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THE PHARMACOLOGY OF MARIHUANA

DISCUSSION A wide range of adverse effects associated with the use of neuroleptics has been described (Sargant and Slater, 1963). New reports of adverse effects continue to appear, with neurological effects predominant in the literature (Crane, 1971). The case reported is believed to belong to a category which has been recently recognized (Behrman, 1972). This category described progressive mutism, increasing inertia and decreasing mental alertness, lapsing slowly or rapidly into fully developed "akinetic mutism". The onset of symptoms began up to 18 months after the commencement of treatment with neuroleptics. In half the patients mutism gradually remitted after the cessation of medication, but in the rest progress was much slower and in one recovery was incomplete. Half the patients also displayed the more well-known neurological side effects of neuroleptics and 2 had persistent stereotyped movements. It was suggested that akinesia may be caused by deafferentiation of the cerebrum from the activating influences of the ascending brain-stem reticular formation as a result of dopamine blocking action.