Efficacy of ECT.
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Antidepressive Agents↗
Biomedical subjects
M Fink
Publications and source records attributed to M Fink.
[Pseudo-hyperkalaemia in myeloproliferative diseases (author's transl)].
In two patients in the blast phase of chronic myeloid leukaemia there was a marked rise in serum potassium levels, while plasma potassium was at the lower range of normal and there were no signs of hyperkalaemia clinically. After reduction of the pathological cells under cytostatic treatment the serum potassium levels returned to normal. This in-vitro phenomenon seems to be more common in patients with marked thrombocytosis and leukaemia than has previously been thought. In such patients hypokalaemia may be undetected because serum potassium levels arenormal. Pseudo-hyperkalaemia exists when the potassium level is normal in plasma obtained by centrifugation immediately after the blood sample has been taken, without addition of plastic spheres and at once separated from the blood cells.
Adult↗
Normal prolactin responses in tardive dyskinesia.
Tardive dyskinesia has been hypothesized to be caused by a neuroleptic-induced dopamine hypersensitivity in the nigrostriatal system. This study evaluated with dopamine antagonists the possibility that such dopamine hypersensitivity extends to the tuberoinfundibular dopamine (TIDA) system, which regulates, by inhibition, pituitary prolactin secretion. Plasma prolactin concentrations in six patients with tardive dyskinesia were assessed in four conditions: During chronic haloperidol therapy; serially after abrupt haloperidol withdrawal; while unmediated; and in response to an acute dose of 0.5 mg IM haloperidol. In all four conditions, prolactin responses did not differ from those observed in normal subjects and schizophrenic patients without tardive dyskinesia. It is concluded that there is no evidence for post-synaptic dopamine hypersensitivity in the TIDA-pituitary pathway in patients with tardive dyskinesia, consistent with other reports assessing hormonal responses to dopamine agonists in such cases. It is further suggested that neuroleptic-induced dopamine hypersensitivity does not occur in the TIDA-pituitary system in humans, since it was not manifest in these tardive dyskinesia patients who would be thought particularly prone to develop it.
Adult↗
CNS effects of the antihistamines diphenhydramine and terfenadine (RMI 9918).
The quantitative EEG profile of a putative antihistaminic drug, terfenadine, was determined in a crossover comparison with diphenhydramine in normal male volunteers. Terfenadine failed to elicit the characteristic EEG or behavioral effects of sedative antihistaminics, and was distinguishable from diphenhydramine. The EEG profile confirmed the lack of CNS effect observed in preclinical and clinical trials.
Adult↗
EEG profile studies of clozapine in volunteers and psychiatric patients.
Among the newer psychoactive compounds, clozapine is classified by some authors as an antipsychotic compound, but it exhibits differences in pharmacology and clinical effects that clearly distinguish it from established antipsychotic compounds. It represents an anomaly in the EEG classification scheme as well. In normal volunteers and in psychotic patients, it elicits EEG effects that are more like those of sedative thymoleptic antidepressants than the established antipsychotic compounds. It is probable that the antipsychotic activity reported by some observers reflected the sedative qualities of the compound and not a prototypic antipsychotic activity. Further testing in other psychiatric populations, particularly patients with depressive illnesses, is warranted.
Adult↗
[Therapy of bacterial infections in infancy and childhood (author's transl)].
83 in-patients, age 3 months to 12 years, with tonsillitis, otitis, bronchitis and pneumonia were treated with a new galenic preparation of phenoxymethylpenicillin V potassium (Star-Pen Trockensirus SANABO). The drug was very well tolerated, no skin-rash was observed, no problems occurred with the oral administration. Diarrhea, not infrequent in oral penicillin therapy, was -- with one exception -- not noticed in patients above one year of age.
Bacterial Infections↗
Mianserin--a new tetracyclic antidepressant.
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Clinical Trials as Topic↗
Phenytoin: EEG effects and plasma levels in volunteers.
The electroencephalographic (EEG) and behavioral effects of oral doses of phenytoin from 100 mg to 1 g in normal male volunteers were measured. The electroencephalogram exhibited decreases in power in the slow frequencies and increases in the fast frequencies, accompanied by an increase in mean frequency. These changes are similar to those seen with psychostimulants. They occurred at average plasma levels of 8 micrograms/ml and above. The time course and the intensity of EEG effects parallel plasma levels. Drug-related EEG changes were bilaterally symmetric. EEG changes at plasma levels of 8--12 micrograms/ml were not associated with behavioral toxic signs. These findings suggest that future psychiatric studies of phenytoin as a psychostimulant should include monitoring for plasma levels, with a minimum of 8 micrograms/ml as a guide to clinical efficacy.
Behavior↗
[Controlled double-blind study on the effectiveness and tolerability of a combination therapy in chronic alcoholic liver diseases].
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Adult↗
Electroshock therapy: myths and realities.
The methodology of the 1940s provided the data base for the myths that grew up around electroshock therapy. Since then indications have been refined and techniques drastically revised--as with many other medical treatments. When administered for carefully defined indications, in the proper setting by an experienced team, and with appropriate safeguards, EST is safe, effective, and often the treatment of choice.
Affective Symptoms↗
ECT in metropolitan New York hospitals: a survey of practice, 1975-1976.
Of New York psychiatric facilities surveyed, 83% used ECT. Five percent of patients in university and private nonprofit hospitals, less than 1% in public hospitals, and 21% in private for-profit hospitals received ECT. Practices and procedures were remarkably uniform, except that less than 17% of units used unilateral ECT. Training programs were minimal and unplanned. Differences in incidence of use result from staff training, public antipathy, and economic factors.
