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The influence of celiprolol on the symptoms of tardive dyskinesia was compared with placebo in a randomized double blind study. 17 female patients were treated with a single daily dose of 200 mg celiprolol and 18 female patients received placebo for a period of 3 months. All patients got additional neuroleptic treatment. Celiprolol produced a small decrease in heart rate and systolic blood pressure, but had no influence on the diastolic blood pressure. The effects of celiprolol on the symptoms of tardive dyskinesia were similar to those of the placebo; in both groups improvements and deteriorations were observed. One patient of the celiprolol group became symptom free. Two cases of collapse occurred after 10 weeks of treatment with celiprolol. In one case collapse was associated with diarrhoea, in the other case the patient had preexisting hypotensive circulatory dysregulation. Sporadic reports about the effect of propranolol in patients with tardive dyskinesia might reflect the normal progress of the disease or the effect might depend on the different pharmacological profile of propranolol.

The effect of the serotonin precursor l-tryptophan on delirium and pre-delirium states was studied in a prospective study on 32 patients. Patients were given 3 infusions each containing 2.5 g l-tryptophan, a day for at least 7 days. The status of the patients was examined with the Mini Mental State Examination, the SCAG (Sandoz Clinical Assessment Geriatric Scale) and a sleep/awake observation sheet. These showed that the patients experienced significant trends toward improvement. Relevant side effects and interactions were not observed. The application of supplemental tranquilizers could be reduced and in 5 cases it was not necessary at all. It was only necessary to apply l-tryptophan for longer than 7 days in 4 of 32 patients. Furthermore, under this medication no patient in a state of predelirium at delivery into the hospital developed full delirium tremens.

Out of all neurological and psychiatric diseases from the international point of view alcoholism is the biggest problem in road-traffic. Psychomotor-ability and self-criticism are already impaired at very low doses of alcohol. Driving-ability almost always is reduced in the acute stage of endogenous psychoses, but improves parallel to the improvement of the psychosis. This happens in spite and sometimes even because of psychopharmacotherapy. Almost all patients are able to fulfill the driving-ability requirements after the acute state. Neurological patients are causing less problems in road-traffic than the average population. In epilepsy a small "risk group" could be objectified. This group has a bad compliance and inclines to alcoholism. In the Western part of Lower Austria we have made arrangements concerning standardized requirements for our patients in 1976. This way from the psycho-hygienic point of view we really were very successful. It also should be mentioned that concerning epilepsy we were more or less pursuing the same ideas since 1976 which got recommended by "Epilepsy International" in 1981.