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Biomedical subjects

D S Janowsky

Publications and source records attributed to D S Janowsky.

At least 127 records · Page 7Linked to original sources
PubMed1981

Effects of anesthesia on patients taking psychotropic drugs.

Psychotropic drugs, often given in combination with each other or with other nonpsychiatric drugs, generally exert profound effects on central and peripheral neurotransmitter and ionic mechanisms. Hence, prior intake of these drugs is an important consideration in the management of the patient about to undergo anesthesia and surgery. This article reviews the effects of anesthetics on patients taking antipsychotics, tricyclic antidepressants, monoamine oxidase inhibitors, and lithium carbonate.

Anesthesia↗
PubMed1981

Indications and guidelines for plasma tricyclic antidepressant concentration monitoring.

Some tricyclic antidepressants appear to have critical ranges of plasma tricyclic antidepressant concentrations necessary for optimal clinical efficacy. For any given dose of tricyclic medication, there are marked interindividual variations in steady-state tricyclic concentrations. Furthermore, plasma tricyclic concentrations may be influenced by factors such as weight, diet, smoking status, differences in bioequivalence among manufacturers, and the addition or withdrawal of concurrent medications. There has been considerable controversy in the literature about the clinical utility of plasma tricyclic level monitoring. These authors believe that, at present, routine plasma level monitoring probably is not warranted, but that there are a variety of instances where plasma tricyclic concentration determinations may be clinically useful. The authors review methodological issues in plasma tricyclic concentration determinations and suggest guidelines for when such determinations may be clinically appropriate.

Antidepressive Agents, Tricyclic↗
PubMed1981

Use of dexamethasone suppression test in clinical psychiatry.

The dexamethasone suppression test (DST) has been used in clinical medicine to evaluate overactivity of the hypothalamic-pituitary-adrenal (HPA) axis. Consistent evidence has linked a specific dysfunction of the HPA axis to depressive illness. This article will review the physiology of the HPA axis and the method of the DST. After a critical review of the studies using the DST in psychiatric patients, the authors conclude that the overnight low dose DST can be a useful tool for the practitioner involved in the diagnosis and treatment of psychiatric illness.

Depression↗
PubMed1981

Cholinergic challenges in affective illness: behavioral and neuroendocrine correlates.

The cholinergic-adrenergic balance hypothesis of affective disorders suggests that, in the areas of the brain that regulate mood, depression may represent a relative predominance of central cholinergic tone over adrenergic tone and that mania may represent the converse. Currently, converging lines of investigation from a number of independent groups suggest that affective disorder patients may have a central cholinergic receptor hypersensitivity that induces a vulnerability to affective and neuroendocrine disturbances. This article reviews the evidence for cholinergic mechanisms in the regulation of affective state and describes current research strategies using centrally active cholinomimetic agents to explore disturbances in affective disorder subjects.

Clinical Trials as Topic↗
PubMed1981

Impaired speed of visual information processing in marijuana intoxication.

The authors conducted a double-blind crossover study to investigate the effects of marijuana on visual information processing. The authors used a tachistoscopic paradigm, and the results show no marijuana effect on the critical stimulus duration, a measure of stimulus intake. The visual backward masking data are compatible with a marijuana-induced slowness of information processing from labile unconscious iconic memory to more permanent memory processes. These results are discussed in relation to reports of marijuana's effects on perception and early information processing.

Adult↗
PubMed1981

Interfaces of psychopharmacology and cardiology--part one.

At least 10% of the American population medically use prescribed psychopharmacological medications; and such psychotropic medications account for approximately 20% of all prescriptions in this country. Furthermore, there is widespread illicit use of psychoactive drugs, including narcotics, psychostimulants, and central nervous system depressants. All of these agents have potent effects on the cardiovascular system and, in addition, may undergo numerous drug-drug interactions with cardiovascular medications. Given the high incidence of both cardiovascular disease and psychoactive drug use in the United States, it is likely that clinicians manage many patients with cardiovascular disease, possible receiving cardiovascular medications, and also needing psychopharmacological interventions. Consequently, the authors have reviewed the pharmacology of the major classes of psychoactive agents: (I & II) Antidepressants (tricyclic antidepressants and monoamine oxidase inhibitors); (III) Lithium Carbonate; (IV) Major Tranquilizers (phenothiazines, thioxanthines, butyrophenones, reserpine); and (V) Minor tranquilizers, Sedatives, and Hypnotics (benzodiazepines and barbiturates) with respect to their cardiotoxicity, cardiovascular side effects, and drug-drug interactions. Management of the cardiovascular complications of psychotropic overdose is discussed, as well as potential therapeutic uses of psychopharmacological medications in patients with cardiovascular pathology.

