo a norable increase. The administtation of haloperidol causeS a rapid
increase in pt;laetin levels afte< only 90 minutes. CASACCHIA [6} has
                                                                                              fot a pedod of 28 da ys; ft. •
                                                                                              hypothalamic phospholipid
                                                                                              administrarion at 8.00 a.m. ,
                                                                                                                               I
demonstrated that phospholipid Iiposomes may be concemed with tbis in·
crease.
                                                                                         ~.
                                                                                                    Group B (the control i
                                                                                              received only sulpiride given .
                                                                                                                               I
     Our aim was to evaluate the experimental validìty     cri these recent dara.
                                                                                              of 28 days.                   I
PHOSPHOLIPlD LIPOSOMES
                                                                                                   The 15 patìents sufferi     I
                                                                                              GtOUP A includìng lO parle
                                                                                              5 patients, 3 women and ; I
       The use of thin !ayer chromatography has been able to provide informa-                 haloperìdol and were treate
 don ahoot the chemical struetUre of the various classes of phospholipids.
 Interpretation of the cole of the phospholipids has opened up a fascinating                       Both the sulpitide and
 field of tesearch. Phospholipid molecules, when organi2ed in the form cri                    out period lasring 7 days, ,
 Iiposomes, ate able to cross vhe blood-hrain barder [7] and to aet at the                    psychodiagnostic tests wete ,
 level of the centraI nervous system; their effects are as follows :                          diagnosric tests wete repeate<
- stimulation of the endogenous synthesis of phospholìpids by the activation                  same assessments were carri
      of dddil-transferase;
- activation of adenylcyclase [8];
                                                                                              RESULTS
- increase of the cerebral content of glucose [9, W];
- aerJvation cri the dopaminergic pathways [11, 12].
                                                                                                   The deptessed patienrs
       Studies by GREGORIADIS [13} and PAPAHADIOPOULOS [14] have esta-                        values of the various tests. :
blished that the charaeteristic properties of Iiposomes ate related to physical               psychodiagnosric tests on ea
stability and the capadty to interaer by fusion with biological membranes.                    piride and hypothalamie ph
       In OUt experiments we used Iiposomes of hypothalamic origin, charac-                   with sulpitide alone (Group
terized by the presence of long polyunsaturated hydrocarbon chains and nega-
                                                                                                    The score trend evaluo
rlvely charged gtoups.
                                                                                              by means of Cassano's tesI
                                                                                              However, the petcentage in
MATERIALS AND METHODS
                                                                                              liposomes were associated w
                                                                                              the gtOUp treated with sulpil
      Thitty padents, age<! 20·52 years, were included in the srudy. Por                            An even cIearer impr<
psychiatdc diagnosis we used the Research Diagnostic Cdteria (RDC) (15).                      and Hamilton tests in pat
Psychopathological status was ra<ed by mean of Hamilton's scale, Cassano's                    phospholipid liposomes tOB
resr and Zung's arociery test for depression and Wirrenborn'$ test for schizo-                15.2 % and 35.1 % respecr:
phrenia. Of these patients, 15 suffered from depression aod 15 ftom schizo-                   sulpitide alone (Fig. 1).

                                                  Acta Therapeutica 10 (1984)                 Acta Therapeutica 10 (198·

                                                                                     .
                                                                                    "}
l
                                          ..,.
                                        "!.'·:'
                                          ,".;:
                                           ':".
                                           c,.
                                          -,."



                                                                               EFFECT OF"HYPOTHALAMIC "PHOSPHOUPID LlPOSOMES


 ed by the use cf antichoIinergic                  phrenia. The 15 depressed patienrs were divided into 2 groups and subjected
·n On other side effeets whieh                     ro different therapeutic programmes.
 ]. Recent data in the literature
.ith chis mechanism [6].                                 Group A, including lO parienrs, 6 women and 4 men, was treated with
                                                   sulpiride Lm. (400 mg per day in 2 administrarions at 8.00 a.m. and 1.00 p.m.)
llpiride, plasma prolactin levels
                                                   for a period of 28 days; from the 7th day of treatrnent 400 mg per day of
1 of haloperidol causes a rapid
                                                   hypothalamic phospholipid liposomes was also given in a single inrravenous
minutes. CASACCHIA [6] has
                                                   administrarion at 8.00 "-m.
'y be concerned with this in-                                                                   .      ,
                                                         Group B (the control group) including 5 padenrs,3 women and 2 men,
li vallidity of these recent dara.                 received only sulpiride giveo in the same way, for the whole observadon perio<!
                                                   of 28 days.
                                                       The 15 patieors suffering from schizophrenia were divided into 2 groups.
                                                  Group A including lO parienrs, 6 women and 4 men, and Group B including
                                                  5 parienrs, 3 women and 2 men, were administered with 4 mg per day of
; been able to provide informa-
                                                  haloperidol and were rreated in the same way as the depressed padenrs.
rious c1asses of phospholipids.
s has opened np a fasdnadng                            Both the sulpiride and the haloperidol were administered after a wash-
Len organized in the form of                      out perio<! lasdng 7 days, at che end of whieh baseline prolactin levels and
 barrier [7] and to aet at the                    psychodiaguosdc tesrs were evaluated. On the 7th day cf treatroent the psycho-
=   are as follows :
phospholipids by che aetivation
                                                  diagnosdc tesrs were repeated and plasma prolacdn levels were detetInined; the
                                                  same assessments were carried out at me end of treatmeot.


[9, lO];                                          RESULTS

lI, 12].
                                                       The depressed padeors in both groups presented very similar haseline
ffADrOPOULOS     [14] hav'e esta-                 values cf the various resrs. Tables I, I! and II! show the scOte rrend from the
osomes are related to physical1                   psychodiagnostic tesrs on eaeh occasion both for che group rreated with sul-
;vith biological membranes.                       piride and hypothalamic phospholipids (Group A) and for the group treated
f hypochalamic origin, charac-                    with sulpiride alone (Group B).
 hydrocarbon chains and nega-
                                                        Tbc score tread evaluated on the 7th day "'ld, at the end of trearment
                                                  by means of Cassano's test revealed a Clear imprb'vemeot in boch- groups.
                                                  Howevet, the percentage improvernent in the group in V{hich phospholipid
                                                  liposomes were associated with the sulpiride was as high as 16.2 %, while in
                                                  che group treated with sulpiride alone it was 8.7 %.
, included in the stiIdy. For                           An eveo clearer improvemeot was found in the resulrs of boch Zung
<gnostic Criteria (ROC) [15].                     and Hamilton tesrs in padenrs who bad been treated wich hypothalamic
of Hamilton's scalIe, Cassano's                   phospholipid liposomes together with sulpiride. This improverneot was of
I Wittenborn's test for schizo-                   15.2 % and 35.1 % respecrively, against the 6 % and 17.7 % achieved with
epression and 15 from schizo-                     sulpiride alone (Fig. 1).

Acta Therapeutica lO (1984)                       Acta Therapeutica lO (1984)                                                135
                                     --"+"--'
El
       E. "AGUGLIA; C. CALANDRA, D. MAUGBRI. V. RAPISARDA




                                                                                                                        ,
                                                                                                                      . 1-.

                                                                                                                       t·
,
i
.'..                                                                                                                          TABLE II: S:ore "end jrom Zur.
                                                                                                                                      .phoJpholipid   JipOJO'I7WJ
       TABLE I: $&01'8 J1'fma tram   CatJlJtJ<l.J test {or JepreISeJ p4lients weated with JUlptride   Ima
               _..pbosphòlipid liposr;nu,s (G...p A) mul sulpirnte oIcn. (&aup B).

