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Biomedical subjects

M H Lader

Publications and source records attributed to M H Lader.

At least 37 records · Page 2Linked to original sources
PubMed1986

A case of resistant schizophrenia.

In an era when it is generally believed that the acute symptoms of schizophrenia can be controlled pharmacologically, the case of a young man who has remained almost continuously floridly psychotic for 13 years, despite treatment, is disquieting. Conventional psychiatric treatment appears to be rendered impotent. It is in this context that it may be of interest to report a summary of the proceedings of a Special Problems Conference held at the Institute of Psychiatry on 18 February 1985 to discuss such a case.

Adult↗
PubMed1985

Determination of excitability in human proprioceptive reflexes: analysis and characteristics of EMG thresholds of postural muscle.

In order to derive indirect indices of reflex excitability, human soleus (Sol) H reflex and direct M response threshold intensities (HT, MT) were determined by probit analysis of quantal responses elicited in the surface electromyogram (EMG). Within sessions, HT and MT co-varied with respect to time along a logarithmic time-course, both attaining effectively stable levels after 40-60 min of recording. The pattern of this co-variation was imposed by non-reflex factors, primarily the electrode system employed. Sampling distributions of stable thresholds were positively skewed (median values: HT, 5.20 mA, MT, 6.83 mA), and concurrently determined values were strongly correlated (r = 0.965). The Sol threshold ratio (HT/MT) was largely unaffected by non-reflex factors and was therefore stable within subjects, both within sessions (with respect to time) and between sessions. This ratio was normally distributed (mean = 0.753 +/- 0.079 S.D.). Criteria of indirect indices of reflex excitability are proposed: HT satisfies the criteria applicable to a relative index. However, the characteristics of the threshold ratio permit its use as a powerful absolute index of proprioceptive reflex excitability.

Adolescent↗
PubMed1985

Treatment of affective disorders.

The diagnosis of affective disorders is difficult, especially at mild to moderate levels of severity. Often symptomatic treatment is given in the absence of a clear diagnosis. Antidepressants are often efficacious in helping anxiety symptoms but antianxiety compounds are generally inefficacious in treating depression. Alprazolam is a possible exception and may have both antianxiety and antidepressant properties.

Alprazolam↗
PubMed1984

Computed axial brain tomography in long-term benzodiazepine users.

Twenty patients who had taken long-term benzodiazepines were submitted to brain CT scan examinations. Some scans appeared abnormal. The mean ventricular/brain area measured by planimetry was increased over mean values in an age- and sex-matched group of control subjects but was less than that in a group of alcoholics. There was no significant relationship between CT scan appearances and the duration of benzodiazepine therapy. The clinical significance of the findings is unclear.

Adult↗
PubMed1983

Psychometric performance during withdrawal from long-term benzodiazepine treatment.

Twenty-two patients were withdrawn from normal-dose, long-term benzodiazepine treatment and their data compared with those of two control groups. Patients and controls were assessed repeatedly on the Digit Symbol Substitution Test (DSST), Symbol Copying Test (SCT), Cancellation Task (CT), Auditory Reaction Time (RT) and Key Tapping Rate (KTR). A substantial and prolonged practice effect was found on all the tests except RT and KTR. Prior to withdrawal the patients did not show the performance decrement on the CT, RT and KTR customarily associated with the initial phases of benzodiazepine therapy. A rebound performance increment was observed on KTR during the withdrawal. Patients demonstrated impaired performance on tasks requiring the combined use of sensory and fine motor skills.

Adult↗
PubMed1983

Monoamine metabolism during chronic benzodiazepine treatment and withdrawal.

Long-term normal-dose benzodiazepine treatment in seven patients was associated with reduced urinary excretion of MOPEG (4-hydroxy-3-methoxy-phenylglycol). Following the discontinuation of the drugs a characteristic withdrawal reaction occurred, with an increase towards normal values of the MOPEG excretion levels and changes in the excretion of 5-HIAA (5-hydroxyindoleacetic acid). No significant changes in the 24-hr urinary excretion of free cortisol or HMMA (3-methoxy-hydroxy-mandelic acid) were detected.

