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Biomedical subjects

M Schou

Publications and source records attributed to M Schou.

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

Lithium in manic-depressive illness: plusses, pitfalls, and perspectives.

Prophylactic lithium treatment of manic-depressive illness offers advantages to patient and family, to society, to the psychiatrist, and to research. The treatment must be administered in accordance with certain guidelines in order to provide maximal efficacy and minimal risk. Research on the mode of action of lithium and its prophylactic alternatives may serve to elucidate metabolic disturbances in the brains of manic-depressive patients. It might also one day reveal biological factors which govern mood, activity and mental speed. Could such knowledge be misused to manipulate mood, one's own or that of others?

Bipolar Disorder↗
PubMed1988

Prospective studies on a lithium cohort. 1. General features.

Since 1979, patients started on long-term lithium treatment at the Psychiatric Hospital in Risskov have been followed systematically with recording of clinical and laboratory variables before the start of treatment, after 6 and 12 months of treatment, and thereafter at yearly intervals. By June 1987, 480 examinations had been carried out before the start of lithium treatment, 236 after treatment for 6 months, and decreasing numbers up to 7 years of lithium treatment. The total lithium exposure time was 548 years. The mean lithium dose was 23.2 mmol/d and the mean serum lithium concentration 0.68 mmol/l. These values are about 30% lower than the corresponding values in patients given lithium treatment prior to 1979. About one half of the patients who had gone through the pre-lithium examinations did not reach the 6-month examination. This was because they did not start lithium, or because they stopped it again before 6 months of treatment or before they had reached that point. Thereafter there was a drop-out rate of about 25% per year during the first 2 years of lithium treatment and about 10% per year after 4-5 years of treatment. More men than women left the cohort.

Adult↗
PubMed1988

Prospective studies on a lithium cohort. 2. Renal function. Water and electrolyte metabolism.

A cohort of manic-depressive patients given prophylactic lithium treatment were examined before treatment started and at intervals during treatment for up to 7 years. The mean lithium dosage was 23.2 mmol/d and the mean serum lithium concentration 0.68 mmol/l. The treatment did not affect glomerulus function. Urine volume rose by 10-20% and renal concentrating ability fell by 7-10% during the treatment. These changes were markedly smaller than those found in patients treated previously with higher lithium doses and serum lithium concentrations. High urine volumes and low renal concentrating abilities were not more frequent during than before lithium treatment. Complaints of increased thirst, frequent urination, and nycturia were presented more often during than before lithium treatment. Serum concentrations, urinary excretions and renal clearances of sodium and potassium were not altered by the treatment.

Adult↗
PubMed1988

Prospective studies on a lithium cohort. 3. Tremor, weight gain, diarrhea, psychological complaints.

A cohort of manic-depressive patients given prophylactic lithium treatment were examined before treatment started and at intervals during treatment for up to 7 years. The mean lithium dosage was 23.2 mmol/d and the mean serum lithium concentration 0.68 mmol/l. About 40% of the patients were entirely free of side effects, as compared with 10% among patients treated previously with higher lithium doses and serum lithium concentrations. Tremor complaints were presented by 5% of the patients before and by 15% during lithium treatment. The frequency fell with continued treatment, and after a few years it was not higher than before treatment started. Tremor complaints were positively correlated with age and with the use of neuroleptics and antidepressants. The tremorigenic effects of lithium and antidepressants seemed to potentiate each other. Tremor complaints were more frequent at serum lithium levels over than under 0.7 mmol/l. Body weight increased during the first 1-2 years of lithium treatment and then remained constant. The average gain was 4 kg. Weight gain was positively correlated with the patients' body weight before treatment and with the concurrent administration of antidepressant drugs. The frequency of diarrhea complaints (loose stools, defecation urge) rose from 1% to 6% during the first 6 months of lithium treatment and then leveled off. The frequency rose steeply at serum lithium values over 0.8 mmol/l. During lithium administration about one tenth of the patients had psychological complaints, which might or might not have been caused by the treatment: memory impairment and concentrating difficulty, tiredness and "greyness of life", in a few cases altered taste or lowered libido and potency.

