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Biomedical subjects

G Sedvall

Publications and source records attributed to G Sedvall.

At least 181 records · Page 10Linked to original sources

Protein binding of chlorpromazine in cerebrospinal fluid and serum.

The binding of chlorpromazine (CPZ) to proteins in human cerebrospinal fluid (CSF) was measured by equilibrium dialysis. In CSF from schizophrenic patients binding of CPZ was found to vary by between 19 and 72%. There was no correlation between the degree of binding and the total amount of protein in the CSF. When CPZ was equilibrated between CSF and serum in vitro almost the same distribution was found as obtained in vivo in drug-treated patients.

Adult↗

Relationships in healthy volunteers between concentrations of monoamine metabolites in cerebrospinal fluid and family history of psychiatric morbidity.

In 60 physically and mentally healthy human subjects, lumbar cerebrospinal fluid was analysed by mass fragmentography for 5-HIAA, HVA and MOPEG. Individuals with a family history of psychiatric morbidity had significantly greater variation in monoamine metabolite concentrations than subjects without such a family history. In subjects with a family history of schizophrenic psychosis 5-HIAA and HVA concentrations were significantly higher than in subjects with depressive disorders within the family. For subjects with deviant 5-HIAA levels the probability of having a psychiatric family history was 2.7 times higher than in subjects with normal values. For HVA and MOPEG similar relationships, but of a lower significance level, were found. The results suggest that the cerebral monoaminergic transmitter amines play critical roles in the pathophysiology of psychotic and depressive disorders with a family disposition. They also indicate a value of monoamine metabolite determination in CSF for the prediction of family vulnerability for psychiatric morbidity in healthy subjects.

Adolescent↗

Relationships among biochemical, clinical, and pharmacokinetic variables in neuroleptic-treated schizophrenic patients.

Concentrations of the major monoamine metabolites HVA, MOPEG, and 5-HIAA were determined by mass fragmentography in CSF of schizophrenic patients before and after treatment with antipsychotic drugs. In addition to the acceleration of central dopamine metabolism, spectra of changes involving all three major monoamine metabolites were induced by different types of drugs. In chlorpromazine-treated patients changes in central norepinephrine metabolism were better correlated to therapeutic response than the alteration of central dopamine metabolism. Changes with time of the drug concentration-effect relationships in chlorpromazine-treated patients indicate tha long-term inductive effects are produced by chlorpromazine treatment. Studies on the monoamine metabolite pattern in untreated schizophrenic patients indicate the existence of a specific subgroup of patients with a disturbed central serotonin metabolism and a family disposition of the disorder.

Antipsychotic Agents↗

Concentrations of monoamine metabolites and chlorpromazine in cerebrospinal fluid for prediction of therapeutic response in psychotic patients treated with neuroleptic drugs.

Concentrations of the major monoaminergic transmitter metabolites HVA, MOPEG and 5-HIAA were determined in the cerebrospinal fluid (CSF) of untreated schizophrenic patients. Patients with aberrated concentrations of 5-HIAA and HVA in CSF had schizophrenia in their families in a frequency significantly higher than that of patients with normal concentrations. These results may indicate the existence of a subgroup of schizophrenic patients having a family disposition for the disorder and an aberrated transmission from central serotonin and dopamine neurons. In young healthy volunteers, aberrated monoamine metabolite concentrations in CSF were also related significantly to a history of psychiatric morbidity in the family. In psychotic patients treated with chlorpromazine significant correlations were obtained between therapeutic outcome on the one hand, and both biochemical effects related to central monoamine metabolism and chlorpromazine concentrations in the CSF on the other hand. Patients with chlorpromazine concentrations above 1 ng/ml in CSF or 40 ng/ml in plasma responded more favourably than patients with concentrations below those levels. The results indicate that biochemical and pharmacokinetic data may be of value for diagnostic classification and prediction of therapeutic outcome in drug-treated schizophrenic patients.

Antipsychotic Agents↗

Quantitative analysis of sulpiride in body fluids by high-performance liquid chromatography with fluorescence detection.

A high-performance liquid chromatographic method for the analysis of sulpiride, N-ethyl-2-(2-methoxy-5-sulphonamido-benzamido-methyl)-pyrrolidine, in body fluids is described. A structurally related compound, N-ethyl-2-(2,4-dimethoxy-benzamido-methyl)-pyrrolidine, was used as internal standard. A fluorescence detector with excitation maximum at 299 nm and emission maximum at 342 nm was used for the quantitation. The detection limit was about 10 ng/ml in serum and cerebrospinal fluid and about 200 ng/ml in urine. The experimental error was 5--10% in the concentration range 25--100 ng/ml. Some preliminary data from a pharmacokinetic study in healthy volunteers are presented. The half-life for sulpiride in serum was about 8 h. Sulpiride was also measured in cerebrospinal fluid from five drug-treated psychotic patients.

Adult↗

Reduction of MOPEG levels in cerebrospinal fluid of psychotic women after electroconvulsive treatment.

