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                  <text>May

Riezen,

Honk van

Scientific

30, lQTh

D.

M.

Development Group

H.V Organon
Oso , Holland

Dear Bank:

First, let

me

apologize for not having reported earlier;

two weeka ago, I was concerned that my
impressions may have been in error, and knowing that she would be

but, after visiting Joyce
at the

her.

meetings. I waited to confirm.my observations with
Following are some notes concerning our projects.
ECDEU

chewed me

is directly involved with these studies.‘ Their optia
in studies of OI~63 was in marked contrast to their pessimism

Milstein

mism

with

1. Jozpe Small. I visited Indianapolis on may 7. Joyce
through the laboratories and we were accompanied by Victor

who

GB~9h.

They have completed nine subjects in
the series, and in no instance have they been able to avoid ECT.
While none of the patients exhibited a clinical.woraening, none im»
proved sufficiently to provide any feeling of optimism. When I enquired about side effects, she called her nurse—monitor who seemed
comforteble with the drug and unable to identify symptoms that were
problems to the patients. There were no "anticholincrgie" symptoms.
But Joyce's questions were sharp and her statements stronger than
the date seemed to warrant. I become concerned that we may be
seeing the development of e halo effect, i.e., the failure of the
first few patienta to improve markedly has set the etege for a
negative evaluation. She asked me whether she could discontinue
the study after ten subjects without 'breaking her worn’ to you.
(In discuseing this in Florida, she was more negative than the date
considering the very severe test to'which the drug was
warranted,
put .

a.

‘-

I'

wwwmm.w«nnnz

'v’.

s
‘2.

m

rang:

I]

r

03—

h:

�Hank van Riezen

May

—2—

30, 197h

I suggested she complete ten subjects, summarize
her observations, send the reports to you (me), and not induct
any new patients into this study until these data have been
digested.

b. OI~6§: This study is progressing well. Enclosed
sheet
data
summarizing her observations in nine subjects to the
is a
end of April. She finds 01-63 to have little effect in the immediate post-seizure recall period, but may improve recall at twenty—
four hours. She is anxious to go to the next groupof subjects, in
the same design, but at the higher dosage of 30 mg. I found this
suggestion reasonable, and encouraged her to proceed.
She and Dr. Milstein indicated that they were also
re-assessing the memory tests and they seemed pleased that some of
the methods they have developed had shown differences in OI~63
effects. Some additional tasks are being tested at the same time

as these studies are in progress.

Both she and Dr. Milstein were somewhat depressed,
however, about their local funding and space problems, reporting
that some of their grantgs had not been approved, and that she was

anxious to-obtain additional industry support for studies.

Joyce has collected tapes of EEG data with 01-63 and
is a unique 8—channel, l/h inch, General
Precision instrument which is no longer made. _Failing to find one
in New York, I decided to send a member of my staff (Peter Irwin)
GB-Qh.

Her tape recorder

with one of my h—channel recorders to Indianapolis to transcribe the
data from her tapes to mine; and we will then analyse the data here
(unless you prefer to use these tapes to test your system in 035?).
;I have set a date for June lB-lh for the transcription.

,,
w.

..

1-,_.-.,

am

.v:.

“View”:

‘qzvrr-rzn

)

-—-:

rm-zwsaﬁr'nn

Lyman-or

.1

14"‘A—W1n-mvimnjwy‘”

I

have had

(Joyce gave

a

little visitor's

and send them

to

packet of her programs;
for your.information.)

you

the presenwell received.
'(Please edit it
of the report is
and I would be grateful for any corrections of fact or-nuance that
you may suggest.) The diacussion was started by Joyce, who reported that she completed nine subjects in the ECT paradigm; that
there was improved recall of learned material twentybfour hours
2.

