Search PubMed⌕ Search

Biomedical subjects

M Soyka

Publications and source records attributed to M Soyka.

At least 37 records · Page 2Linked to original sources
PubMed2005

[Drug analytics in oral fluid using immunoassay].

Drug analytics in oral fluid can be of relevance for various clinical and forensic questions, for example when testing for driving ability. To date few studies have been conducted concerning validity of different methods. The reliability of drug analytics in oral fluid was studied using cedia test and emit test (for cannabinoids). CUT-offs for different substances were defined after evaluation of ROC curves following various prestudies. 97 saliva and 103 urins probes from 31 opioid dependent patients were tested. Only for methadone, the results in oral fluid were comparable to those in urine. For most other drugs including opioids and barbiturates, results were less favourable. For cannabinoids and benzodiazepines, results were unsatisfactory. To date drug testing in oral fluid does not seem to be as accurate as urine analytics. Urine testing using immunoassays or gas chromatography is still the most reliable non-invasive test method. Drug testing in oral fluid may be of relevance as an additional method in substitution treatment and as an experimental tool in epidemiological road surveys.

Adult↗
PubMed2005

Treatment of alcohol withdrawal syndrome with combined carbamazepine and tiapride in a patient with probable sleep apnoe syndrome.

The most frequently used agents for treatment of alcohol withdrawal syndrome are benzodiazepines and clomethiazole. Both have the main disadvantage of potential misuse and respiratory depression. Therefore their use in patients with respiratory diseases is limited. In recent years a treatment strategy with combined carbamazepine and tiapride was reported to be an effective alternative in alcohol withdrawal without the risk of respiratory depression. We report the successful treatment with carbamazepine and tiapride of a patient with probable sleep apnoe syndrome and history of withdrawal-related epileptic seizures.

Aged↗
PubMed2005

Tryptophan hydroxylase gene 1 polymorphisms are not associated with suicide attempts in alcohol-dependent individuals.

A serotonergic dysfunction was suggested to be involved into the biological susceptibility of suicidal behaviour. Tryptophan hydroxylase (TPH), the rate-limiting enzyme in serotonin biosynthesis, is a significant regulating factor in the serotonergic system. Recently the A-6526G, and G-5806T and A-779C polymorphisms of the TPH 1 gene were identified and suggested to be associated with suicidal behaviour, but study results are conflicting. We examined a possible association of the A-6526G, and G-5806T and A-779C polymorphisms with suicide attempts in a sample of 80 alcohol-dependent individuals with a history of at least one suicide attempt. This group was analysed in comparison with 241 alcohol-dependent subjects without such a history. No significant relationship between haplotype and genotype distribution and allele frequencies of these polymorphisms with suicide attempts were detected. Furthermore, no association with number of suicide attempts and TPH haplotypes were found. Our data do not support the hypothesis of A-6526G, G-5806T or A-779C polymorphisms to be associated with suicide attempts in alcohol-dependent individuals.

Adult↗
PubMed2005

Validity of carbohydrate-deficient transferrin (%CDT), gamma-glutamyltransferase (gamma-GT) and mean corpuscular erythrocyte volume (MCV) as biomarkers for chronic alcohol abuse: a study in patients with alcohol dependence and liver disorders of non-alcoholic and alcoholic origin.

