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Biomedical subjects

L H Price

Publications and source records attributed to L H Price.

At least 181 records · Page 10Linked to original sources
PubMed1986

Effects of trazodone treatment on alpha-2 adrenoceptor function in depressed patients.

Tricyclic antidepressant drugs reduce the sensitivity of alpha 2 adrenoceptors during long-term treatment. In the present study, the alpha 2 adrenergic agonist clonidine was administered to 11 depressed patients before and during treatment with the triazolopyridine antidepressant trazodone (TRZ). Clonidine's ability to decrease blood pressure (BP) and plasma levels of the norepinephrine metabolite 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG), and to increase sedation and plasma growth hormone (GH), were measured. TRZ had little effect on these indices of pre- and postsynaptic alpha 2 receptor function, suggesting that the antidepressant properties of TRZ are not related to changes in alpha 2 adrenoceptor sensitivity.

Adult↗
PubMed1986

Does the cholecystokinin antagonist proglumide possess antipsychotic activity?

Cholecystokinin (CCK), a neuropeptide which fulfills almost all criteria for neurotransmitter status, has been co-localized with dopamine in midbrain mesolimbic and mesocortical neurons that have been implicated in the pathogenesis of schizophrenia. Preclinical research suggests that CCK may in part act to enhance central dopaminergic activity. In an attempt to evaluate the role of CCK relative to the dopamine hyperactivity hypothesis of schizophrenia, in the present investigation the putative CCK receptor antagonist, proglumide, was administered to four schizophrenic patients in a double-blind, placebo-controlled study. All patients were receiving concurrent neuroleptic medication, but were still significantly symptomatic. Proglumide was without effect on the patients' psychosis ratings. Potential reasons for this negative finding are discussed.

Adult↗
PubMed1986

Variability of response to lithium augmentation in refractory depression.

Eighty-four patients with major depression refractory to a controlled antidepressant trial had lithium added to their ongoing treatment. Objective symptom ratings showed highly significant improvement in the sample as a whole. At discharge or after 24 days, 31% of the patients showed a marked response, 25% a partial response. Thus, 56% of patients had a significant positive response, while 44% were nonresponders. This study indicates that response to lithium augmentation may be quite variable and a 3-week trial is necessary to assess full benefit.

Adult↗
PubMed1986

Ineffectiveness of clonidine in the treatment of the benzodiazepine withdrawal syndrome: report of three cases.

The effectiveness of clonidine hydrochloride in the treatment of abrupt withdrawal from long-term, therapeutic doses of benzodiazepines was studied in three patients under double-blind, placebo-controlled conditions. The intensity, severity, and duration of the abstinence syndrome were not altered by clonidine at a dose sufficient to markedly reduce blood pressure and plasma free 3-methoxy-4-hydroxyphenylglycol. These results contrast with the established efficacy of clonidine in the opiate withdrawal syndrome and suggest that many of the symptoms of benzodiazepine withdrawal may not be caused by hyperactivity of the noradrenergic system.

Adult↗
PubMed1986

Neuroleptic dose and desipramine concentrations during combined treatment of unipolar delusional depression.

The relationship of response to neuroleptic dose and desipramine plasma concentration was examined in 31 patients with unipolar delusional depression. The patients received either perphenazine or haloperidol for 1-2 weeks, after which desipramine, 2.5 mg/kg of body weight per day, was added. Neuroleptic dose varied among patients but was constant within individuals. Global response was rated retrospectively on the basis of outcome during the fourth week of combined drug treatment. Responders had higher plasma desipramine concentrations and had received higher neuroleptic doses than nonresponders had. The effective threshold level for desipramine was similar to that previously described for nonpsychotic melancholic patients, suggesting a similar mode of action for the drug in the two disorders.

Administration, Oral↗
PubMed1985

Effects of tranylcypromine treatment on neuroendocrine, behavioral, and autonomic responses to tryptophan in depressed patients.

