Search PubMed⌕ Search

Biomedical subjects

A Coppen

Publications and source records attributed to A Coppen.

At least 55 records · Page 3Linked to original sources
PubMed1983

Prophylactic lithium treatment of patients with affective disorders is associated with decreased platelet [3H]dihydroergocryptine binding.

Intact platelet [3H]dihydroergocryptine binding characteristics have been determined in female patients with a history of affective disorders who have been treated with prophylactic lithium. These results have been compared with results obtained from concurrent experiments in normal female controls and acutely-depressed, female drug-free patients. The platelet density of alpha 2-adrenoceptors in the lithium-treated patients is similar to that of the depressed patients as there are significantly fewer sites per platelet when compared to normal controls. It is concluded that lithium treatment with remission from affective illness is not associated with a change toward normal of alpha 2-adrenoceptor density and represents a trait in patients prone to affective disorder. The problem of comparison of results of platelet alpha 2-adrenoceptor density obtained from different laboratories is discussed with particular reference to the non-uniform choice of [3H]ligands used.

Blood Platelets↗
PubMed1983

Drug plasma levels and platelet 5-HT uptake inhibition during long-term treatment with fluvoxamine or lithium in patients with affective disorders.

1 Plasma levels and platelet 5-HT uptake characteristics were determined at baseline and at various times during a long-term study comparing fluvoxamine and lithium prophylaxis. 2 In the fluvoxamine-treated patients after 12 and 24 weeks of treatment, Km was significantly increased and y, the mean overall uptake, significantly decreased compared to the patients' own baseline values and to lithium treatment. No significant change was noted for Vmax. 3 For fluvoxamine, significant negative relationships were established between the Vmax of platelet 5-HT uptake and plasma levels. 4 The trial had to be discontinued prematurely for some patients due to apparent lack of efficacy, unwanted effects or a combination of both in the fluvoxamine-treated patients. Low plasma levels of fluvoxamine may have contributed to the apparent lack of prophylactic efficacy of the drug. 5 Reference is made to the activity of receptor systems in patients receiving lithium and the consequent changes occurring after the administration of a potent 5-HT re-uptake inhibitor.

Antidepressive Agents↗
PubMed1983

Biological classification of depressive illness.

1 A number of biological criteria have been used for refining clinical classification to identify patients who will respond to antidepressant treatment. 2 Subtypes of depressive illness have been postulated to occur depending on whether there is a relative deficiency of central noradrenaline or 5-hydroxytryptamine. However, antidepressants having selective effects on amine systems have similar therapeutic effects and inhibition of re-uptake of these amines does not correlate with clinical outcome. 3 An abnormal response to thyrotrophin-releasing hormone has not been confirmed as specific for depressive illness. Failure to control for age and sex may account for some of the discordant findings. 4 It has been suggested that depressed patients secrete less growth hormone to a variety of stimuli. It appears that the predictive value of a growth hormone response for the diagnosis of endogenous depression is 53%. 5 The dexamethasone suppression test appears to have high sensitivity for the diagnosis of endogenous depression but low specificity and should therefore be used only in conjunction with clinical assessments.

Biogenic Amines↗
PubMed1983

Subjective side-effects of amitriptyline and lithium in affective disorders.

The prevalence of subjective side-effects was studied in 258 control subjects, 65 drug-free depressive in-patients and 94 lithium-treated out-patients. It was shown that drug-free depressives reported more side-effects than both control subjects and lithium-treated patients. Side-effects were studied during amitriptyline therapy. Depressed patients on no medication complained of only slightly fewer side-effects than when they had received amitriptyline. There was a significant positive correlation of Hamilton depression scores and side-effects scores at baseline. Side-effects and affective morbidity over two years were investigated in 94 patients with recurrent affective disorders on long-term lithium therapy. Psychological variables were also investigated in 74 of these patients. Subjective side-effects reported by lithium-treated patients including those specific to lithium were related to their affective morbidity and personality variables. Patients on lithium complained significantly less of headache and unilateral headache than controls.

Amitriptyline↗
PubMed1983

Dexamethasone suppression test in depression and other psychiatric illness.

The prevalence of an abnormal response to the dexamethasone suppression test (DST) was examined in 119 in-patients suffering from a major depressive disorder and in 79 normal controls. Only 11 per cent of controls showed an abnormal DST as against 70 per cent of depressed patients. The specificity of the DST was examined by testing patients with other psychiatric disorders. Abnormal responses were found in one-fifth of a sample of schizophrenics, over one-quarter of abstinent alcoholics, two-fifths of neurotics (including neurotic depressives) and almost half of senile dements. Abnormal DST was also found in 33 per cent of patients receiving prophylactic lithium for recurrent affective disorders.

Adult↗
PubMed1983

Classification of depression and response to antidepressive therapies.

Two hundred inpatients suffering from primary depressive illness were studied. Seventy eight of the patients were treated by electroconvulsive therapy (ECT) and 122 patients received antidepressant medication. Response to ECT and antidepressant medication at 4 weeks showed a curvilinear relationship to Newcastle scores. Patients with Newcastle scores in the middle range (4-8) showed significantly higher percentage improvement than those with low (0-3) and high (9-12) scores. Ninety five patients with unipolar depression who received lithium therapy for one year were also studied. Response to lithium showed a linear relationship to Newcastle scores in these patients. It is suggested that these differences in response to antidepressant therapies reflect the heterogeneity of depressive illness.

Amitriptyline↗
PubMed1983

Strategies for the testing of antidepressants: trials and tribulations. An overview.

Short-term, long-term and prophylactic trials are all important for the thorough assessment of a new antidepressant. Patients are carefully selected for such trials according to rigidly applied selection criteria, and their depressive disorder should be rated using a standard classification system. Multicentre trials are often a useful means of obtaining sufficient numbers of patients for valid conclusions to be drawn, but different assessors obtain quite different results even on the same rating scales. Thus, ideally, the assessors should undergo centralized training in such rating. A useful method of circumventing these problems is to use a more objective test, such as the dexamethasone suppression test. Trials should also compare the new drug with placebo and standard antidepressants (e.g. 150 mg/day amitriptyline). The safety profile should be carefully established by monitoring side-effects and investigating interactions with commonly used drugs (including alcohol). Most new antidepressants are found to be equally as effective as, but no better than, standard antidepressant therapy. However, many new antidepressants have the advantage of causing fewer side-effects.

Animals↗
PubMed1982

Early improvement as a predictor of response to amitriptyline and nortriptyline: a comparison of 2 patient samples.

This study compared serial severity ratings from 2 methodologically similar tricyclic antidepressant studies. Though the groups resembled each other in terms of diagnosis and baseline severity, response patterns were surprisingly different. In particular, early change was highly predictive of outcome in one group but not in the other. The results of response predictor studies must, therefore, be generalized with caution. These data, nevertheless, do allow some guidelines for predicting response from early changes and severity.

Age Factors↗
PubMed1982

Plasma folate and affective morbidity during long-term lithium therapy.

In 107 patients on long-term lithium, those with lower plasma folate concentration had a higher affective morbidity than those with higher folate, both at the time and during the previous two years. The association was not the results of weight change or the concomitant use of other drugs. Animal work reporting a decreased synthesis of 5-HT both in folate-deficient animals and in animals fed excessive amounts of folate suggests that it may be important for lithium patients to receive folate supplements to their diet for maximum therapeutic effect.

Adult↗