                                                                                                                .:     .~:
                                                 GROUP A
                                                                                                                                        Initials          Age
                   IniU.I,         Age          Baseline        Day 7         End of treatment                                           B.L.             37
                                                                                                                                         C.V.             33
                   B.L.             37            50            74                 49
                                                                                                                                         A.R.             32
                   C.V.             33            99            46                 38
                                                                                                                                         B.R.             52
                   A.R.             32            93            40                 45
                                                                                                                                         e.R.             36
                   B;R.             52            60            38                 43
                                                                                                                                         Cur.             37
                   e.R.             36            64            60                 42
                                                                                                                                         e.G.             41
                   Curo             37           90             60                 43
                                                                                                                                         Costo             20
                   e.G.             41           95             95                 84
                                                                                                                                         R.e.              20
                   Costo            20           60             41                 45
                                                                                                                                         M.G.             49
                   R.C.             20           77             79                 63
                   M.G.             49           98             92                 72                          I
                                                                                                            .. l :                      Means
                 . Means                         78.6           62.5               52.4                        i
                                                                                                            _ L:
                                                                                                                                        ± S.D.
                  ± S.D.                         18.63          21.5               15.3                           r
                                                                                                                  j
                                                GROUP B                                                           I
                                                                                                                  I                     Initials         Age
                                                                Day 7
                                                                                                                  j ..
                  IniUals          A8e          BaseUne                       End of trcatment                                           A.L.             29
                                                                                                                  I                      M.G.             43
                   A.L.            29            86             88                 81                             I                                       38
                                                                                                                                         T.G.
                   M.G.            43            75             71       .-        6S
                                                                                                                                         V.A.             32
                  ·T.G.            38            62             58                 54
                                                                                                                                         P.G.             41
                   V.A.            32            92             84                 76
                   P.G;            41            84             80                 72                                                   Means
                                         .. ,                                                                                           ± S.D.
                  Means                          79.8           76.2               69.6
                                                                                                            .    ;
                  ± S.D.                        ·11.67          11.19              10.5

                                                                                                                 I
                                                                                                                i,.
                                                                                                                I
                                                                                                                ,"
                                                                                                                !

                                                                                                                !
                                                                                                                              Acta Therapeutica lO (198'
       136                                                      Acta Therapeutica lO (1984)
EFFEcr OF .HYPOTHALA,MIC PHQSPHOLIPID LIPOSOMES
     <DA




                                                             TABLE II: $&o1'e weml tram Zun~s test lor àep1'(JiSQJ, pt1tiqnts 'rea/ed. w;th sulpiriJe atul
                                                                     phospholipit! Uposomus (Gt-Ofl.P A) and sù/pi;;de tlkntl (.Group B).
 l patiemts trealeJ 'lUi/h Ju/piride   Ima
 p;rid. .Jcn. ( Group B).
                                                                                                     GROUPA

                                                                         lnitials        Age         Baseline        Day 7      En~   or trcatment
 )ay7       End of treatment                                              B.L.           37           38             55               30
                                                                          C.V.           33           56             37               30
 74               49
                                                                          A.R.           32           63             25               36
 16               38
                                                                          B.R.           52           52             33               30
 lO               45
                                                                          e.R.           36           47             38               33                     i
 18               43
                                                                          Curo           37           40             48               3g
 ;O               42
;O                                                                        e.G.           41           58             53               50
                  43
                                                                          Costo          20           31             38               29
15                84
Il                45
                                                                          R.e.           20           65             62               so
19
12
                  63
                  72
                                                ·I·"i·
                                                     "'"
                                                                          M.G.
                                                                         Means
                                                                                         49           67
                                                                                                      52.7
                                                                                                                     56
                                                                                                                     44.5
                                                                                                                                      51
                                                                                                                                      37.7
                                                                                                                                                             I
52.5
11.5
                  52.4
                  15.3
                                                l'.                      ± S.O.                       12.34          11.95             9.17
                                                                                                                                                             I
                                                l    '"
                                                      ..•.
                                                     ?:                 lnitials        Age
                                                                                                     GROUP B

                                                                                                    BaseIine        Day 7      End of treatment
                                                                                                                                                             I
                                                 [

                                                ·Il~
)ay7       End of treat.ment                                             A.L.            29           43            48                39
                                                                         M.G.            43           68            63                56
18               81
                                                                         T.G.            38           51            45                41
'I               65                              i:
;8               54
                                                                         V.A.            n           ·62            57                49
                                               '1 '                      P.G.           .41           37            35                34
14               76                            -:.::.
IO               72                                                      Means                        52.2          49.6              43.8
                                                                        ± S.O.                        12.87         10.85              8.70
'6.2             69.6
'1.19            10.5




                                             ..:1...
                                 :1                          Acta Therapeutica lO (1984)                                                             137
Acta Therapeutica lO (198~__'_-":i~lr"_
. l'r:.
o




    j,                                                                                              ... _--_._~-


     I    E. AGUGl:.IA. C. CALANDRA, D. :M'AUGERI. V. RAPISARDA                                                                                               E




     I
     I



                                                                                                                                          30
          TABLE III:   S&o~e   trend from Hamil/(m.JJ test far Jepresml p8tìents J1'eatea with su/ijirid(l
                  ami i'hospholipid Iiposomes (Gro"" A) ami ndpiriJ, al.ne (Group B).
                                                                                                                                      .   20           Clssan
                                                                                                                                                       16.ZO/.
                                                    GROUPA
                                                                            ..

                    lnitials                        BaseIi~e                                                                              10
     ,                                   Age                       J}ay7.        End or treatment
     i
     ,                 B.L.
                       C.V.
                                         37
                                         33
                                                     11
                                                     33
                                                                   12
                                                                   15
                                                                                       5
                                                                                       7
     l
    ,[                 A.R.
                       B.R.
                                         32
                                         52
                                                     30
                                                     19
                                                                   IO
                                                                    8
                                                                                       8
                                                                                       2                                                       ~        Sulpi
     ,                 C.R.              36          23            12                  8
                       Curo          ,   37         38             23                  7                                                       O        Sulpi
                       C.G.          I   41         33             28                 28
                       CeSt.             20         15             16                 14
                       R.C.              20         12             IO                  9                                       Percentage improvement in
                       M.G.              49         30             31                 19
                    Means                           24.4           16.5               10.7
                    "'s.o.                           9·70           8.05               7.7


                                                   ·GROUP B
                                                                                                                                                100
                    InitiaIs             Age       Baseline        Day 7         End or treatment
                                                                                                                                                80
                       A.L.              29         32             28                23
                       M.G.              43         26             2S                18                                                         60
                       T.G.              38         23             26                16                             !
                       V.A.              32         19             21                16                                                         40
                       P.G.              41         27             24                20
                                               "                                                                   .1                           20
                                                                                                                                                            •
                     Means
                    '" S.O.
                                                    25.4
                                                     4.82
                                                                   24.8
                                                                    2.58
                                                                                     18.6
                                                                                      2.96                                                     ng/ml        • E


                                                                                                                                                       -.-'
                                                                                                                                          Trend of plasm



          138                                                      Acta Therapeulica lO (1984)                             Acta Therapeulica lO (198'
                                                                                                                .::~




                                                                                                               'i
                                                                                                               X
                                                                                                             ,,::--.;!..
                                                                                                                 •<'
.RDA
                                                                                                        EFFECT QP HYPOTHALAMIC PHOSPHOLIPID LIPOSOMES



                                                         .,'
                                                                                                                                     HamlUon
                                                                                                                                     35.1%

                                                                               30
 rQfS~d  pt/tienu /re4leJ. with tulp"itiae
 ",Ipiride aùJne (Group B).
                                                                               20



 :Jay 7      End of treatment                                                  lO
 12                 S
 IS                7
 IO                8                                                                                                                                             "
  8                2
 12                8
                                                                                        ~       'Sulplride + Phospholipld tiposomes
!3
!8
                   7                                                                    D        Sulpiride
                  28
16                14                                                           ,~;;.                          Fig...
IO                 9                                                Percencage improvement in the psychodiagnostic tests in tbe 2 8J:oups               tA and B)
Il                19                                                                            of depressed patients.
 6.5              10.7
 8.05              7.7




                                                                                                                                          ,e
                                                                                         100
lay7        End of treatment                                                                                                     ~
                                                                                        80
'8               23                                                                                                                                                        :.i




                                                                                                    /
:5              18                                                                       60
:6              16
                                                     1
                                                                                                        ~l
:1              16                           '       "
                                                                                         40
:4              20                               -                                       20
4.8
2.58
                18.6
                 2.96                                                                  "!l/m!
                                                                                                    i
                                                                                                    B         7'              .140             29' 99

                                                                                                    Sulpirlde
                                                                                                _:' Sulpiride      +    Phosphollplds
                                                                                                      Fig. 2
                                                                               T:end of plasma prolactin leye1s in depressed patients.

