Biomedical subjects
R Balon
Publications and source records attributed to R Balon.
Impact of suicide on therapists in training.
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Lithium discontinuation: withdrawal or relapse?
The authors review the studies on discontinuation of lithium therapy in terms of subsequent relapse or possible withdrawal symptoms. Withdrawal symptoms following lithium discontinuation including heightened anxiety, sleep disturbances and irritability remain controversial. Relapse of the primary illness following lithium discontinuation is a well documented serious complication.
Psychiatric manifestations of tuberous sclerosis.
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Lithium for paraphilias? Probably not.
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Pharmacological treatment of paraphilias with a focus on antidepressants.
This article reviews the advances in pharmacotherapy of paraphilias. Antiandrogen hormones, phenothiazines, and lithium therapy of paraphilias is briefly reviewed. Pharmacotherapy of paraphilias with serotonergic drugs such as fluoxetine, clomipramine, sertraline, and fluvoxamine is reviewed in detail. In addition, the use of buspirone hydrochloride in paraphilias is discussed. The final focus of the article is on the etiologic theories of paraphilias and some practical advice for the pharmacotherapy and management of paraphilias.
Fluvoxamine-induced erectile dysfunction responding to sildenafil.
Sildenafil, a peripherally acting inhibitor of cyclic guanosine monophosphate((cGMP), has been reported highly effective in treating erectile dysfunction of various etiology. Erectile dysfunction is a common sexual side effect of various antidepressants. Various agents have been used in the treatment of antidepressant-induced erectile dysfunction; however, there are no reports on the use of sildenafil for this indication. This case report describes the successful use of sildenafil in fluvoxamine-induced erectile dysfunction. A possible mechanism of action of sildenafil in this type of erectile dysfunction is discussed.
Ginkgo biloba for antidepressant-induced sexual dysfunction?
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Sildenafil and sexual dysfunction associated with antidepressants.
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Preinfusion anxiety predicts lactate-induced panic attacks in normal controls.
Preinfusion anxiety, heart rate, and blood pressure were measured in 31 normal subjects who received sodium lactate infusions. Eight subjects developed symptoms of panic anxiety during these infusions. Preinfusion anxiety as measured by psychologic symptoms of anxiety on the Panic Description Scale was significantly higher in the panickers while heart rate and blood pressure were not.
Heart rate and blood pressure during placebo-associated panic attacks.
Increases in the anxiety ratings, heart rate, and systolic and diastolic blood pressure were compared in eight panicking and 57 nonpanicking panic disorder patients during placebo (dextrose) infusions. Heart rate and systolic and diastolic blood pressure increased significantly in placebo-infused panickers, but these increases did not correlate well with increases in anxiety.
Risk factors for cardiovascular illness in panic disorder patients.
Supine and standing heart rate (HR) and blood pressure measures were compared among 19 nonsmoking normal controls, 29 smoking patients and 36 nonsmoking patients with panic disorder. The smoking patients had a significantly higher supine HR, standing diastolic blood pressure, standing mean blood pressure and supine and standing cardiac load measures compared to both patient nonsmokers and controls. There was no significant difference between controls and nonsmoking patients for any of the above measures except for the higher standing HR and the delta increase in HR upon standing in female panic disorder patients which suggests increased adrenergic activity. When lipid values of panic disorder patients (n = 92) were compared to National Reference Values for their sex and age for an increased risk of cardiovascular illness, there was no significant risk with regard to plasma levels of total cholesterol, high-density lipoprotein cholesterol or low-density lipoprotein cholesterol.
An important differential diagnosis in CAPD patients with sudden onset of fever, vomiting, abdominal pain, and cloudy dialysate.
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Monoamine specificity of antidepressants and prediction of therapeutic response.
The increase of the availability of monoamines on synapses has been one of the proposed modes of action of antidepressants (AD), but few drugs are specific for one neurotransmitter system, there is a time lag of the onset of action and some substances increasing the availability of neurotransmitters do not improve mood. The monoamine hypotheses of AD mode of action seems too simplistic and hypotheses as the beta receptor down regulation theory or the restored efficient regulation of the dysregulated neurotransmitter system theory are more plausible. Prediction of AD treatment response is an important clinical issue due to the time lag of the onset of action. The dubious theory of monoaminergic specificity has been applied to the prediction of AD response. The pretreatment MHPG levels have been used for prediction of treatment response. Results are contradictory and inconclusive probably due to many methodological problems of this approach. Other monoamine pretreatment levels (5-HIAA, HVA) have also been used, again with inconclusive results. Other approaches based loosely on monoaminergic specificity of various AD such as platelet monoamine oxidase inhibition, platelet imipramine binding and monoamine precursors availability have been used without success. Thus the biological markers may not be useful for a successful prediction of the AD treatment outcome at present.