Nathan S. Kline

Bio: Nathan S. Kline is an academic researcher from Columbia University. The author has contributed to research in topics: Reserpine & Depression (differential diagnoses). The author has an hindex of 4, co-authored 8 publications receiving 236 citations.

Use of reserpine in a neuropsychiatric hospital.

Abstract: There is a completely unverified story about a vacationist in the Maine woods who hired a young hunting dog named “Resident Psychiatrist” to take with him while shooting. The animal showed tremendous promise and, for a relatively inexperienced dog, was unusually good a t both pointing and retrieving. The next year, when the vacationist returned, he asked for the same animal to take hunting with him. “Oh,” said the man a t the kennel “that animal was so good that we changed his name from ‘Resident Psychiatrist’ to ‘Supervising Psychiatrist,’ and it will cost you twice as much to hire him.” This time the hound proved to be a perfect hunting dog in every imaginable respect and, when the vacationist returned the third year he naturally requested the same animal. “NO,” said the kennel master this time “you really don’t want that dog. Toward the end of last year he got to be so good that we changed his name again and called him ‘Director’. And, since that time, all he’s done is sit on his fanny and yapped directions a t the other dogs.” This story probably illustrates the fact that the ways of directors sometimes appear strange to people in different positions. From the point of view of hospital administration, the problem is not solely whether a preparation such as reserpine will cure an individual patient, but whether the over-all therapeutic picture is improved by the addition. Does it act on large numbers of patients more rapidly, more inexpensively and more permanently than other forms of treatment for specific conditions? It is necessary to adhere to the dictum of “the greatest good for the greatest number.” In addition to discharging patients from the hospital, there is the equally important problem of maintaining those patients who cannot be brought to a point of improvement sufficient for discharge in as comfortable, healthy, and economical a manner as possible. Further, although it is not the direct concern of such an administrator, there is interest in fostering whatever procedures will help keep patients out of mental institutions. Although completely definitive answers cannot be provided as to how reserpine serves any of these functions, there is sufficient information available, as the result of our experiences over the past year and a half, to give some indication as to the likely outcome. In one form or another, we have treated well over 1500 patients, so that some of the results have statistical validity. In our initial study,’ results obtained on about 700 patients placed on placebo, on reserpine, and on whole root of RauwoQa serpentina were compared and contrasted with results obtained under premedication conditions. The report was based on the 411 patients who could be judged under all four circumstances. Although, in the light of our present dosage regime, the 1 mg. given daily verged on the homeopathic, the results were still conclusive enough to dem-

The organization of psychiatric care and psychiatric research in the Union of Soviet Socialist Republics.

Abstract: “No. I cmnot stop a moment to give you the character of the people their genius their manners their c u r toms their laws their religion their government thedr mmufactures their commerce their finances. with all the resources and hidden springs which sustain them; qualified as I may be, by spending three days and two nights amongst them. w d during all that time, making these things the entire subJect of my enquiries and reflections.”

Panel discussion on tranquilizing drugs in the clinical management of mental disease in geriatric patients

Abstract: Moderator: FRANK J. AYD, JR., M.D., Chief of Psychiatry, Franklin Square Hospital, Baltimore, Maryland. Panelists: DOUGLAS GOLDMAN, M.D., Assistant Clinical Professor of Psychiatry, Universityof Cincinnati College of Medicine; and Clinical Director, Longview State Hospital, Cincinnati, Ohio; NATHAN S. KLINE, M.D., Director of Research, Rockland State Hospital, Orangeburg, N. Y., and Assistant Clinical Professor of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, N. Y.; ERNEST H. PARSONS, M.D., Assistant Clinical Professor of Psychiatry, Washington University School of Medicine, St. Louis, Missouri; and BURTRUM C. SCHIELE, M.D., Professor of Psychiatry, University of Minnesota Medical School, and Director, Adult Psychiatric Service, University Hospitals, Minneapolis, Minnesota.

Half a century of antipsychotics and still a central role for dopamine D2 receptors.

