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Am J Psychiatry 1957;114:143-146.
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Director of Research and Education, Topeka State Hospital, Topeka, Kansas.

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1. Pacatal is capable of eliciting therapeutic responses in chronically psychotic patients.2. It is most efficacious for those aspects of behavior which are related to increased anxiety and least efficacious for judgment, insight, orientation, memory and affect.3. The clinically significant side-effects are those related to the atropine-like action of Pacatal. Untreated eye complications, following prolonged administration of Pacatal, may lead to ulceration of the corneal epithelium.4. It is recommended that any prolonged ocular disturbance as a result of Pacatal medication be treated with Neostigmine.5. All the side-effects produced by Pacatal can be obliterated by symptomatic medication, lowering of daily dosage or discontinuation of the medication.6. The results obtained with Pacatal are encouraging and warrant further investigation upon a prognostically better group of psychotic patients.

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