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Biomedical subjects

R Gerner

Publications and source records attributed to R Gerner.

At least 19 recordsLinked to original sources
PubMed2000

An MRI study of temporal lobe structures in men with bipolar disorder or schizophrenia.

BACKGROUND: Hippocampal atrophy has been described in postmortem and magnetic resonance imaging studies of schizophrenia. The specificity of this finding to schizophrenia remains to be determined. The neuropathology of bipolar disorder is understudied, and temporal lobe structures have only recently been evaluated. METHODS: Twenty-four bipolar, 20 schizophrenic, and 18 normal comparison subjects were evaluated using magnetic resonance brain imaging. Image data were acquired using a three-dimensional spoiled GRASS sequence, and brain images were reformatted in three planes. Temporal lobe structures including the amygdala, hippocampus, parahippocampus, and total temporal lobe were measured to obtain volumes for each structure in the three subject groups. Severity of symptoms in both patient groups was assessed at the time the magnetic resonance images were obtained. RESULTS: Hippocampal volumes were significantly smaller in the schizophrenic group than in both bipolar and normal comparison subjects. Further, amygdala volumes were significantly larger in the bipolar group than in both schizophrenic and normal comparison subjects. CONCLUSIONS: The results suggest differences in affected limbic structures in patients with schizophrenia and bipolar disorder. These specific neuroanatomic abnormalities may shed light on the underlying pathophysiology and presentation of the two disorders.

Adolescent↗
PubMed1998

Lamotrigine toxicity secondary to sertraline.

Blood level monitoring helps to determine the therapeutic and toxic ranges for anticonvulsants and antidepressants. We investigated initial drug-drug interactions between lamotrigine and sertraline. We report on case histories of two epileptic patients who were initially on lamotrigine and to whom sertraline was added to control psychiatric features. In case 1, a total daily dose of 25 mg sertraline, with nondetectable sertraline and desmethylsertraline blood levels, resulted in a doubling of the lamotrigine blood level with symptoms of toxicity. In case 2, a 25 mg reduction in the total daily dose of sertraline resulted in halving of the lamotrigine blood level even though the lamotrigine dosage was increased by 33%. This shows that sertraline has potent interactions with lamotrigine metabolism. The authors hypothesize that inhibition of glucuronidation is responsible. Clinicians are advised to observe for symptoms of toxicity and to do serial blood levels to monitor this interaction.

1-Naphthylamine↗
PubMed1998

Dose-dependent valproic acid thrombocytopenia in bipolar disorder.

The increased use of anticonvulsants in the treatment of bipolar disorders necessitates a greater appreciation of potential complications from these agents. The authors present a bipolar disorder patient with dose-dependent valproic acid thrombocytopenia and suggest treatment strategies.

Anticonvulsants↗
PubMed1989

Neurotensin-like immunoreactivity in cerebrospinal fluid of patients with schizophrenia, depression, anorexia nervosa-bulimia, and premenstrual syndrome.

Neurotensin (NT) concentrations in cerebrospinal fluid (CSF) were measured by a sensitive and specific radioimmunoassay in psychiatric patients and age- and sex-matched normal controls. No increase in CSF NT concentrations was observed after antipsychotic drug treatment. CSF NT concentrations were significantly lower in one group of schizophrenic subjects. NT concentrations were unaltered in patients with depression, anorexia/bulimia, or premenstrual syndrome, and no rostral-caudal gradient for NT in CSF was evident. NT concentrations were not related to age or sex, and probenecid treatment did not alter CSF NT concentrations. Finally CSF NT concentrations were unaltered in paranoid schizophrenic subjects. These findings confirm and extend previous studies of CSF NT that showed certain patients with schizophrenia, nonparanoid type, have reduced CSF concentrations of this tridecapeptide.

Adult↗
PubMed1987

Event-related potentials and item recognition in depressed, schizophrenic and alcoholic patients.

Auditory event-related potentials (ERPs) to pure tones and performance on a measure of item recognition were compared in 20 controls, 14 alcoholics, 20 depressed and 21 schizophrenic patients. Compared with normal controls, P2 and N2 were delayed and of diminished amplitude in the psychopathological groups. Increased amplitude of P1 in alcoholics, diminished N1 in depressed patients, increased latencies of N1 in schizophrenics and N2 in alcoholics were pathology-specific. Unusual patterns of response in the item recognition test (elevated intercept and flattened slope) and its relationship with ERPs distinguished the diagnostic groups from the controls. Support for the preferential involvement of the left hemisphere in schizophrenia and of the right hemisphere in depression was found. Disinhibition of CNS activity in the response of alcoholics (increased P1 and delayed P3) was indicated. The findings suggested that discriminant analysis of auditory ERPs to simple, pure tones, in conjunction with psychometric data significantly differentiated pathologic groups from each other and from controls.