                                             :1
                                                 "
                                                                                                                   .'    .'          .'   ~,            "   "I



'cta Therapeutica lO (1984)                 "T
                                             :1'               Acta Therapeutica lO (1984)                                                                           139

                            ~--'---t-"""'"
B. AGUGLIA, C. CALANDRA; n'",-MAUGERI. V. RAPISARDA


         The increase in se"rum l'rolactin levels induced by sull'iride was not               i;
                                                                                              ~"
   influenced by adjuvant treatment with hYl'othalamic l'hool'h,?lipid lil'osomes         "   ~"
   (Fig. 2).                                                                              ,-'i.';
                                                                                              i.
                                                                                          . ,.:
                                                                                            'o
           In the schizol'hrenic l'atients treated with haloperidol, the evaluation       '}"
     of the syml'tomatological trends was carriecl out by means of Wittenborn's
     test. The l'rolaetio trend was also evaluated. Table IV shows the values oh·
     tained using thls test on the various examinations carried out on the two groul's
     of patients. In the l'atients who had undergone adjuvant theral'y with phos.
    l'holil'id Iiposomes, a statistically sigoificant iml'rovement was found in 7 of
   '·the 9 subtests with the.,Wlttenhorn test. The. iml'rovement obtained was
     sigoificant in only one of the sub-tests in l'atients treated with haloperidol
    alone.
        A global evaluation bf the sub-tests a1so revealed a greater pereentage
   iml'rovement in the l'atients treated with l'hool'holipid liposomes (Fig. 3).
         In addition, in tbe schizol'hrenic l'arients treated with both haloperidol
. "'and hypothalamic l'hospholil'id Iiposomes the plasma l'rolactin levels tended
                                                                                         -.-;".
    to decrease, wbile in the patients treared with haloperidol alone they continued
    to increased (Fig. 4).




                                    29.55%
                          39·


                          20



                          lO




                                ~

                                O
                                    Haloperidol
                                    Haloperidol
                                                  +   Phospholipids
                                                                                                    j I-"'-j_~--'-"'_~--,-M.:."',---~,-'
                                                                                                           ;j
                                         Fig. 3
            Percentage improvement in the global value ai the Wittenbom test.                                     ù:;Èo:;Èui:;È:
                                                                                                                  CliClia:ip.;~c.h

   140                                                   Acta' Therapeutica lO (1984)    i
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                                                                                                                                                                                                                                    ~. [
                              ':T                                                                                                                                                                                       tr
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                                               TABLE IV: Score "end Irom lflittenborn's test in schizophrenic patients Ireatea wi/h
                                               haloperidol (#fa phospholi'pid uposomcs (Group A) and haloperidol ttlone (Group Bi
                                                                                                         GROUPA
                                                                                                           Schizophrenic                                                    Paranoic                  Ebepbrenic
                      Anxiety                 Hysteria              Mania             Depression                exitabitity                     Paranoia                  schizophrenia              schizophrenia                  Obsession

      Nam.        BL      7         End BL       7       End BL       7     End BL         7     End BL                7       End BL                  7        End BL                7     End BL               7        End BL            7      End

      S.C.  6            3          3     2   2           2    6     5      4     O       O          O     7          5         2           3          3        2          3          3       2      7          5           4   2           2       2
      S.M. 8             7          5     6   4           4    7     7      5     3       3          4     9          9         6         lO        lO          6        lO          lO       6     lO         lO           6   5           5       4
      B.G. 5             5          4     2   l           l    1     l      l     6       6          3     7          6         5          9           7        4          9          7       4      2          2           l   3           3       2
      P.M. 2             2          l     2   l           l    l     O      O     4       3          3     6          4         4          8           5        5          8          5       5      4          3           3   2           2       2
      F.S. ·8            7          5     5   4           2    3     3      2     5       4          2     7          7         4          8           6        4          8          6       4      4          3           2   3           3       3
      C.M. 5             3          2     3   3           2    5     5      2     2       l          l     6          5         4          8           7        5          8          7       5      5          5           4   5           5       4
      SoN.  4            4          2     2 . 2           1    3     2      2     6       6          5     6          5         5          8           7        5          8          7       5      5          5           4   3           3       3
      L.C.  8            5          4     5   5           4    6     4      4     3       3          2·    8          7         4          9           7        3          9          7       3      4          4           3   4           4       3
      P.C.  3            3          2     3   2           2    4     3      3     5       5          4     8          7         3         lO           7        4        lO           7       4      6          6           3   3           3       3
      Se.C. 3            4          2     2   2           l    3     2      2     4       3          3i    5          5         4          8           5        4         ·8          5       4      3          3           2   1           l       l
      Means       5.2 4.3           3.0   3.2 2.6 2.0          3.9 3.2      2.5   3.8     3.4 2.7           6.9 6.0              4.1        8.1        6.9 4.2             8.1        6.4 4.2        5.0         4.6 3.2 3.1                3.1         2.7
           P            ( 0.001                ( 0.05                N.S.                 N.S.                      , 0.01                        , 0.001                           , 0.001                    ( 0.01                   ( 0.05


                                                                                                         GROUPB
                                                                                              .... ;
                                                                                                 '
                                                                                                            Schizophrenie                                                    Paranoic                 Ebephrenic
                       Anxiety                Hysteria              Mania             Depressioi             exitabiIity                       Paranoia                   scbitopbrenia             schizophrenia                  Obsession

      Name        BL       7        Ena BL.      7        End BL      7     End BL          7        End BL             7       End BL                 7        End BL                7       End BL              7       End BL             7      End
       M.R.       8       6         5     2     l          2    l    l      l     6       6          4      3         4          5          8        6           7        8          6        7      3          3           2   6           3           3
       D.L.       5       3         3     2     2          2   4     3      3     2       3          2      4         4          3          3        l           2        3          3        2      6          5           3   3           3           3
       L.A.       3       2         2     2     3          2   6     6      5     O       O          O      7         7          6         lO        8           8        9          8        6      4          3           2   l           l           l
       L.G.       4       4         2     3     3          l   ·1    O      O     3       3          3      l         2          l          9        7           5        9          8        7      5          5           4   4           4           3
       C.S.       4       5         4     3     4          3   2     3      3     5       4          3      3         2          3          3        3          ·2        4          2        3      4          4           3   2           2           2
      Means       4.8     4.0 3.2         2.4 2.6 2.0 2.8 2.6 2.2 3.2                      3.2 2.4          3.6 3.8              3.6        6.6 5.0 4.8 .6.6                          SA      5.0    4.4        4.0 2.8         3.2 2.6 2.4
           P             N.S.                   N.s.                 N.S.                 N.S.                       N.s.                           N.S.                             N.S.                      < 0.01                       N.S.