AIM: To test the clinical performance of carbohydrate-deficient transferrin (%CDT), gamma-glutamyltransferase (gamma-GT) and mean corpuscular erythrocyte volume (MCV) as biomarkers for alcoholism with a special focus on patients suffering from liver diseases. DESIGN: Well-characterized collectives of alcohol-dependent patients with current consumption (ALC patients, n = 101), and relevant control groups (115 social drinkers, 46 patients with unspecifically increased gamma-GT, 51 hepatitis patients and 20/31 patients with non-alcohol/alcohol-dependent liver cirrhosis) were included into the study. The Positive Alcohol Use Disorders Test (AUDIT) score, International Classification of Diseases version 10 (ICD-10)/Diagnostic and Statistical Manual version IV (DSM-IV) criteria and blood drawn within 4 days of last drinking were inclusion criteria for subjects with regular heavy drinking. %CDT was determined using an automated assay which recently had been completely modified. FINDINGS: Median AUDIT scores of patients without/with regular heavy drinking were 1-3/27. The following medians/95th percentiles were obtained for %CDT: social drinkers 2.2/3.0, patients with unspecifically increased gamma-GT 2.1/3.0, hepatitis 2.0/4.4, non-alcohol-dependent liver cirrhosis 2.4/4.8, alcohol-dependent liver cirrhosis 3.0/5.9, ALC patients 3.9/14.9. Differences between patients without and with alcohol abuse were highly significant (P < 0.001). No differences in CDT values were found between males and females. There was no correlation between %CDT values, gamma-GT, MCV and the amount of alcohol consumed in ALC patients; 3.0%CDT (95th percentile social drinkers) is proposed as cut-off for the test used (Tina-quant %CDT 2nd-generation). At this cut-off, the sensitivity for ALC patients was 73.3%, whereas gamma-GT/MCV had a sensitivity of 71.3%/64.4%. Multivariate analysis performed at 95% specificity resulted in an improvement of the sensitivity by combining %CDT with gamma-GT (83.2%). A further enhancement of the sensitivity to 88.1% was obtained by combination of %CDT, gamma-GT and MCV. The diagnostic specificity of %CDT calculated at the cut-off of 3% was 93.5% in patients with unspecifically increased gamma-GT, 88.2% in hepatitis patients and 70.0% in patients with non-alcohol-dependent liver cirrhosis. %CDT was more specific in these patient collectives than MCV, and especially more than gamma-GT (specificity in hepatitis 52.9%, and 35.0% in non-alcohol-dependent liver cirrhosis). CONCLUSION: %CDT is of high diagnostic value to support diagnosis of alcohol-use disorders. The specificity of this marker in patient groups with liver disorders is superior to the biomarkers gamma-GT and MCV.

Adolescent↗
PubMed2004

[Considerations in the combination of clozapine and benzodiazepines].

Serious adverse events and even sudden death have been reported during administration of the combination of clozapine and benzodiazepines. However, this combination does not necessarily result in increased frequency of serious adverse events. Thus it is not regarded as an absolute contraindication and might be useful in distinct clinical situations, e.g., during the occurrence of a malignant neuroleptic syndrome, "catatonic dilemma," or severe agitation during clozapine treatment. In the following report, certain suggestions on how to deal with this combination therapy are provided which may provide a basis for discussion that ultimately may lead to the formulation of guidelines for this combination therapy. Such guidelines may help psychiatrists in dealing with this combination in clinical situations. Moreover, the formulation of such guidelines would help with forensic issues in case of serious adverse events occurring during this combination therapy.

Adverse Drug Reaction Reporting Systems↗
PubMed2004

Hypothalamic-pituitary-adrenal system regulation in recently detoxified alcoholics is not altered by one week of treatment with acamprosate.

BACKGROUND: Acamprosate decreases relapse rates in alcohol-dependent patients by approximately 10-20% within the first year after detoxification. Psychological stress is a major risk fac-tor for relapse and is associated with activation of the hypothalamic-pituitary-adrenocortical (HPA) system. In recently detoxified alcoholics, the HPA system is dysregulated with non-suppression of cortisol after dexamethasone administration. We therefore investigated whether acamprosate normalizes HPA hyperactivity in alcoholics within the first 3 weeks of abstinence, employing a combined dexamethasone/corticotropin-releasing hormone (Dex-CRH)-test. METHODS: Thirty alcohol-dependent patients were tested one week after withdrawal signs had disappeared. In 15 patients, acamprosate, 1332-1998 mg/day, was administered orally and a second Dex-CRH test was performed 1 week later. In the other 15 patients, acamprosate treatment was offered only after the second test. RESULTS: CRH-stimulated cortisol secretion was significantly increased in both the acamprosate group and the group receiving no anti-relapse medication compared to a control group of 15 healthy subjects. Acamprosate treatment had no effect on basal or CRH-stimulated ACTH or cortisol secretion. CONCLUSIONS: We conclude that 1 week of acamprosate treatment does not attenuate the HPA dysregulation ob-served during early abstinence.

Acamprosate↗
PubMed2004

No association of CRH1 receptor polymorphism haplotypes, harm avoidance and other personality dimensions in alcohol dependence: results from the Munich gene bank project for alcoholism.

Because corticotrophin-releasing hormone (CRH) plays a central role in stress regulation, the possible role of CRH1 polymorphism for anxiety-related personality variables such as harm avoidance possibly associated with alcoholism was studied. The research instruments used to phenotype patients were adopted partly from the US collaborative study of the genetics of alcoholism and include a number of personality inventories such as the temperament and character inventory (TCI). Based on the examination of 170 alcoholic subjects no association was found between CRH1 receptor haplotypes of four single nuclotid polymorphisms (SNPs) and low and high temperament traits of harm avoidance, novelty seeking and reward dependence. The possible implications of these findings are discussed.

