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Biomedical subjects

C P O'Brien

Publications and source records attributed to C P O'Brien.

At least 235 records · Page 13Linked to original sources

Plasma testosterone level and sexual behavior of couples.

Eleven couples, ages 21-31 years and married for at least 1 year, were studied intensively over a three menstrual cycle period from both an endocrine and a sexual behavioral standpoint. Each subject was interviewed individually and had a blood sample drawn twice weekly. Interviews were rated independently by two psychiatrists for degree of sexual initiation, responsivity, avoidance, couple interaction, and mood. Wives rated themselves also for degree of sexual gratification (responsivity). Plasma levels of testosterone and cortisol were determined for both husbands and wives while progesterone and estradiol levels were determined additionally for wives. Husband's initiation scores were significantly correlated with their wives responsivity (clinically rated) scores for 10 of the 11 couples; wives' initiation scores were significantly related to their husband's responsivity scores for 8 of the 11 couples. When either set of correlation coefficients was treated as a new variable and intercorrelated with the husband's average testosterone levels, a significant relationship was obtained. Intercourse frequency, while not related to either partner's average testosterone levels, was related to wives' testosterone levels at their ovulatory peaks. The wivess' self-rated gratification scores correlated significantly with their own plasma testosterone levels. Inspection of each wife's plasma testosterone profile across the three cycles indicated that a dichotomy coccurred, with some women showing a high baseline level and others showing a low baseline level. When wives were dichotomized on this basis, it was found that high baseline testosterone level was significantly related to high self-rated gratification score and to ability to form good interpersonal relationships.

Adrenal Cortex↗

Clinical pharmacology of narcotic antagonists.

Both naloxone and naltrexone are effective narcotic antagonists with minimal agonistic effects and a wide margin of safety. Naloxone is useful in the treatment of narcotic overdose and it is helpful in the quantification of physical dependence. Naltrexone is pharmacologically successful as an orally effective, long-acting antagonist but its clinical usefulness in the prevention of relapse is still being determined.

Animals↗

Multimodality treatment of narcotic addiction: an overview.

In closing, it seems important to add that, when viewed longitudinally, addiction resembles a chronic medical disease. Rehabilitaiton may take several years and improvement rather than cure may be the most reasonable goal. Disappointment at the lack of success in finding an effective cure is common, but a relapsing and remitting course does not necessarily imply failure. Return to treatment may signal continuing efforts and progression toward abstinence. Improvement in current techniques may make remissions longer and relapses shorter. Current work on endogenous opiates (endorphins) may lead to tests which will identify those patients who can achieve drug-free status and those who can function only when maintenance opiates are applied.

Ambulatory Care↗

Update of naltrexone treatment.

To summarize, then, our work with naltrexone in a multi-modality treatment program indicates that it appeals to about 5-10 percent of narcotic addicts--those who conciously want to obtain drug-free status. It does significantly attentuate the effect of narcotics to the extent that they lose their reinforcing properties, and it has minimal side effects. Although we treated a self-selected population, it is noteworthy that about 10 percent of those who remained on naltrexone for more than a week were still opiate free 6 months after cessation of treatment. For some it appeared to be a turning point in their lives. It was the first time in years that they could live in their neighborhood and not be either intoxicated or occupied with the pursuit of narcotics. Our behavioral studies have identified a number of conditioned psychophysiological responses associated with the self-injection ritual. So far, although we have succeeded in extinguishing some of these responses, this has not resulted in an improved clinical outcome. We are currently working on more comprehensive behavioral treatments, but the clinical significance of these conditioned responses is uncertain at present.

Adult↗

Conditioned narcotic withdrawal in humans.

Subjective and physiological manifestations of the narcotic withdrawal syndrome were produced as a conditioned response. Withdrawal reactions precipitated by the narcotic antagonist naloxone in methadone-dependent volunteers were the unconditioned response. These data support clinical anecdotes of withdrawal symptoms occurring in former addicts when they return to their drug-related environment.

Adult↗

Depression in veterans two years after Viet Nam.

The authors evaluated the incidence of depression in a sample of 202 Viet Nam veterans an average of 28 months after their return from Viet Nam. Approximately one-third of the sample fell within the clinically depressed range of the Beck Depression Inventory. Comparison of the depressed and nondepressed groups indicated that the former had higher frequencies of drug abuse (particularly while in Viet Nam), more marital difficulties, a higher unemployment rate, and more current legal problems. This high incidence of depression, coupled with the finding that few of these men were being treated for the illness, indicates the need for an outreach approach to this population.

Adult↗

The effect of alcohol and smoking on testosterone function and aggression in chronic alcoholics.

Forty alcoholics without other significant medical or psychiatric problems were studied on a research ward for two weeks. All subjects abstained from alcohol and cigarettes during the first week; 30 randomly selected subjects were permitted unlimited alcohol and/or cigarettes during the second week. Plasma testosterone levels were normal during the first week but decreased rapidly and significantly in those subjects allowed alcohol. A variety of measures of affect failed to show a significant correlation between hostility/aggression and plasma testosterone levels or alcohol ingestion.

Adult↗

Conditioning of narcotic abstinence symptoms in human subjects.

Clinical evidence suggests the possibility of conditioning of narcotic abstinence symptoms. Addicts report subjective and objective signs of withdrawal/craving when exposed to certain stimuli. This may partially explain the high rate of relapse to drug seeking behavior when treated addicts return to their home environment. Conditioning of narcotic abstinence symptoms was produced experimentally in five of eight volunteer subjects. Brief naloxone precipitated abstinence was the unconditioned response. The conditioned stimulus was a tone and odor. After an average of seven training trials, the tone and odor produced a conditioned abstinence response. The conditioned response consisted of subjective components (feelings of sickness, nausea, cramps, craving) and objective components (yawning, tearing, rhinorrhea, irregular respiration and transiently increased blood pressure). These laboratory findings support the anecdotal evidence regarding the existence of conditioned abstinence phenomena.

Acoustic Stimulation↗

Depression and anxiety in heroin addicts: a placebo-controlled study of doxepin in combination with methadone.

Narcotic addicts may manifest symptoms of depression that aggravate their addiction. In this double-blind study of 35 mildly depressed patients in a methadone maintenance program, subjects who received doxepin improved significantly more than control subjects. Even in this short-term study, the reduction in depression was associated with a trend toward better performance in other areas of rehabilitation.

Administration, Oral↗

Double-blind detoxification of methadone maintenance patients.

Twenty-four methadone maintenance patients were assigned to (1) decreasing dose (N = 12) or (2) continued methadone maintenance (N = 12), matching for dose, initial complaint levels, and counselor. After 14 weeks most patients in both groups had terminated from the study. Detoxifying patients usually terminated by obtaining a dose increase or dropping out; maintenance patients usually terminated for external reasons. Prior to terminating, detoxifying patients reported increased withdrawal complaints but no awareness doses had decreased. Termination was not directly related to dose level or percentage decrease. In both groups, terminators were likely to have been high in complaints during the baseline period.

Administration, Oral↗