A prospective study of the treatment of psychotic depression.
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Affective Disorders, Psychotic↗
Biomedical subjects
M R Mandel
Publications and source records attributed to M R Mandel.
Acute extrapyramidal reactions with fluphenazine hydrochloride and fluphenazine decanoate.
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Adolescent↗
Facial electromyography in the assessment of improvement in depression.
Depressed patients who showed decreases in resting corrugator muscle tension levels, as measured electromyographically, also showed improvement in clinical symptoms, as assessed by the Hamilton Psychiatric Rating Scale over a 2-week period. Patients showing good clinical improvement after 2 weeks had resting pretreatment corrugator levels higher than those showing little clinical improvement, suggesting that corrugator activity might also serve as a forecaster of subsequent change. These findings support Darwin's 1872 hypothesis concerning the role of the "grief" muscle in depression. Furthermore, psychophysiological recording of patterns of facial muscle activity may have value in the clinical assessment of depression and treatment effects.
Amitriptyline↗
Catatonic reactions to high-potency neuroleptic drugs.
Eight patients developed a syndrome marked by features of catatonia (including posturing, waxy flexibility, withdrawal and regression) and parkinsonism (including bradykinesia and rigidity) while receiving high-potency neuroleptic drugs. The syndrome had a gradual onset, responded slowly to withdrawal of the neuroleptic or use of an anticholinergic agent, but seemed to respond more rapidly to amantadine. The syndrome may easily be confused with a worsening of schizophrenic symptoms.
Adolescent↗
Facial muscle patterning to affective imagery in depressed and nondepressed subjects.
When subjects imagine happy, sad, and angry situations, different patterns of facial muscle activity are produced which can be measured by electromyography. These subtle, typically covert, facial expression patterns differentiate depressed from nondepressed subjects. Facial electromyography can provide a sensitive, objective index of normal and clinical mood states.
Depression↗
The long-acting phenothiazines.
Injected intramuscularly, the enanthane and decanoate esters of the phenothiazine fluphenazine are an effective treatment of the disordered behavior and thinking of schizophrenia. The decanoate preparation is not only slightly longer-acting but also has a smaller incidence of side-effects that the enanthate. The major adverse effect of these medications is the high frequency of extrapyramidal system disturbance. Since the 50% rate of failure of schizophrenic outpatients to take prescribed oral medications decreases treatment failure to about 20% with the use of long-acting injectable phenothiazines, this route of administration offers an advantage in patient management particularly applicable to community mental health systems. Moreover, parenteral administration of long-acting fluphenazine may be useful for patients who do not attain effective serum levels with medication taken orally because of metabolic or absorption difficulties.
Antiparkinson Agents↗
Electroconvulsive therapy for chronic pain associated with depression.
Electroconvuslive therapy alleviated the symptoms of four out of six patients suffering from chronic pain and from depression as measured by the Hamiliton Depression Rating Scale. All of the patients had been unsuccessfully treated with tricyclic antidepressant medication. The author suggests that ECT may be the treatment of choice for some patients with this combination of symptoms.
Aged↗
Facial expression and imagery in depression: an electromyographic study.
When subjects are instructed to self-generate happy, sad, and angry imagery, discrete patterns of facial muscle activity can be detected using electromyographic (EMG) procedures. Prior research from this laboratory suggests that depressed subjects show attenuated facial EMG patterns during imagery conditions, particularly during happy imagery. In the present experiment, 12 depressed subjects and 12 matched normals were requested to generate happy and sad imagery, first with the instruction to simply "think" about the imagery, and then to self-regulate the affective state by "reexperiencing the feelings" associated with the imagery. Continuous recordings of facial EMG were obtained from the corrugator, zygomatic major, depressor anguli oris, and mentalis muscle regions. It was hypothesized that (a) these muscle sites would reliably differentiate between happy and sad imagery. (b) the instruction to self-generate the affective feeling state would produce greater EMG differences than the "think" instructions, and (c) the "think" instructions would be a more sensitive indicator of the difference between depressed and nondepressed subjects, especially for happy imagery. All three hypotheses were confirmed. The application of facial electromyography to the assessment of normal and clinical mood states, and the role of facial muscle patterning in the subjective experience of emotion, are discussed.
Adult↗
Posterior peribulbar anesthesia: an alternative to retrobulbar anesthesia.
Peribulbar anesthesia is a safe alternative to retrobulbar anesthesia for ophthalmic surgery. Because the anesthetic is deposited outside the muscle cone, the potential for intraocular or intradural injection is greatly minimized. Furthermore, intraconal hemorrhage and direct optic nerve injury is avoided. We illustrate the details of our technique for posterior peribulbar anesthesia and describe our experience in over 3,000 cases.
Anesthesia, Local↗