      BL       = Baseline                                7     =Day7                                      End       = End of rreatment                                      N.S.          = Not significaoe
B. AGUGLIA,   c.   CALANDRA. D. MAUGERl, V. RAPISARDA

                                                                                                            (5] NIEDERER, W., :R.ICHARDS
                                                                                                                     humour production.
                                    100                                                                     (6] CASACCHIA., M., .Mroo,     d.;
      !                              BO
                                                                                                                        POMPEI, P"   FJlAJEsE.:
                                                                                                                         In: Newoendocrine
      I                                                                                                                 A. Agnati Eds., E1s~
      I                              60

                                     40
                                                                             _  ....... ...-:.              {7]   O!U.ANoo, P., CERRrm, F.,
                                                                                                                        lipids administeJ:ed 1

     I                               20       ~~
                                              ..  ",'"              :
                                                                                                            [8]   LEON, A., TOIiPANO, G. -
                                                                                                                        into mice brain l'ho:

      i                           ng/ml L.~.:-'
                                             B
                                                __-::::-_-:,:":,,,_-:::::-,:
                                                    7     0  14             6
                                                                      29- 911     .
                                                                                                            (9]   B'RUNT, A" LEoN. A., Bo}
                                                                                                                        free glucose in mire.
      !
                                                                                                           [lO]   BRVNC, A., TOFFANO, G., :
      !                                           Haloporidoi                                                           phatidylserine liposo
                                                  Haloporidol   +       Pbospholipids                      [I1J   POLLERI, A., ROtA!NDI, I
                                                                                                                        N1NC, A., MURIAUx
                                                        Fig. 4                                                          cerebrol dopamine lì
                              T.rend of plasma prolactin Ievels in schizophrenic pacients.                              dopaminergic nervot
                                                                                                           [12J   TOIiPANO, G., !:BaN, A., :
           CONCLUSION                                                                                                   somes Da the reguJa
                                                                                                                        Lipids, 81 : 407-41<
                                                                                                          [13] GRF.OORIADIS, G. - The ,
                 The results show a clear improvement in al! patients and they are there-                            N.w England J. af .
           fore in agreement with pub)ished literature on SuIpiride end haloperidoL                       [14J PAJ>AHADIOPOlJI.OS, D. -
     i"'         The concurrent use of hypothalamic phospholipid liposomes does not                                  mode! membranes.
     i
     ,                                                                                                               Nonh Holland Pubi
           have a negative effect on the therapeutic potential cf the lWO drugs, but
                                                                                                          [15J SPITZER, R.L., ENDwon,
;    .     rather this therapentic effect is strengrhened as shown by the improved results                           Research Ed., New 'Y
;    ;.

i,::
~"         obcaìned in the vadous. psychodiagnostic teslS in both depresse<! end schizo-
r··
;" .
      i    phtenic patients.
                With regard to pròlaetin levels, the increase induced by sulpidde was not
                                                                                                          Address of the Gbthol': Dr. E.
)    .
           affected by treatment with phospholipid liposomes; this did how~ver occnr in
                                                                                                          RESUME
           patients treated with haloperidoL
                                                                                                                 !.es auteurs ont évalué
                                                                                                          thalamiques chez des patie<
           BIBLIOGRAPHY
                                                                                                          schizophrènes trairés par l'h:
            (1] DmVY. P., BoBAN,     J., Cou.ARD. J., PJNCHAlU), H. - Etude et expérimentation clini~     ceux observés dans deux gr
                        ques du RIG25 ou halopeddol. nouveau neuroleptique et neurodysleptique.           et traités par les memes agel
                       A&ta Neurol. PS'Ychi4tf'., Belgi&al 59 : 337 (1959).                               rée à l'aide des teslS de H:
            (2] SARTESCHl. P., CONTI. I.., CAssANo, G.D. - Sulpicide in the ueatment of psychocic         plasmatiques en p,olaetine .
                       and neurotic syndromes. In: Sulpiride and orber benzamides. ltalian Brain
                       Res. Found. Fress, Milan (1979).                                                   mel!e des phospholipides l
            [3J ULETI, G.H., HEUSlD., A.F., WOtlD, T.J. - The effects of psychorroplcs drugs on           par 105 deux psychotropes.
                       the EEG af the cbJ:onic psychotic patients. In Application of EEG in PsychiatrY~         le.s résilltats démontrer
                       Duke Univo P.ress. North Cacolioe (1965).                                          diques hypotbalamiques SUr
            (4] F'INx, M. - Quantitative EEG and Human psychopharma.cology. Applica.rion of EEG           souS. forme d'un renforcemeJ
                       in Psychiatry. Duke Univo Press, North Caroline (1965).

           142                                                              Acta Therapeutica 10 (1984)   Acta Therapeutica lO (]98.
EFFECT OF HYPOTHALA'MlC PHOSPHOLIPID LlPOSOMES
    DA

                                                         [5J NIEDERER, W" RICHARDSON. B.P.• DoNATSCH, P. - Hormonal concrol of aqueous
                                                                  homour prodnaion. Exp. Eye Ret., 20 : 329 (1975).
                                                         (6J CASACClUA., Mo. MEoo. d.:'C:.utCHEDI, F., DI C:EOr.m•.M., F.ALASCHI. P.) Rocco. A..
                                                                  POMPEI, P., F1w'EsE, G. - Neuroendocrlne side effects of antipsychotic therapy.
                                                                      In: Neuroendocrine Correlates in Neurology and PsychiattY. RE. Muller and
                                                                      A. Agfioli Ed,., E!sevier, 211-224 (1979).
    _ .. __ ..tIo                                        (7]   ORLANDO, P., C'ERRtro, P., ZI!uu.I, P. - The fare of double·lahelled braio phospho-
                                             :~   ..                  Jipid, admioisrered ro mice. Il Parma"" 30: 451-458 (1975)•.
                                                         (8]   LEON, A.) TOPFANO) G. -.I!ossible .cole of BCPL in enhanciog 32 1>i iorozporatioo
                                                                      inro mie< b",in phospholipid. Ad•• Exp. Med. Biol., 72: 307-313 (1976).
                                                         [9J   BR.UNI, A., !.'EoN. A.• BoA:RA"J1O, E. - .:Bffecr of polar lipids on ccrebral content of
                                                                      free gluco« in mice. Ad•. Exp. Mad. Bio/., 72 : 271-2g3 (1976).
                                                        [lO]   BRUNI, A., Topp.A:No, G., l.Eo.N. A.• BoA!R.Aro. E. - Pha.rmacological effects of phoo-
                                                                      phacidy1serine lipooomes. NaJura, 260 : 331·333 (1976).
holipids                                                [l1J   POL'I.ERI, A.• R01AlNDI. E., BA.R!R:EccA. T., GlA!RRossr. R., .M.A'STURZO. P., GAU.A-
                                                                        A.) MUR.J'ALDO, G., NIZZQ. M.c. - Effeet of b.ra.in phO$pholopids on
                                                                     NlNl,
                                                                  cerebral doparnine and on proIacdn serum leveIs. Symposium on non striata!
!ophrenic patients.                                               dopamine.rgic nervous tissue. Foit Village (1976).
                                                        [12J TOFFANO, G.• lEoN, A., SAvolNl, G., 01U.AND0. P. - Effea of phospholipid' lipo-
                                                                  somes 00 the regulacion cf ce.rebral metabolism. pft11&tion 4nd Bi()synthe,Sù of
                                                                  IJpuu, 81: 407-418 (1977).
                                                        [13]             G. - The car.rier potential cf Iiposomes in biology and medicine. Thq
                                                               GREOORIAOIS,
II patients and they are thet'"                                   Net" Engidnd J. oi Med., 295: 765·770 (1976).
lpiride and haloperidoI.                                (l4] PAPARADIOPOULOS, D. - Calcium·induced phase change and fusion in nawml and
pholipid lipooomes does nor                                       mode! membranes. In: Membran Fusion. G. Poste' 'RIld G.L. Nicolson BIs.,
                                                                  North Hnllattd Publi'hio8, Amsrerdam; 765-790"(1978).
:odal of rbe <wo drugs, but
                                                       [15J SPrr.2'ER, R.L., EN:ollCOIT, J., ltoBJNs. E. -    Reseatch diagnostie criteria. Biometrie
~DWn by the imptoved tesults                                        ReSearch Ed., New York (1977).
n both depressed and scnìzo-
                                                       Address of the ailthor: Dr. E. AGUGLIA, Via Etneo, 740, 95128 Catania <Ita/y).
                                                                                                                                                          :I
. induced by snlpiride was not
.es; tbis did however occnr in
                                                       RESUMB

                                                             Les anteurs onr évalué l'efficacité des lipooomes phospbolipidiques hypo-
                                                       thalarnlques che>: des patients déprimés traités par le sulpitide et chez des
                                                       schizophrènes rraités par l'halopéridol en comparant les résnlrats obtenus avec
- Etude et expérimentatibn clini~                      ceux observés dans deux groupes de contròle souffrant des m~mes maladies
J.euroleptique et neurodysleptique.                    et traités par les m~mes agents psychotropes. La qualité des résultats fut mesu·
'59).                                                  rée à l'aide des tests de Harnllton, Cassano, Zung et Wittenborn. Les talIX
.ride in the trearmene of psychoclc                    plasmariques en prolacclne furenr suivis afin de détecter une influence éven-
   other benzamides. Italian Baia
                                                       tnelle des phospholipides hypothalamiques sur l'hyperprolaclinémie induite
~    effects of psychotroplcs drugs oa                 par les deux psychotrQPes.
    Applicacion of EEG in Psychlatry,                        Les résulrats démoiIrrenr une aclion favorable des liposomes phospholipi·
                                                       diques hypothalamiques sur les effets thérapeutiques des deux psychotropes
pharmacology. AppHcation cf EEG                        sous forme d'un renfotcement de leur aetioo.
,lioe (1965).