Adolescent↗
EEG and psychopharmacology.
The waking EEG bears direct relations to chemical changes in the brain induced by drugs. The waking EEG is responsive to the unique characteristics of psychoactive drugs. Their EEG signatures are predictive of their short-term behavioral effects and of their clinical efficacy. This association has led to the development of cerebral electrometry - a technique to predict a drug's clinical profile from experimental trials in normal volunteers. The technique is also useful in pharmacodynamic studies. Cerebral electrometry depends on careful control of behavioral variables, quantification of EEG effects and statistical processing of the data. The EEG-behavioral associations do not depend on a single method of quantification. Behavioral association is predicted for animal studies as well. Lacking, however, are studies in animals with adequate behavioral controls, clinical correlations of direct use to the individual patient and robust tests of this association hypothesis. The past decade has shown the utility of quantitative EEG studies and improved the methodology to a practical art. The next decade should see the techniques used by classical pharmacologists, mindful of the restraints inherent in animal models of the mental aspects of behavior.
Animals↗
Electroencephalogram study of mianserin in depressed patients.
1. Electroencephalogram (EEG) recordings and blood level assessments were included in a clinical comparison of the effects of mianserin (GB-94), imipramine and placebo in depressed, hospitalized patients during a 3-week observation period. 2. Temporal changes in behavioural ratings were observed, but these failed to be distinguished among the active drugs and placebo. EEG measures also showed temporal changes, but these also failed to distinguish among the drug conditions, except at 2 h after administration of the first dose. 3. Plasma levels of mianserin were obtained with EEG recordings in a temporal relationship to the behavioural assessments. There were no correlations between the changes in EEG variables and plasma levels of mianserin, or between EEG and behavioural variables, except on acute administration. The lack of discrimination for the EEG variables may be related to the quality of the EEG recordings and the poor control of the temporal relationships of behavioural assessments to EEG recording and drug dosing.
Adolescent↗
EEG, blood level, and behavioral effects of the antidepressant mianserin (ORG GB-94).
A pharmacokinetic analysis of a new antidepressant drug, mianserin (ORG GB-94), was undertaken in 4 male volunteers, each of whom received 15 mg mianserin on two occasions. Plasma levels peak at 2 h with a median level of 11.0 ng/ml, a median beta-phase half-life of 10.0 h, and a median apparent volume of distribution of 3.3 X 10(3) 1. EEG profile analysis shows mianserin to increase frequencies below 6 Hz, decrease those from 7.5 to 15 Hz, and increase frequencies above 18 Hz, a pattern similar to amitriptyline. Peak EEG effects range from 2 to 5 h with a pattern of measured changes that parallels plasma levels with varying latency. Decreases in vigilance measures and in critical flicker-fusion frequency show a similar time course. Mianserin is a putative thymoleptic on EEG profile analysis with high cerebral penetrance.
Animals↗
[Suppressive effect of somatostatin on secretin-CCK-PZ-stimulated endocrine and exocrine pancreatic function in man (author's transl)].
With a view toward the therapeutic use of somatostatin in the treatment of acute pancreatitis, a preliminary investigation was conducted with 6 healthy volunteers, in which the suppressive effect of somatostatin on endocrine and exocrine pancreatic function was observed. A 30-minute baseline measurement period was followed by the administration of cyclic somatostatin (100 microgram by i.v. injection plus a 90-minute infusion at a rate of 200 microgram/hr). After the first 45 minutes of this infusion secretion was submaximally stimulated by the infusion of secretin-cholecystokinin-pancreozymin (CCK-PZ) (75 U each), over two hours. No decrease was observed in basal bicarbonate or enzyme concentration under somatostatin administration alone. However, secretion did not show the usual steep rise after the commencement of stimulation. After the somatostatin infusion was stopped, i.e. under secretin-CCK-PZ alone, a significant increase occurred in the values of secretin-induced volume, bicarbonate concentration and total bicarbonate contents of the duodenal aspirate, as well as in CCK-PZ-induced enzyme secretion. The release of insulin, both basal and stimulated, was also significantly decreased by somatostatin.
Adult↗
[The Holoscan: a great improvement for diagnosis by ultrasonics].
We present a new B-scan device, the Holoscan, which combines real time imaging and high resolution capabilities. These capabilities are given by electronic scanning of a linear array and by a holographic focusing technique. This instrument is easy to use and allows high quality pictures to be obtained. Some results are presented.
Aorta, Abdominal↗
EEG sleep diagnosis of medical disease in depression.
The diagnosis of medical disease in the context of a depressive syndrome which may mimic medical illness has traditionally relied on a combination of exhaustive medical screening and neuropsychological testing. When 10 patients with primary depression were compared to 10 patients whose depression occurred in the context of concurrent medical disease, a single EEG sleep variable, total phasic REM activity (RA), correctly identified 95% of all 20 patients as either primary depressives or medical patients with depression. Conventional psychiatric assessment and neuropsychological testing were significantly less powerful discriminators among this sample.
Adolescent↗
Myths of "shock therapy".
The author discusses the myths of the ECT process--that shock and the convulsion are essential, memory loss and brain damage are inescapable, and little is known of the process--and assesses the fallacies in these ideas. Present views of the ECT process suggest that its mode of action in depression may best be described as a prolonged form of diencephalic stimulation, particularly useful to affect the hypothalamic dysfunctions that characterize depressive illness. The author emphasizes the need for further study of this treatment modality and for self-regulation by the profession.
Brain Damage, Chronic↗