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Biomedical subjects

J Amsterdam

Publications and source records attributed to J Amsterdam.

At least 19 recordsLinked to original sources
PubMed1992

The efficacy and safety of paroxetine compared with placebo in outpatients with major depression.

Paroxetine, a phenylpiperidine derivative, is an antidepressant that selectively inhibits serotonin reuptake. In this study 111 outpatients with major depression diagnosed by DSM-III criteria were treated with either paroxetine or placebo in a 6-week, randomized, double-blind study. Paroxetine was significantly superior to placebo on six of the seven major efficacy variables. Significant differences in favor of paroxetine were apparent by Week 2. Paroxetine was also well tolerated. These results support the efficacy and safety of paroxetine as a treatment for patients with major depression.

Adult↗
PubMed1990

Buspirone in depressed outpatients: a controlled study.

One hundred fifty-five outpatients suffering from major depression with significant anxiety entered a double-blind study comparing 8 weeks of treatment with buspirone or placebo. Twenty-nine percent of buspirone and 40 percent of placebo patients discontinued treatment before 8 weeks. Major efficacy measures were the Hamilton Rating Scale for Depression (HAM-D) total score, the HAM-D retardation and anxiety factors, the HAM-D Rickels and Bech core depression clusters, the Clinical Global Impressions (CGI), and the Hopkins Symptom Checklist (HSCL). Results were consistent across all outcome measures, including the two core depression clusters, with treatment response to buspirone significantly better than to placebo at treatment endpoint. Seventy percent of buspirone and 35 percent of placebo patients (p less than .01) were rated moderately or markedly improved after 8 weeks of therapy. Buspirone was found to be safe and well-tolerated by patients with major depression and concomitant anxiety at doses of up to 90 mg/day.

Anxiety Disorders↗
PubMed1989

A placebo-controlled, double-blind, clinical trial of paroxetine in depressed outpatients.

A placebo-controlled, randomized, double-blind study was carried out in outpatients suffering from major unipolar depressive disorder to assess the efficacy and tolerability of paroxetine in the treatment of depression. The study lasted for six weeks. After a placebo washout period of 4 to 14 days patients took 20mg of paroxetine or matched placebo as a morning dose for one week; thereafter the dose of paroxetine could be titrated between 10 and 50mg/day. Patients were evaluated at baseline, weekly during the first four weeks of the study, and at the end of six weeks; patients who entered a six-week extension phase were evaluated at 9 and 12 weeks. Evaluations were carried out using HAMD (including ECDEU factors), MADRS, HSCL, Covi anxiety and Raskin depression scales, CGI, and a seven-point rating of global improvement. Adverse events and laboratory values were also recorded at each assessment. One hundred and eleven patients entered the study, and efficacy data were available for 102 of these (49 on paroxetine and 53 on placebo). Efficacy measurements demonstrated significantly greater clinical improvement with paroxetine than placebo after two weeks of treatment, and this became even more marked after six weeks. Patients who continued treatment for a further six weeks maintained their clinical improvement. When adverse events were examined, statistically significant differences between paroxetine and placebo were seen only for sweating, diarrhoea, nausea, and somnolence. No significant changes were seen in any of the laboratory parameters measured. If these results are confirmed in future studies, paroxetine will represent an important addition to the treatments available for depression.

Adult↗
PubMed1986

Patterns of melatonin rhythms in depression.

The nocturnal rise of melatonin in serum of humans is the result of endogenously released norepinephrine (NE) acting upon beta-adrenergic receptors of the pineal gland. As there is much interest in the possibility of there being changes in the function of beta-receptors in depressed patients, the nocturnal rise of melatonin was measured in depressives and healthy control subjects. In one study, multiple serum samples were taken between 4.30 p.m. to 7.30 a.m. in seven male depressed patients with melancholia and five healthy male control subjects. The melancholic patients had a significantly reduced nocturnal elevation of melatonin. In a separate study, serum samples were taken at 8 a.m. and 11 p.m. in melancholic depressives, non-melancholic depressives and healthy control subjects. The melancholic patients had a significantly lower concentration of melatonin at 11 p.m., but not at 9 a.m., than that measured in either the control subjects or the non-melancholic depressed patients. These results are similar to those found recently by several other groups of investigators. Further research is indicated to elucidate mechanism(s) responsible for this phenomenon.

Adult↗
PubMed1985

Detection of serum antibodies to Borna disease virus in patients with psychiatric disorders.

Borna disease virus causes a rare meningoencephalitis in horses and sheep and has been shown to produce behavioral effects in some species. The possibility that the Borna virus is associated with mental disorders in humans was evaluated by examining serum samples from 979 psychiatric patients and 200 normal volunteers for the presence of Borna virus-specific antibodies. Antibodies were detected by the indirect immunofluorescence focus assay. Antibodies to the virus were demonstrated in 16 of the patients but none of the normal volunteers. The patients with the positive serum samples were characterized by having histories of affective disorders, particularly of a cyclic nature. Further studies are needed to define the possible involvement of Borna virus in human psychiatric disturbances.

Adult↗
PubMed1985

Differences in nocturnal melatonin secretion between melancholic depressed patients and control subjects.

