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Biomedical subjects

R N Golden

Publications and source records attributed to R N Golden.

At least 73 records · Page 4Linked to original sources
PubMed1990

Impaired effortful cognition in depression.

Depressed patients have been reported to have deficits in "effortful," but not effortless, cognitive functions compared to healthy volunteers. To test the hypothesis that the effortful cognitive deficits in major depression are not simply a function of psychiatric illness or hospitalization, we administered both effort-demanding and effortless cognitive tasks to 17 inpatients with major affective disorder and 17 hospitalized psychiatric controls. The depressed patients performed significantly more poorly than the controls on the effort-demanding task. The groups did not differ on the effortless task. These findings suggest that depressed patients are impaired in performing effort-demanding cognitive tasks compared to nondepressed psychiatric patients.

Adjustment Disorders↗
PubMed1990

Organic affective psychosis associated with the routine use of non-prescription cold preparations.

A patient experienced an organic affective psychosis on three separate occasions after taking recommended doses of non-prescription cold/sinus preparations. The possible underlying pharmacological mechanisms of this clinical reaction lend support to the cholinergic-adrenergic balance hypothesis of affective disorders. Recognition of this acute drug-induced state can lead to appropriate short-term pharmacotherapy and can prevent misdiagnosis of a major affective disorder or schizophrenia.

Common Cold↗
PubMed1990

Subclinical hypothyroidism: a review of neuropsychiatric aspects.

The authors review current information about the prevalence, causes, course, and consequences of subclinical hypothyroidism. There is evidence that subclinical hypothyroidism may be associated with cognitive dysfunction, mood disturbance, and diminished response to standard psychiatric treatments. Recommendations are presented for the screening, evaluation and treatment of patients in whom subclinical hypothyroidism may be contributing to neuropsychiatric dysfunction.

Humans↗
PubMed1990

Abnormal neuroendocrine responsivity to clomipramine in depression.

We used a pharmacologic probe that measures the neuroendocrine response to acute, intravenous "challenge" with the serotonin re-uptake inhibitor, clomipramine, in our studies of the biochemical bases of depressive illness. In two studies conducted at different sites, depressed patients consistently demonstrated blunted prolactin responses to clomipramine, compared with healthy control subjects. In order to clarify the mechanisms that might account for this abnormal neuroendocrine response to clomipramine in depression, we administered a thyrotropin-releasing hormone (TRH) stimulation test to 7 depressed patients who had also received a clomipramine challenge test. Although these patients demonstrated blunted prolactin responses to clomipramine, their prolactin responses to TRH were robust. These observations suggest that the blunted prolactin response to clomipramine in depression is not attributable to diminished hormonal secretory capacity in anterior pituitary lactotrophs and may be a reflection of dysregulation in central serotonergic systems.

Adult↗
PubMed1989

Measurement of tissue oxidation-reduction state with carbon-13 nuclear magnetic resonance spectroscopy.

The oxidation state of tissues influences their response to cancer therapy. We have devised a novel approach to the measurement of thiol redox which is based on the relative nuclear magnetic resonance signal intensity from carbon-13 adjacent to sulfur in metabolites of the redox-sensitive phosphorothioate drug, S-2-(3-methylaminopropylamino)ethylphosphorothioic acid (WR3689). Incubation of WR3689 metabolites under oxidizing conditions results in quantifiable changes in the 13C nuclear magnetic resonance spectrum stoichiometrically related to the degree of oxidation in mouse liver homogenate in vitro. Drug oxidation is competitive with the oxidation of tissue-derived thiol groups under these conditions. Noninvasive measurement of redox state may assist in designing more effective strategies for altering normal and malignant tissue response to cancer therapy.

Amifostine↗
PubMed1989

Intravenous alprazolam challenge in normal subjects. Biochemical, cardiovascular, and behavioral effects.