ECDEU:
The meeting was well attended,
ACTH Peptides on Memory and Brain
A copy
enclosed.

l,tation "Effects of
5

me

these copied

and

Function" was

�Hank van Riezen

«3~

May

30, l97h

after the seizure;

and that the effects were not evident in the
immediate post—seizure recall. She was encouraged by the find~
ings, and said she was extending the sample at a higher dose of
30 mg. Others enquired about the similarity of 01—63 to UCB

(prracetam) and to Unger's

compound

availability of the materials.

(scotophobin), and to the

timely because the next afternoon was
in depression and schizophrenia. The
N
data was sparse, with the usual of four to ten in each study.
Hoeehst was well represented (six visitors) and Dr. Alan Gordon
summarized the findings of European studies as equivocal or nega—
tive in depression. He reported sleep EEG studies, which failed
to show an effect of TRF. Drs. Prange, Lipton, Hollister and
Huey individually reported small studies without consistent findings in depressed and schizophrenic patients. Yet, each reporter
apologized for the paucity of the results; described some anecdotal,
single cases that were remarkable; and suggested that some findings
were there, although they did not know how to extract them. Itil
presented EEG and the clinical data from Turkey, and his report
was optimistic and constructive. He reported well defined EEG
changes, similar to dextroamphetamine, with clinical effects in
depressed patients of short duration, with self reports more
positive than observer ratings. There was some criticism of his
report, notably the question by Gordon that since he could not
find EEG effects of TRF in the sleep record, how did Itil explain
his findings in the alert subject. This gave Itil an opportunity
to describe the differences in methodology, the problems with
sleep assays, and the necessity for quantitative methods.
The

presentation

devoted to reports of

was

TRF (TRH)

I was left with the impression, both by the interest of
the reporters and the audience, that the peptides were now among
us, and that much study will have to be done in the next few years
defining their activity and developing new methods of analysis. A
few investigators (N. Kline. D.F. Klein, J. Simeon, L. Hollister,
R. Shader) asked about the report and 01—63, and I will send
copies of the report to them, hoping that their interest has been
aroused.
I am sending a copy of the report to the editor of
Psychopharmacology Bulletin for her consideration for inclusion
in a ferthcoming issue.

�~h—~

Henk van Riesen

May

30. 197k

3. FDA Report and Dr. Ksstin: I have decided to send
the report I have given to the ECDEU, as well as a covering letter describing the date of the Miller and the Fink studies.
I will omit reference to the recent Kastin end Sandman reports.
Abba sent me the latest report with a covering letter that seemed
unnecessarily harsh. However, I am willing to serve in the re—
lationship with him being acutely aware of his idiosyncratic and
irritating behavior, but accepting these as necessary accompani—
ments of the program.

the

FDA

In reading Ksstin's letter to you of April 29, I found
references to a study of ? OI—63 in schizophrenic patients. I
have not heard from Kastin regarding this study. Should he wish
to file an amendment again, and to avoid the criticism that we
‘are holding him up, I am writing to him directly (enclosed).

I

Because

h.

Essman:

I read the

Essman

letter

and the two

scales.

these confusing, I called hhn,snd he explained
found
He
derived from some studies by

that the tasks were

Squire.

'esserted that the tests have had some reliability testing (two
forms) and at least two applications. It should be interesting
and if they are sensitive to memory loss
(recent and remote), then thetpplication of the tests may be

to read these reports

useful
in the

5. Klein2 D. F.: we met in Florida (although we live
some community, I tend to see him in fer-away places) and

He wished to read the reports which
basis of my peptide summary, and I gave him a duplicate
set that I had with me. I shall send him a copy of the ECDEU
report and try to meet with him in Great Neck in the next two

began a discussion of OI~63.

were the

weeks.

I

have received a

letter

from Jack regarding

the visit

U. S. for a review of the date analyses of GB~9h, and I
have made arrangements for Drs. Boneto and Guy of the Biometric

to the

Laboratory in Washington

to assist us.

I have become even more interested in the peptides since
the
summary, and I look forward to listening at Utrecht in
writing
my

best regards.
Sincerely yours,
Man

MF:ed

'Enclosures

Fink,_M. D.

Professor of Psychiatry
,

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