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Unlabelled: Riluzole is currently the only drug that holds any hope of prolonging life in amyotrophic lateral sclerosis (ALS) by slowing the rate of disease progression., Methods and Results: Between 1995 and 1997 a total of 7916 ALS patients in 39 countries, were given 100 mg riluzole per day for a mean of 7.2 months. The present report focuses on the German results in comparison to the total population. Nine hundred and nineteen patients were treated in 25 German centres; 162 (17.6%) died from the disease during the course of the study. Serious adverse events attributed to the study medication occurred in 16 patients (1.7%). Most frequently these were reversible changes in liver enzymes (0.9%) occurring during the first 3 months, none resulted in death. In all, 413 patients (44.9%) reported an adverse event. The most frequent were reduced lung function (7.3%), nausea (7.1%), asthenia (5.8%), pneumonia (2.5%) and abdominal pain (2.5%)., Conclusion: The results of the study allow the conclusion that riluzole is well tolerated. The majority of adverse events were symptoms of the underlying disease and were not attributed to riluzole. Overall the safety profile found in the German centres was very similar to the profile seen in the total patient population and was more favourable than in the two published double-blind studies [New Engl J Med 330 (1994) 585; Lancet 347 (1996) 1425].

Gall (1758-1828) and Spurzheim (1776-1832) were among those who developed the basic ideas of biological psychiatry. They attempted to identify a relationship between the structure and function of the brain. Although this led to speculation regarding physiognosis, it simultaneously represented a decisive step towards a scientific approach in psychiatry, which was then in its infancy. The patient was freed of gult. Mental illnesses were considered to be healable, because they were of organic origin, and this led to therapeutic optimism. The emphasis placed on endogenic factors, however, nourished biologistic views.

Heinroth (1773-1848) belongs to the founders of psychiatry in Germany. He represented an idealistic, spiritualistic psychiatric school that had a strong leaning towards materialist ideas. He believed that mental disturbances were caused by guilt and sin. But, besides these speculations, he also expressed views that led to view psychiatric and psychotherapeutic insights. One of these was his postulated psychogenesis of mental disturbances. His thoughts on the importance of social, biographical and psychosomatic factors also contributed to the development of psychiatry.

Reil (1759-1813) was one of the doctors who developed psychiatry in Germany. He represented a materialist psychiatry with dialectical aspects. His concept, which was orientated mainly on therapy, is based on the assumption that mental disturbances can be healed. He proposed the establishment of psychiatric hospitals in order to eliminate the hospitalization of the sick in the same building as healthy and to permit the application of specific forms of treatment. The methods he used to heal mental disorders were partly repressive, but they also contained elements of psychotherapeutic treatment.