The effect of ECT on concentrations of monoamine metabolites in lumbar CSF of psychotic women with a schizophrenic symptomatology was examined. After a series of ECT there was a significant reduction of the concentration of the major noradrenaline metabolite, MOPEG. Levels of HVA, 5-HIAA, prolactin, or total protein in CSF were not significantly influenced by treatment. The results indicate a specific alteration of central noradrenaline metabolism in relation to ECT.

Biogenic Amines↗

The effect of propranolol treatment in shizophrenia on CSF amine metabolites and prolactin.

Recent reports have suggested that high doses of propranolol may be an effective treatment in schizophrenia. To determine whether such treatment has effects on cerebrospinal fluid (CSF) amine metabolites and prolactin similar to the effects of the neuroleptic drugs, we studied CSF from ten patients before and after propanolol therapy. The initial CSF sample was removed after a drug-free period and propranolol dosage was then increased over 1 week to 1000 mg daily in all ten patients. A second CSF sample was removed after 3 weeks of propranolol therapy. Propranolol levels and prolactin in CSF were measured by radioimmunoassay. Homovanillic acid, 5-hydroxyindoleacetic acid, and 3-methoxy-4-hydroxyphenylethylene glycol were measured by gas chromatography-mass spectrometry. Propranolol had no effect on the prolactin or amine metabolite concentrations. CSF propranolol levels averaged 40 ng/ml (range less than 1--78).

Adult↗

A double-blind comparison of melperone and thiothixene in psychotic women using a new rating scale, the CPRS.

Eighty-one women with psychosis of schizophrenic and paranoid type were assigned to a double-blind study comparing the clinical effects of melperone (100 mg X 3) and thiothixene (10 mg X 3). The antipsychotic effect was evaluated by clinical rating according to the CPRS and the NOSIE-30 scales before and after 2 and 4 weeks of drug treatment. A satisfactory interrater reliability was obtained for the CPRS. Significant correlation was also found between the CPRS and NOSIE ratings. Treatment with both drugs was associated with significant reductions in morbidity as estimated by several measures of therapeutic effect from the CPRS, by the NOSIE scale and by global ratings. There were no marked differences at any rating time point between the drugs in this regard. There were more extrapyramidal side effects in the thiothixene group than in the melperone-treated patients. The results encourage the use and further evaluation of melpherone in the treatment of psychotic patients.

Antipsychotic Agents↗

Effects of perphenazine enanthate injections on prolactin levels in plasma from schizophrenic women and men.

Levels of prolactin (PRL) in plasma were determined in schizophrenic women and men after i.m. injections of 50-150 mg perphenazine enanthate (PE). In both sexes PRL levels increased dose-dependently. In men the effect was significant for 2 and in women for 9 days. Biperiden treatment did not influence the effect of PE on the PRL levels. The data support the view that clinically used doses of PE induce a small but significant blockade of central dopamine receptors.

Aged↗

Sex differences in psychoneuroendocrine reactions to examination stress.

Sex differences in adaptation and coping were studied by comparing neuroendocrine and psychological functions in male and female high-school students during 2--3 hr of routine school work (control condition) and a 6-hr matriculation examination (stress condition). In the control condition sex differences were slight and nonsignificant. During examination stress, the urinary excretion of cortisol, adrenaline, noradrenaline, and 3-methoxy-4-hydroxy-phenylethylene glycol (MOPEG or MHPG) increased in both sexes, but to a consistently greater extent in the male group, significantly so for adrenaline and MOPEG. Both sexes performed equally well in the examination, but self-reports showed that feelings of success and confidence were common among males, whereas feelings of discomfort and failure dominated in the female group. High discomfort correlated with poor performance in the males but with good performance in the females.

Achievement↗

Clinical effects and drug concentrations in plasma and cerebrospinal fluid in psychotic patients treated with fixed doses of chlorpromazine.

The clinical effects of chlorpromazine (CPZ) administered in accordance with a double-blind design in one of three doses (200, 400 or 600 mg) were examined in 44 psychotic patients. The relationships between the effects and the CPZ concentrations in plasma and cerebrospinal fluid (CSF) were analyzed. The antipsychotic and side effects were rated according to the CPRS and the Simpson and Angus scale. CPZ concentrations were measured by a mass fragmentographic method. Treatment with CPZ resulted in a significant reduction of morbidity scores, without any clear dose relation. The final outcome was more favourable in women than in men. Extrapyramidal side effects but not somnolence were positively dose related. The antipsychotic effects tended to be positively related to the dose of CPZ in mg/kg as well as the CPZ concentrations in plasma and CSF. The greatest number of significant correlations between the CPZ concentration in CSF and the morbidity scores were seen after 2 weeks of treatment. The results indicated marked clinical improvement with CPZ concentrations above 1 ng/ml in CSF and 40 ng/ml in plasma. After 4 weeks of treatment the correlations between the CPZ concentrations and the clinical improvement were still positive but the coefficients were lower than at 2 weeks and only occasionaly significant. Extrapyramidal symptoms were significantly related to the CPZ concentrations in plasma and CSF. Somnolence was significantly related to the CPZ concentrations in CSF.

Adult↗