Conflicting reports concerning cholinomimetic-induced reduction of
schizophrenic symptoms prompted the authors to study such changes in
schizophrenic symptoms following physostigmine infusions in subgroups of
patients with schizophrenic-like illness. These subgroups were defined by
the presence or absence of antipsychotic response during a 2- week trial of
lithium alone after physostigmine infusion. Patients who showed significant
but temporary improvement in their thinking disturbance on serial Brief
Psychiatric Rating Scale scores following physostigmine infusion
subsequently responded to lithium; patients who failed to improve following
physostigmine also failed to respond to lithium. The authors suggest that
some schizophrenic-like illnesses may be biologically similar to mania both
with respect to physostigmine and lithium-induced changes in
symptomatology.
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