.cta Therapeutica lO (1984)                           Acla Therapeutica lO (1984)                                                               143
                ---_._-_                 .

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Effetto dei liposomi di fosfolipidi ipotalamici in pazienti trattati con sulpiride o aloperidolo

  • 1. JEUTICA I I l Num. 1 I THE EFFEcr OF HYPOTHALAMlC PHOSPHOLIPID LIPOSOMES IN PAT1ENTS TREATED WITH SmPJRIDE OR HALOPERlOOL . volume of distribution 5. E. AGUGLIA, C. CALANDRA, V. RAPISARDA rnagement of hyperten- rdy. 15 i I ltmittIJe of Ps~çhittt1'1 (Remi 01 Dsp4rlmenl: Pro/. ·V. Rapkaraa)J Uni'V6'rfiJy of Catania (1141'1) potassfum conserving / ... D. MAUGERI 23 InJJituie o/ Gero1Jlolccy (Read of Departmento' p.rot. L. Motta), :>SEI, G. ROMAN8!:LI, UnitJt1rsity o/ Cd/anta (1ta1:y) IESAN, M. MOTOLESE, otory heart fa/lure • 31 Summary of cyprohepladlne and 43 We evaluated the effieacy of treatment with hypothalamic phospholipid Iiposomes in depressed patieots treated with sulpiride and io schizophrenie ERICHETII, ":i '. patients !reated with haloperidol in comp,arison with patients having the 'JJlnical trla! of dihydro· 53 J . --1. same disorders and !reated with· the same psychotlopic ~ alone. The results were assessed nsing the tests of Hamilton, CassllJl(>, Zoog and Witten· ZAGUI~~k' , homo Plasma prolactin Ievels were monitored iJr order to detect aetivity of hypothalamic phospholipids on drng-induced hyperprolactinaemia. ~èute appendlcltls wlth The resu!ts obtained showed not only that the therapeutic association n of cfif}damycin phos~ of hypotbalamic phospholipid Iiposomes did not negatively inJIuence the 69 therapeutie potentiai of the two. psychotropic drngs, but indeed eohauced H their efficacy. mQdul® 200 79 The increase of plasma proIactin levels produced· by sulpiride was not nog/ycate pressurlsoo modified by treatment with hypothaIamic phospholipid Iiposomes, whereas 89 .~ this increase was conside,ably blunted in patients receiviog haioperid.ol. 'o dlsorders and post- 97 !NTRODUcrION JOMANGE 'l/meni In tha trt'8tment During Iecent yeaIs pharmacologica1 pIOgICSS has peImitted an improved ..~ . 107 symptomarie ·appIoaeh co mental illnesses. Drugs sueh as haloperidol have made the control of halincinatory phenomena possible [l}, while drugs sueh nad/ne In varlous skin 119 a, sulpiride have pIoved to have a good therapeurle effeef in depression, psy. chosomatic diseases and psychomoror inhibition [2, 3]. Howevèr, tbe pIoblem of undesiIable side effeets hils remained. Acta Therapeutica lO (1984) 133 -•..•., - - - - - - - - . -----:;:te---'-. '
  • 2. i "'--"--+:.,- .._.... __.-....._ _. _ - - J B. AGUGLIA, C. CALANDRA, n. MAUGERI. V. RAPISAR:OA i I Morot side effecrs can be largely controlled by the use cri anrlcholinergic phtenia. The 15 depressed : ! ! druga, but these do nOt have the same acrion on othet side effeets which to diffetent therapeutic proI depend on a neuro·endoctine mechanism [4, 5). Recent data in the literarure have shown that phospholipids can interiere witli this mechanism [61. . Group A, including i l( sulpitide Im. (400 mg pet d I Mter only seven days of trealment with sulpidde, plasma prolaetin levels undergo a norable increase. The administtation of haloperidol causeS a rapid increase in pt;laetin levels afte< only 90 minutes. CASACCHIA [6} has fot a pedod of 28 da ys; ft. • hypothalamic phospholipid administrarion at 8.00 a.m. , I demonstrated that phospholipid Iiposomes may be concemed with tbis in· crease. ~. Group B (the control i received only sulpiride given . I Our aim was to evaluate the experimental validìty cri these recent dara. of 28 days. I PHOSPHOLIPlD LIPOSOMES The 15 patìents sufferi I GtOUP A includìng lO parle 5 patients, 3 women and ; I The use of thin !ayer chromatography has been able to provide informa- haloperìdol and were treate don ahoot the chemical struetUre of the various classes of phospholipids. Interpretation of the cole of the phospholipids has opened up a fascinating Both the sulpitide and field of tesearch. Phospholipid molecules, when organi2ed in the form cri out period lasring 7 days, , Iiposomes, ate able to cross vhe blood-hrain barder [7] and to aet at the psychodiagnostic tests wete , level of the centraI nervous system; their effects are as follows : diagnosric tests wete repeate< - stimulation of the endogenous synthesis of phospholìpids by the activation same assessments were carri of dddil-transferase; - activation of adenylcyclase [8]; RESULTS - increase of the cerebral content of glucose [9, W]; - aerJvation cri the dopaminergic pathways [11, 12]. The deptessed patienrs Studies by GREGORIADIS [13} and PAPAHADIOPOULOS [14] have esta- values of the various tests. : blished that the charaeteristic properties of Iiposomes ate related to physical psychodiagnosric tests on ea stability and the capadty to interaer by fusion with biological membranes. piride and hypothalamie ph In OUt experiments we used Iiposomes of hypothalamic origin, charac- with sulpitide alone (Group terized by the presence of long polyunsaturated hydrocarbon chains and nega- The score trend evaluo rlvely charged gtoups. by means of Cassano's tesI However, the petcentage in MATERIALS AND METHODS liposomes were associated w the gtOUp treated with sulpil Thitty padents, age<! 20·52 years, were included in the srudy. Por An even cIearer impr< psychiatdc diagnosis we used the Research Diagnostic Cdteria (RDC) (15). and Hamilton tests in pat Psychopathological status was ra<ed by mean of Hamilton's scale, Cassano's phospholipid liposomes tOB resr and Zung's arociery test for depression and Wirrenborn'$ test for schizo- 15.2 % and 35.1 % respecr: phrenia. Of these patients, 15 suffered from depression aod 15 ftom schizo- sulpitide alone (Fig. 1). Acta Therapeutica 10 (1984) Acta Therapeutica 10 (198· . "}
