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Biomedical subjects

A Coppen

Publications and source records attributed to A Coppen.

At least 37 records · Page 2Linked to original sources
PubMed1985

Does the dexamethasone suppression test predict antidepressant treatment success?

The 1 mg dexamethasone suppression test (DST) was carried out in patients with a major depressive illness in order to establish whether the results of this test, given before antidepressant or ECT treatment, could predict eventual therapeutic outcome. No significant difference could be detected in overall therapeutic improvement between those patients with a normal or abnormal DST response respectively, based on the 50 ng/ml cortisol cut-off point. However, using 100 ng/ml as a cut-off point it was found that patients with an abnormal DST response (i.e. a post-DST plasma cortisol concentration greater than or equal to 100 ng/ml) responded significantly better than those who had a normal DST response. These observations were statistically significant for those patients receiving antidepressants and in the combined treatment groups of those patients receiving either antidepressants or ECT.

Antidepressive Agents↗
PubMed1984

Classification of depressive illness. Clinico-psychological correlates.

347 patients with primary depressive illness were studied. Patients were classified on the Newcastle Diagnostic Scale and their depression was rated on the Hamilton Rating Scale for Depression (HRS) and self-rated on the Beck Depression Inventory (BDI). Clinical and personality factors were studied in relation to classification. Personality was measured by the Eysenck Personality Questionnaire, Fould's Personality Deviance Scale, the Marke-Nyman Temperament Scale and the Crown-Crisp Experimental Index. The frequency distribution of the Newcastle scores of all 347 patients was unequivocally unimodal. Significant positive correlations were obtained between patients' Newcastle scores, age, and HRS scores but not with BDI scores. Patients with non-endogenous depression showed clinical and personality differences compared with those with endogenous depression, and with a group of bipolar depressives.

Age Factors↗
PubMed1984

Platelet accumulation of histamine in controls, depressed and lithium-treated patients.

The accumulation of histamine into blood platelets of depressed patients, lithium-treated patients and controls was determined using radio-labelled histamine. All groups had significantly different mean accumulation rates: the depressives had the lowest, the controls had the highest while the lithium-treated patients had intermediate rates. No significant difference in histamine accumulation rates was detected between drug-free depressed patients or depressed patients receiving psychotropic medication apart from lithium. Histamine accumulation rates of depressed patients did not appear to have been influenced by their age or severity or endogenicity of their illness; no difference in histamine accumulation was detected between those patients who had an abnormal or normal dexamethasone suppression test response. We have concluded that while the biological significance of these results is unclear it would appear to be a very sensitive test for depression, especially in women. It would appear that prophylactic lithium treatment increased the rate of histamine accumulation: this result is discussed with reference to histamine's association with allergic disorders.

Adult↗
PubMed1984

Treatment of bipolar affective illness with zimeldine, a 5-HT uptake inhibitor.

A small group of patients who had been successfully treated with lithium for a number of years were treated with zimeldine in order to determine whether this antidepressant could be substituted for lithium in patients with a bipolar affective illness. The proposed treatment period of 6 months was not reached by any patient due to depression, hypomania, mania or unusual adverse symptoms. The results of this pilot study suggest that bipolar patients being treated with lithium should not then be treated by antidepressants including those which are potent and selective inhibitors of 5-HT uptake.

Adolescent↗
PubMed1984

Peripheral serotonergic receptor sensitivity in depressive illness.

Platelet aggregation induced by 5-HT was used as a measure of the functional responsiveness of peripheral 5-HT receptors in controls and drug-free depressed patients. No significantly different aggregatory response (5-HT/ADP ratio) was noted between the controls and drug-free depressed patients. If the receptor mediating this response is a 5-HT2 receptor, there is no overwhelming evidence to suggest that the functional activity of this system is abnormal during a depressive illness. The results are discussed with reference to reported abnormalities of 5-HT2 receptors during a depressive illness and to their change during antidepressant treatment.

Adenosine Diphosphate↗
PubMed1984

Dexamethasone suppression test in alcoholism.

The hypothalamic-pituitary-adrenal function was investigated in alcoholic patients using the dexamethasone suppression test (DST). Seventy-two patients were studied when they had been abstinent from alcohol for 3 to 6 weeks. Eight patients undergoing detoxification and 79 control subjects were investigated for comparison. Alcoholic patients after a 3- to 6-week abstinence period showed significantly higher prevalence of abnormal DST results (28%) than control subjects (11%). Patients undergoing detoxification showed even a higher prevalence of abnormal DST results (62%). Abnormal DST status was not associated with the presence of depression in these patients but was associated with abnormal liver function. It is supposed that abnormal DST responses in alcoholic patients are not diagnostic of depression but appear to be related to effects of alcohol either on liver metabolism or on the hypothalamic-pituitary-adrenal function or both.

Adult↗
PubMed1984

Depression, weight loss and the dexamethasone suppression test.

The dexamethasone suppression test (DST) was carried out on 143 patients with a major depressive disorder, who were classified into those with a history of weight loss (n = 89) and those without (n = 54). Seventy-three per cent of patients with weight loss and 61% of patients without had an abnormal DST; this difference was not statistically significant. Of the patients receiving prophylactic lithium therapy, 13 were found to have changed their DST status on retesting after a period of 14 months, but there was no significant difference in their weight. It is concluded that weight loss is not a necessary condition for an abnormal DST in depressive illness.

Body Weight↗
PubMed1984

Novel antidepressants: problems in evaluation.

In conclusion, it is obvious that the program of clinical testing of new antidepressants is a formidable one, taking several years to complete. However, by incorporating careful classificatory, pharmacokinetic, and pharmacodynamic data we should increase our knowledge of the usage of antidepressants generally, as well as the particular novel antidepressant under investigation.

Antidepressive Agents↗
PubMed1983

Frusemide: a safe diuretic during lithium therapy?

This paper reports the effect of frusemide given in therapeutic doses for hypertension in patients receiving prophylactic lithium for affective disorders. It was found that frusemide had no significant effect on plasma lithium concentration in these patients who were studied over a 12-week period. It was concluded that frusemide is a safe diuretic to administer to patients receiving lithium therapy.

Aged↗
PubMed1983

Decreasing lithium dosage reduces morbidity and side-effects during prophylaxis.

In a prospective double-blind trial we examined the affective morbidity and side-effects of 72 patients who were randomly allocated either to continue with their usual dose of lithium or to receive either a 25% or 50% reduction in lithium dosage. Patients who underwent a dosage reduction with consequently lower plasma lithium levels (0.45-0.79 mmol/l) had significantly decreased affective morbidity. Thyroid stimulating hormone levels were also significantly decreased in this group. Total subjective side-effects score and tremor were also reduced. No change in affective morbidity was observed during the trial in patients whose dosage was not altered. These changes were observed in both unipolar and bipolar patients. It was concluded that a once a day dosage with a sustained release lithium preparation that maintained a 12-h plasma level of about 0.6 mmol/l is both more effective and produces less side effects than does conventional dosages.

Bipolar Disorder↗