The authors took multiple serum samples for measurement of melatonin between 4:30 p.m. and 7:30 a.m. in seven male depressed patients with melancholia and five healthy male control subjects and found that melancholic patients had a significantly lower rise of melatonin. They also compared a second, separate group of 14 women and five men suffering from melancholic depression with seven healthy male control subjects and nine depressed women without melancholia. The melancholic patients had a significantly lower concentration of serum melatonin at 11:00 p.m. than either the control subjects or the nonmelancholic depressed patients. These findings support the possibility that the functioning of the pineal gland is altered in these patients.

Adult↗
PubMed1983

Response to dexamethasone in psychotic depression.

The utility of the dexamethasone suppression test (DST) in the diagnosis of psychotic depression was examined by comparing the responses of 11 psychotic and 18 nonpsychotic depressed inpatients. Nine of 11 psychotic patients (81.8%) and 10 of 18 nonpsychotic patients (55.6%) showed nonsuppression (nonsignificant). Using the 0800h cortisol level alone, we found that significantly more psychotic patients (7 of 11; 63.6%) than nonpsychotic patients (3 of 18; 16.7%) showed nonsuppression. Nonsuppression at 0800h postdexamethasone may be a useful biologic marker for patients with psychotic depression. Implications of these data for the nosologic status of psychotic depression are discussed.

Adult↗
PubMed1982

Variability of hormonal responses to a series of neuroendocrine challenges in depressed patients.

Abnormalities of hormonal responses to a number of neuroendocrine challenges have been reported in depressed patients. The authors used a series of four neuroendocrine challenges-thyrotropin-releasing hormone (TRH) and gonadotropin-releasing hormone (GnRH) stimulation, insulin tolerance test (ITT), and overnight dexamethasone suppression test (DST)-and examined eight hormonal responses in 24 healthy subjects and 26 patients with primary unipolar affective disorder. Seven control subjects (29.2%) and 25 depressed patients (96.2%) had at least one abnormal response, and 15 depressed patients (57.7%) had two or mor abnormal responses. These findings suggest that depressed patients show variability in hormonal response across a number of neuroendocrine axes. No consistent patterns of abnormality of hormonal response were observed.

Adult↗
PubMed1981

Sperm function in affective illness.

There is evidence for functional changes in the hypothalamic-pituitary-gonadal axis of patients with affective disorders. Little is known concerning spermatogenesis or sperm function in depressed men. We systematically evaluated the sperm indices in a group of depressed males complaining of diminished libido, and a healthy control group. No differences were noted in sperm parameters between the groups.

Adult↗
PubMed1981

Acute metabolic response to cold exposure in unipolar and bipolar II patients.

The thermoregulatory response to cold exposure was examined in 11 unipolar and 5 bipolar II drug-free outpatients and 12 healthy controls. Subjects were studied in an environmental chamber at 10 C for 60 min. The heat production response was derived from the rate of oxygen consumption measured at 15-min intervals. Rectal and mean skin temperatures were continuously recorded from thermistor probes. Responses of the controls were used to establish a standard range against which the responses of the patients were compared. Six unipolar patients (54.5%) fell outside the standard range (chi 2 = 8.86, df = 1, p less than 0.005). Four of these patients showed a paradoxical decrease in heat production. Responses of the bipolar II patients fell within a narrow segment of the standard range, such that 10 of 12 controls (83.3%) responded outside the segment (chi 2 = 10.12, df = 1, p less than 0.005). These findings indicate that unipolar patients show greater variability and bipolar II patients less variability than controls in thermoregulatory response to cold. These observations extend previous suggestions of hypothalamic-limbic system dysfunction in patients with depression.

Adult↗
PubMed1980

The clinical application of tricyclic antidepressant pharmacokinetics and plasma levels.

The authors present a clinical approach for predicting and using plasma concentrations of tricyclic antidepressants in the treatment of depressed patients. They review the pharmacokinetics of this group of drugs and their side effects and toxicity. There is a suggested therapeutic range for plasma concentrations of imipramine, amitriptyline, and nortriptyline; more definitive studies are needed to determine the necessary plasma levels for achieving clinical response with the other tricyclic antidepressants (desmethylimipramine, protriptyline, doxepin, clomipramine, impiramine N-oxide, and butriptyline). A more thorough knowledge of the clinical pharmacokinetics of tricyclic antidepressants should lead to more rational use of these drugs, with a higher response rate and fewer adverse reactions.

Amitriptyline↗
PubMed1980

Prediction of steady-state plasma levels of amitriptyline and nortriptyline from a single dose 24 hr. level in depressed patients.

Amitriptyline and nortriptyline plasma levels were measured in depressed outpatients 24 hours after a single dose of amitriptyline and following chronic dosing to steady state. Plasma levels of amitriptyline and nortriptyline measured after the single dose correlated highly with steady state plasma levels. Full use as a test to rapidly place patients on a "therapeutic" dosage of drug will need to await a clear delineation of the relationship between blood levels and clinical response for amitriptyline.

Amitriptyline↗
PubMed1979

High dose desipramine, plasma drug levels and clinical response.

The concentration of tricyclic antidepressants in plasma may be a more important factor than the oral dose in determining whether or not a patient will respond to treatment. Knowledge of the drug dose-response curve and its levels in blood may enable the physician to convert a patient from a "nonresponder" into a "responder."

Alanine Transaminase↗