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Biomedical subjects

J Balldin

Publications and source records attributed to J Balldin.

At least 37 records · Page 2Linked to original sources

Guanfacine as an alpha-2-agonist inducer of growth hormone secretion--a comparison with clonidine.

Doses of 0.5 mg and 1.0 mg of the alpha-2-adrenoceptor agonist guanfacine (GUA) and NaCl were administered intravenously (IV) in a randomized order to 18 healthy male subjects. GUA induced growth hormone (GH) secretion in a dose-dependent manner without affecting blood pressure or heart rate or inducing sedation. The effects of GUA 1.5 mg i.v. was compared with those of another alpha-2-adrenoceptor agonist, clonidine (CLON) 150 micrograms i.v. in six other male volunteers. Both alpha-2-agonists increased GH to similar levels. CLON reduced both systolic and diastolic blood pressure levels, whereas GUA reduced only systolic levels. Sedation was significantly more pronounced after CLON. The results suggest that the GUA/GH-test (1.5 mg GUA i.v.) may be an alternative to the CLON/GH-test in neuroendocrine assessment of alpha-2-adrenoceptor sensitivity.

Adrenergic alpha-Agonists↗

Further neuroendocrine evidence for reduced D2 dopamine receptor function in alcoholism.

D2 dopamine receptor function, as assessed by growth hormone (GH) responses to apomorphine (APO; 0.18-0.24 mg i.v.), was investigated in 15 male alcoholics with reported long-term abstinence. Results from only nine subjects could be evaluated. These subjects had been heavy alcohol consumers for a mean of 15 +/- 10 years and had thereafter been abstinent for a mean of 7 +/- 6 years prior to the investigation. Eight male healthy subjects, all of whom were light social drinkers, were selected as controls. The maximum GH responses to APO were significantly lower in the alcoholics (5.8 +/- 5.8 mU/l) than in the controls (22.1 +/- 19.2 mU/l). This finding gives neuroendocrine evidence for reduced D2 dopamine receptor function in alcoholics with long-term abstinence.

Adult↗

Alpha-2-adrenoceptor sensitivity in early alcohol withdrawal.

Growth hormone (GH), blood pressure, and pulse rate responses to clonidine (100 micrograms IV) were studied three times during the first week of alcohol withdrawal in 19 alcohol-dependent patients. Fifteen healthy men were used as controls. The results suggest reduced sensitivity of the alpha-2-adrenoceptors involved in GH secretion for at least 1 week after the end of alcohol intake. In contrast, very short-lasting subsensitivity was found in the alpha-2-adrenoceptors regulating blood pressure.

Adult↗

Neuroendocrine evidence for decreased function of alpha 2-adrenergic receptor after electroconvulsive therapy.

Growth hormone (GH) and hypotensive responses to clonidine (150 micrograms, i.v.) were investigated before and after electroconvulsive therapy (ECT) in 16 depressed patients. Because of high baseline serum GH concentrations, results from only 10 patients could be evaluated. The level of GH secretion induced by clonidine was significantly reduced after ECT, but the hypotensive responses to clonidine remained unchanged. The results indicate downward regulation of the sensitivity of alpha 2-adrenergic receptors in the hypothalamus after ECT.

Blood Glucose↗

Dexamethasone suppression test in alcohol withdrawal: relationship to depression and liver function.

The relationship between dexamethasone suppression test (DST) response, depressive symptoms and liver function tests was investigated in 15 male alcohol-dependent patients for 2 weeks during alcohol withdrawal. Six of the patients relapsed into drinking within the investigation period. There was no association between DST response and relapse, which suggests that abnormal DST response has no predictive value for relapse into drinking. About 50% of the patients had abnormal DST responses during the first week of alcohol withdrawal. There was no relationship between DST response and depression or depressive symptoms. Depression remitted within 1-2 weeks, whereas DST responses remained abnormal for at least 2 weeks in 2 of the non-relapsing 9 patients. Abnormal DST response in alcohol withdrawal is unlikely to be due to alterations in liver function but may be attributable to the effect of alcohol on the hypothalamic-pituitary-adrenocortical axis.