Adult↗
PubMed1983

Insomnia and short-acting benzodiazepine hypnotics.

Insomnia--the chronic inability to obtain the amount and quality of sleep needed for effective daytime function--is a common subjective complaint. Several major causes exist, and many strategems can be used in management. When drugs are indicated, the benzodiazepines are the first choice. Flurazepam, a long-acting compound, has recently been complemented by temazepam, a shorter-acting hypnotic. The pharmacokinetics, actions, and clinical uses of temazepam are reviewed. It is concluded that temazepam is preferable where daytime alertness must be unimpaired, with flurazepam reserved for patients who need daytime sedation.

Benzodiazepines↗
PubMed1982

A controlled comparison of flupenthixol decanoate injections and oral amitriptyline in depressed out-patients.

Sixty-eight depressed out-patients were allocated to treatment with either oral amitriptyline (75-225 mg/day) or intramuscular flupenthixol decanoate (10-30 mg every 14 days) in flexible dosage for 12 weeks under double-blind procedures. Various observer- and self-rating scales were applied before and after 2, 4, 8 and 12 weeks of treatment. Twenty-four patients completed the course of amitriptyline and 20 the course of flupenthixol. All variables improved over time, but there were no significant differences between the two drugs. The Newcastle scores pre-treatment were not related to drug response suggesting that both drugs were similarly effective across a wide spectrum of depressive disorders. Patients on amitriptyline tended to complain of dry mouth; those on flupenthixol had a higher incidence of extrapyramidal signs, the majority receiving anti-parkinsonian drugs at some time during the treatment. Flupenthixol decanoate in low dose is a useful anti-depressant, but should be restricted to short courses of treatment, to patients refractory to other treatments, and to patients suspected of poor compliance.

Administration, Oral↗
PubMed1981

Withdrawal from long-term benzodiazepine treatment.

Long-term, normal-dose benzodiazepine treatment was discontinued in 16 patients who were suspected of being dependent on their medication. The withdrawal was gradual, placebo-controlled, and double-blind. All the patients experienced some form of withdrawal reaction, which ranged from anxiety and dysphoria to moderate affective and perceptual changes. Symptom ratings rose as the drugs were discontinued, but usually subsided to prewithdrawal levels over the next two to four weeks. Other features of the withdrawal included disturbance of sleep and appetite and noticeable weight loss. Electroencephalography showed appreciable reduction in fast-wave activity as the drugs were withdrawn, and an improvement in psychological performance was recorded by the Digit Symbol Substitution Test. Because of the risk of dependence on benzodiazepines these agents should probably not be given as regular daily treatment for chronic anxiety.

Anti-Anxiety Agents↗
PubMed1981

Electrodermal activity in the affective disorders and schizophrenia.

Electrodermal activity was measured bilaterally at rest and during stimulation in 22 schizophrenic, 11 depressed and 12 anxiety state patients, and in 32 normal volunteers. No group showed a distinctive pattern of lateral asymmetry. The frequency of spontaneous fluctuation in electrodermal activity was greater in the anxiety state and schizophrenic groups and in those patients who reported auditory hallucination during recording. Few schizophrenic subjects failed to respond to visual stimulation but substantial minority failed to habituate. The implications of these findings are discussed.

Adolescent↗
PubMed1981

Assessment methods and the differential diagnosis of anxiety.

Anxiety states are commonly encountered, especially in general practice. Some endocrine disorders have features in common with anxiety states, especially thyrotoxicosis and idiopathic hypoglycemia. Functional cardiovascular disorders merge into anxiety states and include a large number of ill-differentiated syndromes. Other causes of anxiety are the drug-associated conditions, such as amphetamine overdose and barbiturate withdrawal. Among neuropsychiatric illnesses, temporal lobe epilepsy and the postconcussional state commonly have anxiety as a prominent syndrome. Psychophysiological technique can be used to assess anxiety levels in a variety of clinical contexts but need cautious interpretation. Anxiety is most easily assessed using rating scales but potential users must be clear as to what they are trying to measure. For clinical anxiety assessed by the physician, the Hamilton Scale is appropriate; for self-assessments linear scales can be adapted.

Adrenal Gland Neoplasms↗