Search PubMed⌕ Search

Biomedical subjects

D R Sweeney

Publications and source records attributed to D R Sweeney.

At least 127 records · Page 7Linked to original sources
PubMed1979

Exacerbation of psychosis by tricyclic antidepressants in delusional depression.

The authors describe three patients with delusional unipolar depression whose delusional thinking worsened markedly following administration of tricyclic antidepressant drugs. The patients had met Research Diagnostic Criteria for major depressive episode and had no evidence of schizophrenia or mania. Since tricyclic antidepressants are known to exacerbate psychosis in schizophrenic patients, it is sometimes suggested that the exacerbation of psychotic thinking in depressed patients indicates schizophrenia. The authors suggest that such an exacerbation does not in itself indicate schizophrenia but may occur in patients with an affective disorder who are prone to depressive delusions. The authors discuss the use of antipsychotic medication in this patient group and present a neurochemical hypothesis to explain the interaction of the drug with the illness, which results in exacerbation of psychotic thinking.

Antidepressive Agents, Tricyclic↗
PubMed1978

Primary affective disorder, clinical state change, and MHPG excretion: a longitudinal study.

Urinary 3-methoxy-4-hydroxyphenethylene glycol (MHPG) excretion, which is thought to reflect CNS norepinephrine metabolism, has been shown to be significantly decreased in some depressed patients. Although there is consensus that urinary MHPG excretion varies directly with mood in rapidly cycling bipolar patients, there is little information on longer term state changes, such as those that accompany recovery from depression. Ten female patients with diagnoses of primary affective disorder were studied initially during an inpatient hospitalization and restudied at least ten months after discharge. Five healthy female comparison subjects were also studied over a similar interval of time. During the baseline period, the patient sample excreted less MHPG than did the comparison group. Improvement in clinical state from a seriously depressed baseline was associated with a significant increase in MHPG excretion, while the patients with recurrences of depression showed no change and continued to excrete less MHPG than the comparison subjects. These results suggest that urinary MHPG excretion may represent an index of psychobiological state in depressive patients.

Adult↗
PubMed1978

State anxiety, physical activity, and urinary 3-methoxy-4-hydroxyphenethylene glycol excretion.

Measurement of urinary 3-methoxy-4-hydroxyphenethylene glycol (MHPG) levels has been suggested as possibly being important in elucidating the role of central noradrenergic function in affective illnesses. The influence on urinary MHPG excretion of the state variables of physical activity and stress has not been clearly defined in previous studies. During a baseline medication-free period, 24 hospitalized depressed female patients underwent a five-day protocol including an eight-hour period of either enhanced or restricted activity. Throughout the protocol, independent measurements of telemetered mobility and stale anxiety were obtained. There were no significant effects of physical activity on urinary MHPG levels. Furthermore, baseline urinary MHPG levels and baseline state anxiety did not covary significantly. However, within-individual analyses yielded a highly significant relationship between changes in urinary MHPG levels and changes in state anxiety. The data suggested that those patients with lower baseline MHPG levels were those more prone to experience increased anxiety under environmentally "activating" circumstances.

Adult↗
PubMed1978

Perphenazine-induced systemic lupus erythematosus-like syndrome.

A small number of cases have been presented in the world literature in which treatment with phenothiazines resulted in clinical and laboratory manifestations of systemic lupus erythematosus (SLE). The clinical picture of such patients tends to be "symptom poor". A 26-year-old patient is presented who had a 7-year history of treatment for a schizophrenic illness and developed clinical as well as laboratory evidence for SLE. The differential diagnosis included: a) phenothiazine-induced SLE; b) SLE presenting with psychosis as a symptom; and c) SLE and sychosis occurring independently. The patient had a complete medical and neuropsychiatric work-up and was followed for 12 months. This challenging diagnostic problem is discussed. Phenothiazine-induced SLE was the most likely diagnosis. Although the possibility of two diseases occurring independently in the same person did not explain the clinical and laboratory data, it is difficult to rule out this possibility completely. SLE presenting with psychosis as a symptom could be ruled out by the work-up and history.

Adult↗
PubMed1978

Dissociation of self-reported and observed pleasure in depression.

