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                    <text>StonYBrOOk

Department of Psychiatry and Behavioral Science
State University of New York at Stony Brook.
Stony Brook, NY 11794
telephone: (516) 246-2413

v

October 18, 1982"
Paul Leber, M.D.
Division of Neuropharmacological Products
Food 6: Drug Administration
5600 Fishers Lane
Rockville, Maryland 20 857

Ref: IND 8,569

-

~ACTH4_10 (OI-63)

Dear Sir:
The sponsorship of IND 8,569 is transferred to the Pharmaceutical
Research Institute of Worthington, Ohio, effective this date.

Other investigators studying this compound under this IND are being
informed of this transfer.

Sinc ely yours,

JM

Max Fink, M.D.

Professor of Psychiatry

�Department of Psychiatry and Behavioral Science
State University of New York at Stony Brook.
Stony Brook, NY 11794
telephone; (516)246-2413

StonyBrook

October I 8,

19 82

Paul Leber, M.D.
Division of Neuropharmacological Products
Food 6: Drug Administration
5600 Fishers Lane
Rockville, Maryland 20857

Ref: IND 12,238 —- GC-46
Dear Sir:
The sponsorship of IND 12,238 is transferred to the Pharmaceutical
Research Institute of Worthington, Ohio, effective this date.

Other investigators studying this compound under this IND are being
informed of this transfer.

Si

M

erelgours,
£14»!
V

Max Fink, M.D.

Professor of Psychiatry

�Department of Psychiatry and Behavioral Science
State University of New York at Stony BrookStony Brook, NY 11794
telephone: (516) 246-2413

StOHYBIOOk

October 18, l982
Paul Leber, MD.
Division of Neuropharmacological Products
Food 6: Drug Administration
5600 Fishers Lane
Rockville, Maryland 20857

Ref: IND 12,987 .- ACTH4_9 (ORG 2766)
Dear Sir:
The sponsorship of IND 12,987 is transferred to the Pharmaceutical
Research Institute of Worthington, Ohio, effective this date.

Other investigators studying this compound under this IND are being
informed of this transfer.

ﬂ!
Sin

relgurs,

M—

Max Fink, MD.

Professor of Psychiatry

�Department of Psychiatry and Behavioral Science
State University of New York at Stony Brook.
Stony Brook, NY 11794
telephone: (5 l 6) 246-2413

Stan-YEW0k

October 18, 1982
Paul Leber, MD.
Division of Neuropharmacological Products
Food 6: Drug Administration
5600 Fishers Lane
Rockville, Maryland 20857

Ref:

1ND

13,059 -'ORG 2566

Dear Sir:
The sponsorship of IND 13,059 is transferred to the Pharmaceutical
Research Institute of Worthington, Ohio, effective this date.

Other investigators studying this compound under this IND are being
informed of this transfer.

W

erelyjurs,
Max Fink, MD.

Professor of Psychiatry

�Department of Psychiatry and Behavioral Science
State University of New York at Stony Brook.
Stony Brook, NY 11794
telephone: (516)246-2413

StonYBl-‘OOk

October 18, 1982
Paul Leber, MD.
Division of Neuropharmacological Products
Food 6: Drug Administration
5600 Fishers Lane
Rockville, Maryland 20 857

Ref: IND 13,060 — ORG 2313
Dear Sir:
The sponsorship of IND 13,060 is transferred to the Pharmaceutical
Research Institute of Worthington, Ohio, effective this date.

Other investigators studying this compound under this IND are being
informed of this transfer.

Lia,“
//
Si

erely yours,

Max Fink, MD.

Professor of Psychiatry

�Department of Psychiatry and Behavioral Science
State University of New York at Stony Brook
Stony Brook, NY 11794

StonyBrook

telephone=(516)246.2413

October 18, 1982
Paul Leber, M.D.
Division of Neuropharmacological Products
Food 6c Drug Administration
5600 Fishers Lane
Rockville, Maryland 20857

Ref: IND 14,915

-' ORG 3770 (6-azamianserin)

Dear Sir:
The sponsorship of IND 14,915 is transferred to the Pharmaceutical
Research Institute of Worthington, Ohio, effective this date.

Other investigators studying this compound under this IND are being
informed of this transfer.
’

d“

Sinc ely yours,
/./l‘
1

,

Max Fink, M.D.

Professor of Psychiatry

�Department of Psychiatry and Behavioral Science
State University of New York at Stony Brook
Stony Brook, NY 11794
telephone: (516)246-2413

StonYBIOOk

October 18, 1982
Paul Leber, MD.
Division of Neuropharmacological Products
Food 6: Drug Administration
5600 Fishers Lane
Rockville, Maryland 20 857

Ref: IND 14,963 -~ ORG 2305
Dear Sir:
The sponsorship of IND 14,963 is transferred to the Pharmaceutical
Research Institute of Worthington, Ohio, effective this date.

Other investigators studying this compound under this IND are being
informed of this transfer.

Si

/

erelyJ/ours,
'
,

Max Fink, MD.

Professor of Psychiatry

�Department of Psychiatry and Behavioral Science
State University of New York at Stony Brook.
Stony Brook, NY 11794
telephone: (516) 246-2413

StonYBIOOk

October 1 8,

19 82

Paul Leber, MD.
Division of Neuropharmacoiogical Products
Food 6: Drug Administration
5600 Fishers Lane
Rockville, Maryland 20857

Ref: IND 16,111

-' GK-78

Dear Sir:
The sponsorship of IND 16,111 is transferred to the Pharmaceutical
Research Institute of Worthington, Ohio, effective this date.

Other investigators studying this compound under this IND are being
informed of this transfer.
-

S/i

cerely yours,

Max Fink, MD.
Professor of Psychiatry

�Department of Psychiatry and Behavioral Science
State University of New York at Stony Brook.
Stony Brook, NY 11794
(516) 246.2413

1b

StonyBrook

October 18,

1982‘

Paul Leber, MD.
Division of Neuropharmacological Products
Food 6: Drug Administration
5600 Fishers Lane
Rockville, Maryland 20 857

Ref: IND 16,195 -.- ORG 2408
Dear Sir:
The sponsorship of IND 16,195 is transferred to the Pharmaceutical
Research Institute of Worthington, Ohio, effective this date.

Other investigators studying this compound under this IND are being
informed of this transfer.

j

/”
SiZerely

ours ,
-

Max Fink, MD.
Professor of Psychiatry

�StonyBrook

Department of Psychiatry and Behavioral Science
State University of New York at Stony Brook.
Stony Brook, NY 11794
telephone; (516)2462413

,

October l8,

19 82

Paul Leber, MD.
Division of Neuropharmacological Products
Food 6: Drug Administration
5600 Fishers Lane
Rockville, Maryland 20857

Ref: IND 16,905 -‘- ORG 6582
Dear Sir:
The sponsorship of IND 16,905 is transferred to the Pharmaceutical
Research Institute of Worthington, Ohio, effective this date.

Other investigators studying this compound under this IND are being
informed of this transfer.

rely

yours,
:4
3,914.4;
//Z
Sin

Max Fink, MD.

Professor of Psychiatry

�Department of Psychiatry and BehavioralScience
State University of New York at Stony Brook.
Stony Brook, NY 11794
telephone: (516) 246-2413

StOHYBm0k

October 18, 1982
Paul Leber, MD.
Division of Neuropharmacological Products
Food 6( Drug Administration
5600 Fishers Lane
Rockville, Maryland 20857

Ref: IND 16,906

-

DGAVP

Dear Sir:
The sponsorship of IND 16,906 is transferred to the Pharmaceutical
Research Institute of Worthington, Ohio, effective this date.

Other investigators studying this compound under this
informed of this transfer.

1ND

are being

Sinc ely yours,

M

Max Fink, MD.

Professor of Psychiatry

�Department of Psychiatry and Behavioral Science
State University of New York at Stony Brook.
Stony Brook, NY 11794
telephone: (516) 2462413

StonyBrook

October 18, 1982
Paul Leber, MD.
Division of Neuropharmacological Products
Food 6: Drug Administration
5600 Fishers Lane
Rockville, Maryland 20 857

Ref: IND 17,365 -.Mianserin
Dear Sir:
The sponsorship of 1ND 17,365 is transferred to the Pharmaceutical
Research Institute of Worthington, Ohio, effective this date.

Other investigators studying this compound under this IND are being
informed of this transfer.

Sincerely yours,
Max Fink, MD.
Professor of Psychiatry

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                    <text>July 21, 1982
Paul Leber, M.D.
Acting Director
Division of Neuropharmacological Drug Products
Food dt Drug Administration
5600 Fishers Lane
Rockville, Maryland 20 857

Ref:

1ND

12,987 (ORG 2766)

Dear Dr. Leber,
Please allow the scientists at the Pharmaceutical Research Institute of
Worthington, Ohio to cross—reference the information in our files of the ACTH4.9
fragment known as ORG 2766 (IND 12,9 87), effective immediately.
Thank you.

Sincerely yours,
Max Fink, Md).

Professor of Psychiatry

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                    <text>July 15, 1982
Division of Neuropharmacologlcal Drug Products
Food a: ~{Mug Administration
5600 Fishers Lane
Rockvllle, Maryland 20857

Gentlemen:
REF: 1ND 12,987

ACTH,-9 (ORG 2766)

Enclosed is an amendment to 1ND 12,987 for a clinical trial of this ACTH
fragment analog in the treatment of patients with pituitary hormone deﬁciency, to
be undertaken by Dr. L. P. Kapcala of the Division of Endocrinology, Department
of Medicine, Cleveland Metropolitan General Hospltal. Copies of his protocol,
consent forms, and curriculum vitae are «closed.

Sincorely yours,

“wr

a:,:yuw'\'wvwnyqu'r:-

"'

mem

Max Fink,

Ml).

Professor of Psychiatry

�</text>
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                    <text>June 28, 1982
Mr. G. Weiss

Cardiorenal Division
Food 6: Drug Administration
5600 Fishers Lame
Rockville, Maryland 20857
Ref: IND 20,310 (kpenbutolol)
Dear Mr. Weiss,

to Hoe‘chst on 23 June regarding the dosage of
be
used
in
advised that the capsules in use are #0 mg in
our studies,
l-penbutolol
all
and
doses
dose;
test
are multiple: of this formulation.
In reference to your can

Sincerely yours,

Max Fink, Md).

Professor of Psychiatry

cc: A. Yacobow, Hoechst'

�</text>
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              <elementText elementTextId="63843">
                <text>Special Collections and University Archives, University Libraries. Stony Brook University Libraries (State University of New York).</text>
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                  <elementText elementTextId="104136">
                    <text>~,

9.»... ,n

..

.—

_..,.W_.W“ . W “m- .m-w~_
,r

V

..

.vm..-

,..

.

.

a“, ”.7. .7 Va.

mw—

'—

72'.
v

#1) 4

&lt;-———v

-—

«w

mv—"-vmﬁu’llr

er—vvwrv-r‘vv

.r—

.

March 1, 1982
w-w_.y..~_wv_..—_r

Mr. C. Prettyman

.

Ail,_“w,wm.

Division of Neuropharmacological Products
FDA
5600 Fishers Lane
Rockville, Maryland 20857

Ref:

A'WHNWW

”WV

- Mianserin

Dear Sir:
The following is in response to your inquiry of February 24, 1982.

-m&lt;wmt=-mV—nwww"7

""1"“

1ND 17,365

in 1981, five TCA non-responding patients were inducted to courses of
mianserin. The first two patients began their treatment as in—patients at University
Hospital. Doses ranged from 20 to 160 rag/day in one patient, and 20 to 60 mg in
the second. Their clinical response was not outstanding and both went on to receive
successful courses of ECT.

Three patients received mianserin as outpatients, with doses of 20 to
nag/day. In one, the response was considered very satisfactory and the
treatment was discontinued on 2/ 15/82. In two others, the results were not
one was readmitted to a chronic hospital and the second was
outstanding
successfully treated with ECT.
120

-

Two patients have been inducted in 1982 and are now doing well under

treatment at maximum dosages of

120 mg/day.

In none of the live completed patients (and in neither of the two in
progress) have we recorded any untoward effects of the medication at these
dosages, either in the self reports, observations, or laboratory tests.
I

trust that this information is useful.
Sincerely yours,
Max Fink, MD.

Professor of Psychiatry

�</text>
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                <text>1980 </text>
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                <text>Special Collections and University Archives, University Libraries. Stony Brook University Libraries (State University of New York).</text>
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                <elementTextContainer>
                  <elementText elementTextId="104135">
                    <text>February 8, 1980

Barrett Scovillo,

M.D.

HINCDS

Bethesda, Maryland
Dear

Barrett,

Thank you for the articles on barbiturate withdrawal. I raised
tho question in answer to the suggestion, made by Dr. Tyrer, that misnserin
may have epileptogonic features. His case report was flawed, however, by
the fact that the patient had had lorszepsm withdrawn two days before
the seizure.

In the recent issue of Lancet (January 19, 1980, p.151), Einsrson
four
cases of withdrawal seizures with bansodissepines in one year.
reports
Dr. Tyror’s response is also included.

It is clear

the paucity of literature and the persistence
of the question of bensodiszopine withdrawal seizures that systematic
studies in man need to be done.
from

Insidentally, I had dinner a few nights ago with Dr. John
Davis of ColuMbus, Ohio, who remarked on your work and some association
with him. I thund him most pleasant and particularly knowledgeable about
FDA and drug regulatory matters.
My

regards and

my

thanks.
Sincerely ydurs,
Fink, M.D.
Professor of Psychiatry
M3:

�</text>
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              </elementText>
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              </elementText>
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                    <text>r”

an

nwywmgp—snvr

"MW“V‘VI‘JK"

«-

~

April 6, 1980
Morris B. Bender, M.D.
Department of Neurology

Mt.

Sinai Hospital
City

New York

Dear Morris,

Belatedly, I heard of the birthday party planned for you
Orleans. I regret that I cannotaattend, and trust that Martin will
extend my best wishes in person.on the occasion, as I do now in good
spirit and with all my heart. May you have many more such happy
occasions.
in

New

We have finally moved from Great Neck, to a smaller
home in Nissequoge. Where is Nissequogue, you will ask ? In Suffolk County,
among the horse fanciers and the farms, near the University. But
is
a part of the land that is like Great Neck was soon after the second
World War, quite rural. We have yet to become acclimated (we moved at

it

the end of January) but the opening of University Hospital provided the
needed spur.o I now have an active service in addition to my laboratory and
teaching. When next you come East. let us know and I will be honored and
pleased to show you around.
Have a happy

in sending our best.

birthday and

many more.

Martha

joins

4933’:-

LEAV'F3IWV

Sincerely yours,

WW7"

'

Fxm'm'”

wwwsun

'~

~'

mz-mvwﬂwr

"‘t‘r’v‘ewﬁt-m“

new"

Fink, M.D.
Professor of Psychiatry
Max

me

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                    <text>April 6, 1980
Dre. R.

Jaffe,

Krieger,

H.

Sencer
Department of Neurology
8 W.

Mt.

New

Sinai Hospital
City

York

Dear Bob, Howie and Wally,

Nothing would please

me

more than to honor Morris on

his 75th birthday, and to meet with all my old comrades-in~ training.
I cannot attend, but in good spirit, and recognizing that you will
surely find something appropriate to record our debt to Morris, I
enclose the check requested.

Have a good

time.

Despite Morris' aversion to EEG, both then and now,
experience has served me well and my laboratory, which has been
dedicated to determining the effects of psychoactive drugs on the EEG
continues to be productive. Lately, we determined the normal profile
of phenytoin, aspirin, and are now working on some olfactory stimulants.
The experience at Sinai also led me to examine HOT and after 25 years,
I have put together a book which reports the clinical and theoretic
knowledge. I am most delighted with the latest theories, which hold
some promise for an improved understanding of the mode of action of this
treatment. The book, "Convuslisve Therapy~ Theory and Practice" was issued
by Raven Press in early 1979, and is already completed the first printing.
(It has also received an international award of the Anna Monika Foundation
for contribution to our understanding of endogenous depression.)
my

My

.v:

,

best regards.
Sincerely yours,

mgr

,.EV;W’hﬂ-'P

Fink, M.D.
Professor of Psychiatry

Max

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                    <text>.

&lt;$I

”A.

.

September 19, 1979

"m'l-M‘WI‘WW—vv

WWW'meﬂ-w

Leopold Bellak, M.D.
Bronx Municipal Hospital Center
Bronx, New York
Dear Leo,
Thank you for your informative letter of September in.
I checked my file, and find that the report I submitted as a review of
the role of BCT in schizophrenia is dated July 13, 1977. Since that time,
there have been some additional publications, some noted "in press' have
been published, and what is more important, the attitude to ECT in schizo—
phrenia has crystallized-~ in part, because of the publications, and in
part because of a meeting sponsored by NIMH in February, 1978.

draft will need editing and revising. Some can be
that such an opportunity will be given
us. Otherwise, I regret to say, the publication will be outdated before
it appears in print.
done in

galley,

The

and I do hope

Let
My

me know how we

can

rectify this problem.

regards.
Sincerely yours,
Max

Fink, M.D.

Professor of Psychiatry

�Leopold Bellak, M.D.

August 17, 1977

Albert Einstein College of Medicine
Bronx,

New

York

Dear Leo,
Thank you for your comments on the report, "EST and Other
Somatic Therapies in Schizophrenia".

suggestion regarding page l,is good. Would the following
penicillin therapy successfully replaced fever therapy
for neurosyphilis, populations of misdiagnosed'schizophrenics' disappeared".
This suggestion comes from my experience at Bellevue. I came to learn about
neurosyphilis and psychosis in lean-us, just when one treatment was
replacing another. Fever therapy was used in patients where syphilis was
presumed, even if the findings were unclear (as was true for the use of
ECT). I am only trying to suggest that diagnosis issa difficult
art,
and that as new modalities are developed, we change our criteria of
diagnosis. If the sentence offends, delete it.
be

better:

The

"When

Page 11: "Whether ssuch a sanguine
an improvement.

justified" is
perhaps

therapeutic outlook is

Page 15:”These are a few questions posed by the EST

it is

Ibis sentence

time to reassess the usefulness of

removes the offending phrases.

EST

data;

in schizophrenia.‘

Page 2: The criticism of NIMH is meant to stay. I am chagrined
that the millions of dollars spent by the schizophrenia research branch
are often wasted on psychosocial approached for a syndrome whose principal characteristics are as clear as a brain disorder as are the
characteristics of brain tumors and epilepsy. The discussion of biological
research is largely biochemical and pharmacological, usually of a limited
kind. I mean to be upset by the absence of supported research in therapies
of schizophrenia. I have listened to Loren Masher and his social views
and I fins them particularly weak. Unless you insist that the paragraph
be deleted for political reasons (very sad, if you do) I would prefer
that it remain on page 2. It states a fact which I believe to be accurate

and

it

suggest

is not out of place.
My

thanks for your critique. Are there any additions you would

My

regards.

?

Sincerely yours,
Max

Fink,

M.D.

�Mme-n

w,—

.