Abstract: A review of the history of antipsychotics reveals that while the therapeutic effects of chlorpromazine and reserpine were discovered and actively researched almost concurrently, subsequent drug development has been restricted to drugs acting on postsynaptic receptors rather than modulation of dopamine release. The fundamental property of atypical antipsychotics is their ability to produce an antipsychotic effect in the absence of extrapyramidal side effects (EPS) or prolactin elevation. Modulation of the dopamine D2 receptor remains both necessary and sufficient for antipsychotic drug action, with affinity to the D2-receptor being the single most important discriminator between a typical and atypical drug profile. Most antipsychotics, including atypical antipsychotics, show a dose-dependent threshold of D2 receptor occupancy for their therapeutic effects, although the precise threshold is different for different drugs. Some atypical antipsychotics do not appear to reach the threshold for EPS and prolactin elevation, possibly accounting for their atypical nature. To link the biological theories of antipsychotics to their psychological effects, a hypothesis is proposed wherein psychosis is a state of aberrant salience of stimuli and ideas, and antipsychotics, via modulation of the mesolimbic dopamine system, dampen the salience of these symptoms. Thus, antipsychotics do not excise psychosis: they provide the neurochemical platform for the resolution of symptoms. Future generations of antipsychotics may need to move away from a "one-size-fits-all polypharmacy-in-a-pill" approach to treat all the different aspects of schizophrenia. At least in theory a preferred approach would be the development of specific treatments for the different dimensions of schizophrenia (e.g., positive, negative, cognitive, and affective) that can be flexibly used and titrated in the service of patients' presenting psychopathology.

Enhancement of Imipramine Antidepressant Activity by Thyroid Hormone

Abstract: Twenty euthyroid patients with retarded depression were studied to determine the possible role of alterations in thyroid function in the etiology and treatment of depression. A battery of tests was administered regularly to measure change. Patients responded better to usual doses of imipramine when 25 µg. of L-triiodothyronine (T3) was administered daily. T3 was physiologically active, altering protein-bound iodine values and accelerating ankle reflex time. A possible explanation, based on relevant data from animal experiments, is that imipramine may elevate effective biogenic concentration, while T3 increases receptor sensitivity.

History of the discovery and clinical introduction of chlorpromazine

Abstract: Background. The historical process of discovery and clinical introduction of chlorpromazine, one of the greatest advances of 20th century medicine and history of psychiatry, is analyzed.Methods. In this review, we have studied the original works of pioneers in the discovery and clinical use of chlorpromazine, as well as the contributions of prestigious researchers (historians, pharmacologists, psychiatrists, etc.) about this topic.Results. The discovery of phenothiazines, the first family of antipsychotic agents has its origin in the development of German dye industry, at the end of the 19th century (Graebe, Liebermann, Bernthsen). Up to 1940 they were employed as antiseptics, antihelminthics and antimalarials (Ehrlich, Schulemann, Gilman). Finally, in the context of research on antihistaminic substances in France after World War II (Bovet, Halpern, Ducrot) the chlorpromazine was synthesized at Rhone-Poulenc Laboratories (Charpentier, Courvoisier, Koetschet) in December 1950. Its introduction in anaesthes...

Mental depression in hypertensive patients treated for long periods with large doses of reserpine.

Abstract: THE introduction of Rauwolfia serpentina into this country by Wilkins and Judson1 and the purification of an active alkaloid, reserpine (Serpasil), has led to the widespread clinical use of the latter drug not only in hypertension2 , 3 but also in neuropsychiatric conditions.4 The purpose of this report is to describe the development of psychiatric complications in hypertensive patients treated with large doses of reserpine for long periods. Case Reports Case 1. Mrs. I.K., a 54-year-old widow, had mild hypertension for 1 year associated with headache and substernal pain. Since the death of her husband 2 years previously she had been more . . .

Chemotherapy in psychiatry

Abstract: Chemotherapy in psychiatry : , Chemotherapy in psychiatry : , کتابخانه دیجیتال جندی شاپور اهواز