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D L Dunner

Publications and source records attributed to D L Dunner.

At least 127 records · Page 7Linked to original sources

The relationship of the lithium erythrocyte: plasma ratio to plasma lithium level.

The relationship of the lithium erythrocyte:plasma ratio to plasma lithium concentration was reviewed in inpatients and outpatients with affective disorders. For some patients, there was a linear correlation between the erythrocyte lithium:plasma lithium ratio and the plasma lithium concentration. For these patients a graph of the slopes and intercepts of the lithium erythrocyte:plasma ratio vs. plasma lithium data formed a line that was not significantly different from the data of Lee et al. (1975). Significant correlations were found between the slopes and intercepts of the lithium erythrocyte:plasma ratio vs. plasma lithium data and the magnitude of active lithium efflux (Ko) from the erythrocyte. Our data confirm the finding of Lee et al. (1975) that the lithium erythrocyte:plasma ratio is dependent on the plasma lithium concentration. We relate this finding to lithium efflux from the erythrocyte.

Adult↗

Life events at the onset of bipolar affective illness.

The authors assessed the occurrence of stressful life events before the initial or subsequent episodes of affective illness in a group of 79 bipolar I manic-depressive patients who were attending a lithium clinic. About half of the patients recalled a life event in the 3-month interval before their initial episode; postpartum onset was prominent among these events. Few patients recalled life events for subsequent episodes. Finally, history data did not differentiate patients who recalled life events and those who did not. These data may be useful in assessing environmental antecedents of populations at risk for bipolar illness.

Adult↗

Bipolar illness: factors in drinking behavior.

Alcohol use and abuse was investigated in 73 patients with bipolar I manic-depressive illness who were attending a lithium clinic. Alcohol-related problems were identified in 7 of the male and none of the female patients. Family data revealed a higher morbid risk for alcoholism among relatives of patients with drinking problems than among relatives of patients without drinking problems. Morbid risks for affective disorder for these two groups of relatives were similar, suggesting that alcoholism among relatives of patients with bipolar illness is not solely "genotypically" related to the affective disorder.

Adult↗

Life events and primary affective illness.

Life events at the onset of primary affective illness were assessed in 183 patients with primary affective disorder who were attending a research lithium clinic. About 50% of patients recalled significant life events in the 3-month interval preceding their initial affective episode. Family history data of those patients who reported life events were not significantly different from those who did not report life events at onset. Furthermore, there were no significant differences among patients classified as bipolar or unipolar regarding reporting of life events at onset of illness. These data suggest that the delineation of a subgroup of patients with "reactive" primary affective illness is not supported by a decreased familial load for affective disorder in their relatives.

Adult↗

Clinical correlates of the lithium pump.

The active efflux of lithium from erythrocytes, expressed as the rate constant ko, was studied in patients with primary affective disorder and in controls. The authors' data suggest that ko is stable within individuals over time, is inhibited during treatment with lithium carbonate, and may be a good index of lithium toxicity. ko correlates significantly with the lithium erythrocyte/plasma ratio but is seemingly not related to age, sex, or affective disease subtype. Preliminary data suggest that ko may be determined, at least in part, by a genetic factor.

Affective Symptoms↗

Repression of a lithium pump as a consequence of lithium ingestion by manic-depressive subjects.

The lithium pump in human erythrocyte membranes, which is responsible for extrusion of lithium against a concentration gradient, has been found to be reversibly repressed during periods of lithium carbonate administration. The pump activity of patients prior to lithium therapy is not different from controls. The onset of repression may require several days to several weeks and occurs at specific individual threshold levels of lithium carbonate dosage. Reactivation of the lithium pump occurs sometime after the dosage is discontinued. We postulate that repression of the lithium pump results from systemically available factors which alter membrane structure, and suggest that is such changes also occur in the central nervous system, they may provide insight into one means by which lithium produces its psychotropic affects.

Adult↗

The effect of L-tryptophan administration on the concentration of probenecid in plasma and cerebrospinal fluid in patients.

The administration of large doses of probenecid has been used to study the central nervous system metabolism of catecholamines and indoleamines in patients with affective disease. It has been reported that alterations of the binding of L-tryptophan to plasma albumin binding sites occur during probenecid administration. The present study sought to determine if the administration of large doses of L-tryptophan affected probenecid concentrations in cerebrospinal fluid and/or plasma. The data indicate that during L-tryptophan treatment, plasma probenecid concentrations are reduced but that no significant alterations in cerebrospinal fluid probenecid concentrations occur. This would suggest that the kinetics of the probenecid blockade of transport of acidic biogenic amine metabolites out of cerebrospinal fluid are not altered by L-tryptophan loading.

Adult↗

Prostaglandins. A review of neurophysiology and psychiatric implications.

This article reviews the function of prostaglandins (PGs) in the nervous system and discusses the possible alterations in PG metabolism as relating to mental illness. The PGs are a unique group of cyclic fatty acids whose immediate precursors are thought to function postsynaptically by inhibition or facillitation of neurotransmission through cyclase inhibition or activation, and by means of a negative feedback loop to inhibit further release of neurotransmitter from the presynaptic nerve. A review of PGs in psychiatric conditions is presented as well as a discussion of the interaction of psychoactive drugs with the PGs. The concluding section of this review discusses possible future strategies to provide insight into PG physiology as it relates to synaptic transmission in normal and pathological conditions in man.

Central Nervous System↗

Erythrocyte catechol-o-methyltransferase activity in primary affective disorder.

Previous studies have suggested that the activity of erythrocyte catechol-O-methyltransferase (COMT) may be reduced in women with bipolar and particularly unipolar affective illness. More recently, increased COMT activity in both men and women with affective disorder was reported. The activity of COMT in erythrocytes was determined in 184 outpatients with primary affective disorder at the Lithium Clinic of the New York State Psychiatric Institute. COMT activity was determined by a modification of the Axelrod and Cohn method with dopamine as substrate. This change resulted in an apparent threefold increase in the values for COMT activity; however, when both methods were compared, the results correlated (r = 0.97, p less than 0.001, N = 37). We found that the values for women were not significantly lower than those for men. In addition, there was no difference between patients with affective disorder and controls. Further, no difference was demonstrated between patients diagnosed as bipolar or uni-polar. Parameters such as mood, medication, and inpatient or outpatient status had no effect on COMT activity. The results of previous studies are discussed in an attempt to reconcile the different results.

Adult↗

Prostaglandin F in patients with primary affective disorder.

Two aspects of prostaglandin F (PGF) metabolism were assessed in patients with primary affective disorder. For a group of hospitalized patients cerebrospinal fluid PGF was measured by radioimmunoassay and the effects of probenecid and L-tryptophan were determined. For outpatients attending our Lithium Clinic, plasma PGF was measured and the acute and chronic effects of lithium were determined. The results of the studies reveal apparently normal concentrations of PGF in cerebrospinal fluid. These concentrations increase twofold after probenecid, indicating that PGF is transported out of the central nervous system by a probenecid-sensitive active transport system. Evidence for inhibition of PGF synthesis during L-tryptophan treatment was found. The results for outpatient plasma studies suggest no effect on PGF with 12 weeks of lithium treatment, although a slight elevation of plasma PGF with chronic lithium treatment may occur. Specificity of the assay technique as applied to plasma is discussed. This is the first report of the direct measurement of PGF in a psychiatric disorder.

Adult↗