  • 3. l ..,. "!.'·:' ,".;: ':". c,. -,." EFFECT OF"HYPOTHALAMIC "PHOSPHOUPID LlPOSOMES ed by the use cf antichoIinergic phrenia. The 15 depressed patienrs were divided into 2 groups and subjected ·n On other side effeets whieh ro different therapeutic programmes. ]. Recent data in the literature .ith chis mechanism [6]. Group A, including lO parienrs, 6 women and 4 men, was treated with sulpiride Lm. (400 mg per day in 2 administrarions at 8.00 a.m. and 1.00 p.m.) llpiride, plasma prolactin levels for a period of 28 days; from the 7th day of treatrnent 400 mg per day of 1 of haloperidol causes a rapid hypothalamic phospholipid liposomes was also given in a single inrravenous minutes. CASACCHIA [6] has administrarion at 8.00 "-m. 'y be concerned with this in- . , Group B (the control group) including 5 padenrs,3 women and 2 men, li vallidity of these recent dara. received only sulpiride giveo in the same way, for the whole observadon perio<! of 28 days. The 15 patieors suffering from schizophrenia were divided into 2 groups. Group A including lO parienrs, 6 women and 4 men, and Group B including 5 parienrs, 3 women and 2 men, were administered with 4 mg per day of ; been able to provide informa- haloperidol and were rreated in the same way as the depressed padenrs. rious c1asses of phospholipids. s has opened np a fasdnadng Both the sulpiride and the haloperidol were administered after a wash- Len organized in the form of out perio<! lasdng 7 days, at che end of whieh baseline prolactin levels and barrier [7] and to aet at the psychodiaguosdc tesrs were evaluated. On the 7th day cf treatroent the psycho- = are as follows : phospholipids by che aetivation diagnosdc tesrs were repeated and plasma prolacdn levels were detetInined; the same assessments were carried out at me end of treatmeot. [9, lO]; RESULTS lI, 12]. The depressed padeors in both groups presented very similar haseline ffADrOPOULOS [14] hav'e esta- values cf the various resrs. Tables I, I! and II! show the scOte rrend from the osomes are related to physical1 psychodiagnostic tesrs on eaeh occasion both for che group rreated with sul- ;vith biological membranes. piride and hypothalamic phospholipids (Group A) and for the group treated f hypochalamic origin, charac- with sulpiride alone (Group B). hydrocarbon chains and nega- Tbc score tread evaluated on the 7th day "'ld, at the end of trearment by means of Cassano's test revealed a Clear imprb'vemeot in boch- groups. Howevet, the percentage improvernent in the group in V{hich phospholipid liposomes were associated with the sulpiride was as high as 16.2 %, while in che group treated with sulpiride alone it was 8.7 %. , included in the stiIdy. For An eveo clearer improvemeot was found in the resulrs of boch Zung <gnostic Criteria (ROC) [15]. and Hamilton tesrs in padenrs who bad been treated wich hypothalamic of Hamilton's scalIe, Cassano's phospholipid liposomes together with sulpiride. This improverneot was of I Wittenborn's test for schizo- 15.2 % and 35.1 % respecrively, against the 6 % and 17.7 % achieved with epression and 15 from schizo- sulpiride alone (Fig. 1). Acta Therapeutica lO (1984) Acta Therapeutica lO (1984) 135 --"+"--'
  • 4. El E. "AGUGLIA; C. CALANDRA, D. MAUGBRI. V. RAPISARDA , . 1-. t· , i .'.. TABLE II: S:ore "end jrom Zur. .phoJpholipid JipOJO'I7WJ TABLE I: $&01'8 J1'fma tram CatJlJtJ<l.J test {or JepreISeJ p4lients weated with JUlptride Ima _..pbosphòlipid liposr;nu,s (G...p A) mul sulpirnte oIcn. (&aup B). .: .~: GROUP A Initials Age IniU.I, Age Baseline Day 7 End of treatment B.L. 37 C.V. 33 B.L. 37 50 74 49 A.R. 32 C.V. 33 99 46 38 B.R. 52 A.R. 32 93 40 45 e.R. 36 B;R. 52 60 38 43 Cur. 37 e.R. 36 64 60 42 e.G. 41 Curo 37 90 60 43 Costo 20 e.G. 41 95 95 84 R.e. 20 Costo 20 60 41 45 M.G. 49 R.C. 20 77 79 63 M.G. 49 98 92 72 I .. l : Means . Means 78.6 62.5 52.4 i _ L: ± S.D. ± S.D. 18.63 21.5 15.3 r j GROUP B I I Initials Age Day 7 j .. IniUals A8e BaseUne End of trcatment A.L. 29 I M.G. 43 A.L. 29 86 88 81 I 38 T.G. M.G. 43 75 71 .- 6S V.A. 32 ·T.G. 38 62 58 54 P.G. 41 V.A. 32 92 84 76 P.G; 41 84 80 72 Means .. , ± S.D. Means 79.8 76.2 69.6 . ; ± S.D. ·11.67 11.19 10.5 I i,. I ," ! ! Acta Therapeutica lO (198' 136 Acta Therapeutica lO (1984)
  • 5. EFFEcr OF .HYPOTHALA,MIC PHQSPHOLIPID LIPOSOMES <DA TABLE II: $&o1'e weml tram Zun~s test lor àep1'(JiSQJ, pt1tiqnts 'rea/ed. w;th sulpiriJe atul phospholipit! Uposomus (Gt-Ofl.P A) and sù/pi;;de tlkntl (.Group B). l patiemts trealeJ 'lUi/h Ju/piride Ima p;rid. .Jcn. ( Group B). GROUPA lnitials Age Baseline Day 7 En~ or trcatment )ay7 End of treatment B.L. 37 38 55 30 C.V. 33 56 37 30 74 49 A.R. 32 63 25 36 16 38 B.R. 52 52 33 30 lO 45 e.R. 36 47 38 33 i 18 43 Curo 37 40 48 3g ;O 42 ;O e.G. 41 58 53 50 43 Costo 20 31 38 29 15 84 Il 45 R.e. 20 65 62 so 19 12 63 72 ·I·"i· "'" M.G. Means 49 67 52.7 56 44.5 51 37.7 I 52.5 11.5 52.4 15.3 l'. ± S.O. 12.34 11.95 9.17 I l '" ..•. ?: lnitials Age GROUP B BaseIine Day 7 End of treatment I [ ·Il~ )ay7 End of treat.ment A.L. 29 43 48 39 M.G. 43 68 63 56 18 81 T.G. 38 51 45 41 'I 65 i: ;8 54 V.A. n ·62 57 49 '1 ' P.G. .41 37 35 34 14 76 -:.::. IO 72 Means 52.2 49.6 43.8 ± S.O. 12.87 10.85 8.70 '6.2 69.6 '1.19 10.5 ..:1... :1 Acta Therapeutica lO (1984) 137 Acta Therapeutica lO (198~__'_-":i~lr"_
  • 6. . l'r:. o j, ... _--_._~- I E. AGUGl:.IA. C. CALANDRA, D. :M'AUGERI. V. RAPISARDA E I I 30 TABLE III: S&o~e trend from Hamil/(m.JJ test far Jepresml p8tìents J1'eatea with su/ijirid(l ami i'hospholipid Iiposomes (Gro"" A) ami ndpiriJ, al.ne (Group B). . 20 Clssan 16.ZO/. GROUPA .. lnitials BaseIi~e 10 , Age J}ay7. End or treatment i , B.L. C.V. 37 33 11 33 12 15 5 7 l ,[ A.R. B.R. 32 52 30 19 IO 8 8 2 ~ Sulpi , C.R. 36 23 12 8 Curo , 37 38 23 7 O Sulpi C.G. I 41 33 28 28 CeSt. 20 15 16 14 R.C. 20 12 IO 9 Percentage improvement in M.G. 49 30 31 19 Means 24.4 16.5 10.7 "'s.o. 9·70 8.05 7.7 ·GROUP B 100 InitiaIs Age Baseline Day 7 End or treatment 80 A.L. 29 32 28 23 M.G. 43 26 2S 18 60 T.G. 38 23 26 16 ! V.A. 32 19 21 16 40 P.G. 41 27 24 20 " .1 20 • Means '" S.O. 25.4 4.82 24.8 2.58 18.6 2.96 ng/ml • E -.-' Trend of plasm 138 Acta Therapeulica lO (1984) Acta Therapeulica lO (198' .::~ 'i X ,,::--.;!.. •<'