Acoustic Stimulation↗
PubMed1985

Orthostatic effect of imipramine and doxepin in depressed geriatric outpatients.

Blood pressure measurements were collected from 36 depressed geriatric outpatients (ages 55 to 81 years) enrolled in a double-blind, placebo-controlled study of the efficacy of doxepin and imipramine. Mean systolic postural changes were 25.9 mm Hg for imipramine, significantly higher than the 10.5 mm Hg for doxepin, and 12.4 mm Hg for placebo. The orthostatic drop in the imipramine group was only weakly related to dose and did not correlate with amount of pretreatment orthostatic hypotension or with duration of treatment. The increased orthostatic hypotension occurred early in treatment and at low doses of imipramine. Accordingly, caution is advised in the use of imipramine for the elderly.

Age Factors↗
PubMed1984

Positron emission tomographic study of affective disorders: problems and strategies.

Because anatomical studies of psychiatric disorders in humans have been largely unsuccessful, and because pharmacological interventions in patients with mental illness can be analyzed by means of biochemical assay techniques, positron emission tomography (PET) provides an exciting new means to study mental illness. Using fluorine-18-labeled fluorodeoxyglucose and PET to measure local cerebral glucose utilization, the investigators examined patients with affective disorders and normal age-matched controls. Patients with unipolar depression were studied in a drug-free baseline state following short-term administration of methylphenidate and in a euthymic state in long-term follow-up. Patients with bipolar disorders were studied in either the manic or depressed phases of illness and again in a euthymic state in long-term follow-up. Age-matched controls were studied both with and without methylphenidate administration. The results demonstrate that metabolic subgrouping of patients may be possible. Mood changes produced by pharmacological agents resulted in changes in the patterns of metabolism when compared with the baseline state. Problems associated with the use of PET to study mental illness fall into the categories of patient classification (diagnosis, state, trait, ambient conditions, and mental processes) and data analysis (anatomical and statistical). These problems, the limitations of the present techniques, and strategies for their improvement are discussed. Despite these difficulties, PET should prove to be a fruitful means of exploring the human biochemical abnormalities associated with mental illness.

Bipolar Disorder↗
PubMed1984

An experimental analysis of the interaction of chemotherapy and behavior therapy in anorexia nervosa.

The interaction of imipramine and operant conditioning on weight gain in an anorexia nervosa patient was examined by a single-subject experiment consisting of a baseline and four treatment phases: phase 1--contingency management only; phase 2--contingency management plus imipramine; phase 3--contingency management plus imipramine placebo; phase 4--contingency management only. The results showed that the interaction of drug and behavior therapy had no significant effect on weight gain, but that imipramine may have contributed to a decrease in depression. Observations are made regarding weight changes related to passes and medication refusals.

Adult↗
PubMed1984

Dexamethasone suppression test and Axis I diagnoses of inpatients with DSM-III borderline personality disorder.

To determine the relationship of Axis I diagnoses to the DSM-III diagnosis of borderline personality disorder, 100 consecutive admissions to an inpatient service were studied. Of the 27 patients labeled borderline, 14 were given an Axis I diagnosis of major depression (unipolar) compared with 8 of 73 nonborderlines; 73% (19 of 26) of all borderlines tested but only 46% (18 of 39) of nonborderlines had a positive DST (p less than .05). Few borderline patients received concomitant nonaffective diagnoses, and even fewer were given bipolar or schizoaffective diagnoses.

Adolescent↗
PubMed1982

Treating geriatric depression: a 26-week interim analysis.

Two concurrent studies of geriatric outpatients who received diagnoses of depression were conducted. In the first, patients were treated with one of two tricyclic antidepressants or with a placebo. In the second, patients were assigned to groups receiving either psychodynamic group therapy or cognitive-behavioral group therapy. Patients in the placebo group showed the least improvement; most patients receiving group psychotherapy showed some improvement, but only 12% had full remissions; by contrast, 45% of patients receiving imipramine or doxepin had full remissions, while 36% of them experienced little or no benefit. An early response to tricyclic antidepressant drugs was a reliable predictor of continued improvement.

Antidepressive Agents, Tricyclic↗