Alprazolam, a novel benzodiazepine derivative is thought to be effective in the treatment of anxiety, panic, and depressive disorders. There is considerable interest in alprazolam's mechanism of action, particularly whether its profile of actions might resemble that of the alpha 2 adrenoreceptor agonist, clonidine. The present study assessed the biochemical, cardiovascular, and behavioral responses of healthy volunteers to acute intravenous infusions of alprazolam and placebo. Alprazolam reduced ACTH and cortisol while increasing growth hormone. There was a transient reduction in plasma norepinephrine and only modest effects on cardiovascular parameters. Subjects became quite sedated after intravenous alprazolam. This pharmacodynamic profile resembles that previously reported for traditional benzodiazepines, although alprazolam may be a more potent stimulator of growth hormone release. Alprazolam's effects on growth hormone resemble those of clonidine, but unlike clonidine, alprazolam has relatively little effect on plasma catecholamine and cardiovascular parameters. This suggests that alpha 2 mechanisms do not play a primary role in alprazolam's mode of action. Since alprazolam infusion affects three different measures (ACTH/cortisol, growth hormone, and plasma norepinephrine) thought to be dysregulated in depression, challenge with intravenous alprazolam may prove to be a useful "probe" in affective disorders.

Adrenocorticotropic Hormone↗
PubMed1989

A comparison of pharmacokinetic versus empirical lithium dosing techniques.

Three methods for estimating maintenance dosage requirements of lithium carbonate were retrospectively evaluated in 20 inpatients who met criteria of the Diagnostic and Statistical Manual, Third Edition, for "bipolar disorder, manic phase." Dosing methods evaluated included a pharmacokinetic method, the single-point method of Perry et al.; a population-based nomogram approach, the Zetin et al. method; and a physician-based empirical dosing procedure. The ability of each dosing procedure to produce dosing recommendations that resulted in a targeted steady-state serum lithium concentration was evaluated. The empirical dosing procedure demonstrated a significant tendency (bias) to underestimate the dose necessary to produce a desired steady-state serum lithium concentration. Comparison of the predictive accuracy of the various dosing methods failed to demonstrate any statistically significant differences among the dosing procedures. There was a strong trend, however, for the Perry method to produce predictions of steady-state lithium levels that were more frequently within 0.2 mEq/L of actual levels.

Adolescent↗
PubMed1989

Use of electroconvulsive therapy at a university hospital: 1970 and 1980-81.

The use of electroconvulsive therapy (ECT) at a university teaching hospital in 1970 and in 1980-81 was reviewed. The percentage of psychiatric patients who received ECT declined modestly over the period, from 4.4 percent to 2.9 percent, despite compelling evidence of its safety and efficacy. Its use as a first-line treatment appeared to drop markedly in 1980-81, however, as indicated by a significantly longer mean period of hospitalization before administration of ECT. Overall length of hospitalization was significantly longer for patients who received ECT in 1980-81. These patients were also more likely to have had previous psychiatric admissions, suggesting they may have been more seriously ill. The findings are compared with use of ECT in other settings.

Adolescent↗
PubMed1989

The effects of intravenous clomipramine on neurohormones in normal subjects.

The neuroendocrine effects of iv administration of clomipramine (CMI), a serotonin reuptake inhibitor, were studied in normal subjects. Under double blind, placebo-controlled conditions, single 10- and 20-mg doses of CMI were administered. Ten milligrams of CMI led to significant increases in plasma PRL and cortisol concentrations; plasma ACTH increased slightly but not significantly. In contrast, plasma GH, melatonin, and norepinephrine concentrations did not increase. Plasma PRL, ACTH, and cortisol levels increased significantly after 20 mg CMI; again, there were no significant changes in plasma GH, melatonin, or norepinephrine concentrations. All subjects tolerated the 10-mg dose well, but the 20-mg dose caused nausea in three of six subjects. Desmethylclomipramine, a metabolite that inhibits reuptake of norepinephrine, was not detectable in plasma after either CMI dose. These results support the hypothesis that serotonin is involved in the regulation of PRL, cortisol, and ACTH in humans.

Adrenocorticotropic Hormone↗
PubMed1989

MR appearance of gallstones in vitro at 1.5 T: correlation with chemical composition.