  • 7. .RDA EFFECT QP HYPOTHALAMIC PHOSPHOLIPID LIPOSOMES .,' HamlUon 35.1% 30 rQfS~d pt/tienu /re4leJ. with tulp"itiae ",Ipiride aùJne (Group B). 20 :Jay 7 End of treatment lO 12 S IS 7 IO 8 " 8 2 12 8 ~ 'Sulplride + Phospholipld tiposomes !3 !8 7 D Sulpiride 28 16 14 ,~;;. Fig... IO 9 Percencage improvement in the psychodiagnostic tests in tbe 2 8J:oups tA and B) Il 19 of depressed patients. 6.5 10.7 8.05 7.7 ,e 100 lay7 End of treatment ~ 80 '8 23 :.i / :5 18 60 :6 16 1 ~l :1 16 ' " 40 :4 20 - 20 4.8 2.58 18.6 2.96 "!l/m! i B 7' .140 29' 99 Sulpirlde _:' Sulpiride + Phosphollplds Fig. 2 T:end of plasma prolactin leye1s in depressed patients. :1 " .' .' .' ~, " "I 'cta Therapeutica lO (1984) "T :1' Acta Therapeutica lO (1984) 139 ~--'---t-"""'"
  • 8. B. AGUGLIA, C. CALANDRA; n'",-MAUGERI. V. RAPISARDA The increase in se"rum l'rolactin levels induced by sull'iride was not i; ~" influenced by adjuvant treatment with hYl'othalamic l'hool'h,?lipid lil'osomes " ~" (Fig. 2). ,-'i.'; i. . ,.: 'o In the schizol'hrenic l'atients treated with haloperidol, the evaluation '}" of the syml'tomatological trends was carriecl out by means of Wittenborn's test. The l'rolaetio trend was also evaluated. Table IV shows the values oh· tained using thls test on the various examinations carried out on the two groul's of patients. In the l'atients who had undergone adjuvant theral'y with phos. l'holil'id Iiposomes, a statistically sigoificant iml'rovement was found in 7 of '·the 9 subtests with the.,Wlttenhorn test. The. iml'rovement obtained was sigoificant in only one of the sub-tests in l'atients treated with haloperidol alone. A global evaluation bf the sub-tests a1so revealed a greater pereentage iml'rovement in the l'atients treated with l'hool'holipid liposomes (Fig. 3). In addition, in tbe schizol'hrenic l'arients treated with both haloperidol . "'and hypothalamic l'hospholil'id Iiposomes the plasma l'rolactin levels tended -.-;". to decrease, wbile in the patients treared with haloperidol alone they continued to increased (Fig. 4). 29.55% 39· 20 lO ~ O Haloperidol Haloperidol + Phospholipids j I-"'-j_~--'-"'_~--,-M.:."',---~,-' ;j Fig. 3 Percentage improvement in the global value ai the Wittenbom test. ù:;Èo:;Èui:;È: CliClia:ip.;~c.h 140 Acta' Therapeutica lO (1984) i ,.
  • 9. ~ ~ ii .. '" 0-0 !'l"''''' '" '~ " ,.,. go .... s- ~ o » a. ~ -1?-. r:t B :> (b"~ .g (l ~ g -o .g tl. f.l ~ g- tg..(i g r:o·a s..~ g:" ~. [ ':T tr ,. !=l ~ l:S <: _.... t O"' (ti ~ a: IO a. .g:a. ti) Ste:. "ttrb~(D'_'<:o ~§~"P-.<:=?ì ~ e..-g ~ e. g. p- P-.., ~. [g~:;g&~s: 'g. B~ ~ ". g f O ~ ii S' &_p- g il ~ ~ '1~~~8~oJ2. ..... ~~O'::l ~g-~~ $O "'t-. 'g.~ g,~ ì~ ... IO ~ ..., ""' p- "li " ~_ &l", eq. 8.. ;1. ~ " !=i'!;! " f~ Q O O - ~ 'i;j8 ~ o ~ 'Q S'!l !:l. ~. fl ~ a. S' "Oa~Ofllo & "" '" g. ~ a.a.s. :~ ., O'Q.P-. li: '1 ..... g- O' o g <:l. 'O ~ 'Y,. $2.. ~ la. '{' --g r:r fA" 8 =g LI o ( ...", .------~_::-- '::,~". ..::' .~;':'; ::::-:-':. ,..,:': i'-': ,.., "r'.·>:·<;,"· ''O" . '"l,'·:: .,;,", o". ,. ,.-.... _·,;"":.:-":,:,." •• ,.'.;::1e.~ TABLE IV: Score "end Irom lflittenborn's test in schizophrenic patients Ireatea wi/h haloperidol (#fa phospholi'pid uposomcs (Group A) and haloperidol ttlone (Group Bi GROUPA Schizophrenic Paranoic Ebepbrenic Anxiety Hysteria Mania Depression exitabitity Paranoia schizophrenia schizophrenia Obsession Nam. BL 7 End BL 7 End BL 7 End BL 7 End BL 7 End BL 7 End BL 7 End BL 7 End BL 7 End S.C. 6 3 3 2 2 2 6 5 4 O O O 7 5 2 3 3 2 3 3 2 7 5 4 2 2 2 S.M. 8 7 5 6 4 4 7 7 5 3 3 4 9 9 6 lO lO 6 lO lO 6 lO lO 6 5 5 4 B.G. 5 5 4 2 l l 1 l l 6 6 3 7 6 5 9 7 4 9 7 4 2 2 l 3 3 2 P.M. 2 2 l 2 l l l O O 4 3 3 6 4 4 8 5 5 8 5 5 4 3 3 2 2 2 F.S. ·8 7 5 5 4 2 3 3 2 5 4 2 7 7 4 8 6 4 8 6 4 4 3 2 3 3 3 C.M. 5 3 2 3 3 2 5 5 2 2 l l 6 5 4 8 7 5 8 7 5 5 5 4 5 5 4 SoN. 4 4 2 2 . 2 1 3 2 2 6 6 5 6 5 5 8 7 5 8 7 5 5 5 4 3 3 3 L.C. 8 5 4 5 5 4 6 4 4 3 3 2· 8 7 4 9 7 3 9 7 3 4 4 3 4 4 3 P.C. 3 3 2 3 2 2 4 3 3 5 5 4 8 7 3 lO 7 4 lO 7 4 6 6 3 3 3 3 Se.C. 3 4 2 2 2 l 3 2 2 4 3 3i 5 5 4 8 5 4 ·8 5 4 3 3 2 1 l l Means 5.2 4.3 3.0 3.2 2.6 2.0 3.9 3.2 2.5 3.8 3.4 2.7 6.9 6.0 4.1 8.1 6.9 4.2 8.1 6.4 4.2 5.0 4.6 3.2 3.1 3.1 2.7 P ( 0.001 ( 0.05 N.S. N.S. , 0.01 , 0.001 , 0.001 ( 0.01 ( 0.05 GROUPB .... ; ' Schizophrenie Paranoic Ebephrenic Anxiety Hysteria Mania Depressioi exitabiIity Paranoia scbitopbrenia schizophrenia Obsession Name BL 7 Ena BL. 7 End BL 7 End BL 7 End BL 7 End BL 7 End BL 7 End BL 7 End BL 7 End M.R. 8 6 5 2 l 2 l l l 6 6 4 3 4 5 8 6 7 8 6 7 3 3 2 6 3 3 D.L. 5 3 3 2 2 2 4 3 3 2 3 2 4 4 3 3 l 2 3 3 2 6 5 3 3 3 3 L.A. 3 2 2 2 3 2 6 6 5 O O O 7 7 6 lO 8 8 9 8 6 4 3 2 l l l L.G. 4 4 2 3 3 l ·1 O O 3 3 3 l 2 l 9 7 5 9 8 7 5 5 4 4 4 3 C.S. 4 5 4 3 4 3 2 3 3 5 4 3 3 2 3 3 3 ·2 4 2 3 4 4 3 2 2 2 Means 4.8 4.0 3.2 2.4 2.6 2.0 2.8 2.6 2.2 3.2 3.2 2.4 3.6 3.8 3.6 6.6 5.0 4.8 .6.6 SA 5.0 4.4 4.0 2.8 3.2 2.6 2.4 P N.S. N.s. N.S. N.S. N.s. N.S. N.S. < 0.01 N.S. BL = Baseline 7 =Day7 End = End of rreatment N.S. = Not significaoe