Adult↗

A rating scale for assessment of alcohol withdrawal psychopathology (AWIP).

For patients in alcohol withdrawal, there are several scales designed to assess physiological disturbances, but there seems to be a lack of scales for assessment of psychopathology. To develop and evaluate a rating scale for psychopathology, items from the Comprehensive Psychopathological Rating Scale (CPRS) were selected, and patients meeting the DSMR-III-R criteria for alcohol dependence (303.90) were rated on these items. The patients were divided into two groups according to the length of time passed since their last period of alcohol consumption. The groups are referred to as the group (n = 53) in early withdrawal, rated daily during 1 week and the group (n = 13) in late withdrawal, rated once a week for 7 weeks. To justify inclusion in the new scale, items had to either indicate psychopathology in at least half of the patients in one of the groups in withdrawal, or be sensitive to changes over time at a 0.1% level of significance. Seventeen items fulfilled one of these criteria. The scale was tested for inter-rater reliability in a new sample of patients (n = 30) in early withdrawal. Inter-rater reliability, as well as internal consistency, was found satisfactory. This new scale, capable of identifying psychopathology and changes over time, may be used alone or together with physiological scales to identify subgroups of patients undergoing withdrawal.

Alcohol Withdrawal Delirium↗

Individual mood profiles in alcohol withdrawal.

Daily self-reports of moods, using a Swedish Mood Adjective Check List with six bipolar dimensions, were performed in patients with alcohol dependence. One group (n = 13), consisting of inpatients in late withdrawal at a home for addicts, was studied for 6 weeks; another group (n = 12), consisting of outpatients in full remission, was studied for 1 week. The results of the ratings on the check-list were used to test a statistical model for its capacity to describe the individual courses of mood states during the recovery process. Time Series Analysis revealed that the individual courses of moods fitted an autoregressive statistical model and could thereby be summarized in numerical measures for individual baselines, amplitudes, and lengths of recovery. Such individual profiles of the alcohol recovery process, may be useful for both clinical and research purposes, making it possible, for instance, to predict points in time for an individual's recovery with respect to his total well-being, as well as the various dimensions of his mood states.

Adult↗

Alcohol withdrawal and mood.

The usefulness of a self-report technique for description of mood was tested at various stages of alcohol withdrawal. The Mood Adjective Check List (MACL), consisting of 71 mood-associated adjectives and measuring 6 bipolar aspects of mood, was used. Three groups of alcohol-dependent patients (DSM-III-R) reported on their momentary mood states twice a day, respectively, during early withdrawal (n = 78), during late withdrawal (n = 13), and after full remission (n = 12). Significant improvement was found in all 6 mood dimensions during early withdrawal. Improvement in 3 basic mood dimensions was also found during late withdrawal, thus indicating a prolonged time of recovery. The reports given by patients in full remission showed no changes in mood over time. Relative to norm group values, significant differences were found in 4 of the 6 mood dimensions for patients in very early withdrawal. The present study shows that mood changes attributable to after-effects of alcohol intake can be assessed and described during various stages of withdrawal.

Adult↗

Growth hormone responses to the alpha 2-adrenoceptor agonist guanfacine and to growth hormone releasing hormone in depressed patients and controls.

Growth hormone (GH) responses to the alpha 2-adrenoceptor agonist guanfacine and to GH releasing hormone (GHRH) were measured in 13 patients fulfilling Research Diagnostic Criteria and DSM-III criteria for major depressive disorder and in 13 controls matched for age and sex. Dexamethasone suppression tests were performed in all subjects. The peak GH response to guanfacine correlated to the peak GH response to GHRH both in depressed patients and in controls. Neither the response to guanfacine nor the response to GHRH was significantly lower in depressed patients than in controls. Dexamethasone suppression tests, which were performed about 3 days before the GH stimulation tests, were abnormal in 61% (8/13) of the depressed patients but in none of the controls. No difference between dexamethasone suppressors and nonsuppressors with respect to GH response to guanfacine or GHRH was observed. The data are discussed in relation to the blunted GH response to clonidine described in depression.

