Effect of N,N-Dibenzyl-β-Chloroethylamine Hydrochloride (Dibenamine) on Autonomic Functions and Catatonia in Schizophrenic Subjects. ∗

Abstract

Summary

1. Certain autonomic functions (B.P., P.R., skin temperature, palmar sweat response, electrical skin resistance), the signs of catatonia, and the psychiatric status of 9 patients with schizophrenic reactions, catatonic type, were evaluated before and after saline, sodium amytal, and Dibenamine infusions.

2. Pre-injection autonomic abnormalities were low systolic B.P., cool extremities, and either very low sweat responses with high E.S. Rs., or hyperhidrosis with very low E.S. Rs.

3. Saline produced no significant changes.

4. Sodium amytal infusions were followed by increased hand temperatures and improvement in the catatonia, especially in the verbal spheres. The subjects became relaxed, showed little interest in surroundings. In those 4 who developed sufficient speech function, hebephrenic or paranoid ideas were expressed. All changes were transient.

5. Dibenamine infusions were followed by a slight increase in systolic B.P. and a large increase in P.R., neither of which changes have been reported in non-psychotic subjects after Dibenamine. Excessive sweating was inhibited, and low E.S. Rs. were raised. The hands became warmer. Significant improvement in the signs of catatonia was noted in most subjects, especially (and in contrast to the effects of amytal) production of increased spontaneous activity and increased interest in surroundings. There was correlation between warming of the hands and the neurologic improvement. As with amytal, verbalization revealed hebephrenic and paranoid ideas. Toxic effects were infrequent and minor. All effects were transient, but of longer duration than with amytal.

6. The possible mechanisms by which Dibenamine inhibits sweating and by which it improves catatonia are discussed.

7. A difference in the descriptive level of catatonia from that of hebephrenia and paranoia is pointed out.

8. The common blood supply of the hypothalamus and the basal ganglia is suggested as a possible basis for the clinical association of certain motor and autonomic abnormalities.