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Biomedical subjects

M Schou

Publications and source records attributed to M Schou.

At least 109 records · Page 6Linked to original sources
PubMed1982

Lithium treatment regimen and renal water handling: the significance of dosage pattern and tablet type examined through comparison of results from two clinics with different treatment regimens.

For many year two Danish psychiatric hospitals having used different lithium treatment regimens. In one, slow-release tablets were given in two daily doses and, in the other conventional tablets were given in a single daily dose. In both hospitals many patients developed polyuria. Multiple regression analyses with sex, age, treatment duration, serum lithium concentration, and treatment regimen as predictor variables showed that the two treatment regimens did not affect the glomerular filtration rate or the proximal reabsorption differently, but that distal water reabsorption was significantly less affected and polyuria less pronounced in the patients given conventional tablets once daily than in those give slow-release tablets twice daily. The authors are divided among themselves as regards the implications of these findings.

Adult↗
PubMed1982

In vitro and in vivo inhibition by lithium of enkephalin binding to opiate receptors in rat brain.

The in vitro and in vivo effects of lithium ions on opiate receptor binding were studied in the cerebral cortex, the hippocampus and the basal ganglia of the rat. In vitro, lithium ions inhibited enkephalin binding to opiate receptors through a reduction in the number of binding sites, whereas the affinity was unchanged or only slightly decreased. In vivo, long term ingestion of lithium (3 weeks), during which the rats were maintained at a serum lithium level of approximately 1 mM, also inhibited enkephalin binding to rat neuronal membranes (P2-fractions) through a reduction of the number of opiate receptor binding sites, whereas the affinity was unchanged. No lithium could be detected in the suspension of neuronal membranes from the lithium-treated rats, and no difference in the concentration of endogenous opioid peptides was found between control rats and lithium-treated rats. The opiate receptors from control rats and lithium-treated rats did no display any difference in lithium sensitivity. This data suggest that administration of lithium to rats in small doses reduces opiate receptor binding of enkephalin.

Animals↗
PubMed1982

Trends in lithium treatment and research during the last decade.

The first systematic study on lithium prophylaxis in 1967 was supplemented some years later by (I) a study involving multiple regression analysis with cycle length and interval length as dependent variables and lithium treatment as one of the predictor variables, and (II) a double-blind study of discontinuation design in which patients were allocated randomly to lithium or placebo. Both studies confirmed the conclusions of the original trial. Interest in lithium remains vivid as reflected in many publications each year and widespread clinical usage. Overuse and misuse presumably occur to some extent. In recent years lithium research has included examination of possible predictors of response to lithium and studies on the effect of long-term lithium treatment of the kidneys. Guidelines for safe and effective lithium treatment are discussed.

Bipolar Disorder↗
PubMed1982

The major histocompatibility complex of outbred chickens. I. Analysis of the B13 haplotype by serology and cellular reactions.

The F antigens, which are serologically defined Class I gene products of the major histocompatibility complex in chickens (the B complex), were analysed in outbred birds. Private specificities of the F13 antigen from the inbred CC strain were detected in 20 outbred chickens by a haemagglutination technique. In the GVH-inhibition-release test F13 antigens from outbred and inbred chickens were identical. The L antigens, which are the Class II antigens of the B complex, were detected with specific anti L13 alloantisera by indirect immunofluorescence. Antisera defining the L13 antigen(s) of the inbred CC line reacted with all F13 positive outbreds. As a test of one-way direct compatibility of the inbred and outbred animals typing F13, graft versus host reactions were performed, injecting blood of F13 positive outbreds into inbred B13/13 eggs. No GVH stimulation attributable to MHC determinants was found. In MLR, responder cells from outbred MHC heterozygous chickens, which typed F13/x, were stimulated by inbred F13/13 homozygous typing cells, and weak, but significant, reactions were found. Further analysis in the accompanying paper, however, revealed no difference in the lymphocyte activating determinants (Lads) of inbred and outbred birds typing F13 and L13. No individual has yet been found which carries one of these antigens in the absence of the other.

