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Biomedical subjects

F K Judd

Publications and source records attributed to F K Judd.

At least 37 records · Page 2Linked to original sources
PubMed1995

Platelet [3H]paroxetine binding in panic disorder.

Platelet [3H]paroxetine binding was measured in 20 patients (14 females, six males) with panic disorder and 20 normal controls (14 females, six males). For patients with panic disorder, Bmax was 1987 +/- 1135 fmol/mg protein (mean +/- SD) compared with control Bmax values of 1626 +/- 611 fmol/mg protein. The mean Kd value for the patients was 0.076 +/- 0.056 nM and for the controls was 0.083 +/- 0.033 nM. ANCOVA indicated no significant effect of sex, diagnosis (panic disorder vs. normal controls) or season of sampling on either Kd or Bmax. The data provide no evidence for an abnormality of the platelet uptake mechanism in panic disorder.

Adult↗
PubMed1995

Fluoxetine treatment of depressed patients with HIV infection.

OBJECTIVE: The aim of this paper is to describe the outcome of fluoxetine treatment of depressed patients with HIV infection. METHOD: An open study was made of 20 patients with varying stages of HIV infection treated for depression with fluoxetine. RESULTS: 15 of 20 patients improved with fluoxetine treatment; the drug was generally well tolerated, with no significant drug-drug interactions. CONCLUSIONS: Fluoxetine appears to be effective for the treatment of depression in patients with HIV infection.

Adjustment Disorders↗
PubMed1994

Serotonergic function in panic disorder: endocrine responses to D-fenfluramine.

1. Prolactin and cortisol responses to d-fenfluramine were measured in 16 patients with DSM-III-R panic disorder and 14 normal controls. 2. Patients showed a greater mean prolactin response than controls but the difference between groups was not statistically significant (P > 0.05, MANOVA). 3. No consistent differences were observed between patients and controls with respect to cortisol responses (P > 0.05, MANOVA). 4. The results do not support the hypothesis of hypersensitive post-synaptic serotonin receptors in patients with panic disorder. 5. Studies in larger groups are necessary to confirm the trend and to explore receptor subtype sensitivity.

Adult↗
PubMed1994

Depression in patients with HIV and AIDS.

In this paper we review studies of depression in patients with HIV/AIDS. Methodological issues of importance in understanding and evaluating depression in this patient population are described, and methodological variations between studies, particularly in reference to methods of case detection, diagnostic criteria used and characteristics of the populations studied, are identified. The findings reported in the current literature in general are contrary to what would be expected from an examination of the significant biological and psychosocial stresses of individuals with HIV, and are inconsistent with those of other life-threatening illnesses and CNS diseases. Clear conclusions regarding the prevalence of depression and its effect in patients with HIV/AIDS cannot yet be made.

AIDS Dementia Complex↗
PubMed1994

Neuroendocrine responses to single doses of buspirone in obsessive-compulsive disorder.

Prolactin and cortisol responses to buspirone, a partial serotonin agonist with effects on the 5-HT1A receptor, were measured in 16 patients with DSM-III-R obsessive-compulsive disorder (OCD) and 16 normal controls. No consistent differences were observed between patients and controls with respect to the hormone responses measured. The results suggest that dysfunction of the 5-HT1A receptor is not present in OCD patients. The limitations of buspirone as a specific agonist challenge of the 5-HT1A receptor are discussed. Although data from other studies generally support a serotonin dysfunction in OCD, the question of which specific subtype(s) of receptor remains unanswered.

Adult↗
PubMed1994

Definition and differential diagnosis of treatment-resistant depression.

There are no agreed criteria for treatment-resistant depression, but the failure to respond adequately to two successive courses of monotherapy with pharmacologically different antidepressants, given in an adequate dose for sufficient time is one pragmatic definition. Inherent within this definition are notions of what constitutes an adequate dose of drug, the length of treatment and pharmacological specificity of treatments. When these factors are accounted for, treatment resistance may be encountered in 15-20% of patients. In attempting to treat such patients a number of pharmacological strategies have been adopted and some are briefly reviewed. Psychosurgery may have a role to play in cases of absolute treatment resistance.