Adult↗
PubMed1988

The integrated approach. On the significance of pharmacological and nonpharmacological factors when lithium prophylaxis fails.

Drugs are easy to prescribe, and if a manic-depressive patient is not helped by one prophylactically administered drug, physicians may be apt as a first reaction to prescribe another drug, especially now that alternatives to lithium have become available. This may or may not be the appropriate course of action. Often nonpharmacological factors determine whether patients consume their medicine and whether they respond to it, and concern about patient selection, patient characteristics, treatment execution, patient and therapist attitudes, treatment organization, and supplementary psychological support may more profitably serve to ensure that manic-depressive patients obtain help from prophylactic drug treatment. Only by employing a treatment approach which integrates pharmacological and nonpharmacological measures can optimal results be obtained.

Animals↗
PubMed1988

Did manic-depressive patients who committed suicide receive prophylactic or continuation treatment at the time?

Ninety-two Danish manic-depressive patients with a first psychiatric admission between 1969 and 1983, who committed suicide before 1 July 1986, were considered. Information on any prophylactic or continuation treatment at the time of the suicide was obtained. In 64 of the patients, every precaution seems to have been taken: 28 patients committed suicide during ongoing treatment; 10 while not receiving prophylactic treatment (not indicated); 7 while not in prophylactic treatment because the patients refused or did not tolerate such; and 19 while in prophylactic treatment with antidepressants (10), or lithium (6), or both (3), in usually adequate dosage. In 28 of the patients, suicide might have been obviated. Guidelines for improvement of suicide prevention in manic-depressive illness are presented.

Adult↗
PubMed1988

Distinction between proximal and distal regulations of sodium and potassium excretion in humans.

The clearances of creatinine (CCr), lithium (CLi), sodium (CNa), and potassium (CK) were determined during three consecutive 2-hour periods in a large number of physically healthy persons who were in lithium treatment for manic-depressive illness. CLi was used as a measure of the proximal tubular fluid output (Vprox). CLi showed considerable spontaneous variations from one 2-hour period to another, and neither bladder emptying errors nor changes of CCr could account for these. The variations of CLi, which reflected variations of Vprox, resulted in joint variations of CNa and CK. Also the ratios CNa/CLi and CK/CLi, which reflected the distal handling of sodium and potassium, showed considerable spontaneous variations. These were correlated neither with each other nor with variations of CLi. Our study indicates that through the use of CLi as a measure of Vprox it is possible to distinguish between a single joint proximal regulation and two separate distal regulations of sodium and potassium excretion. Further studies concerning the interplay between proximal and distal regulations under normal and pathological conditions may provide deeper insight into the way in which the kidney functions.

Bipolar Disorder↗
PubMed1987

Changes in serum thyroxine (T4) and serum thyroid stimulating hormone (TSH) during prolonged lithium treatment.

We determined serum T4 and serum TSH serially in a cohort of patients given lithium treatment for up to 6 years; the total lithium exposure time was 409 years and the average serum lithium concentration 0.69 mmol/l. T4 showed a small and not significant fall at 6 months and returned to the pre-lithium level at 12 months. Hereafter, T4 rose gradually and after 6 years of lithium treatment T4 was 53% higher than the pre-lithium value. TSH was significantly increased at 6 and 12 months and then returned to the pre-lithium level. Eight patients required thyroxine treatment for lithium-induced hypothyroidism, i.e. 2 per 100 years of lithium exposure time. Single deviant values of T4 and TSH could be seen, followed by normal values. We suggest that TSH is determined at intervals during lithium treatment. It may be prudent to subject lithium-treated patients with abnormal thyroid values to re-examination and to abstain from starting thyroxine treatment on the basis of a single deviant value.

Follow-Up Studies↗
PubMed1987

Does long-term lithium treatment induce diabetes mellitus?

Fasting blood sugar was determined in manic-depressive patients before the start of lithium treatment and at intervals during treatment for up to 6 years. The total exposure time to lithium was 495.5 years. Even though the patients gained significantly in age and body weight during the treatment, their mean blood sugar values remained the same as before treatment was started, and only 1 patient developed manifest diabetes. There is no reason to believe that long-term lithium treatment leads to increased risk of developing diabetes mellitus.

Adolescent↗