Analgesics, Opioid↗
PubMed1981

Interfaces of psychopharmacology and cardiology--Part two.

At least 10% of the American population medically use prescribed psychopharmacological medications; and such psychotropic medications account for approximately 20% of all prescriptions in this country. Furthermore, there is widespread illicit use of psychoactive drugs, including narcotics, psychostimulants, and central nervous system depressants. All of these agents have potent effects on the cardiovascular system and, in addition, may undergo numerous drug-drug interactions with cardiovascular medications. Givaen the high incidence of both cardiovascular disease and psychoactive drug use in the United States, it is likely that clinicians manage many patients with cardiovascular disease, possibly receiving cardiovascular medications, and also needing psychopharmacological interventions. Consequently, the authors have reviewed the pharmacology of the major classes of psychoactive agents: (I & II) Antidepressants (tricyclic antidepressants and monoamine oxidase inhibitors); (III) Lithium Carbonate; (IV) Major Tranquilizers (phenothiazines, thioxanthenes, butryophenones, reserpine); and (V) Minor Tranquilizers, Sedatives, and Hypnotics (benzodiazepines and barbiturates) with respect to their cardiotoxicity, cardiovascular side effects, and drug-drug interactions. Management of the cardiovascular complications of psychotropic overdose is discussed, as well as potential therapeutic uses of psychopharmacological medications in patients with cardiovascular pathology.

Adrenergic alpha-Antagonists↗
PubMed1980

Mood and behavioral effects of physostigmine on humans are accompanied by elevations in plasma beta-endorphin and cortisol.

Administration of physostigmine to normal volunteers produced significant elevations in plasma cortisol and beta-endorphin immunoreactivity as well as alterations in mood, cognition, and behavior. These observations might be explained by a cholinergically mediated stress syndrome. However, peak elevations in plasma beta-endorphin immunoreactivity (but not in plasma cortisol) were significantly correlated with physostigmine-induced increases in depression ratings. These results suggest that a cholinergically mediated beta-endorphin pathway may be involved in the observed affective changes.

Behavior↗
PubMed1980

Naloxone-induced behavioral and physiological effects in normal and manic subjects.

Intravenous naloxone hydrochloride (20 mg) was administered to eight normal control subjects and 12 affective disorder patients manifesting manic or hypomanic symptoms. On two consecutive days, in a counterbalanced order, naloxone and placebo were given in a double-blind crossover design. The overall effect of naloxone was to decrease pulse rate and to promote lethargy and inactivation. The normal controls manifested reduced feelings of well-being, and the manic patients noted a subjective sense of slowing. There was a variable response pattern to naloxone in the manic patients in which four of the 12 patients manifested an observable reduction in their manic symptoms and behavior after the naloxone administration. Naloxone seems to have had a nonspecific subduing effect in both normal subjects and patients and may also have had a selectively greater effect in a small subsample of the manics.

Adult↗
PubMed1980

The effects of naloxone on methylphenidate-induced mood and behavioral changes: a negative study.

The effects of naloxone on IV methylphenidate-induced mood, behavior, and neurohumoral changes were assessed in eight psychiatric inpatients. While methylphenidate alone produced anticipated changes, the indications for significant naloxone-methylphenidate interactions were minimal. It is speculated that larger doses of naloxone might be required to produce modification of the psychostimulant effects.

Behavior↗
PubMed1980

Effects of lithium carbonate on memory and other cognitive functions.

The authors studied the effects of lithium carbonate on memory and cognitive function in 16 psychiatric patients, who received lithium for 2 weeks and placebo for 2 weeks in a double-blind cross-over design. At the end of each treatment phase, subjects were administered a battery of memory and cognitive tests. As reported previously, lithium induced slowing of performance on certain of the perceptual motor tests; however, lithium did not cause memory impairment or a change in self-assessment of memory functions.

Adult↗
PubMed1979

Lithium administration antagonizes cholinergic behavioral effects in rodents.

Physostigmine, a centrally acting cholinesterase inhibitor, antagonizes methylphenidate-induced stereotyped gnawing behavior in mice and rats. This effect is significantly attenuated when lithium chloride is concurrently administered, indicating that lithium chloride may antagonize central cholinergic activity. This observation may have theoretical implications for an adrenergic-cholinergic balance hypothesis of affective disorders.

Animals↗