—-

—\-.-w

V‘vr'“:

July 16, 1977

w-w-m

anwn’,"'w“f

Dr. Leopold Bellak
Bronx Municipal Hospital
Bronx, New York 10u61
Dear Leo,

Enclosed are two copies of the report, "EST and Other
Spmatic Therapies in Schizophrenia" for the next volume in the
reviews of schizophrenia.

raised not for the
ridiculously small and
in
previous ventures, byt to spell out the
quite unimportant
usual questions of reprints, author's reductions in additional
question of ’royalties'

The

amounts involved, which have been

was

volumes purchased, and complimentary copies of the volume. These
are quite customary, and it is unusual to carry out a venture

without the usual details written. For example, as a gentlemen, I
know that you will supply each author with a fuse copy of the final
volume and 100 reprints of the chapter. Yes ? And that additional
copies of the book can be obtained from the publisher at a 30%
discount ? Yes ? And that royalties will be given to the editor's
favorite charity. Yes ? (Hopefully, the royalties do not go to
the publisher who is making too much already.)
No,

In any case, I assume the above 'usual' conditions apply.
I do not need any subvention for the costs of the article. Yes,

you may have

it

for your

volume as a

gift.

I look forward to seeing the whole; I enjoyed working on

this part.

My

best regards.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

�August 3, 1978

Leapold

Ballet,

M.D.

22.Rockvood Drive

Larehnont, N. Y. 10538
Dear Leo:

Enoloeed are some notes as you requested

report in your forthcoming volume
these additions are useful.
My

to update my
I trust

on achiaophrenie.

regards.
Sincerely yours,
Fink, M.D.
Profeeeor of Psychiatry

Mn:

Mszc
Encl.

�</text>
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                    <text>relax-nary 25 1980
,
Dr. Samuel Bailine and
Dr. John Reu

Department of psychiatry
Long

Island Jewish-Hillside Hospital

Glen Oaks,

New

York 1100a

Deer Dre. Bailine end Ran,

to attend your presentation on February 13. The
topic is of interest to me. in large part because of my experience at
Hillside with ECT and insulin come in the 1950's. I am writing to
request a copy of your report, when it is available.
I

was unable

Thank you

for your cooperation.
,Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

�</text>
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                    <text>For‘i 91.28

Adm.

State of New York
Department of Mental Hygiene

5}"
41

LONG ISLAND RESEARCH INSTITUTE
State University of New York at Stony Brook

.

fIiﬁj/

5L

y "hf/WI}
”X?

Health Sciences Center 101'

9

IL

Stony Brook, New York 11794
STANLEY F. YOLLES. M.D.

.

DIVISION OF CLINICAL SCIENCES
MAX FINK, M.D.. DIRECTOR

M.P.H. , F.A.C.P.

INSTITUTE DIRECTOR

(516) 444-2447

(516) 444-2163

February 29, 1980

Florentine
Cambridge University Press
New York City 10022

Mr. Harry

Dear Mr.
My

Florentine,
reasons for cancelling the subscription

to Psychological

Medicine are many, some general and some quite specific. The general
reasons are the usual-- I find few articles of interest to me, and
these are generally those of a review type. Such articles are often
reproduced elsewhere so that the failure to read the article in this
journal is rarely a handicap.

for specifics, I have found the attitude of the editors to one
issue in medicine, that of convulsive therapy, quite inconsistent with
the prevailing experience. The editors seem to find the treatment
repugnant and seem to have made efforts to discredit it. In the past
As

article

on ECI' was published by Dr. Crow. I found
done, and wrote a critique addressed to the editors as a

year,

an

it

poorly

letter. It

rejected with the statement that letters are not accepted by the
journal. If true, then how can the readers redress the balance of bias
that may creep into any editorial board or correct errors that may

was

occur in any

article,

no

matter

how

well reviewed

?

I recently wrote a book on convulsive therapy, which has been
reviewed rather favorably by a number of journals, including Lancet,
New England Journal of Medicine,
and the American Journal of
Psychiatry. Yet, your reviewers chose to combine a review of this
volume, the result of more than 25 years of research, with a review of
an earlier published diatribe written by a psychotic medical
resident. In combining the two reviews, the editors did my serious
volume a distinct disservice, but more importantly, they exposed what

is clearly their bias.

�Last year, Professor Ottosson of the University of Goteborg and I
submitted a review article on a theory of the mode of action of ECT to
the journal. It was rejected as too speculative. While we accepted
this response as reasoned, the Crow article appeared subsequently. Its
quality is so inferior to our effort, that I believe bias also entered
into this decision. (The article has since been published in a fine

journal, needless to say.)

This experience follows an

earlier experience with the editor.

In 1977, I co-edited a volume on the effects of chronic hashish use.
The study was undertaken by a team of scientists working in two
countries over six years. The data were presented carefully. The
editors could not agree as to the significance of one of the findings
and it was my burden to write a concluding chapter. To indicate the

difference in opinion, I entered

a

footnote that the opinions stated

were mine alone. It was this fact that piqued the excitement of Dr.
Shepherd, and which was the highlight of the review. At an
international meeting I: met Dr. Shepherd before the review appeared
and he was gleeful that the reviewer would highlight this point. His
glee was matched by my later discomfiture at having a serious effort
distorted by the reviewer and the Editor.
These are some of the reasons
longer interests me.

why

Psychological Medicine

Thank you for your inquiry.

Sincerely yours,
Max

Fink,

M—
M.D.

Professor of Psychiatry

cc:Prof.

M.

Shepherd

no

�</text>
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                    <text>March

1, 1980

Dr. Lawrence J. Lewis, M.D.
Anclote Manor Hospital
Tarpon Springs, Florida

33589

Dear Dr. Lewis,

It was kind of you to send me a copy of the evaluation summary
of the progress of Ms. Judith Parnam. She is qpito ill, and your efforts
on her behalf are interesting and described well. I hope that some progress
witl be achievod.
Thank you

for keeping

me

informod.

Sincerely yours,
Fink, H.D.
Professor of Psychiatry

Max

�</text>
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                    <text>December 4, 1979
Ms. Hertha Baird

University Hospital
Stony Brook, N‘Y'

Ref: Leon Hankoff, M.D.

Dear Ms. Baird,

I am pleased to write the following on behalf of the
application of Dr. Leon Hsnkoff for privileges at University
Hospital. I have known of his work in psychopyarmecology for more than
two decades, and have come to work with him in the Department at
SUNY at Stony Brook during the past two years, both in the invitation
and planning phase and in his present position as clinical director this
year.

Dr. Hankoff is a skilled researcher in psychophermacology
and in clinical sciences. He has written a fine treatise on suicide,
which has lately received excellent reviews. In the past year, he
has developed the clinical programs at University Hospital and in

this regard, he has impressed me with his patience, clarity of'
purpose, administrative and clinical skills, and reliability. He
is a skilled teacher of medical students and residents; and he has
organized a fine clinical staff which should do a credible job in
the development of the Psychiatry Service at University Hospital.

I am pleased to racemmend him for appointment to the
Psychiatry Service of University Hospital.
Sincerely yours,
Mex

Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>‘

Form ”91.28 Adm.

_

State of New York
Department of Mental Hygiene

LONG ISLAND RESEARCH INSTITUIIE
State University of New York at Stony Brook

2

"

,
'

‘

If ﬂ)?

,5

-

._\

’

My!”

Health Sciences Center 101'
Stony Brook, New York 11794
STANLEY F. YOLLES.

DIVISION OF CLINICAL SCIENCES
MAX FINK. M.D.. DIRECTOR

M.D.. M.P.H.. F.A.C.P.

INSTITUTE DIRECTOR

(516) 444-2447

(516) 444-2163

March 20, 1980

Stanley F. Yolles, M.D.
Professor and Chairman
Department of Psychiatry

Health Sciences Center
SUNY at Stony Brook
Stony Brook, NY 11790
Dear Stan,

I have known of Leon Hankoff since the early 1960's when he was
a research associate of David Engelhardt and Norbert Freedman and
published articles in Psychopharmacology. After that research period,
I

he assumed more administrative roles. Our first working association
began last year, when he joined the Stony Brook faculty to enhance
'

the clinical services of the Department.

Since coming to Stony Brook, he has organized the clinical
services and is responsible for their continued management. In this
service, we have gained from his experience.
His principal interest is in psychiatric history and he is
studying both the phenomenon of suicide and the interrelations of
religion and mental illness. I am unable to assess this scholarship or
his teaching ability since I have had no occasion to review or observe
either. Despite the demands of the clinical service, he has continued
his studies and has published an interesting book on suicide. I have
often participated with him on committies of the Department, and recall
that he is usually with the majority.

In personality, he is friendly, out—going, and soft spoken. He is a
am encouraged to recommend the

dedicated member of the Department, and I
renewal of his term appointment.

Sincerely yours,

W

Fink, M.D.
Professor of Psychiatry
Max

MFzsl

�</text>
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                    <text>/

Form 91.28 Adm.

11wa

State of New York
Department of Mental Hygiene

LONG ISLAND RESEARCH INSTITUTE
State University of New York at Stony Brook
Health Sciences Center IOT
Stony Brook, New York 11794
STANLEY F. YOLLES. M.D.

.

DIVISION OF CLINICAL SCIENCES
MAX FINK. M.D.. DIRECTOR

M.P.H.. F.A.C.P.

INSTITUTE DIRECTOR

(516) 444-2447

(516) 444-2163

April 2, l980
Dr. Heinz Lehmann

Associate Director for Research
Office of Mental Health
hh Holland Avenue
Albany, NY 12229

Dear Heinz,
The tragic death of a patient undergoing ECT at Manhattan State HoSpital
month should be a stimulus to an improvement in ECT practice at MSH and
at other state hospitals. Some time ago, in October, in response to an
OMH
request for suggestions for "technology transfer", I submitted a
proposal for ECT training and monitoring. (I sent it to R. Whalen and
s. F. Yolles at LIRI. )

last

No response has been forthcoming, and of
course, such is not unusual.
However, one element of that recommendation was an invitation for ECT
therapists and nurses to attend an ECT.training session. Three are
scheduled —— in Chicago on April
at Stony Brook on April 25, and at the
APA Meeting in San Francisco in May.

ll,

I enclose copies of the Stony Brook program. Perhaps you will wish to
take credit for the application of some LIRI research to improve state
hospital services, by recommending, to the appropriate officers at OMH, that
designated users of ECT attend the session at Stony Brook.
I trust there will be an Opportunity for you to
’
regards.

visit

us soon.

.

Sincerely yours,
Max Wink, M.D.

Professor of Psychiatry
MF:sl

Encs.

My

best

�</text>
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                    <text>April 5, 1980
Corbett Thigpen, M.D.
Sebastian Way

820

Augusta, Georgia 30902
Dear Dr. Thigpen,

It

was kind

of you to send me a copy of your film, which
viewed on Monday. I have since sent the film

my associates
separately, and I trust that it will arrive safely. We found the
film interesting and a historical gem. The discussion of the history of
BCT, the experience with different modifications, the assurance of the
reporters in describing your clinical experience did make a good report
of the type of practice that has become a hallmark of modern American
psychiatry.
We were disappointed with the actual treatment, however.

I and some of

to

you

unusually busy, serving as psychiatrist, anesthetist,
seemed unfortunate that the presentation was made
as a 'modern' method of therapy. Neither the task Force report nor my own
The

and

therapist

was

physiologist. It

work would be as sanguine about such

practice in major medical centers.

would hope that such practice would be limited to those parts of the
nation where psychiatrists serve alone and where the usual support services,
so common now in major cities, were unavailable.
One

I also thank you for your letter and the reprints. I
assured that you find the use of pentelenetetrazol (Metrazol) useful in
securing a seizure in some patients, for this application is not widely
known or practiced. However, the large number of seizures you ppopose for
schizophrenic patients is a conclusion that is not supported by the data
available to us in the literature. Indeed, the conclusion is that ECT is
only occasionally useful in cases of schizophrenia, and that the use of
many treatments, spaced at three times a week is of limited usefulness.
The recommendation of the use of regressive treatment, howuumn,remains open,
following the work of Exner and Murillo who seem to find that such multiple
treatments particularly useful in therapy resistant psychotic patients. But
in their experience it is not the total number of seizures that seems to
be the controlling variable, but the frequency of the seizures and the
organic mental syndrome induced.
am

I,”
.3

-,

.1
,.

c

,uyy.

,
v

.

-1r'w[/r4._w'y:

“u

—.

i‘ﬁw‘ww.

-

wannvu-n-uv

WW

,p...w

film.

My

regards.

Again,

my

thanks for the opportunity to see this historic
Sincerely yours,
Max

Fink,

M.D.

�</text>
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                    <text>-

7.71%-. "I

..»~

a

w

W'V—w‘" r‘Pdh-M-I'vvr- —‘_Y'Y‘--,'9"W.'.“'

4

V

.

.-

v-r

.

v.

-

a

~

~

w

.

.w,

7-

.

W.-*m

.

.

i...-

M‘“

.—

V

~1‘r.~

-

.----.

iswe;

sun

April 16, 1980
Barry Reisberg,
New
New

York
York

M.D.

Unietrsity College of
City

Medicine

Dear Barry,-

Please excuse the delay in answering your letter of March
24. There is no misunderstanding regarding reimbursement for BEG analyyes,
and I am well satssfied that our relationship is sound.
We

ask for reimbursement where investigators have funds

in their grants; or if they have private (industry) funds, we expect a
higher rate of reimbursement. It has been my understanding that the
studies by Gregory and Burt have not been funded and that our contribution
was in the national interest. We are pleased to have been of service, and
will continue to do so, when possible.
Call us

when you have

digested the data in hand.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

�</text>
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              <elementText elementTextId="63712">
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          <element elementId="48">
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            <elementTextContainer>
              <elementText elementTextId="63713">
                <text>Special Collections and University Archives, University Libraries. Stony Brook University Libraries (State University of New York).</text>
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                    <text>WrﬂaV‘m‘m

w

Wvuv—u—r.

2m

“0"“,

w.

A,

m

May

5, 1980

Dr. Salvatore Manuzza

Senior Psychometrician

Child Development Clinic
Long

Island JewishéHillside Medical Center

271-11 Union Turnpike

Glen Oaks,

NY

lthO

Dear Doctor Manuzza:
The

literature

on ECT, including my own

large that I wrote an exhaustive review in
sent to the Heany Lorand library.
so

contributions,
1979.

A

became

copy was

You may also wish to see the APA Task Force report #lh published
in 1978. Between the two volumes, you should get a good grasp of ECT
issues for 1980.

Sincerely yours,
Fink, M.D.
Professor of Psychiatry
Max

MF:sl

�</text>
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                    <text>May

7, 1965

Iwm

:4
«-

“'1‘!

""V-

‘

m

w-w-nwwv

Mr. Milan Matejcek
Sandoz A.G.
CH—h002

Basel, Switzerland

VII"?

”9‘"

mu

«raw-w»,

Dear Milan,

For your examination of the EEG effects of ngptropic drugs,
you mmyujﬁgrto write to Per Mindus (Department of Neurophysiology,
Karolinska Institute, Stockholm). I understand he has some reports
on piracetam which are inconclusive.
My

best.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry
Max

MFzsl

�WI
WHOM
1’

May

5, 1980

Mr. Milan Matejcek
Sandoz A.G.
CH-QOOZ

Basel. Switzerland

Dear Milan,
have never developed a special program of analysis for
'nootropic' drugs. In our work, we have taken compounds of different
structure, and sought to assess their EEG profiles against the known
active compounds for different mental conditions. In the absence of
any effective compounds for the alleviation of the memory changes seen
in the elderly, we have not been able to define a nootropic profile.
I have enclosed copies of our most recent reports, including the summary
We

wv

wr~m.7.

..

W.W‘~:v;wvw

'v

"W".

V“

New:

-

v-vnn-vn

vuwny

mu“

'
w

5

.mpsz

111'

-

""WWNIW'ITM

"WW1

’rwmwr

prepared for the

1978 EEG

congress.

two occasions, we analyzed tapes prepared by others in their
study of supposed vasodilators. These reports were negative, but I enclose
copies of the data summary for your information. While these are unpublished, you may quote them if you wish as personal communications.
On

that the evidence presented so far,
for a definite profile for a nootropic class of drugs is unconvincing. I
have yet to see a definite report of either EEG or clinical activity for
piracetam, and the data for other such agenst is equally weak. In a
similar vein, we have been uanble to define activity for the fragments
of ACTH and it is unlikely that the slight behavioral effects will have
As

any

when

an opinion, I would say

clinical utility.

it is

Good luck

completed.
My

in your review. I look forward to reading a copy

best regards.

W
a
.

Sincerely yours,
Max

Fink,

M.D.

�</text>
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[

8, 1980

Dr. Mary Jasti, M.D.
thOhO Queens Boulevard
Forest Hills, New York
Dear Dr.

Jesti,

I regret to tell you that we lack facilities to support the
studies of lithium that you propose on behalf of yuur sister. Such
studies could be undzrtaken by the many laboratories dedicated to
lithium research.
Thank you

for your interest.

,
E

Sincerely yours,
Fink, M.D.
Professor of Psychiatry
Max

�</text>
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FWVlmVr-z

November 17, 1981
Dr. Richard A. Hrachovy, MD.
Department of Neurology
Epilepsy Research Center
Baylor College of Medicine
6516 Bertner Avenue
Houston, Texas 77030

Dear Dr. Hrachovy,
l was sorry to hear of the problem in patient recruitment. The amendment

is acceptable end has been filed.
to the
enclosed for your records.
1ND

A

copy of the letter of submission is

if you are coming to the ARNMD meetings in New York in December,
perhaps we could meet ? i plan to attend the afternoon session on Friday and will
look for you at the registration desk at the end of the session.
Good luck.

Sincerely yours,
raw—r

Max Fink, M.D.

Professor of Psychiatry

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‘
-..,

m

mwmmmww-v

November 18, 1981
Solomon Sobel, MD.
Division of Metabolism
and Endocrine Drug Products, HFD~130
FDA
5600 Fishers Lane
Rockville, Maryland 20857
Dear Dr. Sobel,
This letter is in response to your letter of October 30, regarding 1ND
16,906, and our study of DGAVP. l have written to the manufacturers in Holland
and requested their advice as to whether they have made
any further in assaying
the 34% of material not identiﬁes in the present DGAVP formulation.
Their reply
will be sent as soon as received.
To date, in our normal volunteers, we have observed no untoward effects
of the use of this formulation in acute trials.

Sincerely yours,

Max Fink, MD.
Professor of Psychiatry

�</text>
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wwwmmgv

“W

Wrwv-Vt

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wuv-wvw

3*

WW
\W

October 1, 1979

Prof. Dr.

H. Helmchen

Nussbaumallee

1000 Berlin

36

19

Dear Helmchen,

for the reprints of your studies of the behavioral
changes in epilepsy. I found the work quite good and complementary to
our own interest in the effects of seizures in ECT. Over the years,
I have often wondered why more epileptologists did not take advantage of
the natural experiments which psychiatrists provide in the BCT process, in
aleowing a study of the interrelations between degree of brain change,
number and frequency of seizures, and psychopathology. When I did my
principal studies of psychopathology, in the late 1950’s, not as much was
known about the assessment of behavior and our work was quite coarse.Were
we to do the same studies today, our methods would be more detailed and
would parallel your efforts more closely.
Thank you

I also enclose a reprint of our recent study of the EEG
effects of phenytoin. It shows clearly that there is an intimate relation
between plasma level of phenytoin and BEG response. I think the failure
of many physicians to get behavioral effects in patients with neurosis may
be due to the low levels they used.
Again,

my

thanks for your help.

My

best regards.

Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

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                    <text>yr.

,

‘rww-v ﬂ...“ 1. «w, ”w . .2...‘_-..,..

,

~

v...”

,nmuvwm...wnmww.-m

,e-

,P\,.—

WWW...

Sctober-l2, 1979

a...

Theodore R. Waugh, M.D.

Department of orthopedic Surgery
York University Medical Center

New
New

York

City

Dear Dr. Waugh,

RE:

Jan Volavka,

M.D.

