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                  <text>,

rmW.~—-m.

“W‘Fw—nswmh—u

..

-

m——-W

“mmmmm“
,

-

,
.m—u-wwmw—p—«vm—v—w

w

...‘mm.mv—u-—.y

w»-

.

..

_

mm, mm.

... “fume. V7,-.. ._...

December 30, 1985
Thomas Bolwig, M.D.

Psychochemistry institute
Rigshospitalet

9, Biegdamsvej
DK-ZlOO Copenhagen
Denmark
Dear Tom,

At the recent ACNP meetings in Maui, Martha and I had a most pleasant
time with Ole. He seemed to be enjoying himself (when he wasn't politicing for the
CINP or the WPA or the August meeting in Copenhagen).
-

As he had in Philadelphia, Robert Friedel presented a report on the greater
efficacy of the combination of ECT with thiothixene than thiothixene alone in

'therapy-resistant' schizophrenic cases. He reported on nine cases, eight of whom
recovered with the combination, and one who was much improved.

In the discuSsion, Seymour Kety asked what possible mechanism could
Friedel suggest for the greater efficacy; and he presented the view that ECT (and
ECS) produces greater permeability of the blood brain barrier, thereby allowing
greater levels of thiothixene in the brain tissues, for greater efficacy.

had discussed this theory with Sam Gershon, who quickly suggested that
this theory was eminently testable in animal studies. i put together a package of
citations from your summary in the Handbook of Biological Psychiatry, my book,
and that of Stanley Rapaport (Blood-Brain Barrier in Physiology and Medicine), as
well as a citation list for him. He may be able to undertake such a study.
1

Perhaps you have already done such a study? If yes, have I missed it? Are
the data available? If not, perhaps you or one of your associates would be able to
undertake a systematic study? If Bob Friedel's idea gets any play at all, there will
be a rash of trials of the same suggestion, and it would be nice for CONVULSIVE
THERAPY to have a definitive article on this possible mechanism.
Have you organized or will you organize an ECT session for the August

WPA meetings in Copenhagen?

My best wishes for a happy and healthy 1986!

Sincerely yours,
Max Fink, M.D.

.

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