  • 10. B. AGUGLIA, c. CALANDRA. D. MAUGERl, V. RAPISARDA (5] NIEDERER, W., :R.ICHARDS humour production. 100 (6] CASACCHIA., M., .Mroo, d.; ! BO POMPEI, P" FJlAJEsE.: In: Newoendocrine I A. Agnati Eds., E1s~ I 60 40 _ ....... ...-:. {7] O!U.ANoo, P., CERRrm, F., lipids administeJ:ed 1 I 20 ~~ .. ",'" : [8] LEON, A., TOIiPANO, G. - into mice brain l'ho: i ng/ml L.~.:-' B __-::::-_-:,:":,,,_-:::::-,: 7 0 14 6 29- 911 . (9] B'RUNT, A" LEoN. A., Bo} free glucose in mire. ! [lO] BRVNC, A., TOFFANO, G., : ! Haloporidoi phatidylserine liposo Haloporidol + Pbospholipids [I1J POLLERI, A., ROtA!NDI, I N1NC, A., MURIAUx Fig. 4 cerebrol dopamine lì T.rend of plasma prolactin Ievels in schizophrenic pacients. dopaminergic nervot [12J TOIiPANO, G., !:BaN, A., : CONCLUSION somes Da the reguJa Lipids, 81 : 407-41< [13] GRF.OORIADIS, G. - The , The results show a clear improvement in al! patients and they are there- N.w England J. af . fore in agreement with pub)ished literature on SuIpiride end haloperidoL [14J PAJ>AHADIOPOlJI.OS, D. - i"' The concurrent use of hypothalamic phospholipid liposomes does not mode! membranes. i , Nonh Holland Pubi have a negative effect on the therapeutic potential cf the lWO drugs, but [15J SPITZER, R.L., ENDwon, ; . rather this therapentic effect is strengrhened as shown by the improved results Research Ed., New 'Y ; ;. i,:: ~" obcaìned in the vadous. psychodiagnostic teslS in both depresse<! end schizo- r·· ;" . i phtenic patients. With regard to pròlaetin levels, the increase induced by sulpidde was not Address of the Gbthol': Dr. E. ) . affected by treatment with phospholipid liposomes; this did how~ver occnr in RESUME patients treated with haloperidoL !.es auteurs ont évalué thalamiques chez des patie< BIBLIOGRAPHY schizophrènes trairés par l'h: (1] DmVY. P., BoBAN, J., Cou.ARD. J., PJNCHAlU), H. - Etude et expérimentation clini~ ceux observés dans deux gr ques du RIG25 ou halopeddol. nouveau neuroleptique et neurodysleptique. et traités par les memes agel A&ta Neurol. PS'Ychi4tf'., Belgi&al 59 : 337 (1959). rée à l'aide des teslS de H: (2] SARTESCHl. P., CONTI. I.., CAssANo, G.D. - Sulpicide in the ueatment of psychocic plasmatiques en p,olaetine . and neurotic syndromes. In: Sulpiride and orber benzamides. ltalian Brain Res. Found. Fress, Milan (1979). mel!e des phospholipides l [3J ULETI, G.H., HEUSlD., A.F., WOtlD, T.J. - The effects of psychorroplcs drugs on par 105 deux psychotropes. the EEG af the cbJ:onic psychotic patients. In Application of EEG in PsychiatrY~ le.s résilltats démontrer Duke Univo P.ress. North Cacolioe (1965). diques hypotbalamiques SUr (4] F'INx, M. - Quantitative EEG and Human psychopharma.cology. Applica.rion of EEG souS. forme d'un renforcemeJ in Psychiatry. Duke Univo Press, North Caroline (1965). 142 Acta Therapeutica 10 (1984) Acta Therapeutica lO (]98.
  • 11. EFFECT OF HYPOTHALA'MlC PHOSPHOLIPID LlPOSOMES DA [5J NIEDERER, W" RICHARDSON. B.P.• DoNATSCH, P. - Hormonal concrol of aqueous homour prodnaion. Exp. Eye Ret., 20 : 329 (1975). (6J CASACClUA., Mo. MEoo. d.:'C:.utCHEDI, F., DI C:EOr.m•.M., F.ALASCHI. P.) Rocco. A.. POMPEI, P., F1w'EsE, G. - Neuroendocrlne side effects of antipsychotic therapy. In: Neuroendocrine Correlates in Neurology and PsychiattY. RE. Muller and A. Agfioli Ed,., E!sevier, 211-224 (1979). _ .. __ ..tIo (7] ORLANDO, P., C'ERRtro, P., ZI!uu.I, P. - The fare of double·lahelled braio phospho- :~ .. Jipid, admioisrered ro mice. Il Parma"" 30: 451-458 (1975)•. (8] LEON, A.) TOPFANO) G. -.I!ossible .cole of BCPL in enhanciog 32 1>i iorozporatioo inro mie< b",in phospholipid. Ad•• Exp. Med. Biol., 72: 307-313 (1976). [9J BR.UNI, A., !.'EoN. A.• BoA:RA"J1O, E. - .:Bffecr of polar lipids on ccrebral content of free gluco« in mice. Ad•. Exp. Mad. Bio/., 72 : 271-2g3 (1976). [lO] BRUNI, A., Topp.A:No, G., l.Eo.N. A.• BoA!R.Aro. E. - Pha.rmacological effects of phoo- phacidy1serine lipooomes. NaJura, 260 : 331·333 (1976). holipids [l1J POL'I.ERI, A.• R01AlNDI. E., BA.R!R:EccA. T., GlA!RRossr. R., .M.A'STURZO. P., GAU.A- A.) MUR.J'ALDO, G., NIZZQ. M.c. - Effeet of b.ra.in phO$pholopids on NlNl, cerebral doparnine and on proIacdn serum leveIs. Symposium on non striata! !ophrenic patients. dopamine.rgic nervous tissue. Foit Village (1976). [12J TOFFANO, G.• lEoN, A., SAvolNl, G., 01U.AND0. P. - Effea of phospholipid' lipo- somes 00 the regulacion cf ce.rebral metabolism. pft11&tion 4nd Bi()synthe,Sù of IJpuu, 81: 407-418 (1977). [13] G. - The car.rier potential cf Iiposomes in biology and medicine. Thq GREOORIAOIS, II patients and they are thet'" Net" Engidnd J. oi Med., 295: 765·770 (1976). lpiride and haloperidoI. (l4] PAPARADIOPOULOS, D. - Calcium·induced phase change and fusion in nawml and pholipid lipooomes does nor mode! membranes. In: Membran Fusion. G. Poste' 'RIld G.L. Nicolson BIs., North Hnllattd Publi'hio8, Amsrerdam; 765-790"(1978). :odal of rbe <wo drugs, but [15J SPrr.2'ER, R.L., EN:ollCOIT, J., ltoBJNs. E. - Reseatch diagnostie criteria. Biometrie ~DWn by the imptoved tesults ReSearch Ed., New York (1977). n both depressed and scnìzo- Address of the ailthor: Dr. E. AGUGLIA, Via Etneo, 740, 95128 Catania <Ita/y). :I . induced by snlpiride was not .es; tbis did however occnr in RESUMB Les anteurs onr évalué l'efficacité des lipooomes phospbolipidiques hypo- thalarnlques che>: des patients déprimés traités par le sulpitide et chez des schizophrènes rraités par l'halopéridol en comparant les résnlrats obtenus avec - Etude et expérimentatibn clini~ ceux observés dans deux groupes de contròle souffrant des m~mes maladies J.euroleptique et neurodysleptique. et traités par les m~mes agents psychotropes. La qualité des résultats fut mesu· '59). rée à l'aide des tests de Harnllton, Cassano, Zung et Wittenborn. Les talIX .ride in the trearmene of psychoclc plasmariques en prolacclne furenr suivis afin de détecter une influence éven- other benzamides. Italian Baia tnelle des phospholipides hypothalamiques sur l'hyperprolaclinémie induite ~ effects of psychotroplcs drugs oa par les deux psychotrQPes. Applicacion of EEG in Psychlatry, Les résulrats démoiIrrenr une aclion favorable des liposomes phospholipi· diques hypothalamiques sur les effets thérapeutiques des deux psychotropes pharmacology. AppHcation cf EEG sous forme d'un renfotcement de leur aetioo. ,lioe (1965). .cta Therapeutica lO (1984) Acla Therapeutica lO (1984) 143 ---_._-_ .