I am pleased to write this letter of recommendation in
support of the appointment of Jan Volavka, M.D. as Professor of Psychiatry.
I have known of his work since 1966, and I was instrumental in providing
a place for him in the United States when the Russians overran Czechoslovakia
in 1957. He joined my staff at the New York Medical College and worked with
me until I left in 1972. Thereafter he moved to Missouri, where he worked
in the laboratories-at the Missouri Institute of Psychiatry which I had
established in 1962~ 1966.‘
He

Volavka is a personable and unusually talented researcher.
is a trained psychiatrist and physiologist, and has skills in computer
vDr.

sciences, electroencephalography and statistics. While with me, he made
interesting contributions to our studies of the effects of ECT on brain
function, the.EBG effects of cannabis, and the relations between EEG
measures and behavior. He has since made important contributions in the
study of opioids and endorphins, and he is best known for his studies of
the relations between genetic markers (XXY and XYY) and EEG variables. The
latter studies have been in progress in Denmark for mere than a decade.
He is an independent investigator, with innovative ideas
and unusual skills and talents. His writings are clear and definitive. He
has managed patients and treatment units with ease, and he is well liked
by his co-workers.

I commend him, without reservation, for appointment as
Professor. (Indeed, I did the same in recommending him for a position
at this University a few years ago, when he decided to go to St. Louis.)
Sincerely yours,
Fink, M.D.
Professor of Psychiatry
Max

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                    <text>October 15, 1979

Peter J. Knott, Ph.D.
Marshall University
Huntington, West Virginia
Dear Dr. Knott,

principal recent publication devoted to studies of
mianserin is the special issue of the British Journal of Clinical
Pharmacology, Supplement 1, volume 5, 1978, titled "Proceedings of
a Symposium on Mianserin- October 1977". This should be in your library.
The

As

best as I can

tell,

the spondors of mianserin are

clinical trials necessary to establish an NDA in this
country. I have no knowledge as to when it is likely that it will

doing the

be introduced.

Thank you

for your interest.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry
Max

�</text>
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October 15, 1979

Jose Carranza, M.D.
University of Mississippi Medical Center
Jackson, Mississippi 39216
Dear
New

Jose,
I was sorry to hear that the arrangements
York did not work out. I enclose a copy of the

requested.

for the move to
report which you

During the past year, I have curtailed my travel since
I have been away from my laboratory more than it could bear. If you
wish to arrange a lecture in Jackson, I would make the time in the
late spring of 1980 or the early fall.
Thank you

for thinking of

me.

My

regards.

Sincerely yours,
Pink, M.D.
Professor of Psychiatry

Max

�</text>
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                    <text>my”

u

vi,—

s,

mmwwrw-qryq

a-m

October 15 , 1979
Jerome Levine, M.D.
Chief, Psychopharmacology Research Branch
NIMH

--

-

Rockville, Maryland 20857
Dear

Jerry,

-Thank.you for the copy of "Coordinating Clinical Trials
in Psychopharmacology", which I was able to read this past week-end.
to the earlier guidelines which have been
It is an excellent addition
and
provides an enViable standard for
issued by the Institute,
it some
of the sponsors of our studies of
notified
have
future trials. I
and
am sure that they will find it
I
of
the
volume,
the publication

useful.

I also want to thank you for the assistance you have given
of Organon. He has accepted the responsibility for
of
guidelines for the clinical trials sponsored by that
developing a set
he
has
and
written
a number of recommendations which clearly
company,
NCDEU
these will be adopted by his masters
believe
I
standards.
meet
well
as world-wide (although they have some
0.8.
the
as
for studies in
in countries where the AMP system
the
with
coordinating
trials
problems
Dr. Hank van Riezen

is standard).

:

Our own

-

-.

.

laboratories continue to assess new drugs in
we have identified three new putative psychoactive

phase I trials, and
3770, is
drugs in the past 18 months which have much promise. One, Org EEG
and

active than mianserin and tields a similar
behavioral profile, promising to be even safer than mianserin in lack
frustrated by
of cardiotoxicity and anticholinergic effects. We have been 1980
studies
the
ACTH
and
that
optimistic
are
fragments,
the studies of
My book on
DGAVP)
he
rewarding.
and
(DTVE
will
tore
of other peptides
BCT (Cbnvulsive Therapy: Theory and Practice) has been well received and
the first reviews were most kind. It also receiVed.0he of the 1979 Anna
Monika Foundation awards, so I am rather pleased.
clearly

much more

Again; thank you for sending the Volume.

My

best regards.

Sincerely‘yours,

'

"‘I-vw-rc

Max

Fink,_M.D.

Professor of Psychiatry

�</text>
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                    <text>m... V"...we:

November

2, 1979

Peter T. Loosen, M.D.
Dorothea Dix Hospital
Raleigh, NC 27611
Dear

Peter.

Thank you for the two articles, on the oral treatment
of depressed patients with 80 mg TRH and the review of peptide effects.
I had seen the Karlberg et al article, but in light of our discussion,
I should be disappointed and assume that the likelihood that TRH over
three weeks would be significantly antidepressant. Yet, the many observations
including the three patients who responded in this series, suggests that
we may be close, as close as the early workers were with l-dopa in parkin-

son patients.

For the meanwhile, I have decided not to replicate the study;
but rather to try with two of the newer peptides, DGAVP and des-Tyr-gammaendorphin, to assess their central (EEG) effects.
My associate, Yiannis Papakostas has been carrying out
stimulation tests and dexamethadone—cortisol tests in every one
of our depressed patients, referred for drug therapy or BCT. So far, in
the first 15 patients, he has found more consistent DM-cortisol abnormalities which resolve with treatment, than TRH-TSH but the latter do occur
in about 1/3 the cases, and he is confirming the observations of TSH blunted
response in some depressed. He is using our schizophrenic patients as
controls, and we are particularly interested in the ECT group.

TRH-TSH

It

was kind

of

you

to think of

me, and my

thanks.

Sincerely yours,
Pink, M.D.
Professor of Psychiatry

Max

�</text>
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                    <text>E’ ,7 wn

,

-~-

—.

-

“er—w.“

v

www.mm u.‘

~

.

u

77x-

_,_, awe—mm

, Wu-“'~"AV‘—W1m’

av ‘I'run‘rrr-w—Mc'

'Vw-v-mr'w.u-r“-u-.mmw “cw-«ww’ww‘

v.

,

mummy» Mm..." ”WWW". "HM", _-,,
a—nwmw-eu-r-vmrv-“v—hw.’»-~»

.

__

.

WM”
November 3, 1979

E

g

g

E

Alan

Frazer,

Ph.D.

Depression Research Unit

Hospital
Philadepphia,

VA

PA.

Dear Alan,
Thank you

;

E

'

’

E

n

{

E

I
i

r

for sending

of beta-adrenergic receptors as a

me

your report on the subsensitivity

test for antidepressant drug activity.

report is quite interesting and well done, but like other such
efforts,which seek a single test to define 'antidepressant' activity,
seems to fail in not being inclusive. The problems with such efforts
are many, but the principal one highlighted by this report is the
expectation that a single system is involved in treatments as diverse
as BCT, TCAD, MAOI, stimulants, etc., just because these various systems
seem to be useful in relieving a single symptom. Is it not likely that
the various 'depression' syndromes reflect different mechanills, just
like fever and headache may reflect different underlying pathophysiologies
The

course, that mianserin did not fit within the model leads
to the speculation that perhaps mianserin is not an antidepressant But,
as you are well aware, it is also possible that the single system studied
is not general enough to be related to the syndrome of depression. I
am confident that mianserin is an antidepressant, not because of its
clinical evidence, but because its EEG profile in man is so like amitryptiline,
that it will have the same or similar effects on brain function, and in
depressed patients, should have the same behavioral effects as seen ﬁith
amitryptiline. To the extent that amitryptiline is "antidepressant', so
is mianserin.
Of

I

I
b

E

?

liberty of sending your report to my
studies, Dr. J. J. de Ridder of Gas, Holland,
with a note that he may write to you if he wishes additional information.
I would be grateful if you would oblige his inquiries, if any.
I

am taking the
my mianserin

collaborator in
My

regards.

Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

�</text>
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          <element elementId="48">
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              <elementText elementTextId="63593">
                <text>Special Collections and University Archives, University Libraries. Stony Brook University Libraries (State University of New York).</text>
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  <item itemId="6358" public="1" featured="0">
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                    <text>November 5, 1979

Mark S. Beaubien, M.D.

Assistant Chief, International Cooperation
and Geographic Studies Branch
Fogarty International Center
Dept. of Health, Education &amp; Welfare
Rational Institutes of Health
Bethesda, Maryland 20205

Dear Dr. Beaubien,
Dr. Drigoltav V. Ereegovse visited our facilities during
week of October 29. He toured our Health Sciences Center,
observed EEG recording sessions in volunteers and discussed our
EEG methodology; visited our V.A. clinical study unit and observed
modern methods of ECT and discussed principles and theories of ECT.
we fOund him to be a delightful visitor and guest, and we hope that

the

we

contributed to his
Thank you

"ETA".

for referring

'

him

to us.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry
Max

MF:bo

�£1239£0537

9’9

R

,

$0M];

/

@950 75% 30’
§:P

A

{90

(7‘94:
I

0'
f/if?

q

5951

71/
.

July 17.
MBrk

1979

8. Beaubien, M.D.

Assistant Chief, International Cooperation
and Geographic Studies Branch
Fogarty International Center
Dept. of Health, Eaucation &amp; Welfare

National Institutes of Health
Bethesda, Marylanﬁ 20205
,Dear Dr. Beaubien,

We would be pleased to hava Dr. Ercegovac visit our laboratorics
during the week of Octdber 29, 197§. It would be helpful for
Dr. Ercegovac to let me know what aspect of our studies interest him.

the

I suggest he call

visit.

me

at

516~hhh~2hh7

'

in September to discuss
Sincerely yours,
Fink, 14.1»;
Professor of Psychiatry

Max

MF:bc

3,?

�</text>
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                    <text>November 5, 1979

Richard

D.

Weiner, M.D., Ph.D.

V.A. Hospital
Durham, North

Carolina 27705

Dear Rich,

After a hectic few months, I have finally had the time to
read the many reports and papers that have been on my desk since my
holidays. Among these, was the report "ECT and Seizure Threshold" as
presented at the Society of Biological Psychiatry. The paper is quite
good, reflecting many more cases than I thought had been studied.
There is little that I can argue with in the data, but there
questions inherent in the attitudes expressed. As I understand
the study. it is an assessment of two aspects of induction, electrode
placement and electric currents, with a number of criteria—- duration
of seizure (or seizure threshold). degree of amnesia, total energy,

are

some

clinical efficacy. Others have carefully documented that electrode
placement alters clinical outcome little, but does reduce the degree of
amnesia and alters the type of disorganization in neuropsychological
tests. But the evidence for different effects for brief stimuli is
still sparse. In Weaver's recent studies, he found that his LEBS delivered
less joules to the 'head', but he could not demonstrate a difference either
in clinical assessments or in degree or type of amnesia. In similar
and

.

fashion, the present report also fails to define such differences.

Yet, in a number of places, the implication is raised that
brief stimulus treatment (MBCTA) is 'better'. For example, on page 1, you
combine two thoughts in one sentence: "Two modifications of BCT technique;
lateralized brain stimulation via unilateral electrode placement and the
use of brief pulse stimuli have made it possible to diminish the
severity of side-effects . . ." Again, on page 8: "No difference in

suprathreshold seizure duration on the basis of stimulus waveform

was

found, suggesting that not only are the seizures with brief pulse stimuli
produced by lower amount of electrical energy, but also that they are
equivalent in terms of potency. . ." Now, the word 'potency' is not defined;
I know you mean potency to deliver a seizure, but then, could it not mean
potency in clinical terms ? This is compounded by the phrase (page 9, top)

".

.

and thereby possibly

less therapeutically potent.9

I agree that a detailed test of the MECTA machine (or other
brief stimulus) is needed, but the assessment should indicate the number
of patients treated, the number of missed inductions, the number of seizure

�Richard D. Weiner, M.D., Ph.D.

......

November 5, 1979

.........

page

2

seconds, changes in depression ratings, tests of neuropsychological
functions, etc. Much of this has already been done for unilateral
and bilateral electrode placements, and the evidence is quite compelling.
Similar assessments need be done for brief stimuli, and until these are
done cleanly, the equivalent efficacy of brief stimuli and safety in side—
effects will remain open questions.
Perhaps, such an assessment can be the basis of a collaborative
and I would urge you to work with Dick Abrams to fermulate a useful
protocol. I would hope that the issues (induction factors, assessment
factors) will be defined carefully.

effort,

Again,

My

thanks for sharing these progress reports with
for the delay in reading.

my

me, and my apologies

regards.
Sincerely yours,

-

.
-

u

A.

Fink, M.D.
Professor of Psychiatry
Max

~m-aw&gt;r-w~.W;w--—m—.——W&lt;Wmnwp

that a bill regulating the consent procedures for
psychosurgery and convulsive therapy is being prepared for the Assnmbly
of the State of New York. I have read a preliminary draft, and it is clearly
modelled upon the recent Califbrnia statutes. It is probable that the APA
will be asked for its help by a committee in New York headed by Dr. Hurray
P.S.

W&gt;w‘a\w"'

.w

wan—,v.

w,.._..——wy

v
V

w.»

.v

You should know

Glusman of the New York State Psychiatric
fitter from him or from the APA.

Institute;

and you may be hearing

�</text>
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                    <text>November 5, 1979

Dr. P. Tyrer
Department of Psychiatry

University of Southampton
Southampton, 509

hPE

Deer Drs. Tyrer, Steinberg and Watson,
The report of the possible epileptOgenic effect of misnserin
(Lancet, October 13, 1979) is for from compelling. You note that the
patient. with a long history of recurrent depressive illness, received
nitrezepam, lorszepsm, and misuserin on admission for "a further episode
or depression precipitated by the death of her husband." Hitresepsm was
stepped soon thereafter; and for six weeks she received lorszepem and
misneerin. Three days before a seizure, she stopped her lorszepsm.
You conclude that this episode suggests that misnserin may have
epileptogenic features, and caution physicians in prescribing misnserin
in patients with a history of seizures.
Was the possibility of the seisure as secondary to the withdrawal
of benzodissepines ruled out as an explanation for the seizure? If so,

how?

If

she presumably had no history of seizures, how can one conclude

that misnoerin should not be given to patients with a history of seizures?

�Dr. P. Tyrer

‘

2.

Nov. 5, 1979

'

have examined the EEG effects of mienserin in volunteer subjects
in patients.“ we have described systematic EEG effects, but these
are unlike those usually seen with compounds inducing seizures. While
such studies do not preclude seizure induction, the likelihood is
remote, and we suggest the alternate explanation, of benzodiezepine
We

and

withdrawal, as more likely.

Sincerely yours,
Fink, M.D.
Professor of Psychiatry
Mex

“Fink, M., Irwin, Pi, Gastpar, M. and do Bidder, H.: EEG, Blood Level, and
Behavioral effects of the Antidepressant Mienserin (Org GB 9h).
Psychoghermacologggigg; 2h9—25h, 1977.

Irwin, P. and Fink, M. EEG Study of Misuserin (GB 9h) in Depressed Patients.
Brit. J. Clin. Phamacol. 2: (Suppl.): h38-h93, 1978.
MF:bc

�</text>
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                  <elementText elementTextId="104115">
                    <text>November

Paul G. Meyer,

7,

1979

M.D.

Texas Tech University School of Medicine
79u30
Lubbock, Texas
Dear Dr. Meyer,
Thank you for the invitation to apply for the position of
chairman of the Department of Psychiatry at the Texas Tech University
Health Sciences Center. I am not unhappy at my present location and
am not available for such an eppointment; I am honored that you thought

of

me.

'

Two of my students and co-workers, Dre. Michael Allen
Taylor and Richard Abrams are now at the Chicago Medical School. I
believe that they are restive and that either one would be a fine

academic leader.

Sincerely yours,
Fink, M.D.
Professor of Psychiatry
Max

�</text>
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            <elementTextContainer>
              <elementText elementTextId="63552">
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                  <elementText elementTextId="104114">
                    <text>‘55“:

._

November 7, 1979
Hon. May w. Newburger
N.Y.S. Assembly

Albany,

New

York

Dear Ms. Newburger,

It was kind of you to remark on my award for my 25 years
of research into the mode of action if convulsive therapy. I hesitate to
presume on this kindness, but in the same mail, copies of legislation
being considered by the Assembly Ways 8 Means Committee came to my attention
which led to this ﬂatter. The proposed legislation ire amendments to the
mental hygiene law establishing standards for consent and disclosure for
the administration of psychosurgery and convulsive therapy (Amendments to
Sections 33.03).
The amendments for ECT are badly intentione-, seeking to
deprive the mentally ill of the State of this specifically effective and
safe form of treatment. The regulations propose to make more difficult
the task of administering treatments to voluntary hespdtdiized patients
and to render almost impossible to administer the treatment to involuntary
patients. The law is patterned after legislation in California, which has
led to the present traffic of patients from California going to Oregon
and New Mexico for treatment. This, of course, provides that only the
wealthy and self—insured are able to obtain this treatment. The legislation
is based on the erroneous belief that convulsive therapy is unsafe and
ineffective; the contrary being true, since all evidence finds that this
therapy is the most effective and the safest for endogenous depression.
In our 1976 survey, 5% of admissions to University centers in New York
City received this treatment (and only 1% of admissions in V.A. and
State facilities; clearly evidence of some reasoned use at University

settings.)

The amendment

for psychosurgery is also flawed. This

treatment is still an experimental one, and is at present only available
in Descarch setting where cases are reviewed by Institutional Review Boards.
The legislation adds additional onerous requirements for consent, making
the research even more difficult. At this time, the reports from Great
Britain suggest that this therapy has a usefulness with patients with severe
obsessive compulsive and phobic states. Thése data need verification. The
legislation will serve to reduce the studies, not encourage them.

�Hon. May

Newburger.........

November

7, 1979

..........

page

2

I hope that you will have an opportununity to review
these proposed laws and do what you can to prevent their adoption. If
there is any question regarding theta objections, I will be pleased to
meet with you in Great Neck to discuss it further.
Thank you

for your consideration.
Sincerely yours,

Fink, M.D.
Professor of Psychiatry

Max

39

Arleigh

Great Neck,

Road

516 #66 sunu

New

York

�</text>
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                    <text>November 1n, 1979

E. Kielkopf, Chief
Contract Review Unit
Ms. Mary

NIDA

5600

Fishers Lane

Rockvﬁlle,

ND

Dear Ms. Kielkopf,

I am willing to participate in the NIDA contract review
I
enclose
system.
a short resume which highlights my professional
experience, oaitting the publication list which is a bit long. My
publications in drug abuse encompass the long term effects of cannabis,
narcotic antagonists, EEG effects of opioide and antagonists, methadone
and levomethadyl therapy, among others.
Thank you

for the invitation.
Sincerely,yours,
‘ﬂé:§¢”ﬁﬁiﬁlﬁr

Pink, M.D.
Professor of Psychiatry
Max

�</text>
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                    <text>November 1n, 1979
Sigurd Aokermen, M.D.
Montefiore Hospital
Bronx, New York 10MB?
Dear Sig,

Enclosed are the two

reprints concerning our

studies of lactate in anxiety. The letter was a way to indicate that
we-had replicated the findings of Pitts and McClure. We did not go
further as the proposals, sent to NIMH, were not accepted. (Since
then, the reviewers have undertaken very similar studies.)
sample.