Adult↗
PubMed2003

Association of 5-HT1B receptor gene and antisocial behavior in alcoholism.

The 5-HT1B receptor gene has been postulated to play a modulatory role in alcohol consumption and alcohol dependence, and was considered a candidate gene for alcoholism. More recently, the association of the 5-HT receptor gene polymorphism and antisocial personality traits in alcoholism has been discussed. This possible association was studied using material from our gene bank for alcoholism. The research instruments used to phenotype patients were partly adopted from the US Collaborative Study on the Genetics of Alcoholism (COGA) which include anxiety- and depression-related scales from personality inventories such as the temperament and character inventory (TCI), the NEO-Five-Factor Inventory (NEO-FFI) and the Minnesota Multiphase Personality Inventory (MMPI-2). Based on the examination of 164 alcoholic subjects, an association was found between a lower frequency of the 5-HT 1B 861C allele, antisocial personality traits and conduct disorder in alcohol-dependent subjects. Adult antisocial personality occurred more often in males than females. Possible implications of these findings are discussed.

Adult↗
PubMed2003

[General practitioner plays a central role as case manager. Diagnosis and therapy of alcoholism].

The family doctor plays an important role in the treatment of alcoholism, especially in the initial contact and motivation phases, but also in the aftercare phase following outpatient or inpatient detoxification and rehabilitation. The central tasks are the diagnosis of alcohol dependency and possible neurological and somatic sequelae, mediation, information about consequences and motivation to undergo further treatment. After successful treatment (abstinence)--prevention of relapse, where necessary using so-called anti-craving drugs such as acamprostate.

Alcohol Deterrents↗
PubMed2003

[New possibilities in treatment and rehabilitation of alcohol-dependent patients--a catamnestic study on the efficiency of outpatient treatment programmes demonstrated by a model procedure].

First results of a clinical and catamnestic investigation are reported for the efficiency of a highly structured outpatient therapy with alcohol-dependents. One hundred and two patients were included in the study. Of the patients,60% were male and 40% female. The average age was 45 years (+/-8). The average duration of alcohol dependence amounted to 15 years (+/-9), and the last average quantity of pure alcohol drunk was 193 g. Twenty-seven per cent of the patients had completed inpatient therapies in the past. Treatment retention amounted to n=74 (72.5%), and 18 of the 25 dropped out because of alcohol relapse. On average, relapsed dropouts indicated a longer abuse of alcohol and significantly more pretreatments than completers, and they also reported significantly stronger craving for alcohol (measured with the OCDS). Furthermore, they also achieved significantly higher total scores in the BDI (depression) and STAI (anxiety) scales at the beginning of therapy. At 6/12-month follow-ups, 90%-95% of the patients were successfully located and interviewed. Analyses revealed that 64% of the patients were still abstinent at 6-month follow-up evaluation, and 56% had remained abstinent until 12-month follow-up. Therapeutic implications of these satisfying therapy results are discussed, and the current knowledge on the efficiency of outpatient therapies is presented.

Adult↗
PubMed2003

Alcoholism-related phenotypes and genetic variants of the CB1 receptor.

OBJECTIVE: Neurotransmitter release of GABAergic and glutamatergic neurons may be significantly influenced by cannabinoid CB1 receptors located at presynaptic nerve terminals. GABA and glutamate have been reported to be involved in the pathogenesis of severe alcohol withdrawal-induced seizures and delirium tremens. The aim of this study is to test the potential influence of a bi-allelic cannabinoid receptor gene (CNR1) polymorphism (G1359A) on severe alcohol withdrawal syndromes. METHODS: Based upon a sample size estimation, 196 subjects meeting DSM IV and ICD10 criteria for alcohol dependence and 210 non-alcoholic controls were recruited for study. CB1 polymorphisms were determined using polymerase chain reaction (PCR). History of alcohol withdrawal-induced delirium tremens, seizures and other alcohol withdrawal-related phenotypes were obtained using the SSAGA (Semi-Structured Assessment of Genetics in Alcoholism). Data were corroborated with information from the inpatients' clinical files. RESULTS: Allele frequencies of the CNR1 G1359A polymorphism were within the range reported by previous studies. After correcting for multiple testing, no association of the A- or G-allele of CNR1 polymorphism with a history of alcohol withdrawal-induced seizures was detected. In addition, no significant relationships with other alcoholism-related phenotypes were found. CONCLUSION: This study failed to confirm an earlier report of a potential role of a CNR1 polymorphism in the pathogenesis of delirium tremens.