Gallstones from 63 patients were evaluated by in vitro 1.5-T MR imaging, with T1- and T2-weighted images, and in 14 cases, a fat-suppression sequence (short-T1 inversion recovery imaging). Subsequent chemical analysis was performed on 43 gallstones. In vitro proton MR spectroscopy was performed on 14 stones. On T1-weighted MR images, foci of increased signal were seen in 46 of 63 stones (faint in 17, moderate in nine, and bright in 20). T2-weighted images showed areas of increased signal in 18 of 63 stones (faint in 15, moderate in three). T1-weighted MR imaging patterns were homogeneously dark (17), homogeneously bright (two), homogeneously faint (three), rimmed (dark rim and bright center, 32), and laminated (nine). Short-T1 inversion recovery imaging suppressed the foci of increased signal in 13 of 14 cases. Despite imaging characteristics suggestive of high lipid content, spectroscopy revealed only a single peak corresponding to a large water-proton signal. The T1 relaxation times of the water were shortened, ranging from 0.006 to 0.92 sec, explaining the increased signal seen on MR images of the gallstones. MR imaging characteristics (signal intensity, relative signal area, or imaging patterns) did not correlate with chemical composition. We hypothesize that different structural relationships must exist within gallstones of similar chemical content that alter the water bonding and hence the MR imaging characteristics.

Cholelithiasis↗
PubMed1989

Immune correlates of stress and depression.

This paper reviews the evidence for alterations in immunity associated with depression and stressful events. The reviewed studies examine a variety of immune parameters (e.g., mitogen response, natural killer cell activity and number, T-cell, and T-cell subpopulations) in relation to depression and in relation to a number of stressful events (e.g., death of spouse, examinations). There is considerable variability in the findings of the available studies. However, the review finds considerable evidence for an association between a variety of stressful events and lowered immunity and between severe depression and lowered immunity. The clinical relevance of these psychoimmune relationships remains in question.

Depressive Disorder↗
PubMed1988

Bupropion in depression. I. Biochemical effects and clinical response.

We studied the biochemical effects of bupropion hydrochloride, a unicyclic antidepressant, in 11 depressed patients. Plasma homovanillic acid level increased significantly in patients who had poor responses to treatment but not in patients who obtained good clinical responses. Although bupropion is characterized preclinically as a weak dopamine reuptake inhibitor without appreciable effects on norepinephrine (NE) reuptake, it reduced whole-body NE turnover without altering plasma NE levels at rest and following orthostatic challenge. There was a trend toward a reduction in cerebrospinal fluid 3-methoxy-4-hydroxyphenylglycol and homovanillic acid concentrations following bupropion treatment, although these changes did not achieve statistical significance. Reduction in whole-body NE turnover has now been described for six disparate antidepressant treatments. Poor clinical outcome following treatment with bupropion may be related to perturbations in dopaminergic systems.

Adult↗
PubMed1988

Bupropion in depression. II. The role of metabolites in clinical outcome.

We studied the steady-state pharmacokinetics of bupropion hydrochloride, a unicyclic aminoketone antidepressant, in depressed patients. The metabolites hydroxybupropion (HB), threohydrobupropion, and erythrohydrobupropion predominated over the parent compound in plasma and cerebrospinal fluid at steady state. Plasma concentrations of each metabolite correlated with cerebrospinal fluid concentrations. Higher plasma metabolite concentrations were associated with poor clinical outcome. This relationship was most striking with HB; plasma HB levels were greater than 1250 ng/mL in all five nonresponders and less than 1200 ng/mL in all seven responders. Plasma HB levels correlated with postreatment plasma homovanillic acid levels. High levels of bupropion metabolites may be associated with poor clinical outcome due to toxic effects involving dopaminergic systems. Alternatively, a curvilinear dose-response relationship may exist for bupropion metabolites. Future studies should explore the clinical utility of plasma metabolite measurements in enhancing the efficacy of treatment with bupropion.

Adult↗