The EEG

report

summarizes our few records

in the
.

I hope these are of interest.
discussing your work.
My

It

was a

pleasure

regards.
Sincerely yours,

"ﬁfe-w
Fink, M.D.
Professor of Psychiatry
Mex

first

�</text>
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                    <text>November 20, 1979

Dr. Henry H. Work, H.D.
Deputy Medical Director

APA

1700 Eighteenth

washington, D.C.

St.

N.W.

Dear Henry,
EEG

Thank you

Society guidelines

for the opportunity to
in

EEG,

1976.

comment on

the American

Clinical electroencephalography is a discipline which is
more than 50 years old. Mich information has been extracted from EEG
recordings by clinical and research neurologists and psychiatrists; and

yet, there remains a divergence of opinion in different centers retarding
the applications of this methodology. The disagreements are not related to
technical equipment, since these are quite sophisticated and reasonably
foolproof. Much of the discordance seems to relate to the differences
in montages used, controls for recording, location of electrodes, and
measurements made. The awareness of the divergence in skills of recordists
and eiectroencephalographers led.the American EEG Society to establish a
Board for qualification, training courses for recordists and readeree and
these guidelines.
The guidelines are an amalgam of many opinions, and there
are many fine points with which one could argue. In breadth of detail,
in sensitivity to the need for adequate training and the realities of
what the marketplace would hear, and as a service to our profession, the
guidelines seem excellent and servicable. I believe they should be
adopted by the APA,~and recommended to our membership. There are many
institutions, particularly those proprietary hospitals without academic
affiliations, and the State and V.A. hospital systems which may find the
recommendations onerous, even expensive, but in fairness to their patients
and with the optimism that the best medical care should be provided all
Americans, these guidelines are a small step in upgrading an important
service.
I

recommend endorsement.

Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

�</text>
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                    <text>November 10,

Dr. Barend

ter

luA Regent

Street

Editor,

TINS

Hear

-

ter

\

\

'

Balbridge, England.
Dear Dr.

me

L

‘

Hear,

Since submitting an article on.the neuroendocrine aspects
of convulsive therapy in early August, the BCT scene in Great Britain
has been noticed by the editorial writers of Lancet, British Medical
Journal. and Psychological Medicine, making our article in TINS more
timely.

note in

What

file is

is the publication dtttus.of the report

dated
an additional paragraph.
my

23 August 1979 and acknowledges

? The

Sincerely yours,
Pink, M.D.
Professor of Psychiatry

Max

last

receipt of

�</text>
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                    <text>‘

m»

December 4, 1979
Mb.

Hertha Baird

University Hospital

Stony Brook, ﬂew York

Dear Ms. Baird,

Re: Dr. Sherman

Kieffer

I hate known Dr. Kdeffer since 1972, as a fellow Professor in
the Department of Psychiatry and Behavioral Science at SUNY at
Stony Brook. In that time, I have worked closely with him in
Departmental matters and have come to know his skill as administrator,
clinician, and teacher.
Dr. Koifﬁer has an extensive experience In the U.S.
Public Health Service, and his knowledge has been most useful in the
development of programs in drug therapy. He is a kind and gentle
man, with infinite patience, tolerance, and reliability. Hie
expertise is in the study and management of drug abusers and in
this regard, he is one of our nation's ﬁeaders.

I

am pleased to recommend him for appointment to the
of University Hospital.
service
Psychiatry
:v.

:,

Py-w-vw‘u

Sincerely yours,

«ﬂy-32:"

wwmmW—rMa—vn-w

"W

'
=-=

ELY!

m

rmL-m

‘rvggw;

a”

wawvsvmvrw-wbw

Fink, M.D.
Professor of Psychiatry

Max

�</text>
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              <elementText elementTextId="63493">
                <text>Special Collections and University Archives, University Libraries. Stony Brook University Libraries (State University of New York).</text>
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                    <text>-&gt;«

"awn-w-

~

\- m—s-uu—v-n-rr—w-v-rwrwwvvvv-m—uws

,..._

v

.x-.—u .,.

uwv V-‘r—W&gt;a’-Yn~lswrw—m~¢wr-.‘

-

.4

-

.

~

w-‘vrl

wavy-mam--v—.-mw

.»

»:

‘r—rr—IW

m.

1-

. _.~- 'WJVAWW'WWM-Prw

‘wn-Wy' um. q-ww

h

”Mg/MM.

19 December 1979

-

John T. Brauchi, M D
Professor and Chairman

Department of Psychiatry
Louisiana State University Medica1 Center
P. 0. Box 33932

Shreveport, Louisiana 71130
Re: Dr. D1iver T. Nikd1ovSki
‘

Dear Dr. Brauchi:
Dr. 01iver Niko1ovski was a member of the staff at the New York Medica1\
Co11ege during my tenure in 1966 to 1972.1nitia11y, he served as a
research psychiatrist in psychopharmaco1ogic studies; 1ater. he was the

c1inician in the

Day

Hospita1.

.

“

=

During the time he worked with me. I found him a 10ya1 and dedicated .\.
worker. He is Sincere, honest, and responsibie. He was we11 1iked by
the Staff and the patients and he was enthusiastic to carry out the studies
we designed.
Dr. Niko1ovski is an exce11ent member of a c1inica1 team. and he has the
ski11s to carry out c1inica1 functions in the management of the treatment
of the menta11y'i11. I recommend him for a c1inica1 position. without,
hesitation. 'With regard to his capacity—as a residency trdhing director.
I am unabie to give'you any definite opinion. since_he did not function
in this ro1e during his tenure with us; nor was I ab1e to observe his
teaching sessions, since these were 1arge1y part of the c1inica1 teaching

sessions.
I

,

trust this information is useful.
Sbncere1y yours,

MF:BK

Fink, M.D.
Professor of Psychiatry

Max
'

.

_.

\

�</text>
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                    <text>A

lav/W
,9
111

r.

fl

.

4-.

we.-.

m.

7‘

v..._,..__,.,.,..y,w..._

19 December 1979

Hubert A. Carbone, M.D.
Chief of C1inica1 Affairs

Northviiie Regiona1 Psychiatric Hospitai
_

41001 Seven Miie Road

Northvi11e, Michigan 48167

mu”

1-

Re:

n

01iver T. Niko1ovski, M.D., D.P.M.

'Dear Dr. Carbone:
mmru—w—uow'uw

01iver Nik010vski was a member of the staff at the New York Medicai
Co11ege during my tenure in 1966 to 1972.1nitia11y, he served as a
research psychiatrist in psychopharmacoIogic studies; Iater, he was

’Dr.

the c1inician in the

Day

Hospitai

During the time he worked with me. I found him a ona1 and dedicated
worker. He is sincere. honest. and responsib1e. He was we11 1iked by
the staff and the patients and he was enthusiastic to carry out the
studies we designed.

DrI'Niko1ovski is an exceIIent member of a c1inica1 team, and he has

the sk1115 to carry out ciinicaI functions in the management of the
,treatment of the menta11y i119 I recommend him for a c1inica1 position,
_without hesitation. VWith regard to his capacity as a residency training
director. I am unabie to give you any definite opinien, since he did not
function in this ro1e dUring his tenure with us; nor was I ab1e to
observe his teaching sessions. since these were 1arge1y part of the
c11nica1 teaching sessions.
I

,

trust this information is usefui.
,

Sincerer yours,

'

In“,

Ame

yarn—m“...

'
“always“

g‘v'

-~

.
2.»

WWW—"we,

0.,..,}...V

Wmm—

MFzBK

'
.

.g

.

Max Fink, M. D.
-Professor of Psythiatry

'

�</text>
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'

July 5.

1979

Simha Tyk
1651 h7 St.
Brooklyn, N.Y. 1120b

Dear Mt. Tyk,

referred to in your letter of June 18, 1979 is
not yet in trial in the U.S. we are required to undertake extensive
clinical trials in hospitalized patients to verify the European
claimn before the U.S. Government will allow the compound in
'The compound

clinical use

—

if it is

this material will

It is not likely that
in the U.S. before 1982.

safe and effective.

be available

Regretfullx,
Me: Pink, M.D.
‘

MF:bo

Professor 5: Psychiatry

�</text>
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                    <text>July 10.

1979

Dr. C. L. Faingold
P.O. Box 3926
Springfield, IL 62708
Dear Dr. Faingold,

for sending me a copy of your report on the
I found it interesting and
of
antihistamines.
action
therapeutic
when
me
studied
the effects of antireminded
I
that
helpful. It
induced
slow
in the EEG by induced
waves
the
on
cholinergic drugs
seizures (ECT), I found that a series of central anticholinergics
(atropine, diethazine, benactyzine, diethaidlsuld reduce slow wave
activity dramatically. At the time, Dias-Guerrero, Feinstein and
Thank you

Gottleib (Electroenceph. clin. Neurophysiol. §5299-306, 1956)
reported that diphenhydramine also reduced EEG slow wave activity
after ECT. We believed then that this effect was related to central
anticholinergic effects of diphenhydramine-- perhaps that was a
reasonable guess.

have not continued our studies of antihistaminics,
back
but may get
to it if terfenadine gets to the marketplace.
We

My

thanks again.

Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

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                    <text>July 20, 1979
John Mann, M.D.
Department of Psychiatry
New York University College of Medicine
New

York City 10016

Dear Dr. Mann,

I

returning the EEG samples sent me. As we discussed,
these samples seem to represent the four montages of a single session
in each of four subjects. It is not possible to determine 'drug effects'
from such a sample, and when you reach the investigators again, you
may indicate that the need is for serial records, taken with bee same
montage, preferably at the same time of day and with some control for
the state of vigilance of the subject. (It does us little good to
get records with subjects asleep on one occasion, awake the next; one
hour after dosing on one occasion, and six hours on anther; etc.).
I am sorry about the crossing of the two protocols for the
study of depression, but look forward to your combining the best of
both. Let

am

me know
My

what tou decide.

regards.
Sincerely yours,

v

.,

.
v

.
..‘.v..:..

w,‘.,_,-,-.~.,..v

”A

Fink, M.D.
Professor of Psychiatry

Max

�</text>
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                    <text>Joly 20,

1979

Dr. Joe Tacos
Department of Psychiatry

Tufts University

Boston, Massachusetts
Dear Joe,
was kind of you to write and to send your latest
have Just cited your work id a summary of the
Dahlem Conference on pattern recognition, in which we were
interested in different methods to describe the changes induced
in behavior by various stresses or agents.

It

.reprint. I

Enclosed are some examples of our recent EEG studies.
For the most part, these reflect the two themes of our EEG
work, the characterization of new drug profiles and the

determination of the pharmsoodynsmio activity of psychoactive
drugs. The DPH paper is particularly illuminating, indicating that
even when some authors fail to find a profile for a psychoactive
grog, determination Ind cognizance of the pharmacokinetics will

win

it

out.

I aid complete 3 book on
has been well received.
My

regards,

and

I

EDT

this year,
earlier
*

do look forgard

to

and

San Juan.

sincerely yours,
Fink, M.D.
Pfofeasor of Psychiatry

Mix

�</text>
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                    <text>1".'~——-..,»m

..

‘

var.-

r-‘(uV—V'V mar-Hr

v.

wr-Irw“'

Hm

-

mw-

.r-I“

wu-

——u-——mv—_l—,‘

w—m—m—rw—

"WW—w

.npmww—quur

;

;

E

July 28,

Dr. Barend ter Hear
Trends in Neurosciences
Elsevier/ North Holland

1979

Cambridge CB2 lDB, U.K.

Dear Dr.

ter

Hear,

Enclosed is a draft copy of the revised report on the
in convulsive therapy, re—titled, A Neuroendbcrine Theory
of’aonvuleive Therapy. I am grateful for the clarifications resulting
from the questions raised by your reviewers, and I believe the paper
clearly separates what is established by research and experience and
mechanisms

what

is speculation

on my

part.

the criticism of the lack of citations and yet,
I have noted that all
citations to the experience with convulsive therapy are to my volume;

to

To answer

meet the normal standards of the Journal,

all the statements regarding the

neuroendocrine hypothesis are
supported by references to the work of others. Almost all the
citations to articles to the end of 1978 are also included in my
volume, but the ones in 1979 are not. It seems that this solution
to the questions may be manageable.

I look forward to your review..
Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

~v.‘lw-uwunm.vw—.'—Fv—

�</text>
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                    <text>‘
IV_'

{4.

i
v?!“

”mum‘s.”

-‘l."!£

..

Must I.
Philip

R.A.M&amp;y, M.D.

U.C.L.A.

~:

1979

Lon Angeles,

California

9002h

wreamatrm-“w

Dear

Phil,

.‘h'
'1‘

I was pleased ta submit a letter on your behalf for
pramotion to Professor in Residence V. I did so at the request of
Milt Greenblatt. I hope you get the promotion.
my

.vys—n

~

best regards.
Sincerely yours,
Fink, M.D.
Pgofessor of Psychiatry
Mg;

‘

.

rmi‘m‘i‘iw"’

"'

x
mar,

-—.v

�</text>
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                    <text>Milton Grocnhlatt, M.D.
Department of Psychiatry &amp; Behavioral Sciences
U. California, Los Angeles
Los Angeles, California 9002h
Deni-

Milt ,

It

an
;. following on behalf of the
preposed. advancement of "
Professor in Residence V.
My acquaintance 175th Dr. ?..
q'
his
publications and in
our activities in the American Collcge of Neuropsychopharmacology.
'

.

.

Dr. May's outstanding contribution has been a study of the
treatment of the severe mentally ill by drugs, milieu and ECT. This
work clearly demonstrated the efficacy and safety of drug therapy in
those patients. Surprisingly. the efficacy of ECT was also demonstrated
and in this regard, the reports are among the more important in the
literature. For this contribution, he was awarded the Paul Book Award
of the American Psychopathologicnl Association.
His breadth of intsreat is seen in his writings in such
topics as statistics, prediction of treatncnt response, paychologicll
teats, rehabilitation, mantel health care delivery and nursing. He
has also written on natural history topics, particularly in the habits
of woodpeckers.

In addition to his teaching of residents in training and

modical students, Dr. Mhy is an authority on the treatment of
schizophrenia and has preparcd cassette tapes for post graduate education
on

this topic.

He

has served as President of the Amcrican College of
serving that socioty wall for a number of years.

Rouropnychophnrmacology,

Dr. May in well known in this nation and overseas for his
contributions, erudition, and divcrsc inteiesta. It is a pleasure to
recommend him highly for promotion to Professor in Residence V.

Sincerely yours,
Fink, M.D.
Pfofccsor of Psychiatry
Max

�</text>
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                    <text>awn, u...“

m: “grew”.—
&lt;

1:
August 16, 1979

Richard Friedenberg, M.D.
New York Radical College

Valhalla,

New

York 10595

RE:

‘

Rhea Dornbush, Ph.D.

Dear Dr. Friedenberg

I have known Dr. Dornbush since she Joined me at the College
in 1967, to participate in an HIMH supported study of the effects of
ECT on memory function and behavior. In this study, she developed
sensitive

memory

tests

which were applicable to studies in elderly and

depressed patients, and her contributions were invaluable.

we then worked on the problem of the long-term egfects'of
cannabis use, both in studies at the College and in a special population
in Greece. In this study, she became the principal organizer of the studies,

made many trips to Athens,,developed the data analyses, and formulated
" Hashish:
many of the publications which resulted, including the volume,
Raven
1977.
in
Press
Studies of Long-Term Use", which was published by
ﬂew
York
the
She also organized a conference on chronic cannabis use at
Academy of Sciences and published the Iolume of the proceedings.

left New York to work as research director for the Masters~
Johnson institute in St. Louis. Apparently, that was an unfortunate choice
because it was seemingly impossible to provide a scientific basis for the
heuristic clinical skills and dogma expressed by these chiarismatic teachers.
NINE
She

She

returned to

New

supported study of

York a few years ago, and has since developed an

memory

effects of peptides, in collaboration with

other investigators working

on

this interesting problem.

me

and

is a skilled, dedicated, experienced, and talented researcher.
She has exhibited skills in teaching, organisation of experiments, writing,
and in her professional talents, in the design of experiments and their
Rhea

She is well liked by her co-workers and has the
experience and knowledge which are required for a position as Professor

statistical analysis.

of Psychiatry (Psychology). I

recommend

her highly.

Sincerely yours,
Me: Pink, M.D.

Professor of Psychiatry

�</text>
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                    <text>F752“
WM'Wv—ww—Frmiwﬂ"

__

August 16, 1979
Ming T. Tsuang, M.D.

University of Iowa
Iowa City, Iowa
Dear Ming,

Thank you for letting me read the report on death and suicide
in schizoaffective patients. It is an important contribution to our
growing awareness that ECT may have some long-term etfects on behavior
and death rates. Mbst impressive, is the careful follow-up and the
contribution to our assessment of schisopffective disorders. I
interpret the finding as another clue to the inclusion of schizoaffective
disorders under the rubric of depressive disorders, and not schizophrenia.

I look fbrward to the succeeding reports cited in the article.
Good luck in your year in England. I hope that you will have
opportunity to consult with those scientidts assessing the effects
of ECT in Britain. Apparently, the Royal College has received a grant
to assess the long-term effects of ECT and your skills would surely
some

be

helpful.

My

best regards.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

�</text>
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                    <text>Deanery 28, 1979

Drs.

J.

Knowle

Gill

Lambourn and D.

Hospital

Fareham, Hants , England

Gill,

Dear Drs. Inmbourn and

I have read your interesting report comparing simulated and
in the latest issue of the British Journal of Psychiatry. As
you know, the findings seem contrary to the studies which we and
Ulett gg_al. published in the 1950's. A principal difference in the
studies is the use of different electrode placements to induce seizures.
It is possible that this difference may explain the findings.

real

ECT

The procedure

notes that "Those in the active group received

a

brief pulse stimulus of approximately

a

bilateral seizure

to produce

a

How

the seizures

10

Joules.

bilateral modified convulsion on
was

the seizure monitored

. . . This was noted
every occasion."

? How

was

this assurance of

documented ? What was the average duration of
so induced ? And, was there a measure of total seiture

time for each patient

?

Another way to these data may be in the interseizure
measurements. Were any measures of brain function, as EEG or psychological

tests,

done before and

after

6

treatments, or after the final series

I would be grateful for any additional data
to help explain the unusual findings of this study.
Thank you

you may provide

for your help.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

?

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                    <text>r—w—
.

.‘mw—wWWWWlW “we"...‘

...v

1mww‘ we .

,

.

1mm.'~v

w-—‘-—mm——qu

.. _is .Vr

w-v—

wriv

-u-v:

C

l

August 17 . 1979

Drs.J.

Lambourn

Harrison Hospital
Dorset, England
Dear Dr. Lambourn,
me a
ECT.

letter is in the nature of a belated thank you for sending
detailed version of your ECT study comparing full ECT with simulated
It is difficult to fault your study, for some of the controls which
This

seemed necessary (and omitted from the BJP article) were included in
your study, notably measurement of seizure duration and evidence of
bilaterality of seizures. Your findings remain inexplicable in the face
of our experience, and perhaps the best explanation may lie in the
question raised by Jan-Otto Ottosson. He notes that not every seizure
is full in the brain, and indeed, in our studies of the EEG effects of
ECT and flurothyl seizures, we did find patients in whom the EEG changes
were astonishingly small compared to others; yet we believed we had
achieved full seizures and had measured their duration. While this
remains a conjecture at this Junction.
may be an explanation,

it

In our study of subconvulsive—convulsive ECT, we used a minimum
of 12 seizures and our data fell compellingly on the side of sonvulsive

therapy being more effective than subconvulsive. The best description is
found in my book which has Just been published by Raven Press.

