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Biomedical subjects

A L Pottash

Publications and source records attributed to A L Pottash.

At least 55 records · Page 3Linked to original sources
PubMed1981

Relationship of thyrotropin-releasing hormone test and dexamethasone suppression test abnormalities in unipolar depression.

The thyrotropin-releasing hormone (TRH) test and the dexamethasone suppression test (DST) were administered to 50 inpatients with unipolar depression. Of the patients tested, 64% had a blunted thyroid-stimulating hormone (TSH) response to TRH and 50% failed to suppress on the DST. There was no significant association between these two abnormalities by chi-square test. This lack of association suggests that the blunted TSH response to TRH is not an artifact of hypothalamic-pituitary-adrenal hyperactivation. The TRH test and the DST complemented each other as biological markers for active unipolar depression: 30% of the patients were identified by both tests, 34% by the TRH test only, 20% by the DST only, and 16% by neither test. The two tests may be useful in developing a nosology for major unipolar depression that is based on both descriptive and neurobiological information.

Adult↗
PubMed1981

The thyrotropin-releasing hormone test in the diagnosis of unipolar depression.

The establishment of criteria for a blunted thyroid-stimulating hormone (TSH) response to thyrotropin-releasing hormone (TRH) may prove useful in distinguishing patients with major unipolar depression from patients with nonmajor depressions and controls. To this end, we administered the TRH test to a group of depressed, euthyroid inpatients diagnosed by Research Diagnostic Criteria and 20 normal volunteer controls. The mean maximal TSH response (delta TSH) to infusion of 500 micrograms of TRH of 7.3 +/- SD 4.6 microIU/ml in the 105 patients with major depressive disorder, primary unipolar subtype was significantly lower than that of 13.4 +/- SD 4.4 in the 20 controls and 10.9 +/- SD 4.4 in the 40 patients with nonmajor depressions. The differences were not explainable by differences in baseline thyroid function, age, or sex. When a delta TSH less than or equal to 7.0 microIU/ml was used as a diagnostic test for unipolar depression, the sensitivity of the TRH test was 56%, the specificity 93%, and the predictive value 91%. These results suggest that the TRH test may be useful in confirming the diagnosis of major unipolar depression and hence identifying patients likely to respond to antidepressant medications or electroconvulsive therapy.

Adult↗
PubMed1981

Evidence for an endorphin dysfunction in methadone addicts: lack of ACTH response to naloxone.

Chronic exogenous opiate administration might be responsible for the acute and protracted abstinence syndrome by producing a prolonged decrease in the availability of endogenous opioids (endorphins). However, the hypothesis that potent exogenous opiates may have anti-endorphin effects has been difficult to test. We have been investigating this hypothesis with neuroendocrine test paradigms which have provided preliminary evidence of anti-endorphin effects for chronic methadone. Naloxone-induced ACTH response data from chronic methadone addicts offers preliminary support for the hypothesis that chronic exogenous opiate administration has anti-endorphin effects. The subjects were 7 male methadone addicts who had been addicted to greater than or equal to 40 mg of methadone and 7 male healthy opiate-naive volunteers. Naloxone failed to produce a significant increase in ACTH in methadone addicts while opiate-naive normal volunteers demonstrated a significant naloxone-induced release of ACTH. Five of the seven methadone addicts ahd no demonstrable ACTH response to naloxone. These impaired naloxone response data reported here for recently detoxified addicts suggest that chronic methadone administration comprises the functional integrity of the endorphin system. Prolonged abstinence, post-detoxification depression and other affective symptoms which contribute to relapse may result from a prolonged endorphin derangement.

Adrenocorticotropic Hormone↗
PubMed1981

Psychiatric complications of antihypertensive medications.

Psychiatric complications of antihypertensive medications have been identified in the literature primarily in case reports. Most other studies to date have suffered from major design flaws. Side effects seriously complicate the treatment of hypertensive patients and no doubt decrease compliance. There are significant interactions between psychotropic medications and antihypertensive drugs. The literature is reviewed, and the implications for clinical practice of psychiatric side effects of antihypertensive treatment and of psychotropic-antihypertensive interactions are discussed.

Antihypertensive Agents↗
PubMed1981

Thyrotropin-releasing hormone test and male unipolar depression.

Change in maximal TSH response to a TRH infusion were measured in 18 unipolar depressed males and 2 control groups matched for age, sex, and base-line thyroid status. The mean maximal change in TSH response was significantly lower for the unipolar than the control groups. Clinical and research implications of these findings are discussed. By using a deltaTSH cutoff of 7.0 rather than 5 microIU/ml, 14 rather than 7 depressed patients were correctly identified as having a blunted deltaTSH; 29 rather than 32 to 36 control patients were correctly identified as having a normal deltaTSH score.

Adult↗
PubMed1980

The thyroid-stimulating hormone response to thyrotropin-releasing hormone in mania and bipolar depression.

The release of thyroid-stimulating hormone (TSH) from the pituitary after infusion of 500 microgram of thyrotropin-releasing hormone (TRH) was decreased (p < 0.01) in manic patients and increased (p < 0.01) in bipolar depressed patients compared to a control group of patients with personality disorders. These results suggest that the TRH test may be useful in the diagnosis of psychiatric disorders and in the prediction of response to pharmacotherapy. We discuss the role of central monoaminergic systems in changes in the TSH response to TRH.

Affective Disorders, Psychotic↗