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Biomedical subjects

M J Garvey

Publications and source records attributed to M J Garvey.

At least 73 records · Page 4Linked to original sources
PubMed1988

Benzodiazepine withdrawal: a review of the evidence.

In a recent series of controlled studies, investigators looked at what happened when benzodiazepines were discontinued. Despite methodological problems, these studies showed that rebound anxiety occurred in a substantial minority of patients after several weeks of drug use. Also, a withdrawal syndrome developed in nearly half of patients who used benzodiazepines for more than a year. In these studies, risk factors included dose, duration of use, elimination rate of the drug, and abruptness of discontinuation. Patients who are physically dependent on benzodiazepines may need help in stopping these agents. Physicians should advise gradual discontinuation and, along with emotional support, should consider the use of alternative medications for the control of symptoms.

Anti-Anxiety Agents↗
PubMed1988

A retrospective evaluation of plasma trazodone concentrations and clinical response in a primary care clinic.

Trazodone has become a very popular second generation antidepressant. In our experience, trazodone levels are frequently obtained albeit interpretation/utility of these levels and purported normal ranges are in question. We analyzed 39 consecutive cases of major depressive disorder treated with trazodone in a primary care medical clinic. Thirty (79%) of subjects had a positive response. While a positive correlation existed between dosage and concentration of the parent drug, no dose-response correlation could be identified within this cohort. However, a minimum level of 250 ng/ml did appear necessary for a response. The overall utility/cost efficacy of second generation antidepressants, in the absence of well designed dose response studies, is questioned.

Adult↗
PubMed1987

Occurrence of myoclonus in patients treated with cyclic antidepressants.

Myoclonus associated with cyclic antidepressant therapy has been considered to be a rare phenomenon. Ninety-eight patients who were to begin receiving cyclic antidepressant therapy were prospectively evaluated for myoclonus. Thirty patients experienced clinically insignificant drug-associated myoclonus. Nine patients had clinically significant myoclonus. The myoclonus was reversible with the discontinuation of therapy but tended to persist if medication changes were not made. None of the tested clinical variables were able to predict which patients would develop myoclonus.

Adult↗
PubMed1987

Elevations of urinary MHPG in depressed patients with panic attacks.

Anxiety may be associated with increased norepinephrine activity. Urinary levels of the norepinephrine metabolite 3-methoxy-4-hydroxyphenylglycol (MHPG) were examined in depressed patients with and without panic attacks. Depressed patients with panic attacks had significant elevations of MHPG.

Adult↗
PubMed1987

Comparison of color preference in depressives and controls.

Color preferences of 61 patients with major depressive disorder were compared to 69 controls. A multidimensional scaling analysis revealed a difference in overall color arrangements between groups. The possible significance of this is discussed.

Color↗
PubMed1987

Dextroamphetamine treatment of mania.

Five of six acutely manic patients treated with dextroamphetamine experienced a 50% or greater reduction in their mania severity scores. Side effects were noted in only one patient. The treatment results suggest that dextroamphetamine might be useful in the treatment of mania.

Acute Disease↗
PubMed1987

Alcoholism.

Alcoholism is a major health problem that impinges on a multitude of areas. This article will emphasize common primary care presentations, diagnosis, genetics, epidemiology, medical complications, and management.

Adult↗
PubMed1986

Prediction of postdexamethasone cortisol levels by serum sodium levels in patients with major depression.

The authors analyzed the dexamethasone suppression test (DST) results of 54 patients with major depressive disorder in relation to their pre-DST levels of cholesterol, sodium, potassium, and blood glucose, which are thought to have adrenocorticotrophic links. Discriminant analysis revealed that sodium alone was a significant predictor of nonsuppression. Validation of the predictive power of sodium could minimize the need for DST administration.

Adult↗
PubMed1985

Thyroxine binding and TSH in recurrent depressive episodes.

Evidence of a link between recurrent affective disorders and the hypothalamic-pituitary-thyroid (HPT) axis has been frequently reported. The clinical course of 40 recurrent major depressive patients was monitored over 2 years with respect to several parameters of thyroid function. Patients entering a depressive recurrence manifested lower free versus bound thyroxine quotients and had higher TSH secretion. A dynamic HPT axis response may enhance the clinical outcome of acute depression during continuation pharmacotherapy.

Adult↗
PubMed1984

Hypersomnia in major depressive disorders.

Hypersomnia was experienced by 17 of 102 patients with major depressive disorder. Comparisons between hypersomnic and non-hypersomnic depressives demonstrated significant associations between hypersomnia and increased appetite, weight gain, agitation, headaches, depression in a first-degree relative, and earlier age of illness onset.

Appetite↗
PubMed1984

Elevated plasma tricyclic levels with therapeutic doses of imipramine.

Nine (15%) of 59 patients treated with imipramine at doses of 150 to 300 mg/day had steady-state plasma levels greater than 500 ng/ml. Low capacity for hydroxylation was found in all six patients for whom hydroxy metabolites were measured. Maximum tricyclic levels in the nine study patients were comparable to levels found in tricyclic antidepressant overdoses (651-2439 ng/ml). No study patient experienced any adverse effects: QRS durations were all less than 100 msec, and a mildly dry mouth was the most commonly reported side effect (five of nine patients). Depressive symptoms recurred in three patients when their imipramine dose was decreased.

Adult↗
PubMed1984

Migraine headaches and depression.

After taking the lifetime migraine headache histories of 116 patients with major depressive disorder, the authors compared the prevalence of migraine headaches in these depressed patients with the prevalence of migraine reported in four community surveys. There was a trend for the depressed men to experience a higher prevalence of migraine than men in the general population, but the depressed women had a migraine prevalence similar to that of women in the general population. No differences on multiple variables of depressive illness were found between depressed patients with a history of migraine and those with none.

Child↗
PubMed1984

The neuroleptic syndrome and central dopamine metabolites.

The neuroleptic malignant syndrome remains an intriguing syndrome, yet its pathogenesis is unknown. Despite numerous analogies with peripheral disorders of aberrant calcium migration in the sacroplasmic reticulum, the probable loci are striatal and hypothalamic (preoptic) dopaminergic pathways. In order to clarify the characteristics of dopamine activity, analysis of the central metabolites 3,4-dihydroxyphenylacetic acid and homovanillic acid in one case revealed marked elevations. A possible role for postsynaptic dopamine receptor inhibition is discussed. These findings further suggest that the syndrome may be similar to other extrapyramidal disorders, and they lend credence to observations of its reported drug induction and management.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1984

Postpartum depression.

Postpartum depression (PPD) occurs in 4% of women during the puerperium. Patients with a previous history of depression, especially a postpartum depression, have a much greater incidence of PPD. Those patients should be evaluated carefully during the six-week period following parturition. PPD is to be differentiated from "baby blues," which occur in more than 50% of women postpartum. Baby blues are characterized by intermittent, mild affective symptoms that remit spontaneously after several days.

Antidepressive Agents↗