Your data are puzzling and one would hope that in addition
to your further studies of differenttcurrents on the ECT process, that
the mesurement of the seizure itself may be done to assess whether the
differences in outcome may be related to ancettbeal difference—~ shorter
EEG seizure time, less spiking activity, gtg_as suggested by Ottosson.

regret that I find in the aftermath of your study is
Dr.
Kalinowsky to harangue the psychiatric readership
the opportunity given
with his antipathy to unilateral ECT. I cannot believe that this factor
alone explained the difference in outcome, but perhaps it was a factor.
(Our studies and those of Ulett were with bilateral electrodes.)
The only

These thoughts are inconclusive, as you can tell. I think
your study well done and I congratulate you and Dr. Gill on carrying
out. I can only hope that you will persevere to explain the difference
between your findings and some of the others in the literature.

it

Good

luck in your work.
Sincerely yours,
Max

Fim‘,

MOD.

-

raw

.

w n-rw

"

v

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&lt;:l$&gt;

July 16,

1979

Dr. Candace B. Pert

Clinical Center,

Bethesda,

MD

Dear Dr.

Pert,
I

NIMH

20205

embarrassed that other committments kept me from
my associates were kind enough to keep notes and
me. I have sent your expensesvouchers to the
administrative assistant, Mr. Vacnon, and you will be reimbtrsed
am

your lecture, but
shared these with

in

due course.

Our studies of des—Tyr-ypendorphin are on 'Hold', pending
re-assessment of the pharmacologic data. The material prepared by the
chemists in Holland meets all the chemical standards for purity, but
has not shown the pharmacologic activity claimed in the initial samples.
Our studies will wait on the re-assessment and possibly another batch
production. Perhaps these experiences are a caution to the workers
in this field, that chemical purity may not be a guarantee of
pharmacologic equivalence.
him

Have you thought of writing to Dr. David de Wied and asking
for samples of his original material to test in your test systems ?

I trust we will meet on another occasion, and have the
opportunity to discuss this exciting work.
My

regards.
Sincerely yours,

Anal“

th Fink, M.D.

‘WW‘WMLVWJ

‘v'a

*LWJV.

A

4

{MM

know if my associate showed you the book on ECT that
I published earlier this year. I took a flyer in that work to
suggest that the mode of action of convulsive therapy was bound up in
its liberation and stimulation of brain peptides with behavioral
effects. I emphasized the experiences with TRH and ACTH more than
with the endorphins, however.

P.S..I don't

�«we. .m-n—

wiwvwv-m—v-

W~wwmw~v~v~w

..._,.

v”

a,..,.-.rm.._....-....._.-.w—~-w

.._

May

.1

~_

1*.

,— “H...”

1979

Candice Pert, Ph.D.

NIH

Bethesda, Maryland
Dear Dr.

Pert,

It was kind of you to accept our invitation, and I
look forward to your visit on June 25. Separately, you will receive
a formal invitation and details regarding the arrangements for your
lecture. I am writing to give you some background to our present
needs and our wishes for your contribution to our program.
The Long Island Research Institute is the youngest and
smallest of the three research institutes in mental health in New
York, having been established three years ago. Many members of the
staff are involved in research efforts which had their origins in the
enthusiasms of the past two decades. The Division Directors have
recognized the nature of these ifforts, and seek to broaden the ex—
perience of the staff. One of the issues which has been prominent this
year, is that of the developments in psychoneuroendocrinology. In this
regard, we have invited Peter Stokes, Arthur Prange, Bernard Carroll to

lecture to our staff.

Both Dr. Harvey Karten and I have been interested in
studies of the effects of peptides on behavior and we are interested
in your experiences and the development of the concepts underlying

the activity of endorphinsﬁ:opiate receptoss with their possible
effects on behavior. No work of this kind is in progress at this
time. The closest is our EEG studies of ACTH fragments and the studies
of des-Tyr—f-endorphin which will begin in the next few weeks.
we would be delighted to have you describe your present
theories. It would be particularly helpful if you could help
us see this work in the context of the developing science.

work and

Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

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                    <text>mum-~-&lt;m-..,.

1.3:":

Ww

July 16, 1979
Dr. Harry G. Pars
SISA

Incorporated

Cambridge, Mass. 02138

Dear Harry,

It

to chat with

you again

in Baltimore. I

interesting, particularly the reports of the

antidepressant effects of endorphin.

I enclose two reprints- one, our assessment of DH-52h
suggesting that its EEG profile was more similar to that of
cannabis derivatives and therefore of psychopharmacologic interest;
and a recent summary of the EEG profile methods, indicating that

the methodology seems to have a place in phase-1 evaluation of
new putative psychotherapeutic moieties.

mg.-

A—w

was good

found the sessions very

EEG

Let

enhancer'

place).

-

My

me know

it

if you

come

across a viable 'alpha
clinic (and the market-

should be useful in the

regards.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

é /7« 3f“ 2J3";

�</text>
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                    <text>77......

.

,._v-w.-,~.

.

a

.,

.

-.-.rr 'W-v&lt;
-

.. v

.—

»

-Vrl'-v—v—vv.‘I—v'~-—y--w--...» «.7...

W" c mu”... yawn-m.- ,,,_,._,,_
.

7.7—.

V

W... _ e. .u

__

”urea..." _.,n««......_...r-

.7

w.

“Ha.

.vv-..

September 5, 1979
Tom G.

Bolwig, M.D.

University Hospital
Copenhagen, Denmark

Dear Tom,

St. Moritz,

Your

where

letter

I had

was waiting
some pleasant

for me when I returned from
meetings, with among others,

Dr. Rafaelson. I will be pleased to have you visit anytime between
October 25 and 31, as I shall be at the University during that period.
The University is about an hour from my home, and about 1.6 hours tram
midtown New York. If you will let me know what other arrangements you
want to make during your stay in the city, I can suggest arrangements
that would be most convenient for your stay.
The study of the the MECTA and other currents is needed.
One such study is underway by Dr. Richard Weiner (V.A. Hospital,
Durham, North Carolina 27705) and a few others have been talked about,
but I do not know that they are actually in progress. Dr. Weiner has
you may
some data already, and
your visit to the U.S. allows

want

to

meet with him.

it,

if

few weeks ago, I received a careful letter from Dr.
that I had mix-read the European usage of ECT in
delirium. He clarified the issue for me, much as you have done. I think
any report in the U.S. Journals which indicates that delirium may be
A

Heshe, indicating

ECT is needed. I regret that the Amer. J. Psychiat.
editors rejected the article. If you would like to have it published
in the U.S., perhaps you should try Dr. Fritz Freyhan (2015 R.Street, N.W.,
Washington, D.C. 20009) who is editor of Comprehensive Psychiatry. If
you decide to submit it to him, indicate that the usage is different in
the two countries, that my book needs amplification, and that I suggested
referral to him. Good luck

an indication for

1

Would you be willing to discuss your work with some of
our residents during your visit 1

Give my regards

pleasant dinner.

My

regards.

to Dr. Rafeelson and thank

him

Sincerely yours,
Fink, M.D.
Professor of Psychiatry
Max

for a

most

7.. e 7,,

v... w _

new—3...".

�</text>
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                    <text>July 2.
TO:

Stanley F. Yolles,

FROM:

Max

SUBJECT:

Fink,

1979

M.D.

M.D.

Proposal by N.S. Lehrman, M.D.: "Psychotherapy with a

Recidivist Chronic Schizophrenic Population..."

This

is

l.

description of the characteristics of the

an ambitious treatment program dedicated

to a

psychotherapeutic interaction in chronic, relapsing schizophrenic
patients. The study is based on an uncontrolled, impressionistic
study in which "More than 30 chronic, repeatedly admitted...
patients have been receiving treatment in this fashion... since
November 1978, with apparently excellent results so far...".
Since neither the case description, the intervention, nor the
outcome criteria are described, it is not possible to assess the
success of this "intervention". If the therapy is so rapidly
(November 1978 — May 1979) effective, it must be powerful indeed,
and we are entitled to a better description. Specific questions
that should he answered to allow a reasoned review are the
“
following:

selected.

A

°

30

patients.
'

.

2. Number, frequency, duration of interventions .
3. were medications maintained at pro-therapy leVels, or
changed? If changed, how often, by shat criteria and with what

outcomes?

.

,

u

,

b. What are range of changes,

which are the basis

their incidence,

for' 'excellent results".

duration,

and

f?
-\
*

a

*R

.

}

are the characteristics of the panposed psycho—
therapeutic interventions, particularly, how are these distinguished
5.

from

What

established therapies ordinarily available in the

institutions.

:

OMB

]IX
.

I

'.:\A\.“
\

�~

If; i d

\‘r

89F. Y°1.QB,

Until such
for support.
MF2bc

2.

MOD.

data. are provided,

'

«1111?

2! 1979

the study cannot be recomended

�may

To:

8. F. Yolles, M.D.

FROM:

Mex

SUBJECT:

Fink,

9. 1979

M.D.

Replacement for Mr. Robert Bienatook

I

would like to recommend the appointment of two young
women, Miss Stephanie Orson and Miss Jane Engele to replace
Mr. Robert Bienetock. Each of these appointees is recommended
on a half time basis, effective June 2, 1979. Attached are

copies of

their

Thank you

Mszc

Att.

Curriculum Vitae.

for your help.

�October 13, 1978

Stanley F. Yolles,

HSC
SUNY

at Stony

M.D.

Brook

Dear Stan,

I am writing this letter on behalf of Dr. Kenneth Tardiff,
in support of his application for promotion to Associate Professor.
I have known him since he Joined our faculty in 1975 and while I have
had little opportunity to assess his clinical or research
ability, I
have worked with him th the Psychobiology System, and
is
that
it
I came to appreciate his skill as a teacher and his interest there
in the
students. In the year that we worked together, I found him enthusiastic,
dependable, and appreciative of the problems of the students. He worked
well with
us on the committee and

facilitated

my

teaching.

It is from his record that I have to assess his research
clinical skills. It is clear that he has the academic training and
interest, and his publication list and independence of research efforts
and

during the past year indicate that he has the basis for a research
contributions of high quality and innovative creativity.
fellow

of the Department, I have found him
and quiet. In the committee, he has
been prepared and presented his work welll I believe he carried outalways
this assignnent to our satisfaction; I surely have no awareness of any
deficiency in the training program or in the appreciation of the students.

warm,

As a

member

interested, restrained,

From a number of points of vies, I believe he has achieved
the record which will Justify an enthusiastic recommendation for promotion
to Associate Professor of Psychiatry.

.Sincerely yours,

_

Fink, M.D.
Professor of Psychiatry

Max

�April 11,
8. F. Yolles,
Pink

1973

Institute Director

T0:
From:

N.

Subject:

Appointment of Dr.

Y.

Papakestos

will complete his third year of residency
has applied to me to join the LIRI research
programs and I would be pleased to have him work with us, if we
could generate the support necessary.
Dr. Papakostos

training in June.

He

In 1977, Dr. Asnis was a full time employee of the
Division of Clinical Science. When he went to the V.A., he went
as half-time LIRI and half—time VA. When he resigned in January,
I recohmended that John Lee, then on 'soft money', be appointed to

his half-line at

LIRI.

Dr. Lee will be appointed to 5/8 VA in order to take
advantage of the rules that only employees at the VA who are 5/8
or more can apply for VA grants. That will occur in May/June and
will leave 1/8 of a line free at LIRI.
Whatever happened to the

other half of Asnis' line

?

it permanently 'lost' ? Is it possible to use that half a
line plus the 1/8 from John Lee to create a 5/8 LIRI line, possibly
for Dr. Papakostoa ?
Is

Two issues are at hand: the abailability of the 5/8
line and the possibility of appointing Dr. Papakostos to that line
if available.

�){1

£11in

March 23. 1978
MEMORANDUM

TO:

Dr. S. F. Yolles

mom Dr.

Max

Fink

I am writing to recommend the appointment of Dr. Leon D. Hankoff to
the Department of Psychiatry. at the rank appropriate to his experience.
I have known Leon for two decades, primarily as an administrative physician
who headed local hospital departments of
psychiatry. Three
ago, he
consulted me with regard to the development of a study of theyears
behavioral
and EEG effects of benedialysis. A grant application was
prepared but was
not approved. In working through the details of the protocol, I came to
respect ht! clinical experience and judgement, and his enthusiasm for
research. He is skilled in the administration of a psychiatric clinical
service, has an interest in clinical research and has supported research
studies of members of his staff. He would be a valuable
addition to our
clinical service.
He has served as a teacher at the various schools with which
he has
been affiliated—- Downstate Medical Center and New York Medical College,
and has taught social work students. His skills as a teacher would be

most

useful.

It is a pleasure to recommend his appointment to a senior position in
the faculty of the Department of Psychiatry and Behavioral Science.

bc

�February 20, 1978
TO:

S.F. Yolles,
Fink

M.D.

From:

Max

Subject:

Leb~0ffice Building

are completely out of the Lab—Office building as
of today; except for the air conditioning unit in Room 8323.
As soon as this is disconnected, I vill arrange to have it stored
in Great Neck.
We

to have the
Brookdale.

is a better source of payment, I will arrange
paid for from the Psychopharmacology funds at

Unless there
move

�</text>
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                    <text>C3¢.:

‘/:/ici;€§xéd’

September 6. 1979

Dr. Jack weinberg
Chairman, A.P.A. Nominating Committee

c/o American Psychiatric Association
1700 Eighteenth Street, N.W.
Washington, D.c. 20009
Dear Dr. Weinberg:

I

would

like to endorse the nomination of Stanley F. Yolles,

as candidate for the position of Treasurer of the

Association.

American

M.D.

Psychiatric

both nationally and internationally for
his contributions to the prevention or and treatment for the mentally
National Institute of Mental Health, he
ill. As Director of thewhich
made the Clinical Center one of the
provided the leadership
and
training sites; and in his eight years at
world's finest research
Stony Brook, he has stimulated the development of a leading Department,
research institute, and training center. In all these years, he has
been an active supporter of the A.P.A.
Dr. Yolles is currently Professor and Chairman of the Department
or Medicine of the
of Psychiatry and Behavioral Science in the School
He
held this post
has
Brook.
New
York
at Stony
State University of
and developed its
school
medical
new
when
he opened a
since April 1971
Director of
been
the
has
he
1975
also
Since
programs in psychiatry.
N.Y. State
or
the
arm
research
the Long Island Research Institute, a
Brook
campus.
Stony
on
the
located
Office of Mental Health, which is
in
he
a
completed
career
Chair
Brook,
at Stony
Prior to assuming the
with
internship
an
Service
beginning
the United States Public Health
in his appoint—
at one of its hospitals on Staten Island andHe culminating
from
the Service
l96h.
retired
ment as Director of the H.I.M.H. in
Admiral)
1971.
in
(Rear
General
with the rank of Assistant Surgeon
the P.H.S.
in
Bureau
status
achieved
N.I.M.H.
Under his stewardship, the
500
million
over
was
slightly
with resources reflected in a budget that
Stanley Yolles

dollars

when he

is

left.

known

�Dr. Jack weinbcrg

I have

known

“

'

2.

Stan Yolles since 1962,

Sept. 6, 1979
when

I

first

worked with him

is an outstanding administrator and a dedicated and
He has been a menber of the A.P.A. since 1953 and
worker.
tireless
active in A.P.A. budgetary affairs since 1970. This background in
at N.I.M.H.

He

administration and finance qualifies him uniquely among the A.P.A.
for the position of Treasurer. A copy of his Curriculum
Vitae is attached.

membership

I an pleased to endorse his nomination and commend him to the
Nominating Committee.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry
Max

MF:bc

Encl.

�</text>
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                  <elementText elementTextId="104090">
                    <text>September 9, 1979
Dr. R.

M. Hodges
3720 Hampton Road
Pasadena, Cal. 91107

Dear Dr. Hodges,

of the

Enclosed are a number of reprints of our recent studies

effects of drugs.

We have two applications of these methods—and classify putative psychoactive agents, and to describe
the phramacddynamics of the compounds.

EEG

to identify

In our work, we use an IBM 1800 which was programmed mar
machine language more than 12 years ago. I fear that these programs are
of little merit to any investigator wishing to program modern machines.
The logic of power spectral density is published in engineering volumes,
particulary by Blackman and Tukey (Measurement of Power Spectra, Dover,
N.Y., 1958) and that of period analysis by Burch et al (Ann. N. Y.
Acad. Sci. 115: 827—893, 1964). The most recent descriptions of programs
(HZI Research,
for small computers were those written by Dr. T.
150 White Plains Road, Tarrytown, N.Y.) and Dr. D. M. Shapiro (2 Hemlock
Drive, Kings Point, NY 11023). Dr. Shapiro is a computer consultant who
programmed my machine and a number of successors, and you may wish to
write to him for the availability of programs and their translation for
your instrument and purposes.He would be particularly helpful in advising
you as to the feasibility of doing BEG spectral work on small instruments
of the kind that you describe.

Itil

Thank you

for your kind

Good luck

in your work.

comments on my book on ECT.

It

has

received a favorable review in Lancet and has been awarded the 1979 prize
by the Anna Monika Foundation of Germany for its contribution to the
study and understanding of endogenous depression.
Sincerely yours,
Max

Fink,

M.D.

PRofessor of Psychiatry

�</text>
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                    <text>WWW—"ww

-s—FVV‘m—u—rw.

w

"w...““wwraw—w—q—Tv—

W"

ram—-

WWW

{is

September 12, 1979

;

l

Mrs. E. L. DeRnbeis

5

McLean Hospital
115 Mill Street

g

l

Belmont, Massachusetts
'
i

,

E

:

é

i

F

i

i

02178

Dear Mrs. DeRubeis,

I am pleased to recommend the election of Dr, Philip
Skolnick for membership as a-Scientific Associate of the ACNP. Dr.
Skolnick is a senior investigator at the NAIMDD in Bethesda and
despite his years, has already made an excellent reputation as a
pharmacologist. He has published more than #0 papers and his work
has been accepted as pioneering.
Dr. Skolnick has developed a methodology

to demonstrate

that brain tissues have henzodiazepine receptors. This striking finding
(Did God really anticipate that Hoffmann La Roche would develop and
sell benzodiazepines ?) has been replicated by others and is the subject
of a 0.8. patent held by Dr. Skolnick.

i

E

5

f

f

I have

known

of his work for the past two years, and have

heard him present his findings with

clarity

and enthusiasm. He

E

I

i

Sincerely yours,

I

i

I

|

E

i

I

i

Q

i

I

t

I

is

an

experienced investigator and his contributions to the ACNP could be
important. I would welcome him as a member of the College.

Max

Fink,

Fellow,

M.D.

ACNP

Professor of Psychiatry

�</text>
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/

"WT—w.“

Am‘mm‘

‘7

September 12, 1979

“mm—WWW-

Corbett H. Thigpen, M.D.
820 St. Sebastian Way

Augusta, Georgia

30902

Dear Dr. Thigpen,
Would it be possible to boorow a
of your film
for a review at my University ? I would becopy
interested
in
the opportunity to see your way of treatment and will accept
responsibility for careful handling here.

on ECT

Good luck

in your presentation at the

APA.