Antidepressive Agents↗
PubMed1994

Isoniazid and antidepressants: is there cause for concern?

The antituberculous drug isoniazid has weak monoamine oxidase inhibiting properties. Drug and dietary restrictions generally applied to the use of monoamine oxidase inhibitors (MAOI) have not been routinely recommended with its use. Here we report three cases in which antidepressant drugs and isoniazid were co-administered. In two, adverse events, possibly due to an interaction between the drugs prescribed are described. We suggest that the combination of isoniazid and antidepressants be used with caution until further data are accumulated.

Adult↗
PubMed1993

Long-term drug treatment of panic disorder.

Drug treatment of panic disorder with benzodiazepines and antidepressants has been established as efficacious in the short-term (6-8 weeks). The efficacy of medications during long-term (i.e., continuous) treatment has not often been addressed and a review of the evidence is presented. Most data exists for the long-term effectiveness of benzodiazepines. Experience with the triazolobenzodiazepine, alprazolam, is reviewed together with some other high potency drugs, e.g., clonazepam. Tricyclic antidepressants are also effective in the long-term treatment of panic and the relevant studies are presented. Long-term efficacy for monoamine oxidase inhibitors is not as clearly established. The issue of relapse following drug withdrawal is addressed and some strategies for patient management in long-term therapy are discussed.

Anti-Anxiety Agents↗
PubMed1993

Prolactin response to dl-fenfluramine in panic disorder.

The objective of this study was to test the hypothesis that serotonin receptors are hypersensitive in patients with panic disorder. Eleven patients and 12 controls received a single PO dose of 60 mg of dl-fenfluramine at 0900h on a single occasion. Blood samples were collected with an indwelling intravenous catheter at 30-min intervals from 0930h to 1530h and prolactin determined by radioimmunoassay. In both groups, fenfluramine induced a rise in the plasma prolactin concentration from baseline. The patients showed a greater increase in prolactin response than the normal controls. This result is consistent with the hypothesis of increased serotonin receptor function in patients with panic disorder.

Administration, Oral↗
PubMed1993

Relationship between antidepressant response and plasma concentrations of fluoxetine and norfluoxetine.

The relationship between plasma concentration, clinical outcome and side-effects was examined in 23 patients with major depressive disorder (DSM-III-R) treated with fluoxetine. All patients received a fixed dose of 20 mg for 6 weeks. Good response was observed in 57% of patients, while 30% of patients had moderate responses after 6 weeks of treatment. Fluoxetine and norfluoxetine plasma concentrations were not significantly influenced by age and sex. At 6 weeks, plasma fluoxetine concentrations were not significantly different between responders and non-responders to treatment (82.2 +/- 59.6 micrograms/l vs. 84.7 +/- 6.7 micrograms/l) or those with or without side-effects (74.6 +/- 28.7 micrograms/l vs. 87.0 +/- 66.6 micrograms/l). Similarly, norfluoxetine concentrations were not significantly different for responders and non-responders (65.5 +/- 28.9 micrograms/l vs. 66.5 +/- 26.2 micrograms/l) or those with or without side-effects (66.6 +/- 14.4 micrograms/l vs. 61.5 +/- 33.6 micrograms/l). Plasma concentrations and clinical outcome were not related in a simple manner. Further studies are needed to evaluate the role of monitoring plasma fluoxetine/norfluoxetine concentrations as a routine procedure.

Adult↗
PubMed1993

Human immunodeficiency virus infection, dementia and the older patient.

