Comparative efficacy and tolerability of 32 oral antipsychotics for the acute treatment of adults with multi-episode schizophrenia: a systematic review and network meta-analysis

Entropy is a dimensionless quantity that is used for measuring uncertainty about the state of a system but it can also imply physical qualities, where high entropy is synonymous with high disorder. Entropy is applied here in the context of states of consciousness and their associated neural dynamics, with a particular focus on the psychedelic state. The psychedelic state is considered an exemplar of a primitive or primary state of consciousness that preceded the development of modern, adult, human, normal waking consciousness. Based on neuroimaging data with psilocybin, a classic psychedelic drug, it is argued that the defining feature of ‘primary states’ is elevated entropy in certain aspects of brain function, such as the repertoire of functional connectivity motifs that form and fragment across time. It is noted that elevated entropy in this sense, is a characteristic of systems exhibiting ‘self-organised criticality’, i.e., a property of systems that gravitate towards a ‘critical’ point in a transition zone between order and disorder in which certain phenomena such as power-law scaling appear. This implies that entropy is suppressed in normal waking consciousness, meaning that the brain operates just below criticality. It is argued that this entropy suppression furnishes consciousness with a constrained quality and associated metacognitive functions, including reality-testing and self-awareness. It is also proposed that entry into primary states depends on a collapse of the normally highly organised activity within the default-mode network (DMN) and a decoupling between the DMN and the medial temporal lobes (which are normally significantly coupled). These hypotheses can be tested by examining brain activity and associated cognition in other candidate primary states such as REM sleep and early psychosis and comparing these with non-primary states such as normal waking consciousness and the anaesthetised state.

/pdf/the-entropic-brain-a-theory-of-conscious-states-informed-by-99bqqui5xr.pdf

The entropic brain: a theory of conscious states informed by neuroimaging research with psychedelic drugs

We examined the effects of maintenance chlorpromazine and major role therapy (MRT) in forestalling the relapse of 374 schizophrenic patients recently discharged from the hospital. Chlorpromazine is significantly more effective than placebo in forestalling relapses (p There is no significant effect of MRT during the entire treatment period. However, MRT does reduce relapses among those who survive in the community for six months after hospital discharge. These results were replicated at three clinics.

https://jamanetwork.com/journals/PSYCH/articlepdf/490818/archpsyc_28_1_007.pdf

Drug and Sociotherapy in the Aftercare of Schizophrenic Patients: II. Two-Year Relapse Rates

• It is clinically useful to have a table listing the equivalent doses of the various neuroleptics to a standard, such as chlorpromazine. This article derives such data by reviewing doubleblind controlled studies that used a flexible dosage schedule of neuroleptics in treating schizophrenic patients. Each neuroleptic is then converted to 100-mg chlorpromazine equivalents. This empirically derived dosage comparability table is compared with a similar table derived from the opinions of experts. Since these comparable doses produce equivalent amounts of antipsychotic activity, the cost to provide such medication was then calculated, and a table comparing the costs of the different neuroleptics was constructed. In absolute amounts, the cost differences between drugs are small. However, for any drug, large savings accrue when the largest possible capsule or tablet to achieve the desired dose is prescribed.

Comparative doses and costs of antipsychotic medication.

Current developments in psychopharmacology

The intravenous injection of 0.5 grams of mescaline sulfate in 25 schizophrenic patients produced a varied clinical picture, with a predominance of emotional over ideational reactions.

https://link.springer.com/content/pdf/10.1007/BF01567467.pdf

Studies on mescaline. I. Action in schizophrenic patients; clinical observations and brain wave patterns, showing effects before and after electric convulsive treatments.

1. Butyrylperazine was administered to 20 patients at Manhattan State Hospital, New York City, and 26 patients at the University Psychiatric Clinic of Erlangen, West Germany. 2. There were significant differences between both groups in (a) dosage requirements, (b) side effects, and (c) clinical results. 3. It is suggested that genetic factors may play some role in explaining at least two of these findings (2a and b).

Comparative analysis of the action of butyrylperazine at Manhattan State Hospital and the University Psychiatric Clinic at Erlangen.

The clinical and laboratory data following the inections of mescaline sulfate and chlorpromazine hydrochloride are briefly reported. The relative importance of each drug, the physiological mechanisms involved, and the psychodynamic factors implicated in the clinical remissions are now being intensively investigated under rigidly controlled conditions.

A note on some therapeutic implications of the mescaline-induced state.

The ant a,gonism :of one psychotropie drug for another may be studied according to a particular field of interest--clinical, pharmacological, neurophysiologic~], electro-eneephalographie or psychologieal. For instance, the inhibiting effects of anti-Parkinsonian drugs on the extrapyramidal syndrome induced by psycho tropic drugs can be considered from any one or any co,mbination of these disciplines. Much b~sie work has so far been centered :on the blocking action** of various compouncts again.st .drugs capable of inducing states of disordered behavior resembling the psyeho.ses. 1 A comprehensive neur.ophysiologieal .analysis of the problem has been made by Marrazzi, et a l , ~ whose studies with their \"transealtosal mono.synaptie\" preparation have yielded results that seem to parMlel clinical findings. I t has been shown that c.hlorpromazine directly antagonizes the action of mescaline in psychiatric patients, and po.tentiates the abnormal brain wave pattern.s of epileptics?,\" Sehwarz, et al.? found that 25 rag. of intramu:scu~ar .ehlorpromazine blocked 400 rag. of o.ral mescaline, and in 15 minutes \"the subject was essentially restored to his control condition.\" tIoch 6 reported that when ehlorpromazine was given intravenously it was the most effective antagon'i~st of mescaline, but he e.ould not confirm the repo.rted effectiveness of Frenquet. ~ T~he relevant neurop,hysio~logie and biochemical data have been reviewed elsewhere. ~ In a comparative clinical analysis of the antagonism of various phenothiazines to mescaline, it wa,s found that ehlorpromazine and triflupromazine were most effeetive. ~ Proetorperazine and thiopropazate were only moderately effective. Promazine and promethazine were ineffective, although ~ e y produced transient

Studies on mescaline XI: Biochemical findings during the mescaline-induced state with observations on the blocking action of different psychotropic drugs

It was not possible to influence the clinical picture in 21 of 30 acute and chronic female psychotic patients following treatment with R-1625.

Herman C. B. Denber

Papers

Studies on mescaline. I. Action in schizophrenic patients; clinical observations and brain wave patterns, showing effects before and after electric convulsive treatments.

Comparative analysis of the action of butyrylperazine at Manhattan State Hospital and the University Psychiatric Clinic at Erlangen.

A note on some therapeutic implications of the mescaline-induced state.

Studies on mescaline XI: Biochemical findings during the mescaline-induced state with observations on the blocking action of different psychotropic drugs

Problems in evaluation of R-1625.