Animals↗
PubMed1982

The major histocompatibility complex of outbred chickens. II. Analysis of the typing response in mixed lymphocyte culture stimulated by homozygous typing cells.

MLR phenotypes of outbred and inbred chickens typing B13 of the major histocompatibility complex (MHC) of the chicken were compared. F1 hybrids of outbred and inbred B13 positive chickens were analysed in mixed lymphocyte culture (MLC). The intermediate strength responses of cells from B13 heterozygous outbred chickens stimulated by inbred B13 homozygous chicken cells were not due to minor variations of B encoded lymphocyte activating determinants (Lads). Nor were Lads encoded by genes unlinked to the B complex responsible for these reactions. In contrast, F1 anti-parental type reactions were observed, and these alone are probably responsible for the intermediate strength reactions so often seen in typing of heterozygous outbreds with homozygous typing cells.

Animals↗
PubMed1982

Plasma arginine-vasopressin, renal-concentrating ability and lithium excretion in a group of patients on long-term lithium treatment.

Plasma arginine-vasopressin (AVP) was measured before and after 24 h of a 26-hour renal concentration test in 47 patients treated with lithium for 6-180 months (mean 70 months). In 34 of the patients, plasma AVP was also measured before and after a 2- to 4-hour period of water loading, and in 31 of the patients, creatinine, 125iothalamate, 131I-hippuran and lithium clearances were measured. Plasma AVP values were compared to those obtained in 8 healthy controls. Baseline AVP levels were significantly higher in the lithium-treated patients than in healthy controls. During the period of water deprivation AVP values increased significantly and during oral water loading a significant decrease took place, AVP values still being significantly higher in the lithium-treated patients than in the healthy controls. During oral water loading a slight increase in lithium clearance as well as fractional lithium excretion was seen as compared to values obtained during the last 2 h of a renal concentration test. This study demonstrates that antidiuretic hormone production is neither blocked nor inhibited during lithium treatment. The hypothalamic system reacts on water deprivation as well as on water loading. This study supports the notion that the main lithium-induced renal affection is a vasopressin-resistant impairment of renal concentrating ability.

Adult↗
PubMed1981

Flupenthixol decanoate in recurrent manic-depressive illness. A comparison with lithium.

The hypothesis that flupenthixol decanoate may serve as an alternative to prophylactically administered lithium in recurrent manic-depressive illness, bipolar and unipolar type, was tested in two groups of patients. In Group I the patients were allocated randomly to maintenance treatment with either lithium or flupenthixol decanoate. The patients in Group II had previously been given lithium and were switched to flupenthixol decanoate because of unsatisfactory prophylactic effect of lithium, doubtful tablet compliance, troublesome side effects, or fear of later harmful effects. The flupenthixol decanoate dosage was 20 mg every 2-3 weeks. The study was not blind. In Group I neither lithium treatment (14 patients) nor treatment with flupenthixol decanoate (19 patients) led to a significant fall of mean episode frequency or mean per cent time ill. The reasons for this lack of response are not clear, but prognostically negative selection of the patients presumably took place before and possibly also during the hospitalization. Since absent effects cannot be compared, this part of the trial remains inconclusive. In Group II (93 patients) treatment with flupenthixol decanoate was associated with significant falls of the frequency of manic episodes and per cent time ill in mania and with significant rises of the frequency of depressive episodes and per cent time ill in depression. Increase of depressive morbidity was seen only in patients who had been given lithium during the pre-trial period and was presumably a result of the discontinuation of lithium. It is not known whether flupenthixol decanoate is of value in the prophylactic treatment of recurrent manic-depressive illness, but the drug may be worth trying in patients whose disease is dominated more by manic than by depressive recurrences and who do not respond to lithium or do not tolerate it or do not take it.

Bipolar Disorder↗
PubMed1981

Serum lithium concentrations around the clock with different treatment regimens and the diurnal variation of the renal lithium clearance.