Adrenergic alpha-Agonists↗

A double-blind evaluation of electroconvulsive therapy in Parkinson's disease with "on-off" phenomena.

Eleven patients with severe Parkinson's disease and on-off-phenomena were included in a controlled double-blind study on the effect of electroconvulsive therapy (ECT). Pharmacological treatment was optimally adjusted before the trial. The severity of extrapyramidal symptoms was measured before, during and after the treatment. The patients were randomly allocated into one group, receiving active ECT and another, receiving sham treatment. The patients given active ECT showed significantly (P less than 0.05) prolonged duration of "on"-phases after ECT, in comparison to the sham-treated group. When collecting data from the controlled part of the study and the subsequent with open administration of ECT, the treatment was in addition found to significantly decrease the time and number of steps required to walk 10 meters. Moreover it reduced the severity of parkinsonian symptoms according to the Webster scale. The improvement induced by ECT was generally short-lasting. Lumbar punctures were performed before and after ECT. The concentrations of monoamine metabolites in cerebrospinal fluid were not affected by the treatment. The results indicate that ECT has an antiparkinsonian effect which probably is mediated via changed responsiveness of dopamine receptors and that further improvement is possible in patients, therapy resistant to the presently available medication.

Aged↗

Changes in dopamine receptor sensitivity in humans after heavy alcohol intake.

Dopamine (DA) sensitivity, assessed through maximal growth hormone (GH) response to stimulation by apomorphine (APO) (0.18-0.24 mg iv) was studied in 16 chronic alcoholics newly admitted after a period of heavy alcohol intake. Repeated hormonal tests were thereafter performed during a 2-month period under strictly controlled conditions to avoid relapse into alcohol consumption. Eight healthy volunteers with alcohol consumption slightly less than that of the general population were used as controls. It was found that DA sensitivity in the early abstinence phase was higher than later in the 2-month recovery period but not significantly different from control values. The relatively higher DA sensitivity in the early abstinence phase might be responsible for a lower threshold for psychotic symptoms and neuroleptic-induced extrapyramidal side effects. The results of this study give further evidence of a prolonged recovery phase after heavy alcohol intake.

Adult↗

Abnormal dexamethasone suppression test in normal females.

Eighty women taking part in a population study were subjected to a dexamethasone suppression test (DST) intended as a diagnostic aid for melancholia. The women were selected systematically from two age strata, 38 and 50 years. Fifteen subjects (19 per cent) were found to be non-suppressors. High post-dexamethasone serum cortisol concentrations were not the result of elevated concentrations of the main cortisol binder, transcortin. There were no differences between suppressors and non-suppressors as regards depressive symptoms, strain experience, body mass, gynaecological history, drug use, smoking, erythrocyte sedimentation rate, number of leucocytes, activity of serum aminotransferases and gamma-glutamyltransferase, serum iron, bilirubin, ferritin content, serum growth hormone or serum prolactin. However, the nonsuppressors reported a significantly lower (P less than 0.01) orgasmic capacity in a questionnaire inquiry about two weeks before the DST. The outcome of the study indicates that DST as the presently recommended procedure for out-patients has a lower specificity for melancholia than has been reported previously.

Adult↗

Dexamethasone suppression test and serum prolactin in dementia disorders.

The dexamethasone suppression test (DST) was performed on 21 patients with dementia of the Alzheimer type (DAT), 11 patients with multi-infarct dementia (MI) and 14 healthy controls. Twelve of the DAT patients and eight of the MI patients showed abnormal lack of suppression, compared with just one member of the control group. Abnormal DST was related to dementia as such and not to age or depression, or to levels of CSF monoamine metabolites. Basal serum prolactin concentrations were not increased.

Aged↗