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Biomedical subjects

R M Post

Publications and source records attributed to R M Post.

At least 379 records · Page 21Linked to original sources
PubMed1982

Biological relationships between mania and melancholia.

Although opposite mood and psychomotor disturbances usually occur in mania and melancholia, clinical features may also be shared in common or may be present at the same time in both phases of manic-depressive psychosis. In a parallel fashion, most pharmacological agents are selectively effective in one mood phase (tricyclics and monoamine oxidase inhibitors for depression, and neuroleptics for mania) and frequently precipitate or exacerbate the opposite phase. These agents, therefore, may be affecting biological substrates mediating the opposing phase of affective illness. With the exception of electroconvulsive therapy and lithium chemotherapy, few treatments are effective in both mania and melancholia. It is noteworthy, therefore, that carbamazepine may be useful in the acute and prophylactic treatment of mania and melancholia, including some lithium non-responders and patients vulnerable to tricyclic-induced "mood switches". The clinical and biological effects of carbamazepine will be discussed with special emphasis on its biochemical action and the possible mechanisms by which it might influence biological substrates mediating both phases of manic-depressive illness. In addition, the theoretical implications of the presence of both shared and opposing clinical, pharmacological, and biochemical characteristics of the illness will be discussed.

Affective Disorders, Psychotic↗
PubMed1982

Atypicality in primary depressive illness: a preliminary survey.

Primary depressive illness comprises a wide variety of clinical presentations which may represent disorders with different underlying biology, life course, and treatment response. In order to explore possible correlates of such clinical heterogeneity, we have constructed a rating scale for atypical depressive illness. Forty-four patients, all meeting Research Diagnostic Criteria for primary major depressive disorder were evaluated for atypicality using the scale. Within this group, atypicality was found to be characterized by lack of clearly encapsulated episodes of depression, a high degree of character pathology, prominent anxiety, somatization, and neurotic symptoms, and a past history of diagnostic confusion. Atypical patients were younger than typicals, more likely to be unipolar or bipolar II, and more often hospitalized, despite lower frequency of depressive episodes. While both typical and atypical groups showed decreased REM latency and increased urinary-free cortisol, they differed in measures related to noradrenergic metabolism, monoamine oxidase activity, and slow wave sleep. Preliminary results also raised the question of possible differences in treatment response between typical and atypical patients.

Age Factors↗
PubMed1982

State-related cyclical dyskinesias in manic-depressive illness.

Cyclical dyskinesias in two rapidly cycling manic-depressive patients recurred during depression and disappeared during mania. One case is reviewed in detail including findings of a 2-year follow-up. Spinal fluid biochemical data are presented and discussed. The finding of a reversible neurological alteration associated with changes in clinical state is of interest in relationship to the mechanisms underlying tardive dyskinesia and also provides evidence of a biological dysfunction in manic-depressive illness.

Adult↗
PubMed1981

Effects of vasopressin on human memory functions.

Arginine vasopressin and a number of its synthetic analogs augment memory functions in experimental animals. One of these analogs, 1-desamino-8-D-arginine vasopressin (DDAVP), influences human learning and memory. Cognitively unimpaired, as well as cognitively impaired adults, treated with DDAVP for a period of several days, learn information more effectively, as measured by the completeness, organization, and consistency (reliability) of recall. DDAVP also appears to reverse partially the retrograde amnesia that follows electroconvulsive treatment.

Adult↗
PubMed1981

Plasma MHPG in rapid cyclers and healthy twins.

We measured plasma 3-methoxy-4-hydroxyphenylglycol (MHPG) in 13 pairs of healthy drug-free monozygotic twins. High concordance for both free and conjugated MHPG suggests that plasma levels of the metabolite may reflect a heritable biological trait. In two drug-free rapidly cycling patients studied longitudinally, plasma MHPG levels reflected alterations in psychiatric state; they were significantly higher during mania than during depression. Although largely reflecting peripheral sources, plasma MHPG level as a global index of noradrenergic function may complement urinary MHPG excretion as a probe for diagnostic subgroups or pharmacologic responsiveness in psychiatric research.

Adolescent↗
PubMed1981

The effect of amygdala kindling on spontaneous and cocaine-induced motor activity and lidocaine seizures.

Interactions of amygdala kindling and drug effects were explored in two experiments. Pretreatment with cocaine (40 mg/kg, IP) for 10 days did not significantly affect the rate of amygdala kindling compared to saline or non-kindled controls. In contrast, daily amygdala kindling with 200 microA for 0.5 s for 20 days substantially altered subsequent behavioral responses in a long-lasting fashion. Animals showed decreased spontaneous vertical rearing activity, as well as decreased cocaine-induced vertical activity. In contrast, they were more reactive to the direct dopamine receptor agonist apomorphine. Eighteen days following completion of amygdala kindling, kindled animals were more sensitive to lidocaine-induced convulsions; 88% of kindled animals, but only 24% of the implanted sham-stimulated controls, had seizures. These data suggest that amygdala kindling may produce long-lasting changes in selected spontaneous and drug-induced behaviors, as well as convulsive thresholds. Possible physiological and neurological changes underlying this altered responsivity are discussed.

Amygdala↗
PubMed1981

Age-related changes in sleep in depressed and normal subjects.