The serum lithium concentration was determined around the clock in patients treated with conventional tablets given once daily, in the evening, and in patients treated with slow-release tablets given twice daily, in the morning and in the evening. Curve shapes differed markedly in the two groups, with much wider variation of serum concentrations in the former than in the latter. The data were used to calculate for the two patient groups the ratio of the mean serum lithium concentration over the 24-h day to the serum lithium concentration in blood samples drawn 12 h after the last intake of lithium. Around-the-clock determinations of the patients' renal lithium clearance showed about 20% lower values during the night than during the day.

Bipolar Disorder↗
PubMed1981

Zinc concentrations in human plasma and in rat plasma and tissues during lithium administration.

Zinc concentrations, determined with atomic absorption spectrophotometry, did not differ significantly in plasma from manic-depressive patients about to start lithium treatment and in patients having been in lithium treatment for six months or 1-2 years. Plasma zinc concentrations and zinc concentrations in liver, muscle, kidney, bone, and skin did not differ in control rats and rats given lithium with the food for four weeks.

Animals↗
PubMed1981

Problems of lithium prophylaxis: efficacy, serum lithium, selection of patients.

For safe and effective lithium prophylaxis the following points should be given attention: (1) selection of patients, (2) treatment management, (3) treatment monitoring, and (4) information and instruction. Indications for lithium treatment depend not only on diagnosis but also on factors predicting the extent to which the patient would be at risk of relapse without lithium. The criteria used for prophylactic trials seem too narrow, since they exclude patients who might benefit from the treatment. Treatment management involves gradual adjustment of doses and 12-hour serum lithium levels to values that for the individual patient give a maximum of prophylactic protection and a minimum of side effects. In some patients serum lithium may with advantage be maintained around 0.6-0.8 mmol/l instead of the usually recommended 0.8.-1.1 mmol/l. Patients, relatives and health personnel should be carefully instructed about the aims, the management, and the risks of lithium treatment.

Bipolar Disorder↗
PubMed1981

Late side effects of lithium treatment.

Many patients have now been given lithium for 10-15 years, and the overall picture as regards late side effects is not alarming. Changes of renal morphology and function currently attract interest. Histologically demonstrate interstitial nephropathy may be observed in 10-15% of patients, but glomerular filtration rate is little affected or unaffected, and the risk of progressive renal failure with terminal azotemia is remote even in patients given lithium for many years. Renal water reabsorption is often impaired, and the patients may develop polyuria or lowered concentrating ability. These changes are not in themselves dangerous, but since dehydration may lead to lithium poisoning, the patients should drink extra water during situations with risk of a negative water balance.

Bipolar Disorder↗
PubMed1981

Kidney morphology and function in lithium-treated patients.

The findings of morphological changes in the kidneys of some patients given long-term treatment with lithium and indications that lithium intoxications frequently are preceded by alterations in water and electrolyte metabolism have generated new interest in the effect of long-term lithium treatment on kidney structure and function. Today it is not firmly established to which extent renal morphological changes are present in unselected groups of patients given long-term treatment with lithium. Neither is it clear what is the clinical significance of these changes and what are the relative roles played by lithium, concomitant and previous treatment with other psychotropic drugs, previous occurrence of lithium intoxications, and coexistence of somatic illness for their development. Studies on kidney function in long-term lithium-treated patients, however, have revealed that affection of GFR was either moderate or absent indicating that the risk of renal insufficiency and terminal azotemia is remote even when lithium is given for many years. A large number of patients have altered water excretion with polyuria or lowered urine concentrating ability or both. Due to the extra fluid loss these patients are apt to develop dehydration, and they may then be in danger of lithium intoxication. We hypothesize that lithium-induced changes of kidney function may become less frequent and less pronounced if patients are maintained at serum lithium levels somewhat lower (0.5-0.8 mmol/l) than those commonly employed. We recommend careful monitoring of serum lithium levels, regular control of kidney function, and extra caution when physical illness or additional drug treatment may lead to disturbance of fluid and electrolyte balance.

Glomerular Filtration Rate↗