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Biomedical subjects

J Ananth

Publications and source records attributed to J Ananth.

At least 91 records · Page 5Linked to original sources

Drug-induced mood disorders.

Various drugs including antihypertensives, anxiolytics, antibiotics, antidepressants, corticosteroids, choline, indomethacin, levodopa, metronidazole, neuroleptics, oral contraceptives, sulphonamides and physostigmine have been reported to produce depression as a side effect. Clinically, these drug-induced depressions may go unnoticed and thus create therapeutic problems. Although causal relationship is difficult to establish, depression occurring during the course of drug treatment needs an evaluation of all the medications that the patient has been receiving. We believe that postpsychotic depressions include three types of depression: pendular depression--primarily disease related; chronic depression--primarily environment related, and amine-depletion depression--drug related. Thus, drug-induced depressions constitute a subgroup of postpsychotic depression. Clinically, it is essential to carefully monitor patients receiving drugs known to produce depression. Thus, prompt recognition of the drug-induced depressions may assist in initiating proper therapeutic measures.

Adrenal Cortex Hormones↗

Lithium carbonate in the treatment of movement disorders. A critical review.

In this paper, the efficacy of lithium therapy in the treatment of tardive dyskinesia is reviewed. It is noted that most of the published papers on this topic are anecdotal and single case reports with contradictory results. The well-designed studies indicate that lithium is useful in certain tardive dyskinesia patients and that the red blood cell lithium level may be related to the therapeutic response. Therefore, on the basis of the available information, we conclude that routine clinical application of lithium in the treatment of tardive dyskinesia is not warranted. However, further evaluation of lithium in the treatment of tardive dyskinesia and identification of the responders are extremely useful. In addition, as suggested by animal studies, the prophylactic value of this agent against tardive dyskinesia needs exploration.

Adult↗

Review of 13 cases of Capgras syndrome.

The authors describe 13 psychotic patients who had Capgras syndrome. Only 4 patients had evidence of organicity. The authors conclude that Capgras syndrome occurs equally in functional psychosis and in the presence of organicity and recommend that the presence or absence of organicity be determined in every patient with Capgras syndrome.

Adolescent↗

Evaluation of lithium response. Psychometric findings.

Fifty-nine lithium treated patients were administered the MMPI test to differentiate the responders from the non-responders. The non-responders obtained higher scores on the Psychopathic Deviate, Paranoid and Mania Scales while the responders obtained higher scores on the Hypochondriasis, Psychasthenia and Social Introversion scales. Further work with pre- and post-treatment MMPI administration may provide additional and more definitive results.

Adult↗

Prediction of lithium response.

Even though lithium has been established as an effective agent in the management of primary affective disorders, not all manic-depressive patients respond favourably to lithium therapy. Therefore we attempted to delineate lithium responders from non-responders in a group of 54 manic-depressive patients on the basis of an assessment which included 64 variables and the results showed that only two thirds were pure responders. Females, patients with prior manic episodes, onset of the illness initially with a manic episode, and premorbid psychothymic personality were all indicators of favourable long-term lithium response. Patients with retarded depression, severe anxiety, though disorder and those with higher scores on the Psychopathic Deviate and Paranoia scales of the MMPI were poor lithium responders. It should be noted, however, that only a few of the differences between responders and non-responders were statistically significant. Our study suggests a number of predictive variables for the identification of lithium responders.

Adult↗

Drug induced dyskinesia: a critical review.

Tardive dyskinesia (TD) has been reported to occur after the long term administration of neuroleptics. Its prevalence has been reported to vary from 0.5-56%. However, no clear relationship is established between a particular neuroleptic, its dosage and duration of administration and the diagnosis and occurrence of TD. Neuropathological investigations have not provided any definitive lessons. in addition, TD can be produced by a number of drugs of different chemical classes. Similarly, the evidence for dopaminergic hypersensitivity is equivocal. The only definitive feature seems to be an individual predisposition, the nature of which needs to be elucidated. Of course, basic to any future research into new insights regarding etiology, the fundamental problem of definition and identification based on the accepted definition are most essential. This solid foundation is necessary for the resolution of any conflicting results that may be reported in the future.

Acetylcholine↗

Chlorimipramine therapy for obsessive-compulsive neurosis.

Twenty patients with a history of treatment-resistant obsessional neurosis underwent a 4-week clinical trial of chlorimipramine. Scores on the Psychiatric Questionnaire for Obsessive Compulsive Neurosis, the Leyton Obsessional Inventory, and 3 self-assessments indicated that although there was no significant change in obsessive ruminations, obsessive rituals, horrific temptations, or pervading doubt, there was a substantial significant improvement in the obsessive symptom item and severity of obsessions, as well as anxiety, depression, and phobia. Side effects were mild. The authors believe that chlorimipramine is the most promising treatment for obsessive-compulsive neurosis.

Adult↗

Clinical prediction of antidepressant response.

Depression is not a unitary disease and not all cases of depression can be treated alike. Therefore, predictors of antidepressant response to different drugs need to be identified. Premorbid personality, age and sex and family history are useful in prediction. As an example, only females respond to the addition of triiodothyronine to the antidepressant therapy. Endogenous depressions respond favourably to antidepressants, so also do psychotic depressions. On the other hand, delusional depressions do not respond to antidepressants. While atypical depressions are best treated with MAOI, motor retardation improves with imipramine and obsessive symptoms with chlorimipramine. In addition to clinical variables, biochemical and statistical approaches have also yielded significant results in prediction.

Age Factors↗

Side effects in the neonate from psychotropic agents excreted through breast-feeding.

Neuroleptics, antidepressants, lithium, anxiolytics, and hypnotics may be excreted in breast milk. Because of the danger to the neonate, drugs such as diazepam, lithium, bromides, reserpine, and opium alkaloids should not be given to lactating women, and barbiturates, haloperidol, and penfluridol should be administered with caution. The side effects produced as a result of breast-feeding of the infant by mothers consuming psychotropic drugs are reviewed and possible preventive measures are discussed.

Barbiturates↗

Prediction of lithium response in affective disorders.

Lithium carbonate has established itself as an effective therapeutic agent in primary affective disorders. As not all the patients with primary affective disorders respond to lithium therapy, it is necessary to identify responders prior to treatment. The important indicators of favourable lithium response include a definitive diagnosis of primary affective disorder, occurrence of less than four episodes of mania and depression within one year, psychotic features during both manic as well as depressive episodes, "grandiose-elated" picture during manic episodes; a family history of bipolar illness and response of affected family members to lithium treatment. While those with more than four episodes are not likely to respond to lithium therapy, those with episodes less frequent than once a year or two may not need prophylactic lithium. Among the depressed, hypersomnic depressed patients respond to lithium combined with a monoamine oxidase inhibitor. In addition to clinical predictors of response to lithium treatment, there are a number of pharmacokinetic, neurophysiological and biochemical indices which have been employed as supplementary predictors of response to lithium therapy.

Age Factors↗