Effects of intravenous administration of the serotonin precursor tryptophan (TRP) on serum prolactin, neuromotor function, subjective mood, and blood pressure and pulse were determined in nine depressed patients before and during placebo-controlled treatment with the monoamine oxidase inhibitor (MAOI) tranylcypromine. Tranylcypromine significantly increased the prolactin response to TRP. Four patients developed a distinctive neuromotor syndrome following TRP during tranylcypromine, but not placebo, treatment. Symptoms included hyperreflexia, ankle clonus, nystagmus, incoordination, tremor, myoclonic jerks, and nausea. There were no differences in peak prolactin, mood, or autonomic responses between patients with and without the syndrome, but those with the syndrome had received active tranylcypromine for a significantly shorter duration. Tranylcypromine had little effect on TRP-induced changes in mood or autonomic function, except for a modest enhancement of the TRP-induced rise in diastolic blood pressure. These results suggest that tranylcypromine treatment may enhance serotonin function in depression.

Adult↗
PubMed1985

Noradrenergic function and the cortisol response to dexamethasone in depression.

Abnormalities of the hypothalamic-pituitary-adrenal (HPA) axis and the noradrenergic system have been reported in depression. To study possible interrelations between these two systems, plasma free 3-methoxy-4-hydroxyphenylglycol (MHPG) was compared with the cortisol response to dexamethasone in 64 depressed patients. Postdexamethasone cortisol nonsuppressors had higher baseline plasma free MHPG values than did cortisol suppressors. Increased severity of some depressive symptoms was associated with increased post-dexamethasone cortisol levels. These results indicate that depressed patients with dexamethasone nonsuppression have increased noradrenergic turnover.

Adolescent↗
PubMed1985

Efficacy of lithium-tranylcypromine treatment in refractory depression.

Twelve inpatients with major depression refractory to at least two controlled antidepressant trials had tranylcypromine added to ongoing lithium treatment. Eleven patients showed reliable improvement in nurses' depression ratings compared with a prior trial of lithium added to an antidepressant that was not a monoamine oxidase inhibitor (MAOI). Eight patients were blindly judged much or very much improved, and all 12 patients improved sufficiently to be discharged. Preclinical studies of conjointly administered lithium and MAOIs suggest that central serotonergic pathways may mediate this robust clinical effect.

Adult↗
PubMed1984

Family history in delusional depression.

Family psychiatric history was compared in the 472 first-degree relatives of 31 delusional and 35 nondelusional inpatients who met DSM III criteria for major depression with melancholia. Morbid risks for psychiatric illness or for psychiatric treatment variables did not differ between the two groups. Specifically, rates of affective and psychotic illnesses in families did not distinguish delusional from nondelusional probands. The findings do not support the hypothesis of a genetic relationship of nonaffective psychosis to delusional depression.

Adult↗
PubMed1984

The clinical utility of family history for the diagnosis of melancholia.

History of psychiatric illness in 982 first degree relatives of 155 inpatients with major depression was examined to determine its clinical value for distinguishing melancholic from nonmelancholic major depressions. A positive family history of unipolar depression was not more common in the melancholic patients, although relatives of melancholic probands were more likely to have received electroconvulsive therapy or experienced nonaffective psychosis. Whereas the morbid risk estimate for unipolar depression was higher in the relatives of nonmelancholic probands, this appeared to be related to the manner in which morbid risk was calculated. Two methodological problems, variability in the risk periods of depressive subtypes, and the reliability of subtyping depressed family members, are discussed with respect to their implications for future family studies.

Adult↗
PubMed1984

Effects of desipramine on clinical liver function tests.

Results of liver function tests in 46 depressed patients changed little during treatment with desipramine and were uncorrelated with drug plasma levels. The findings suggest that tricyclic-associated hepatitis, rather than being dose dependent, is an uncommon, idiosyncratic phenomenon.

Adult↗
PubMed1983

Lithium augmentation of combined neuroleptic-tricyclic treatment in delusional depression.

Recent clinical studies have reported rapid improvement following administration of lithium to depressed patients who are unresponsive to tricyclic antidepressants. The clinical value of lithium augmentation would be greatest in subtypes of depression refractory to tricyclic treatment, such as delusional depression. The authors describe the results of a preliminary study of lithium augmentation in six patients with delusional depression who were unresponsive to combined neuroleptic-tricyclic treatment. Of the six, three had a dramatic response, two had a more gradual response, and one was unresponsive. The authors discuss alternative mechanisms of lithium action in these patients.

Adult↗