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Amisulpride is an atypical antipsychotic with selective affinity for dopamine D2D3receptors. In this longterm, open, randomised, multicentre trial, patients with chronic or subchronic schizophrenia received amisulpride n370 or haloperidol n118 for 12 months. Dosage regimens were flexible amisulpride 200800 mgday, haloperidol 520 mgday. Improvement in mean Brief Psychiatric Rating Scale total score was significantly greater for amisulpride than haloperidol 17.0 versus 12.8,P0.01. Positive symptoms Positive and Negative Syndrome Scale PANSS positive improved in a similar way in each group but amisulpride caused a significantly better improvement in negative symptoms PANSS negative 7.1 versus 3.7,P< 0.0001. Improvements in Global Assessment of Functioning GAF and Quality of Life Scale QLS scores were also significantly greater in the amisulpride group GAF 20.1 versus 13.6,P0.001 QLS 0.64 versus 0.30,P0.02. Adverse events were mainly psychiatric in nature, and occurred with similar frequency in each group amisulpride 254370, 69 haloperidol 82118, 70. Extrapyramidal symptoms were more frequent for haloperidol 48118, 41 versus 96370, 26 for amisulpride, leading to a greater requirement for antiparkinsonian medication haloperidol 66118, 56 versus amisulpride 118370, 32. Haloperidol significantly aggravated parkinsonism, akathisia and involuntary movement compared to amisulpride. The overall incidence of endocrine events was comparable between groups 4 for amisulpride, 3 for haloperidol. Maintenance of efficacy was comparable in both treatment groups 59 of amisulpride patients and 55 of haloperidol patients improved after 1 month of therapy remained improved throughout the study period. Amisulpride is effective following flexible longterm administration and significantly improves social functioning and quality of life.

Nowadays, the rehabilitation of schizophrenic patients is a major issue for psychiatry. Regarding the role of conventional neuroleptics, the following points will be considered in this paper: the role of neuroleptics in the number, length and frequency of hospitalisations; the role of neuroleptics in the number, degree and length of relapses; the clinical effects of neuroleptics focusing particularly on their disinhibitory action, the most controversial and least studied of the clinical effects of these drugs; and the side effects, which have been intensively studied and particularly criticised during these last years, leading to the development of new drugs discussed in the next article. All the published data relating to the psychosocial profile of schizophrenic patients clearly demonstrate the need for further research in order to improve the familial, social and professional rehabilitation of these patients

We describe the clinical and laboratory findings of a young man with mycosis fungoides. The disease was associated, since the early stages, with autoimmune purpura. Interferon alfa (IFN-@a) administration improved this patient's condition, both the purpuric eruption and patchy cutaneous lesions, thus suggesting T-cell abnormalities may be responsible for the development of the disease. (J Am Acad Dermatol 1999;40:298-9.)