Anhedonia, or the inability to experience pleasure, is an important component of depressive symptomatology. Observer ratings of positive affect and self-ratings of pleasurable experience were collected from ten depressed inpatients and ten ward staff members during the patients' base-line, medication-free period. Depressives were observed to display significantly lower degrees of positive affect than the normal group, but they reported significantly higher degrees of experienced pleasure. The normal group displayed positive affective behavior that was consistent with self-reported data. Thus, normal subjects showed synchronous, or associated self-reported and observed activity, whereas depressives appeared to be dissociated along those same dimensions. A dissociation also appeared in self-reports of positive versus negative mood states, suggesting the existence of a malfunction in these normally inhibitory affective mechanisms.

Depression↗
PubMed1978

Urinary 3-methoxy-4-hydroxyphenylglycol and psychiatric diagnosis.

The authors examined the quantities of 3-methoxy-4-hydroxyphenylglycol (MHPG) in the urine of 11 schizophrenic female patients, 14 primary affective disorder (depressed type) female patients, and 10 healthy comparison women. The primary affective disorder patients had significantly less MHPG in their urine than did the comparison subjects. The schizophrenic patients when compared with the healthy subjects or the depressed patients did not excrete significantly different amounts of MHPG in urine. The variance in MHPG in schizophrenic patients was quite large; some had very low urinary MHPG. There was a significant positive correlation between agitation and urinary MHPG for schizophrenic but not depressed patients. The authors discuss theoretical and practical implications of these findings.

Adult↗
PubMedDate not supplied

Ecstacy: a review of MDMA and MDA.

The Drug Enforcement Administration classified the drug methylenedioxymethamphetamine, MDMA, also known as Ecstacy, as a Schedule I controlled substance on July 1, 1985. The controversy surrounding the classification of MDMA is related to the question of its efficacy as an adjunct to psychotherapy and the larger issue of how to regulate the production and use of designer drugs. The authors review the literature on MDMA and its predecessor, MDA, a substance that differs from MDMA by one methyl group.

3,4-Methylenedioxyamphetamine↗
PubMedDate not supplied

Bromocriptine treatment for cocaine abuse: the dopamine depletion hypothesis.

The authors review the evidence that cocaine exerts its rewarding effects through the acute activation of dopamine (DA) pathways in the brain. Chronic cocaine administration is hypothesized to lead to DA depletion, which results in cocaine craving and cocaine abstinence states. Treatment of these states with bromocriptine, a DA/antagonist, appears to have efficacy with acute and maintenance trials, and may represent a new adjunctive treatment for cocaine abuse. DA antagonists appear to exacerbate cocaine craving, which is consistent with the DA depletion hypothesis of chronic cocaine abuse. Theoretical issues relating to drug addiction and endogenous reward centers are discussed.

Adolescent↗
PubMedDate not supplied

Cortisol secretion and urinary MHPG in unipolar depression.

The authors examined the relationship between both pre-dexamethasone 8:00 AM serum cortisol level and the dexamethasone suppression test (DST) with urinary 3-methoxy-4-hydroxyphenyl glycol (MHPG) excretion in a group of fifteen men and fourteen women with unipolar depression. No significant difference was found between the mean MHPG excretion for either male or female DST suppressors or non-suppressors. No significant correlation was found between the pre-dexamethasone 8:00 AM serum cortisol level and urinary MHPG. These results do not support the hypothesis that DST non-suppression in depression is related to central noradrenergic deficiency.

Adult↗
PubMedDate not supplied

Plasma levels of tricyclic antidepressants in panic disorder.

Five patients with panic disorder were placed on low doses of imipramine. All patients had shown dramatic improvement after three weeks of treatment, when plasma levels of imipramine and desipramine were measured. Plasma levels corresponded to the low doses being administered. This result implies that the mechanism of action of tricyclic antidepressants is different in patients with panic disorder than in patients with depressive disorder.

Adult↗
PubMedDate not supplied

Multifocal neurological impairment caused by infection-induced rise in blood lithium and amitriptyline.

We present the case of a thirty-eight-year-old woman who developed a febrile illness which was associated with a rise of blood lithium and amitriptyline, and subsequently suffered permanent neurological impairment, implicating CNS dysfunction at several levels. Medical, laboratory, radiological and neuropsychological findings are described, and the attribution of the syndrome is discussed. It is crucial to emphasize that the authors are not challenging the frequently useful combination of lithium and antidepressants. Rather, we urge psychiatrists to be vigilant when such patients develop febrile illnesses.

Adult↗