Adult↗
PubMed2003

[Cannabinoids and mental health].

Cannabis and marihuana are psychoactive substances. Beside alcohol they belong to the most widely consumed drugs in most western countries. Psychiatric complications are frequent: substance use, dependence, possibly withdrawal, intoxications and cognitive dysfunction. There is substantial evidence for an increased risk for psychosis in chronic cannabis consumers. Recent data also indicate a high comorbidity with affective disorder. Chronic pain is only rarely mentioned as reasons for cannabis use, psychological or social reasons prevail. Psychiatric complications in cannabis consumers and its relevance for mental health are discussed.

Cannabinoids↗
PubMed2003

[Glutamatergic mechanisms in alcohol dependence--genetic, molecular-biological and neuropharmacological findings].

A number of preclinical and clinical findings suggest that the glutamate system, especially NMDA-receptors has a major function in neuropsychiatric disorders related to chronic alcoholism. Other findings suggest, that glutamatergic mechanisms may also play a role for the addictive process itself including craving and addiction memory. A number of genetic and molecular-biological findings and more recent neuropharmacological studies point in this direction. NMDA-modulators and antagonists have been found to be possible or even clinically effective so called anti-craving-drugs. A better understanding of the glutamatergic mechanisms in alcohol dependence may therefore also be of relevance for the development of new anti-craving-drugs and therapy-research.

Alcoholism↗
PubMed2003

[Factor structure and validity of a german version of the barratt impulsiveness scale].

OBJECTIVE: Impulsive traits are key characteristics in a number of psychiatric disorders and are part of the normal behavior spectrum. The BIS-5 is an instrument developed to assess impulsivity. The aim of this study is to evaluate the BIS-5 in two German psychiatric inpatient samples and healthy controls proving the originally proposed four-factor structure as well as convergent and discriminate validity. METHODS: 159 alcohol-dependent subjects and 77 suicidal inpatients were recruited in an University psychiatric hospital. 182 healthy subjects were recruited from town community. BIS-5 items were translated and back-translated. Principal component analysis with oblique rotation was conducted in the whole group. Furthermore, the discriminate and convergent validity of the BIS-5 was evaluated by correlation with other instruments measuring impulsive traits and comparing sample subgroups. RESULTS: A two-factor solution could be identified in this German sample. Alcohol-dependent individuals showed significantly higher factor 1 values compared to suicidal patients. The group of suicidal patients had higher scores in factor 2 compared to controls. Factor 1 correlated most significantly with extraversion-related personality traits while factor 2 showed significant relationships with irritability and neuroticism. CONCLUSIONS: A two-factor solution may be more appropriate in using the BIS-5 scale in German samples. These two factors might reflect different aspects of impulsive behavior and might be useful to characterize impulsive behavior in psychiatric and non-psychiatric samples.

Adult↗
PubMed2003

Effects of scopolamine on matching to sample paradigm and related tests in human subjects.

This was a double-blind placebo-controlled study with a cross-over design to examine the effects of scopolamine on cognitive functions in young healthy subjects. Scopolamine hydrobromide was administered subcutaneously to 12 subjects (mean +/- SD age 23.8 +/- 2.2 years) at doses of 0.3 and 0.6 mg in comparison with two placebo conditions. Scopolamine at both doses produced marked sedation as rated by subjects and an observer. In the continuous performance test, vigilance was impaired by both doses of scopolamine. The span of apprehension test showed differing results (only the high dose of scopolamine showed a performance decrement only in the three-character version of the span of apprehension test). Significant impairment by both doses of scopolamine was seen in immediate and delayed free recall, continuous visual recognition, running word recognition and running picture recognition. While scopolamine caused a significant slowing in average reaction times for simultaneous matching as well as for delayed matching, subjects made more errors under scopolamine compared to placebo only in delayed matching, not in simultaneous matching. Also, the main outcome of matching to sample showed significant effects only in delayed matching, not in simultaneous matching. Notable in this study is the incongruity between the simultaneous matching test and the span of apprehension test on the one hand and the other cognitive tests used on the other. These results demonstrated that scopolamine has a greater effect on memory than on attention. Thus, the scopolamine-induced effects in the present study seem to be more relevant to Alzheimer's disease in an advanced phase than to normal aging.

Adult↗