Sincerely yours,
Fink, M.D.
Professor of Psychiatry
Max

�</text>
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                    <text>September 12, 1979

Prof. Dr. J. Angst

Psychiatric Clinic

Zurich, Switzerland

Dear

Jules,

Thank you for your kind letter, congratulating me on
election as President of the Association of Academic Psychiatry. I
regret to say that I have not been so honored, and I imagine you are
thinking of Paul Fink of Philadelphia.

my

and
my

I have been honored, however, by the Anna Monika Foundation,

just passed through your city on route St. Moritz. The award, for
efforts in developing a theory of convulsive therapy and my 25 years

of research, was a special honor, as I believe
award to BCT since 1958.

me know

it

was

the

first

such

I await your reprints and will probably read them. Let
whether I should send them on, and to whom.
My

best regards.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

�</text>
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                    <text>September 18, 1979
Mrs. K. Hildreth

Dept.

OB/GYN

630 West 168 Street
York City

New

Dear Mrs.

Hildreth,

u have received the invitation to continue participation
in the Neuroendocrine Journal Club, and have been asked to monitor two

journals, Brain

and Experimental Neurology.

I regret to say that I shall be moving my home to the
University, and it will be unlikely that I will be able to continue to
attend the meetings of the Club, or to participate further.
Please thank Drs. Ferin and Krieger for thinking of
Sincerely yours,
Max Fink, M.D.
Professor of Psychiatry

me.

�</text>
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                    <text>9,495“
...

,.

-_.

.7.

-m-Wmu-r

.

mum."

3,“...

September 26, 1977

Dr. H. van Duijn

Valeriuskiiniek
Valeriusplein

9

Amsterdam, The Netherlands

a
-

Dear Dr. van DuiJn,

.W"...a~uw.,

,"ﬂw

_.__

the

EEG

for the careful editing of my contribution to
issue.
I accept each of your suggestions and make
special
Than you

the following amendments.

pg 6,

par.

3: Replace sentence 1 with:

In the past ten years, approximately 70

have been studied by
~
&lt;

:."'-'m'

*n’4.~“'lI-'me.w‘llsar

quantitative

EEG

new chemical

methods (Table

III).

entities

pg,8 and others: I have checked the dosage schedule as reported by
Itil in a number of reports and the proper dosages are
20 to 300 milligrams orally given; and 500, 600, 1000 and 1200
micrograms. Please correct the text using the proper symbols for the
measures.

-

Also, page 8,

v-'

uW'

With TRH,

.—

report

.

.

.

Itil

line

6 should be

(197ha) and

corrected to read:

Itil

and

his

co—vorkers (197ha, 1975)

va'wl-JW‘DV'

‘
:-

Table 2: The coreection can be made by adding to the top of the table,
the following phrase, centered under the heading:

"aver—um.“

(As
Vaw‘wrvwn

defined in Table I)

l. Abuzzahab. The correct citation is
Clinical Research $39-15, 1970.

Reference #

American Journal of

mr

v.-

date on the volume by Matecjek and Schenk is 1975.

page 12:

The only

page 16:

Blackman and Tukey (1958)

is correct.

Citations: Deletedthe citation
errors.

citation list.

by Irwin and Fink (1975) from the
The sentence above, page 8, corrects the other

I trust these corrections are helpful.

Many

thanks.

Sincerely yours,
,
,

rvmwm

Max

Fink,

M.D.

�</text>
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                    <text>mwmﬂ

April

A,

1979

Laura Bossi M.D. and
V.

Bettellochi,

L.E.R.S.
75013

Deer

Ph.D.

Paris, France

Drs.,

studies of new drugs and their classification
spread throughout the scientific literature. Many
reports bear the names of M. Fink, T. Itil, B. Seletu, J. Roubicek,
and M. Metecjek, among others. Some of the papers are cited in the
paper which I enclose. This represents the latest end most complete
summery 5f the methodology and its applications. For an earlier
set of papers, I suggeet you obtain a copy of "Psychotropic Drugs
and the Human EEG", edited by T. 1:11, 3. Kerger, 1974.

by

The

EEG

criteria are

If you are planning to undertake the assessment of
using quantitative EEG (camputerised EEG), I suggest that
.you visit one of the laboratories that ere using the method. The
techniques are distinctly different than conventional EEG, sleep EEG,
and averaged evoked potentials, and it is en edventage to see a
»

new compounds

system in operation.

Good

luck.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry
Mex

�</text>
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                    <text>F

E

i
f
E

i.

April 9. 1979
mr. Glen Ross;

Box 5522 Duke

Durham,

NC

Station

27706

Dear mr. Ross,

been sent to

Your
my

letter

concerning

former University.

ECT was

Just received, having

The best source of demographic data concerning ECT may
be found in two recently published volumes- one is the report of
the Task Force of Baa American Psychiatric Association Report # 1h,
dated November 1978; and the second is a volume, "Convulsive Therapy:
Theory and Practice" which I published in February, 1979 (Raven
Press, New York). In both, you will find the latest survey data
summarised. These should be available in the medical school library.

For earlier reports, you will find the fill citation
in my book. There was attmme, in the 1950's, when ECT was given to
patients in the lower social classes in a greater degree than to
upper class patients. That situation is clearly reversed today, with
almost all EDT being given to upper class patients who attend private
or University hospitals. Practically none is given in state, municipal
and V.A. hospitals, where the largest concentration of lower class

mentally

ill

can be expected
Good

to be found.

luck.

i
E

Sincerely yours,

Hex Fink, M.D.
Professor of Psychiatry

�</text>
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                    <text>‘_

-

-

an...“

..

.mpwwvwnwv

.7

.m.--‘—v.

-

Q

3W

v—n

‘1

w.”

.c

April 11, 1978

.

.

urns-I'm)..-

WW.

Mr. G. S. Avery, Editor—in-Chief
ADIS

Auckland,

New

Zealand

Dear Mr. Auery,
The

report

on Minaserin

written

by Brogden, Heel, Speight

is well done, and I find little to modify. There are some
errors in citations which I can bring to your attention, but the
sense of the text is consistent with my experience with mianserin.
and Avery

that could be modified has to do with the
screen and how this led to the study of
mianserin as a thymoleptic. EEG analysis as a basis for the
classification of psychoactive drugs has a long history with some
definitive studies in 1961 and 1963 published by myself and Itil.
In the mid—1960's, we saw the possible usefulness of the classification
in predicting the activity of new drugs and the first studies were
done with such drugs as fenfluramine, cyclazocine and doxepin. In each
instance, the EEG screen was a better predictor of the clinical
activity of the compound than the animal pharmacology. This was
particularly true for doxepin, whose pharmacology was scan as anxiolytic
in the early studies. Our study found it antidepressant, and since then,
this view has been confirmed. Based on these data, I recommended to
Organon that new drugs be screened and in 1970 they sent a number of
compounds to Itil and myself, than working in separate laboratories.
He found mianserin to be active and its profile as a thymoleptic led
to the subsequent development. Even after the EEG screen and clinical
trials, the pharmacology failed to meet the accepted thymoleptic standards.
The importance of-the EEG screen could be emphasized, because, as Dr.
Itil noted in his 1972 paper, he 'discovered' its thymoleptic activity.
One emphasis

significance of the

EEG

As to the citation errors-~ I note that Fall et al are
dated 1972 on page 6 and 1973 on page 7. 1973 is correct. The citation
is lacking in the citation list. Also, there is a citation to Pink
at al (1977) on page 6, which is lacking 6n the citation list. I enclose
a cepy of the 1977 report for your reviewer to cite if he wishes.

Thank you for the opportunity to review this article
presents the data in a fashion similar to my view of it.

Sincerely yours,
Max Fink, M.D.
Professor of Psychiatry

which

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                    <text>March 29, 1979

Turan Itil, M.D.
Research

HZI

Tarrytown,

New York

Dear Turan,

I have had a chance to read the Final Report
Task Force on
with some
attention to the details, and Bioavailability
I am writing because I believe
the report is less sanguine than need be with regard to the
methods already available to us to assess bioavailability
and pharmacodynamics of drugs. Specifically, the section
7.2.2 should be expanded in some way to reflect the state of
knowledge presented at our sessions. You may recall that two
methods were discussed at length as
the changes in
brain function induced by drugs whichreflecting
crossed the brood-brain bustier
barrier, that of pupillography and of quantitative electroencephalography. These methods provide valid end~points to
the effects of drugs on the brain, and
as quantitative as
established biochemical methods in this are
regard.

of the

by

ACNPwFDA

Would you consider amending the paragraph 7.2.2
the addition of the following:
". . . There is currently no recognized standard

approach, although pharmacodynamic methods such as the
quantitative EEG and pupillography, which are responsive to
the effects of drugs which cross the blood-brain barrier,
provide the most logical opportunity for such development."
Quantitative EEG methods provide indices
the assessment
of benzodiazepines (diazepam, bromazepam),formianserin,
doxephn,

thiothixene, phenytoin, among others, in studies from my
laboratory alone. Others have made similar contributions, and
the negative statement of 7.2.2 ought to reflect this experience.
My best regards.
Sincerely yours,
Max

Fink, M.D.

Professor of Psychiatry

�Y'"

m...

wwwknm

April
Turan
HZI

Itil,

Research

150 White

Tarrytown,

-

10 , 1978

M.D.

l

Plains

Rdd

New York

Dear Turan,

It

nice seeing you again, and we did enjoy the
visit with Ellen. I felt a bit better after the debacle in
Ottawa since we did have the occasion to talk again.
was

I enclose the reprints from the recent work by
Bolwig. It is the clearest data that ECT produces an increase
in permeability of the blood—brain barrier, and is quite compelling.
Maybe it could be used in the TR? problem.
My

best regards.
Sincerely yours,

Max

Fink,

M.D.

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                    <text>Turan Itil, M.D.
HZI Research
150 White

Tarrytown,

Plains
New

Road
York 10671

~

Dear Turan,

It

was a pleasure to visit your laboratory on Thursday.
The development of a neuropsychologicai test battery which can be

easily applied, and easily scored, in an important contribution to
diagnosis and I look forward to the developments in your laboratory.

I were heavily involved in
psychiatric probleﬁs for computer resolution, we
organized a diagnosis system based on the interaction between the
psychiatrist and a computer terminal. Our aim was to ask the salient
questions, and based on the psychiatrist's response, provide him
with a statistical statement as to the most likely diagnosis for
the subject and the confidence with which the statement could be
Some

when Donald and

years ago,

programming various

viewed.

Two

programs were completed and

included in the report enclosed.

I hope that
My

it

is of

some

their program listing is

help.

best regards.
Sincerely yours,
ﬂex Fink, M.D.

grotessor of Psychiatry

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                    <text>.
Dr.

M.

tar

B.

Hoar

Elsevier/ North Holland
Cambridge, UfK.

Dear Dr.

tor Hoar,

Enclosed is a draft copy of a report, "ECT, Hood and
for your consideration for TfKS. I tried to follow the
'guidelinos and I hope the text meets your standards.
Hormones" ,

Hone

of the material

is

copyraghtod elsewnere,

For your book review section, you may wish to ask someone
volume, "Eonvulaivo Therapy: Theory and Practice" (Raven
Press, N Y., 1979) which has Just been published. or the practitioners.
in Great Britain who would provide a reasoned review, I would
recommend Professor Max Hamilton of the Department of Psychiatry
at Leeds, Professor Martin Roth at Canbridge, or Dr. Grahame~$m1th
of Oxford.

to review

my

b.

Sincerely ydurs,

’

Fink, M.D.
Preseasor of Psychiatry

Mgr

�</text>
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                    <text>April 23, 1979

Fritz A. Freyhan, M.D., Chairman
U.S. National Committee (USNC/PTD)
2015 H. Street, N.W.
Washington, D.C. 20009
Dear

Fritz,

for the invitation to visit the P.T.D. Committee
Unfortunately; I will not be able to attend
the APA sessions as I will be at the DAHLEM Conference on pattern
recognition. I am interested in the work of the Committeo, and
particularly therapeutic issuos and drug therapy~reaistant depression.
Thank you

exhibit at the

know.

APA.

If there is

a specific contribution that I can make, let
I look forward to reading tﬁo P.T.D. bulletin.

My

me

regards.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry
Max

MF:bc

�</text>
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                    <text>3M”

April 23, 1979
Albert J. Stunkard, M.D.
Professor of Psychiatry
Hospital of the University
of Pennsylvania
205 Pieraol Bldg./Gl

‘

Philadelphia, Pa. lQth
Dear Mikey,
much

I will miss you
less erudite.

on

the

V. A.

committee, and the sessions

will be

I found reading your report on fenfluramine interesting and
The data tables are more imgresaive than the figures, which
suggest that the placebo treated subjects lost almost as much weight

useful.

.

;

f

as those who were medicated. The graphs indicate a median loan of
9.5 kg for the medicated aubJecta and 7.5 kg for placebo. What was
the secret ingredient in both groups? WOuld the report be strength—
ened by adding some weight lose data? Have you considered OPT for

these data?

report of our study on fenfluramine is enclosed. we were
less interested in the clinical effects than in the EEG profile.
In another study in 1968, we carried out an open trial of fenfluramine in obese subjects, found sedation and dry mouth with weight
and appetite loss. We did not publish these data, which were
useful principally in examining whether sedation or stimulation
occurred in our subjects, as a follow-up of our EEG assessment.
A

My

regards.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry
Max

MF:bc

Encl.

�</text>
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                    <text>April 2h, 1979
A/

3.0.3.

D

er,

M.D.

Department of Psychiatry
University of Louisville

Louisville ,

Ky.

Dear By.

I

to receive the'Textbook of Clinical Peychopharmacology".
sections thougquarovoking, with views of drug usage that
are quite distinct from my own. The case vignettes, in particular, are
helpful. Considering my present interest, the references to the use of
was pleased

I found

ECT

many

are appropriate and well balanced.

So few of our peers have been willing to present their experience
volumes
in
of their own. In earlier times, such volumes were fashioneble. Now, Joint offsets, sympoeie, and invited volumes are common.
You know what they lose. You are to be congreﬂuleted in your volume,
and my thanks for the inscription.

Incidentally, I attended the Antiquarian

Book

Fair last

week.

John Geeh of Baltimore had a bound volume of Freud's ”Translation of

Charcot'a"1ecturea on hysteria for sale. By itself, the volume would
sell for less than $100. But this copy was inscribed by Freud, to his
teacher and friend, Josef Brewer, and the asking price was $12,500!
My

regards.

Mszc

Ab

M

Sincerely yours,

:

Max Fink, M.D.
Professor of Psychiatry

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                    <text>April 25, I979
Giacomo D'Elia, M.D.
Psychiatric Institute

Bergen, Norway
Dear Giacomo,

Thank you

Therapy in Sweden".

return address.

for the reprint of the article, "Electroconvulsive
More interesting than the reprint, was the new

Congratulations on your appointment. I look forward to the
papers that you will stimulate in your new center. If there is
something I can do to

assist you, let

me know.

I have completed my book on convulsive therapy and it has
appeared in the U.S. It should be in Europe shortly. Not only
this
volume, but apparently there have been many new articles on ECT ythat
have appeared during the past few months, and I think there is a renewed
interest in the problem. I have been talking to my associates, Richard
Abrams and Michael Taylor, and will try to set up a collaborative
study
of ECT mechanisms in the U.S.
Congratulations again, and

my

best regards.
.Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

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                    <text>“wuwwmw'mw—

WWW—v”...

A

rwv—(VJ'

u a

"a

n" “a...“ w

"m

«w

H

,

.‘

m,

_

V

\
'\
\

April

Fritz Freyhan,
2015 R Street,

M.D.
H.W.'

Washington, D.C. 20009
Dear

26,;“511979

1
,

'4

\\

Fritz,

Ten days ago I shared the platform at the 100th anniversary
celebration of St. Vincent's Hospital at Harrison with Tony O'Connell.
In chatting about the-Journal, Comprehensive Psychiatry, I came to
understand that the publisher was requiring a long lead time for

articles.

A few days later I was in my publisher's office, Dr. Alan
Edelson of Raven Press, reviewing the progress with my book. He talked
about a number of new Journals that he was setting up and asked what I
thought about a new Journal in psychiatry or psychopharmacology. Believing
that only a very good new Journal would serve a useful purpose, and
recognizing the effort that went into such a venture, I thdught that
he might do better by taking over a Journal that was already active,
but one that could use his drive and publishingoslills. I mentioned

respect for Comprehensive Psychiatry and the little history that
knew. Yesterday, I-received a letter in which he asked whether I could
tell him any more about the Journal.

my

I

I

have no knowledge

of the arrangements with Stratton, or your

satisfaction with them. If there is an opportunity to consider moving
the Journal to another publisher, and if you think it may be useful,
would you like to meet with Dr. Edelson to explore the possibilities ?
At the least, he is an excellent host and raconteur.
Let
My

me

know.

best regards.
Sincerely yours,

,.

Max

Fink,

M.D.

..Professor of Psychiatry

1..

e...

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                    <text>April 30. 1979
Marc D. Schwartz, M.D.
26 Trunbull St.
New

Haven, Conn. 06511

Dear Dr. Schwartz,
Thank you for the copies of the past issues of Micro-Psych.
Psychiatrists were among the firstvphysicians to see the merit of
digital computers and the present enthusiasm based on smaller and
less expensive devices continues this drive. There are many
excellent applications vhich are being developed and I expect such
devices to be as secure in clinics and offices in the 1980's as
typewriters areztoday.
Our initial interest in digital computers was to reduce the
tedium and inaccuracy of hand counts of EEG and ECG wiggles, and in
measuring the changes induced by drugs on behavior. My first digital
computer EEG analyser was established in 196h at the Missouri Institute
of Psychiatry (IBM 1710) with the support of the staff of the Computer
Center of Washington University; second an IBM 1800 system developed in
New York in 1967, by D. M. Shapiro, D. So. This system is operatidnal at
SUNY at Stony Brook and consists of an IBM 1800, 36K memory, 2 disks,
printer, typewriter, card read and punch and assorted other gear. The
system has steadily churned out EEG analyses using period analysis and
power spectral density analysis for the initial data reduction, and I
wide range of statistical and display packages for later presentations
(t—test, AHOVA, AECOVA, linear and quadratic regression, etc.). The
system analyses tapes from drug studies ~—- about 8/year from our
laboratory and as many from outside laboratories that collect their
data and ship the tapes to us for analysis.
‘

also developed an interactive diagnosis system based on a CD0
interactive display terminal (one 217A with digiscribe) and an IBM ass/ho.
The programs were written in PL/I (DOS) and were basedoon two diagnostic
logics --— that of DIAGNO—II develOped by Spitzer and Endicott and the
We

by Overall and Gerham. These exercises found such interactive
diagnostic systems very useful in research studies but their expense

BPRS

�M.

2.

D. Schwartz, M.D.

April 30, 1979

precluded a general utility. Those programs were published in 1971, and
I have-not gone book to that problem since, but the newer systems of
psychiatric diagnosis, particularly the DEM—III and RDC use logics that
allow computerization with little translation. I an optimistic that
some of your headers will be able to accomplish these translations and
programs for the smaller machines. Such facitity will provide the
necessary underpinning for a more systematic diagnosis system and much
better data for the inevitable revisions of D8M~Iv and —V which are
sure to come.

