Myriad difficulties exist in analyzing the pharmacology of the serotonin 1A (5-HT1A) receptor. The receptor may demonstrate a different activity depending on the tissue or species used for analysis, the agent used, laboratory conditions, and differences between in vitro and in vivo effects of compounds. Affinity for 5-HT receptors also varies widely, presenting difficulties in drawing definitive conclusions on affinity values for various compounds. At least two possibilities exist to explain the diversity of pharmacology of 5-HT receptors. First, it is possible that different 5-HT1A receptor subtypes exist. Second, the 5-HT1A receptors may play a far more complex role than previously believed.

In an open nonblind clinical trial, clomipramine was administered to five previously medicated prepubertal boys with autistic disorder and severe mental retardation unmanageable due to behavior and motor problems. Although all five boys initially displayed marked behavioral symptom reduction, they developed behavioral newotoxicity necessitating discontinuation of clomipramine for all five and immediate hospitalization for three. Serious adverse effects included increased seizure frequency and symptoms of a serotonin syndrome. Our findings indicate that clomipramine enhances adaptive behavior and produces serious adverse effects in severely retarded autistic children whose symptoms were complicated by dyskinesias.

Trichotillomania (TTM, repetitive hair pulling) is a complex underdiagnosed syndrome that often causes considerable psychological distress and physical disfigurement. Although many aspects of hair pulling bear similarity to compulsions of obsessive-compulsive disorder (OCD), TTM lacks obsessions associated with OCD. The phenomenology of TTM also is similar to tics in Tourette Syndrome (TS) and overlaps with TS in both limited structural neuroimaging data and in terms of treatment response to pharmacotherapy with dopamine antagonists.

In order to study potential comorbid relationships between TTM, TS, and OCD, a total of 61 patients with either TS, OCD, or OCD comorbid with TS were assessed using structured interviews as part of a phenomenological study of these groups. Post hoc analyses indicated significantly higher proportions of hair pulling in those subjects with OCD comorbid with TS compared to subjects with either OCD or TS alone.

These data, in conjunction with clinical phenomenology, neuroimaging results, and response to pharmacotherapy suggest the possibility that some forms of TTM may be more closely related to tic disorders than OCD. Futher research is needed to clarify and confirm these observations of putative relationships between TTM and TS and potential treatment implications.

The purpose of this study was to evaluate the effect of risperidone on the cognitive functioning of patients with schizophrenia and how it relates to the alleviation of psychopathological symptoms usually observed in patients receiving treatment. Twelve schizophrenic patients were evaluated while being treated with a traditional neuroleptic, and again approximately 8 and 24 weeks after initiation of risperidone. Patients were compared with a group of normal controls (n=24) who underwent the same cognitive evaluation across time. The normal control group was included to evaluate the level of impairments in patients, but also to test for practice effects. The cognitive evaluation included measures of short-term and long-term memory; attention (alertness, sustained and selective); and executive functioning (verbal and category fluency). Clinical symptoms were rated on the Positive and Negative Symptoms Scale (PANSS) and the Brief Psychiatric Rating Scale (BPRS). Extrapyramidal symptoms were rated with the Extrapyramidal Symptoms Rating Scale.

During treatment with risperidone, schizophrenic patients improved their BPRS and PANSS scores, their performance level on tests of alertness, and both sustained and selective attention.

During the past decade, an increasing interest has been shifted from the study of neuroreceptors to their links with second-messenger pathways. In the present article, we shall briefly review the methodological tools for evaluating adenylyl cyclase activity in several human brain and peripheral models, as well as the studies suggesting its involvement in the pathophysiology of mood disorders. We shall present also some preliminary data obtained in our laboratory providing evidence for the measurement of serotonin-sensitive adenylyl cyclase activity in human brain postmortem.

We present the case of a 27-year-old man treated unsuccessfully for 1 year for chronic cough, who was thought to suffer from psychogenic cough. Vocal tic was suspected by a liaison psychiatry service, and treatment with low-dose haloperidol was successful. This case suggests that more attention to tic syndromes is needed before qualifying persistent idiopathic cough as psychogenic.