Optimum Dosage of Neuroleptic Agents by Electronic Recording of Extrapyramidal Fine Motoricity in Handwriting (NTI HAASE)
In the beginning of the fifties, working as an intern at the University Psychiatric Clinic at Bonn, I was prompted by a research assignment by the Psychological Institute of the University of Bonn to investigate the relation between drive and motoricity in patients suffering from Parkinson’s disease, even before neuroleptic agents had been introduced. This was a peculiar coincidence, committing me for a lifetime, as I was soon to discover. Shortly thereafter, i.e. in 1953, I was given leave to join the Psychiatric Hospital at Oberwill/Zug (Switzerland), where numerous psychotic patients were then treated with the first neuroleptic agent available at the time, namely chlorpromazine (Megaphen, Largactil). When it became evident, that a patient treated with chlorpromazine shows a parkinsonian restriction of the movement of his arms when walking, my respective letter addressed to the scientific department of Messrs. BAYER/Leverkusen was answered to the effect, that there was no indication of a connection between this parkinsonism and the effect of chlorpromazine. At that time, however, evidence existed already in medical literatur, that the rauwolfia alkaloid reserpine, known in Indian folk medicine, with a similar therapeutic effect on delusional diseases repeatedly evokes parkinsonism. Allowing for the discrepancy between extrapyramidal coarse motoricity in walking and fine motoricity in handwriting, I had discovered during the a.m. investigation in Bonn, I embarked on a systematic study of the fine motoricity of handwriting, first of patients treated with chlorpromazine, and then of those receiving reserpine, as from the autumn of 1953. I found out, that parkinsonian fine-motor symptoms of inhibition in handwriting, but not the subjectively unpleasant coarse-motor extrapyramidal symptoms, give a basic indication of the required dosage of drugs for the treatment of psychotic experience productions, i.e. delusional diseases, drugs that were soon referred to as neuroleptic agents by Delay and Deniker.
KeywordsPositive Symptom Fine Motoricity Neuroleptic Agent Psychotic Positive Symptom Research Assignment
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