Quantitative EEG analysis is esteblished as a useful process in
psychOphsrmscology ——— to classify'and identify new psychoactive drugs
one to define their pheroacodynamic properties. Some references are
cited betas for the readers who may be interested. There is an oppor»
tunity for those who wish to collect EEG or ECG date on compatible tapes
(IRIG T~channel Annex SP 300, 1/2 inch; or 1316 h—chsnnel Hewlett Packard
3760A or 376b, l/h inch) to have them processed in our laboratories at
nominal expense.
Good Luck

in your venture.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

References:
Fink, M., Shapiro, D.M,,ssdckman, c. and Itil, T. Quantitative Analysis
of the Electroencephalogrsm by Digital Computer Methods. III.
Applications to Psychophsrmscélogy. Computers and Electronic Devices
,' in Psychiatry, (Ed.) H.S. Kline and E. Leaks, Grune and Stratton,
109-123, 1968.

Fink, M.,
EEG

Fink,
.

Itil,

:

T. and Shapiro, D.

in Psychiatric Research.

classification of Psychoactive Compounds in Man: Review and
of
Behavioral Association. Psychopharmacology A vaisw of
Theory
Progress, 1957-1967, (Eds.): ﬁ. Efron, J. Cole, J. Levine and
J. R. Wittenborn, v.8. Govtt.”Printing Office, washington, D.C.,
M.

EEG

—

pp. h97~507. 1968.

3

Fink,
.

Fink,

Computer Analysis of the Human
Qbmprohsns. Psychiat., 8: 521-538, 1967.

Digital

:

5.3 aes- S. and Fink, M. computer Aided Interactive
Psychiatric Diagnosis Programs. New York, Biodeta, Inc. 75 pp., 1971.
M.

in

M.

EEG

Profiles of Fenflurenine, Amobarbitel and Dextroemphetemine
volunteers. Psychogharmooologia (Barl.)'23:,369—383, 1971.

Normal
EEG

Profiles

Itil
Problems in
In: T.

Biosvailability Measures of Psychoactive Drugs.
(Ed.): Psychotropic Drugs and the Human EEG. Modern
Pharmaopsychiatrﬁ, Basel, S. merger, pp. 76-98. 19714and

�www—ssz

Fink,

Cerebral Electrometry: Quantitative EEG applied to Human
Psychopharmacology. In: H. Kﬂnkol and G. Dolce (Eds.): Chan M.

computeriacd’EEG

analysis.

Sﬁuttgart,

G.

Fischer, 271-288, 1975.

Empirical Comparison of Three EEG Digital
In: M. Matejcek and G.K. Sohnnk (Eds.):
Quantitative Analysis of EEG.“ Konstann, Switzerland, AEG Telefunken.

Irwin, P. and Fink,

M.

An

Conversion Techniques.

—.—

1“

379-39h . 1976.

AA.._,_—,_.‘V.

._.V

April 30, 1979

References continued:

-

_m

2.

Schwartz, M.D.

M. D.

:

Fink, M., Irwin, P., Gastpar, M. and de Bidder, H. EEG, Blood Level,
and Behavioral Effects of the Antideyressant Mianserin (ORG GB 9h).
Psychopharmaaologia 54: 2h9—25h, 1977.

Fink,

M.
Mania and
Manic Illness.

Mszc

Eloctroseizure Therapy (EST). In: Shopsin,
New York, Ravgn Press, 221-230, 1978.

B.

(Ed.):

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                    <text>.

.

A...” aim—.wv—u—V

wry—mu.—

\

‘

ra-w’rw

:

..«_.

'In-“vm-m Tum-war

v—nvw:—:

mm

w"

--r

vwd‘w—‘W'wv—Wm-wr—w'Lx'mmmmIv-lrn‘.

May 3 .

Inns

.

~

w—r

1979

Dr. Gerald Roskin
LIJH- Hillside
Glen Oaks, New York llOOh
Dear Dr. Roskin,

It was kind of Dr. John Kane to invite me to lecture
at Hillside in April, 1980, and I had looked forward to that meeting.
What was not clarified in my discussions with him were the topic of
the session and the reimbursement and fees. I believe he assumed
that you or your office would handle these details.
As I indicated in our conversation, the customary fee
for such lectures is $350, and expenses. Fees are waived for
institutions in the Office of Mental Health of the State of New York
and post-graduate teaching sessions of the University. It was a
surprise to me that the invitation was based on some agreement that
no fees would be paid to the staff at Stony Brook. Since I am not
a member of the LIJH faculty, nor a party to the agreement which you
enunciated, the usual conditions of lectures will apply.

Unless I hear otherwise, I will assume that the invitation
has been withdrawn.
Thank you

his kind invitation.

for your time,

and please thank John lane for

Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

«yu.mm ,u ,—.-.~p.w-w.w-u~--uwux

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                    <text>HIV

7. 1979

Fritz Freyhen, M.D.
2015 B. Street, N.W.

Whahington, D.C.
Dear

Fritz,

Thank you for the explanation of the present status
of nggrehensive Pszphietgz. I understand fully new, and I am a hit

ambarreeeel that I may have misinterpreted the signals from Tony O’Connell.
I have called Dr. Edelson and told him of the content of your note,
suggesting the$ if there is any desire to take over a Journal, he V111
have to seek elsewhere.
my

best rsgarda.
Sincerely yours,
Me: Pink. M.D.

Professor of Psychiatry

�an

May

5%“

3. 1979

Alan Edeleon, Ph.D.
Raven Press

llho Arcana of tho

New

York City

American

Dear Alan,

Following our discussion and your note regarding further
explorations with the editor of Comprohensive Payohietry, I wrote to
Fritz Froyhan, opening the dialogue. His reply is enclosed, and it
indicates that no matter how poor tho outward atpearanoes, the Journal
is operating to his satisfaction.

I

know

of no other Journal with as good a reputttion
if you are interested, perhaps you will

which may be on the block, so,
consider a new one.
My

’

regards.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

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                    <text>W

New

ADCMD

25. 1979

for Operations (lSlJ)

Department of medicine and Surgery
V100

Washington, D. c. eohso
‘Gentlemen:

I an pleased to write this letter on behalf of Dr. Richard D.
Weiner, M.D., Ph.D., vho is applying for a position as e V.A.
Clinical Investigator. I have known Dr. Weiner for three years,
and in this period, I have come to respect his enthusiasm and his
dedication for research.
Dr. Weiner first came to my attention as e member of the
American Psychiatric Association Teak Force on Convuleive Therapy
when he was asked to serve as a consultant for the electrical
parameters of the ECT process. His report and discussions were
very ugeful and served to expand the final report.which appeared
in 197 .
became acquainted with his work when his application
V.A.
research
for a
grant was reviewed by the Merit Review Board
of which I an a member. Hie application showed a good knowledge
of the ECT process, and reflected his reading. The application
was approved and since then I visited his laboratory. We have
communicated often and I have reed a number of his reports before

I next

they have been published.
Following his

training in electrical engineering at M.I.T.

and

the University of Pennsylvenie in $973, he received his Ph.D. in
neurophysiology and his M.D. from Duke University in 1973. Subsequent

training at Durham in psychiatry and in electroenecephelogrephy
”provided the skills he needs for his present research efforts.

�2.

Mey

25. 1979

is interested
in the convulsive therapy process,~end his skills are directly applicable
to his studies. He has a demonstrated ability to formulate a progrem,to
write the necessary applications well, and to undertake the studies
without additional supervision. He is clearly an independent investigator
with the skills and enthusiasm necessary to establish a V.A. research
In

all,

Dr. Weiner

is a well trained scientist.

He

study.

For these reasons, I

Clinical Investigator.

am

to recommend his appointment as a
pleased
'
Sincerely yours,
Fink. M.D.
th
Professor of Psychiatry

�</text>
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                    <text>June 13, 1979
Joyce G. Small, M.D.
Larue D. Carter Memorial Hospital

Indianapolis, Indiana

h6202

Dear Joyce,
Thank you for the copies of the progress report on ECT and
the preprint on the lithium-BOT study. I found both interesting and
useful. If I understand the ECT-drug study, so far the ECT alone,
drug alone and combined treatments are equally effective with son:
advantage for the combined drug—ECT combination. I do hope that these
findings are examined further.
The lithium study is quite stimulating. The data are the.
basis for a prospective study witch needs to be done. I found three
citations that I missed (Hoenig &amp; Chaulk, Ray, and Remick)-- and I thank
you for bringing these to my attention. I believe that the cautions
you recommend (not to use ththium and ECT together) are good ones, and
I will adopt them, until further data are developed. (While the other
combination, lithium and haloperidol [or chlorpromazine] is controversial
as to its toxicity, as a therapeutic conservative, I still do not like to
use the two together, and so teach my students).
Many thanks. My regards to Iver and
help in teaching in the two courses in Chicago.

my

thanks for his

Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

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                    <text>June 18, 1979

TD:

Carl Letson, Program Aide
Assembly Whys and Means Committee
Capitol

The

'

Albany, N.Y.
FROM:

122148

Fink, M.D.
Professor of Psychiatry
School of Medicine

Max

‘

at Stony Brook
Island, N.Y. llT9h

S.U.N.Y.

Long
SUBJECT:

Assembly

Article

Bill

3h.

The proposed law

7237: proposed amendment

to Mental

Hygiene Law

ignores present procedures which already provide

that psychiatric treatments only be given after proper consent has been
obtained. The law ignores the experience that when the restrictions on

medical practice are increased, treatments are no longer given and
patients are deprived of the best (most effective and safe) treatment
for their care. The preposed amendment will serve to further deprive
patients in state mental facilities of the type of care which may he
most effective. As an example, we found that less than 1% of patients
admitted in 1975-1976 to state facilities received ECT, while 5.2% of
patients admitted to University hospitals received this treatment (Annie,
Fink and Saferstein, 1978).
This

is particularly true for

patien€;who have the following

diagnoses: psychotic depression. involutionsl depression, depression in
the elderly, endogenous depression, depression with delusions; as well
as some patients with mania and catatonia. It is for such illnesses that
ECT is particularly effective, with efficacy rates that are greater than
other available therapies, including drugs (APA Task Force Report, Chapter 2,
8. Pp. 13-56. 1978; Fink, Chapter 3. pp. 21-h1).
The proposed law restricts the sunber of ECT treatments to 15 in
any-12 month period. Such a restriction ignores variability in response

of subjects, relapse rates, and experience with different illnesses.
While most patients respond with an average of 7-9 treatments, about 10%
require more treatments. About 10% of depressed patients who are not
given maintenance drug therapy

may

relapse within six months.

�Letson

C.

2.

June 18, 1979

risk—benefit analysis of ECT finds it more effective and as
safe (or safer) than antidepressant drug therapy for patients with
A

psychotic depression (Fink, 1978; Pink, Chapter 5, pp. 51-58, 1979).

also believe that present guidelines for consent as described
Task Force (Chapter 7. pp. 132-151, 1978) and Fink (pp. 219-222,
1979) are adequate safeguards. This is particularly true for experimental treatments. which already must meet peer review under existing
by

we

APA

IRB

guidelines.

This proposed law is heincus on many counts - deprives patients
of an effective treatment, increases”the cost of care, increases risk
of suicide and death, as well as impairs confidentiality, consent and
freedom of choice in the doctorupatient relationship. Further. the
history of such laws, as exemplified by the effects of a similar law
in California, is to deprive lower class minority patients (those
'served principally'lthWate mental health services), of a useful treat;ment, while upper class patients, with the same illness ere able to
obtain care in facilities in neighboring states. Such deprivation of
fservicee of our minorities is not an acceptable position for the
y'legislature of the Empire State.

ra'References:
American

ikAsnis,

Psychiatric Association, Task Force Report #1h,

6., Fink,

end
‘h79-h82, 1978.
M.

Saferstein, 8.

Am.

J. Psychiat.

1978.
135:

i

a

h

Fihi;
Fink,
MF:be

M.

”Convulsive Therapy: Theory and Practice.

-‘Nsv_York, 1979.
M.

Campr.

h

Psychiat. 19: 1.18, 1978.

Raven Press

�</text>
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                    <text>‘

Judith

June 20, 1979

H. Quattlebaum

President and Executive Director
National Committee on the Treatment
of Intractable Pain

P.O. Box 3h571

Washington,

D. C . 2003‘:

Dear Mrs. Quattlebaum,
My experience with Opioids in limited to experimental studies
of.the central effects of heroin, methadone and levomethadyl. and
their antagOnists, naloxone and cynlaaooine. These studies were done
between 1966 and 1972, at the New York Medical College. Some reprints
derived from these studies are attached. It is not clear to me how

;

othese experiences, which are focussed on EEG, pupillary response,
gheart rate, respiration and mood, would be helpful to your mission.
In our experience, we did find that intravenous heroin could

produce a seizure. This effeet'could be blocked by naloxone. We
‘also found_that tolerance to methadone and levomsthadyl developed
rapidly (balk days), as did tolerance to the agonist (opioid) effects

ﬁftcyclazocine.

concluded that the narcotic antagonists could be a useful
therapy'of opioid dependence, if drug delivery could be assured; but
opme to no conclusions regarding the usefulness of heroin.
1;

1
§

we

I

J],

e.

K."

-

‘

As

1.

Evidence of heroin

2.

No

effects.

See

reports.

special knowledge.

‘3, h, 5.

Not

studied.

6.

Hot as therapy; only as a "challenge"

7.

Ho.

__

‘w.
.:—‘/¢fy

.

to your specific questions;

activity of antagonists.

to determine

�J.

H. Quattlebenm

8.

2.

June 20, 1979

I could testify to the experience noted in the references.
Scheduling e drug is an aﬂminiatretive and political act,
not medicel. Nothing in our experience would suggest that
heroin is uniquely different from other opioide, except in

rate of entry to the brain and in half-life. The present
restrictions are not based on the pharmacology of heroin; but
on political considerations. Similarly, the suggestions that
heroin is a "uniquely" mofe effective analgesic than other
opioids, is not clearly pfoven.

9.
10.

No.

Probably not.

history, and my con experience from 1966—1967.
You may wish to write also to Dr. John Kramer (University or
California at Irvine) and Dr. Arthur Zeke (971 Madison Ave., N.£.I.).
11.

who haVe

Only by

extensive experience and knowledge of the pharmacology and

history of heroin use.

I trust these reports ere of

game

help.
Sincerely yours,
Fink. M.D.
Profeeeor of Peychiexry
Mex

MF:bo

Att.

�</text>
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                    <text>June 22, 1979
v.—

WWW—

W

Ww-W..&lt;,—~

‘IIKW

W

V.

.
.7

“a."

WW

_
w
w

VIPI'-w

‘I’y‘m‘l

~Wﬂ'lm4

wWWWWWWW—w

Dr. Barend

ter

Hear

Trends in Neurosciences
Elsevier/North Holland

Cambridge C32 lDB U.K.

Dear Dr.

ter

Hear,

Following the receipt of your detailed letter of June 12
regarding the review of the manuscript, "ECT, Mood and Hormones", I

went through the text with the comments of the reviewers in mind.
To minimally document the facts in the article, and to allow for the
separation from speculation, will require about 80 citations. In
writing the report and submitting
initially, I was mindful of

it

the instruction regarding referencing: "Since TINS is primarily intended
as a newspaper for the neurosciences, only a limited number of references
should appear in the text.". . . of up to 10 titles in alphabetical order. .
For this reason, I cited my book so frequently, since it is in that volume,
of 308 pages and more than 1000 citations, that complete referncing is
available.
I think it would be unfortunate to withdraw the artecle
since I believe it does follow the spirit and the interest reflected
in the earlier reports by Crow and Johnstone and by Green. The decision
to accept is yours, but if you wish to include the article for your
readers interest, I am.prepared to re-submit with an extended citation
and speculation.
list and with some clarification as to observations
wonder
and
indeed
such
I
am
not sure that
I
is
if the reviewers'
necessary,
comments do not reflect their difficulty in making the Jump from their

preconceptions regarding ECT. The present views may in time be proved
wrong, but they have as much, if not more evidence in their support than
other theories of the mode of action of ECT. Perhaps they deserve the
opportunity to appear in your press, at the least for the response they
seem

to engender.

cbtations

can re-submit the article with extended or with
within a few days of your reply.

I

My

thanks for your review.

limited

Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

"

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                  <elementText elementTextId="104075">
                    <text>0 ‘

g...

.l..
r.10 aeqsq

M in (J o ‘3

":4. now?
ﬁne
no

'
.
dol,ervom
a
.

.

’

.,

lie

'5‘?

.
~va
LSALSW
’—

.’/

\H
.
has
ten:
7

n

.

H

M

.ifiiiﬂ-Eir’

05w
December 21, 1978

Michael A. Taylor, M.D.
Chicago Medical School
North Chicago, Illinois
Dear Mickey,
While

I

am

not at

all enthusiastic

about your going to

Deteoit —— I am sure you can do better -- I have answered the letter
of inquiry with appropriate enthusiasm and encouragement. I know the
Clinic and there is a good research base, good equipment, and some
financing-- but it is a state school which will always remain in the
shadow of the Mental Health Institute in AnnArbor, both in reputation
and funding, and in status with the legislature (not to mention

location).

Have you given any thought to returning to Stony Brook ?
The changes in the last two years have been truly astonishing. The

climate is surely better, and

social turmoil,

we

have

better delicatessen, lesser

the Division
position in Clinical Sciences or both.

and a few more Jews. You could head

of Diagnosis or take

my

My ECT book is at the binders and should be out at the
end of January. My debt to you and Dick is spelled out and you
should be pleased with the chapters on usage, prediction and theory.
For a few weeks I had a post~partum depression, wondering what I
would do with my free time, and now seem to have filled it up with

some experiments
When

can

with putative psychoactive peptidefstudées.

I get the protocol

on

testosterone

luck in your interviews in Detroit. I
helpful.

Good

have been

My

?

hope

that I

best regards.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

P.S. I have Just returned from a lecture in Vancouver. Now, that is
a fine center with an excellent residency training program. I
lectured to the redidents—— not only did they all speak and understand
English, about half were women and there were a few tho looked like

�they had walked or! a 19119

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m...

January 7, 1989

.
m

m—p

um"?

_m

"a...

r

W'mﬂ'l‘

v-m-arrsrm

s-

«WWW

WY’

‘g’MWa'avﬁ'v—"W‘M

Frank Ayd. M.D.
Medical Communications

Ayd

Baltimore, Maryland
Dear Frank,

Enclosed is a copy of the report which we recently
published describing our experiences with phenytoin. From these data,
I think we can understand that the varied reports of the efficacy of
this compound in the treatment of the mentally 111 may have resulted from
inadequate dosage“ poor compliance with resulting plasma levels that were
possibly inadequate for the induction of changes in brain function. If
these findings are to be trusted (and I think they should be), then we
are justified in undertaking additional studies of phenytoin in cases
of neurotic depression and anxiety, monitoring the plasma levels so that
persistent levels of at least Sag/ml are maintained.
My

best wishes for

a healthy and

successful

1980.

Sincerely yours,
Max Pink, M.D.
Professor of Psychiatry

�</text>
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                    <text>,-.

A,

.-.A

H

3‘
«.-

mum—v.

January 16, 1979

‘ryl..:'l$'-r;."

\v'

.&lt;

William Karliner, M.D.

20 Franklin Road
Scarsdale, R.Y. 10583

..

vm'ewrm‘-$wwu:www“

Dear
Kevan-'33

an

'dv‘r

Bill,

Enclosed are xerox copies of the relevant pages from the
book, Convulsive Therapy: Theory and Practice, which will be
published in February by Raven Press, New York.

crazy—-

awn-w

“Maw—11w:

1?”

.

I have found very little about maintenance ECT, and I have
abstracted the two sections from the book and the citations which
may be of help to you. There is a distinct need for a study of
maintenance treatment, particularly the benefits of repeated seizures
compared to drug therapy.
You may also wish to look into the APA Task Force report
#lh which has Just been issued. I recall notstatement about maintenance treatment in that volume, and since it lacks an index, I
cannot check it easily.