All-night electroencephalographic (EEG) sleep data were examined a function of age in normal control subjects and hospitalized, unmedicated depressed patients with primary affective illness. By analysis of variance, Total Sleep time, Delta Sleep, Sleep Efficiency, Rapid Eye Movement (REM) Sleep, and REM Latency decreased as a function of age, whereas Early Morning Awake time and Intermittent Awake time increased. Compared with normal controls, after the effects of age were covaried out, depressed patients had a greater Sleep Latency, Early Morning Awake time, Intermittent Awake time, Duration and REM Density of the first REM period, and average REM Density for the night, as well as less Sleep Efficiency, less Delta Sleep, and shorter REM Latency, Early Morning Awake time increased with age in depressives but not in normals.

Adolescent↗
PubMed1981

Slow and rapid onset of manic episodes: implications for underlying biology.

The authors describe affectively ill patients with two different patterns of manic onset observed during medication-free periods. One group of patients had rapid onsets in which the full severity of mania was achieved largely by day 1 of a manic episode; a second group had slower onsets, gradually reaching maximal severity of mania later in an episode. Compared to gradual onset patients, those with the rapid onset manic patterns were ill significantly longer, had a greater number of previous depressive episodes, and had more manic and depressive episodes in the year before hospital admission. The clinical and theoretical implications of these data suggesting that patients with a more rapidly cycling and progressive course have an altered pattern of manic onsets are discussed.

Adult↗
PubMed1981

Effect of carbamazepine on CSF opioid activity; relationship to antidepressant response.

Carbamazepine, a drug useful in the treatment of trigeminal neuralgia and temporal lobe epilepsy, has recently been found to have positive psychotropic effects in patients with manic and depressive illness. The possible effect of carbamazepine on opioid activity in cerebrospinal fluid (CSF) were assessed in patients with affective disorders using a radioreceptor assay that detects total opioid binding activity. No effect of carbamazepine was noted on CSF total opioid activity, although conclusions about its possible effects on discrete opiate systems must await other methodologies. Initial medication-free levels of opioid activity were positively correlated with the degree of antidepressant response to carbamazepine.

Carbamazepine↗
PubMed1981

Relationship between urinary free cortisol and CSF opioid binding activity in depressed patients and normal volunteers.

We investigated the relationship between hypothalamic-pituitary-adrenal (HPA) activity, as measured by 24-hour mean urinary free cortisol (MUFC), and cerebrospinal fluid (CSF) opioid activity in patients with major affective disorder and normal volunteers. Among depressed patients, but not normal volunteers, mean 24-hour urinary cortisol values were significantly correlated with CSF opioid activity measured by radioreceptor assay, but were not significantly correlated with beta-endorphin immunoreactivity measured by radioimmunoassay. MUFC, as expected, was significantly higher in depressed patients than in normal volunteers. Mean values of CSF opioid activity and beta-endorphin immunoreactivity did not differ significantly in the two groups. The positive opioid-MUFC correlation found in the depressed group appeared to depend on patients who were cortisol hypersecretors. These data, using relatively crude measures of cortisol and opioid activity, are suggestive of a relationship between these two systems, particularly under "activated" conditions such as those observed in depression.

Adult↗
PubMed1981

Heterogeneity of amphetamine response in depressed patients.

There is considerable diversity of opinion as to the nature of the response of depressed patients to amphetamine infusion. The authors report on the clinical response of 18 endogenously depressed patients to double-blind, intravenous administration of amphetamine or saline. Although the drug produced activation, mood elevation, and recall of emotionally charged material in the group as a whole, there was considerable heterogeneity of response as well as a tendency for response dimensions to vary independently of one another. The heterogeneity of clinical response may be associated with differences in underlying clinical, biological, and genetic variables in affectively ill patients.

Adult↗
PubMed1981

Endogenous opioid activity and beta-endorphin immunoreactivity in CSF of psychiatric patients and normal volunteers.

The authors measured total opioid activity by radioreceptor assay in the CSF of 41 normal subjects and 89 unmedicated psychiatric patients, including schizophrenic, schizoaffective, depressed, and manic diagnostic groups. Schizophrenic men had significantly lower levels of opioid activity than the normal men, although these levels did not significantly differ from levels of other male patients. The authors observed higher opioid activity during mania than during depression in paired samples for 4 manic-depressive patients. beta-Endorphin immunoreactivity in a subsample of the same subjects was no different in the patient group than in the normal group, suggesting that the differences in CSF opioid activity between schizophrenic men and normal patients may be related to opioids other than beta-endorphin.

Adult↗
PubMed1981

The effects of sleep deprivation on average evoked responses in depressed patients and in normals.

The effects of a single night of sleep deprivation on the amplitude and amplitude/stimulus intensity function of the visual evoked potential (EP) were studied in 16 patients with primary affective disorder and 20 normal controls. Visual EP amplitude and amplitude/intensity slopes tended to increase after sleep deprivation in the patient group, a direction found in other studies to be associated with a spontaneous mood improvement and changes with antidepressant medication. In contrast, normal volunteers who showed little or no mood elevation showed generally opposite EP effects. Taken together, the results suggest a similarity in the neurophysiological effect of sleep deprivation between patient and antidepressant medication in depressed patients.

Adolescent↗