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Biomedical subjects

B Bonin

Publications and source records attributed to B Bonin.

At least 73 records · Page 4Linked to original sources

Metabolism of amitriptyline in patients with chronic renal failure.

The metabolism of amitriptyline (AMT) has been studied in two groups of depressed in-patients on long term AMT therapy: 11 patients with no other major disease and 8 patients with chronic renal failure, who were being dialysed. The patients with renal insufficiency had decreased concentrations of AMT, nortriptyline (NT) and their unconjugated hydroxymetabolites compared to patients with normal kidney function. The plasma levels of conjugated products were extremely high in the uraemics. The latter metabolites are probably inert. The reduced concentration of unconjugated hydroxymetabolites , which are active compounds, may decrease the clinical effectiveness of the drug.

Adult↗

Biotransformation of amitriptyline in alcoholic depressive patients.

The biotransformation of amitriptyline (AMT) during steady state conditions was studied in plasma and urine from 11 nonalcoholic and 10 alcoholic depressive inpatients treated with oral AMT. The 2 groups of patients had a different pattern of biotransformation. The Demethylation of AMT was lower in alcoholic than in nonalcoholic depressive patients, and conjugation and hydroxylation of AMT were also more marked in the former group. The results may be of clinical relevance since the conjugates of AMT are inactive.

Adult↗

[Pharmacokinetics of psychotropic drugs: importance in psychiatric practice].

The clinical importance of pharmacokinetic studies of psychotropic drugs is described. First, definitions of the main pharmacokinetic parameters which allow accurate evaluation of the fate of a drug in the organism are given. Secondly, two important points are considered: the variability of drug plasma concentrations from one patient to another with identical doses makes "standard dosages" worthless; current data evidences correlations between the therapeutic effect of a drug and it's plasma concentrations. Clinical implications of the above points are as follows: adjustment and prediction of dosages; definition of rational precepts of prescription; definition of principles for monitoring treatment. These implications are exemplified by clinical cases reported in the medical literature or seen in the department of psychiatry at the university hospital in Besançon.

Biological Availability↗

[Abuse of tianeptine. A case report].

The authors report a case of tianeptine abuse in a 30 year-old woman. After a medical prescription of the recommended dosage of 12.5 mg 3 times daily of oral tianeptine for a depressive illness, the patient spontaneously increased the dosage which after two months reached 150 tablets per day. No severe toxic effects were observed. As adverse effects, the patient, in the beginning of this high treatment period suffered from nausea, vomiting, abdominal pain, anorexia with weight loss, constipation. These side effects progressively disappeared. The biological tolerance was excellent, and hepatic parameters were not affected. The patient experienced and seek a psychostimulant effect. After seven months of such a therapy, she was hospitalized to undergo a withdrawal. The discontinuation of the tianeptine treatment occurs in four days. A withdrawal syndrome marked by myalgia, and cold feeling was transient, and alleviated by sedative phenothiazine (cyamemazine) and myorelaxant benzodiazepine (tetrazepam).

Adult↗

Drug extrapyramidal side-effects or not: is there a dextromethorphan phenotype difference?

A recent hypothesis suggests the possible role of cytochrome P450 2D6 (CYP2D6) polymorphism (involved in the metabolism of a large number of drugs), as a potential risk factor for the development of extrapyramidal side-effects of psychotropic drugs. The CYP2D6 metabolizer phenotype (dextromethorphan test) of 31 drug treated psychiatric adult patients suffering from extrapyramidal side-effects (group 1) and of 31 matched patients without drug side effects (group 2) were compared. In the first group, 13 poor metabolizer patients (41.9 per cent) were found, characterized by a dextromethorphan metabolic ratio > 0.3, and only two patients in the second group (6.4 per cent). These data provide some support for the notion that in subjects in whom CYP2D6 is probably saturated, the risk of drug extrapyramidal side-effects may be increased. In such patients the choice of psychotropic drugs 'without' this risk must be preferred.

Adolescent↗

[Consumption of benzodiazepines in a university hospital center].

Benzodiazepine consumption has been studied in an inpatient population of a hospitalo-universitary center. The different user wards were classified by their cost or the importance of their benzodiazepine use. In a second step, the authors studied the prescription in the 6 most consumer medical wards. The most prescribed benzodiazepines were lorazepam and dipotassium clorazepate (27 and 23% respectively). In these six wards, on the day of the study, 48% of the 227 inpatients were taking benzodiazepines. Fourteen out of them were taking more than one of these drugs. In 80% of the cases, the patient was asking for the prescription. Out of the 110 inpatients found to have taken a benzodiazepine on the day of the study, 74 had already regularly used it during the years before hospital admission, mainly women (64%) and old people. Finally, out of the 227 inpatients studied, the hospitalization is a possible inducer of the benzodiazepine intake and dependence in 16% of the patients. The results are discussed against the background of other studies concerning benzodiazepine consumption.

Adult↗

[Dexamethasone test: suppressors and non-suppressors, what's the difference?].

In sixty-six depressed in-patients, 20 of them showed marked resistance to suppression after dexamethasone. The authors found no difference between the two subgroups of suppressors and non suppressors, when considering the following parameters: age, sex, duration of illness, number of prior episodes, family history, intensity of depression, response to antidepressant treatment, relapses, diagnoses. Furthermore the normalization of DST after a 28 day treatment did not systematically correlate with a good clinical improvement.

Amitriptyline↗