Australian statistics have shown that 10.9% of AIDS cases have occurred in the 50 years and over age group. To date little attention has been given to the many issues surrounding HIV infection in the older population, for example, the failure to consider HIV as an aetiological factor in the older person presenting with neuropsychiatric disorder and the potential for misdiagnosis of AIDS dementia complex as dementia of the Alzheimer type. This paper includes a discussion of the clinical features of the AIDS dementia complex, its resemblance to the syndrome of "subcortical dementia", and review of the literature reporting dementia as the presenting feature of HIV infection in older individuals.

AIDS Dementia Complex↗
PubMed1993

A multicentre double blind trial of fluoxetine versus amitriptyline in the treatment of depressive illness.

The antidepressant efficacy and side effect profile of a fixed dose of 20 mg/day of fluoxetine, a specific serotonin reuptake inhibitor, were compared to those of amitriptyline. Fifty-eight patients with DSM-III-R depression were randomly assigned to receive either fluoxetine or amitriptyline. Fifty-six patients (fluoxetine N = 23, amitriptyline N = 23) completed the 6 week study. Comparable antidepressant efficacy was demonstrated for the two drugs. Patients taking fluoxetine reported less side-effects than those taking amitriptyline.

Adult↗
PubMed1992

Suicide following acute traumatic spinal cord injury.

The rate of suicide following spinal cord injury has not been extensively studied but appears to be greater than in the general population. Six patients who died by suicide, from a total of 342 patients who were treated for acute spinal cord injury over a 5 year period are described. Clinical features shared by this group of patients included being male; having schizoid, depressive or narcissistic personality traits; alcohol or drug abuse; family or significant others favouring death as a preferred option; and the development of significant depression.

Acute Disease↗
PubMed1992

New pharmacological approaches to the management of depression: from theory to clinical practice.

A review of the clinical efficacy of four structurally distinct antidepressant drugs is presented. Their antidepressant activity can be rationalised within current pharmacological hypotheses of drug action, despite markedly different effects on "in vitro" testing. Fluoxetine, a specific serotonin re-uptake inhibitor, has proven safe, effective treatment for depressive illness and may have a role to play in the treatment of obsessive-compulsive disorder and panic attacks. While it has few of the anticholinergic side effects of the tricyclic antidepressants, nausea, tremor, headache, weight loss, nervousness and sweating are side effects most frequently reported. Minaprine, a compound with weak MAO inhibiting properties and effects on serotonergic receptors, has clinical efficacy in the treatment of depression based on several comparative studies. It is claimed that minaprine lacks anticholinergic and sedative properties. Moclobemide, a specific, reversible inhibitor of MAO-A, has been extensively evaluated in depressive illness. The major advantage of this agent over other irreversible, non-specific MAO inhibitors, is the significant attenuation of the so-called "cheese effect" with doses of tyramine likely to be encountered in foodstuffs. Rolipram, a phosphodiesterase inhibitor, represents a new approach to antidepressant treatment. Limited clinical data suggest that the drug may be an effective antidepressant with few side effects. The place of these agents in therapy is yet to be established.

Antidepressive Agents↗
PubMed1992

Psychiatric consultation in a spinal injuries unit.

The function of a consultation liaison service to a spinal injuries unit is described. Within this context, a study was conducted in which sociodemographic and clinical data were collected over a 4 year period for consecutive admissions to the unit. Data are presented for 227 patients admitted during this period. Forty-seven patients were found to have discrete psychiatric disorders (DSM III) which required treatment during the course of their inpatient care. For forty-two of these patients the psychiatric disorder first developed following spinal cord injury.

Activities of Daily Living↗
PubMed1991

Depression, disease and disability: application to patients with traumatic spinal cord injury.

Depressive symptoms are common in medically ill patients. Methodological difficulties of many of the studies demonstrating this do not allow differentiation of depressive symptoms from depressive illness. This paper examines representative samples of studies in the medically ill to highlight these problems. Data from a study of patients with traumatic spinal cord injury are used to demonstrate (1) ways of overcoming some of these difficulties and (2) the means of differentiating depressive symptoms and depressive illness. Difficulties of detection and diagnosis of depression in the medically ill are discussed.

Depression↗