.v-wv

)‘Q‘

and

Kalinowsky and Hippius have a small paragraph (page 181)
Geoghegan and Stevenson.

report only the findings of

wrnx-vwvm-

r.

I know of no other sources for your search. I look forward
to your paper in Chicago.
My

best regards.

‘(t'nt‘rlr’z‘4-M-ﬂwbr1‘r‘wae'iﬁ'3wuwv'rf'nxn—hl'

Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

z

,x

mgr

Wov-

y
5.1
.

[Ivy-mitiwulm'wrtmr:”Jory“.

-

�</text>
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                    <text>January 2h, 1979
Mr. James

Kipfer

Mental Health Association in Michigan
Lathrup Village, Michigan
Dear Hr. Kipfer,

I am pleased to write this letter on behalf of
Dr. Richard Abrams who is being considered for the
position of
Chairman, wayne State University Department of Psychiatry.

I met Dr. Abrams when he returned from
service
to complete his psychiatric residency training at thehisNewmilitary
York Medical
College in 1966. Based on his experience with ECT in the Army, we
designed a study of ECT which was funded by the NIMH and which was
done at the Gracie Square Hospital. The work was done between 1967
and
1972. During that time, Dr. Abrams completed his residency with
distinction, and Joined our staff as a staff psychiatrist. In
rapid progression, he became the chief of the inapatient unit at
Metropolitan Hospital, and then moved to Stony Brook where he directed
the University service at Central Islip Psychiatric Center. In 1976,
he moved to the Chicago Medical School with Dr. Michael
Taylor.
is an outstanding clinician, researcher and
work has been innovative and with Dr. Taylor,
they have challenged some of the diagnostic concepts which have been
{current for a number of decades. Their work on the identification of
/ mania, catatonia and bipolar disease is exemplary.
~teaeher. His

Dr. Abrams

clinical

In his teaching, Dr. Abrams has shown excellent skills,
particulary in encouraging resdients to undertake research projects.
A record is seen in the
long list of publications which he has with
Junior personnel. Another evidence has been his rapid rise in academic
grade, from assistant professor, 1971-197h, associate 197h-1976 and

progessor since d976.

In his research, he has exhibited skill and a
of the literature. His work in convulsive therapy,thorough
in directing
the ECT studies under MB 15561, has resulted in many publications,
particularly regarding the efficacy of unilateral and multiple ECT,
the changes in EEG and biochemical parameters, and effects
on memory.
knowledge

�-2.
His

Joint efforts in psychopathology with Dr. Taylor have already
to, and it is in this effort that he has shown excellent

been alluded

skills.

Finally, his administrative experience also encourages
his consideration for the position of leadership. At the time that
he took the position of director of the University Service at
Central Islip Psychiatric Center, the unit was little more than a
back ward in a primitive state hospital. By the expenditure of
much effort and travail, he impaoved the staffing, trained personnel,
obtained the support of the adminsitration, and with the aid of the
resdlents, developed a fine teaching unit, which served to treat
patients and as a source of publications and research. (It is fair
to say that his successors have been unable to maintain the high stand—
ard of academic excellence which he established.)

It is clear that

Dr. Abrams has

the academic, clinical

research experience to undertake the position of chairman at wayne
State University in psychiatry, and I recommend him highLy.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

and

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                    <text>,
-

n

:er-tl’wvo—r‘v—y

w..77¢

"w

u.

way

v—rxuru-e

'wwwc

,r.

Im

January 30, 1979
Dr. L.C. Kiloh
School of Psychiatry
University of New South Wales

Little

Bay,

Australia

Dear Dr. Kiloh,
Thank you for sending me the review, "ECT:Its Place
and Value in Present Day Psychiatry". I found
thorough and detailed,
and congratulate you on the effort. While I agree with most of what

it

is included, including the conclusions, there is

our understanding of the mode of action.

.

7mm,

mpg“!

,

.

a,

some

question about

It seems to me that one can deduce much about the efficacy
of convulsive therapy from the information in your review—~ notably
the
importance of the bilateral central seizure, the equivalence of inductions,
the need for multiple seizures, the predictors of outcome, the diagnostic
classes which respond, and the neurophysiological evidence of the importance of bilateral EEG changes in the adsessment of efficacy. From these
-observations, it seems to me that there must be an influence on some
centrencephalic structure, an influence which is expressed after a
number of seizures, and therefore in the persistent biochemical
changes.

It has been the influence of the neuroendocrinologists that
suggests the next step in the process. The neuroendocrine changes which
mark endogenous depression have been defined in part; and in your
excellent review of the predictors of ECT, you noted that the vegetative
symptoms are the best predictors of ECT outcome. These observations,
plus the notes on changes in calcium metabolism and the btood brain
barrier have led me (and others, as Jan Otto Ottosson) to define the
present view of the mode of action of convulsive therapy in terms of the
hypothalamic effects. Surely, in relation to our knowledge of the mode of
action of other psychiatric therapies, we are farther along in convulsive
therapy, and a ummary of your views is the only omission in your report

which I missed.

other question of persistent concern is the role of
It is not clear from the literature whether such treatments
are effective, for whom, and at what rates. Their role should be clarified
One

maintenance ECT.

�”an?”

-2in the review.
I am acquainted with most of the citations but that of
Osselton which you cite as personal communication, 1978. I would be
grateful if this report is published, if you will let me know the

citation.

work on the Task Force and the reviews which you
volume which will be published
by Raven Press next month. In "Convulsive Therapy: Theory and Practice",
I expanded on the theoretic background of the process and (hopefully)

cite led

My

me

to expand the reports into a

present a cogent theory of

mode

of action which is quite testable.

to Graham Burrows in Vienna, I had hoped it
to Australia this year, and I had hoped to
visit with you. That seems unfeasible at this time. Should you be
coming to the States, let me know and I will be pleased to arrange
for you to visit us, to discuss this and other similar issues.
Thank you again for sending the preprint. I look forward
to its publication.

would be

When-I spoke

possible to

come

Sincerely yours,

Fink, M.D.
Professor of Psychiatry

Max

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                    <text>.

wow-pv-

,

w—m

“we—“rm.“

“unwan-ntv

WWI-“1”,”.

—A'rI.-‘

February 6, 1979
Barry Maletzky, M.D.

Portland, Oregon 97202
Dear Dr. Maletzky,
Your letter of inquiry relating to our experience with
the MECTA and with MMECT was referred to me fbemreply. As you know,
I visited Paul Blachly in Oregon in 1968 and undertook a series of
confirming studies of MEOT. The publications relate our experience,

which was not good.

In 1976,

we

purchased a

MECTA

instrument. In our

initial

treatments, we were unable to achieve a grand mal seizure using maximum
current intensity and settings. We called the manufacturer, returned the
instrument as he requested, and it was returned to us, with the
assurance that a faulty part had been replaced. We again attempted
to induce seizures and could do so at the maximum settings. When we
attempted to use unilateral electrodes, we were unable to achieve the
higher currents needed for such inductions. Gradually, the therapists
replaced the instrument and when it was no longer useful, it was
shelved, where

it

remains today.

In the review of

which was undertaken by the

MECT

(among

other modifications of

ECT)

Task Force on Convulsive Therapy, we were
unable to find systematic data which would assure us that this modification
was safe or more effective than routine ECT, expecially with unilateral
APA

electrode placements. Our conclusions are cited in the Task Force report,
#lh of the APA reports, dated November, 1978.

In my own review of ECT, which is in press and which will
be available by the end of the month, I come to the same conclusion, that

ﬂlﬂl indications for MECT are unclear, and further study is necessary before
its role in treatment is defined." In that statement, I am being kinder
than my real feelings, which are that MECT the little Justification
except as a research

tool.

acquainted with your very interesting report on the
outcome in ECT, as published in the
issue of Comprehensive Psychiatry. I have cited the report in

I

am

relation of deizure duration to

latest

�MuetZky,

wv.

BoMo

Coco-ell... FGbrum 6,

1979 ocean-000.co- page 2

review, and find your conclusions most useful. The possibility of
a therapeutic window for ECT is an important concept, and is consistent
with the experiences reported from my laboratory by M. A. Green,
who found that the duration of seizures changed with treatment,and
that thresholds usually fuse. But we were unable to define a ’window',
my

but then

we

didn't

have the concept.

With regard to the MECTA, there is need for better
ECT, and perhaps the unidirectional brief stimulus
approach recommended by Lieberson in the 1950's and lately by Weaver
is the way to go. But there seem to be inherent faults in the MECTA that

instrumentation for

.

will be useful in the clinic.
Similarly, the efficacy and applicability of MMECT is so far from demonstrated,
that a text as to how it should be applied clinically may be premature.
need remedying before the instrument

window'

in

ECT.

I look forward to your next report
‘

on

the 'therapeutic

Sincerely yours,
Max

Fink,

M.D.

VWGW’

w

Citations:
R. Abrams.

What have we
McGaugh, J. and

MECT:

learned 2 in Fink, M., Katy, 8.,
Williams, T. (Eds.): Psyyhobiology of

Convulsive Therapy, Washington, V.H. Winston, 197h. T9-8h.

M.Fink.
-

Convulsive Therapy: Theory,and Practice.
306

pp..

1979.

New

York, Raven Press,

M. Clinical experience with multiple electroconvulsive
treatments. gggprehensive Psychiatry 1;: 115—121, 1972.

Abrams, R. and Fink,

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                    <text>September 12, 1978

Gerald Sarwer—Foner, M.D.

Professor

&amp;

Chairman

Department of Psychiatry

University of Ottawa
Ottawa, Canada
Dear Gerry,

Enclosed is a draft copy of the report "A History of
Convulsive Therapy" which relates the history of the past forty
years. I felt that to limit the description to a shorter period

did not do Justice to the

men who embarked on

this treatment,

nor did it give a flavor of the continuing process of evaluation
and development that has marked this remarkable treatment of the

mentally

ill.

I hope that you find this acceptable for publication.
I look forward to your critique.
My

best regards.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

�</text>
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                    <text>1.1%?

March h, 1978
Dr. Karen Allen
Texas Tech University
El Paso, Texas
Dear Karen,

It was kind of you to send me the pictures of the
participants at the ECT session. It reminded me of a very pleasant
occasion and I do hope we can meet in lilanta.
The Task Force has completed

will be submitted to the Trustees of the

its

APA

work and the

shortly.

It

report

should be

debated at the meeting in may and perhaps it will be out in the
Fall. There has been a brouhaha about the recommendation that
unilateral ECT is to be preferred as effective and safer. Otherwise

the

critics

have been kind.
my

regards to Michael.
Sincerely yours,
Max

Fink,

M.D.

�</text>
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                    <text>March 5, 1979

.

Dr. L. K. George Hsu

St. Getrge's Hospital Medical School
London, England
Dear Dr. Ken,

for your inquiry regarding a position in this
laboratory. At this time, we have no openings, but I will keep your
application on file in the event our situation changes.
Your interest as anorexia nervosa is of-special interest
Dr. Michael
to me, and in this regard, I any suggest that you.write to Chicago
of
Psychiatry,
Department
Taylor,(Chairman and Professor,
medical School, VA Hospital, North Chicago, Illinois ‘6006h). He has
an interest in the same condition and may have a position open.
Thank you

In the recent literature on anorexia nerVOsa,

'

it

has

been unclear whether the vegetative disturbances, particularly the
evidence of hypofunction of the hypothalimo-pituitary axis, are primary
loss. In a recent
to the disease or secondary to the anorexia and weight have
come to the
others
we
ECT,
among
of
analysis of the mode of action
ECT
stimulating
in
much
of
the
is
process
of the thrust
conlcusion that
substances.
hermenal
of
release
axis
to greater
the hypothalmo-pituitary
respond
should
anorexia
nervosa
with
'If this be true, then patients
well to ECT, and the-evidence in the literature are that they do. However,
unable to find any
the reports are clinical and anecdotal and we hare beenanorexia
nervosa. In
ECT
of
the
course
on
of
sytematic study of the effects
the
7
share
can
ECT
you
received
If yes,
your studies, have any patients
schedule,
treatment
hormonal
status,
date with me- state of subject,
outcome, etc . ?'

If this

problem

interests you, perhaps

you could apply

for support for such a project in a center where such cases are available
(as in Chicago or Iowa City)or New York), and defray your support by this
A

mechanism.

I trust these

comments

are helpful.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

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                    <text>:7

par u

'2." 1m!

\vr'ax4

on“

».-

-

n-w

.7

v van

»—~‘ w

y.-

m- mm. rwww

u-w—w~«-mww—mw

March 5. 1979

Dr. John R. Robertsen
Comox,

3.0.,

Canada.

Dear Dr. Robertsen,

It would be difficult fer a suit to be sustained on
the basis of permanent ingury following ECT after a single induced
seizure, unless the record indicated that a particular complication of
the procedure- prolonged apnea, cardiac arrest, laryngeal stridor, for
example-- had supervened and was not corrected. If the treatment
procedures were within the range of the usual, i.e., with anesthesia
which was of reasonable duration, and oxygenation was maintained, it
is unlikely that a seizure induction would induce a prolonged brain
damage.

If the lawyers wiah to send the full record, it is
previous experience to respond to the record, and I would
be willing to do so-— if it were to be of some help.

within
be

my

The Task Force report
helpful to your counsellors.

# 1h

of the

APA

should also

Sincerely yours,
Max

Fink,

M.D.

PRofessor of Psychiatry

�</text>
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                    <text>Mrs. Mbry Winkcls
,4

Health Sciences Library
L—3

—~m~.«-«-~.—7:

..,

:,~v:v

Health Sciences Center
Stony Brook, H. Y.

v-

vf-imzwrv

Deer Mrs. Winkels:

I an pleased tc submit this letter

»-WM

on

behalf or

Miss Jeanne

Galbraith. As you knew. I have completed en extensive review of
convulsive therapy. During the past two years, I have called
upon the library for a great desl of assistance. Throughcut this
time, Miss Gslbreith hes been particularly helpful in satisfying
the needs which developed, including sesrchcs fbr citations,
verification of foreign citsticns, and searches for unccmmcn
documents. In addition. she has been particularly helpful in
assisting me in my teaching sssignments.

I have always found her cooperative, prompt. helpful

relisble. I
1"-

an pleased

to

and
and
continued
recommend her promotion

service in the Health Sciences Library.

Sincerely ycurs,

ladv-ﬁm‘

-

«an-

~

,
a

n-

»,m-gn-g

Fink, M.D.
Professor of Psychiatry

Mix

n!-/ﬁ§{'.¢*-\&gt;-V—n

.

MF:bc

�</text>
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                    <text>ww.~mvmmhr'7Vw'.

erw—Il-‘HW

W

m

February 3. 1978

Professor

Max Hamilton.
Department of Psychiatry
Leeds , England

Dear Max,
We are pleased that you will be able to visit us again.
I have arranged with the Director of Residency Training, Dr.
Lester Shapiro, for you to lecture to the residents on Thursday,
March 2 from 1 to 3 p.m. If agreeable to you, we have provisionally
titled the presentation as "Diagnosis and Treatment of Depression."
It is important. we believe. for these students to have another
point of View with regard to the issues in the identification and class—
ification of depressed patients, the treatments that are available.
and the decisions involved in their care. If possible, it may
be helpful for them to hear about the development and your view of the
present status of the Hamilton Depression scales.

and

Martha and I would be pleased to have you stay with us,
you to the University on Thursday. We

I will arrange to take

can make the

final arrangements in

New

Orleans.

I am processing the letter from your registrar and I
should have an answer from the Department within the week. I have
recommended that an invitation be extended to her, and would like
to have her assistance in the clinical research unit at the VA
Hospital in Northport,

centers.

New

York, one of our

affiliated clinical

.

I think

we

will

have some fun

forward to seeing you there.

My

best.

in

New

Orleans and I look

Sincerely yours,
Max Pink, H.D.
Professor of Psychiatry

cc:

L.

Shapiro,

H.D.

W3 .—..~... ",7. VFW—7m—

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                    <text>March 29. 1979

Robert L. Williams, M.D.
Departmant of Psychiatry
Baylor College of Medicine
Houston, Texas
Dear Bob,

.

is a draft of the requested PESAP- IV Syllabus
have tried to follow the guidelines,
and trust that this submission meets the standards that you have
set. If not, let me know and I will make the necessary adjustments.
Enclosed

for convulsive therapy. I

m

mmwrn.

Thank you
Wm

My

for the opportunity to contribute.

regards.

&lt;

Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

�</text>
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                    <text>November 6, 1978

Office of Research Reports

NIGMS

-

NIH

Bethesda, Maryland 2001h
Gentlemen:
We

\

would apprecaite receiving single copies of the following

publications for our use in the teaching of students at this Health
Sciences Center:

Inside the Cell

The New Human Genetics
An

addressed

Thank you

labll is enclosed for

your use.

for your help.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Mex

�</text>
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                    <text>1v

V$dﬂme

—

a...

November 7, 1978

Lothar Kalinowsky, M.D.
30 East 76 Street

New

York City 10021

Dear Lothar,

It was a pleasure working with you once again in explaining
the progress in convulsive therapy. I was pleased by the presentations
and by the audience response, but was disappointed that the time was
so limited. Nevertheless, I believe the message was clear, and the
discussion indicated that the process of exploration by the Task Force and
the interaction with the community was successful. Thank you for your
contribution.

I also want to take this opportunity to thank you for the
splendid copy of your first edition. It is a welcome addition to my
library of works on convulsive therapy, and I will treasure it.
My

best regards.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

�</text>
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                    <text>November 7, 1978

Alice Leeds,

M.D.

PRB- NIMH

5600 Fishers Lane
Rockville, Maryland
Dear

20857

Alice,

I have read the latest issue of the Psychopharmacology Bulletin,
and following your ibvitation on page 3, I am writing to suggest some
additional

titles for

the Recurrent Bibliography.

(Electroencephalography): I sought this item since the
effects sf psychoactive drugs are clearly defined in EEG measures. At
but when I
first I thought there were no such articles to be indexed,
found three among the citations that would clearly be so indexed, I
assumed the class was not in the master index file.
EEG

Convulsive therapy (ECT; Electroshock therapy): It is fairly
clear that the effects of ECT are operative through biochemical mechanisms
that are similar to those which are invoked as explanations for the effects
of antidepressant drugs. The index includes reference to ECS, the animal
equivalent of ECT when doen properly, but not to ECT.
Other items of

interest that

Mianaerin

seem

lacking are:

(GB—9h)

pharmaeokinetics, drug
pharmacodynamics, drug
plasma (blood) levels

I trust these

comments

are of

some

use;

My

regards.

Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Hex

�</text>
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                    <text>November

7. 1978

Research Resources Information Center
1776 East Jefferson Street

Rockville,

MD

20852

Gentlemen:
We would appreciate a single copy of Biotechnology Resources,
Research Resources Directory, Revised 1978, as described in a recent
issue of NIH Guide to Grants and Contracts.

A

Please send to address on label attached.
Thank you]

Sincerely yours,

Max

Fink,

M.D.

�</text>
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                    <text>;

Been Tania, M.D.

Central

Islip Paychintric

Contrtl 1311p.

New

York

November

8, 1978

Center

Delr Dr. Tania,
confirm

on ward

In response to your latter of October 25, I with to
that projects 5 20, 2h Ind 25, which had been undertaknn
L—6 at CIPC, ha»! been discontinnsd.
Sincerely yours.
x Fink, M.D.
Professor of Paychiatry
M

�</text>
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