Active efflux of lithium from erythrocytes of manic-depressive subjects.
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Biological Transport, Active↗
Biomedical subjects
R R Fieve
Publications and source records attributed to R R Fieve.
Plasma dopamine beta hydroxylase activity in affective disorders.
Plasma dopamine beta hydroxylase (DBH) activity was measured in patients with affective disorders and in their relatives. The groups studied had wide distributions of values for plasma DBH activity. No significant difference of plasma DBH activity was found between unipolar and bipolar patients, nor between patients given lithium or placebo. Exercise on a treadmill at 40 degrees or 10 degrees C elicited a different pattern of response for plasma DBH activity in three patients as compared to control subjects. In familial studies we found the values of plasma DBH activity to be almost identical in monozygotic twin pairs and quite similar in dizygotic twin pairs. All pairs, however, were discordant for affective illness. There was also a marked similarity of plasma DBH activity in 15 pairs of the same sex sibs discordant for affective illness. These studies suggest that the resting level of plasma DBH activity is not related to affective illness but is genetically determined.
Adult↗
The life table. A method for analyzing longitudinal studies.
The life table is presented as the method of choice for analyzing data from longitudinal studies in which the outcome under study occurs randomly and in which patients are followed up varying lengths of time. We discuss the superiority of the life table to methods typically used, the calculation of its entries, and some of the clinical uses that can be made of its results. The method is applied to follow-up data on manic-depressive patients maintained with prophylactic lithium carbonate or with control regimens, and it is shown to disclose mathematical regularities in the parameters of longitudinal course.
Adult↗
Lithium carbonate and affective disorders. V: A double-blind study of prophylaxis of depression in bipolar illness.
The efficacy of lithium carbonate as a prophylactic drug against depression in bipolar manic depressive patients was assessed through a double-blind, placebo-controlled study of patients who had histories of recurrent depressions and hypomanias ("bipolar II"). The results revealed that treatment with lithium carbonate resulted in a reduction in the frequency of depressive attacks was observed with lithium carbonate treatment during the study (mean length of study, approximately 16 months), although there was a suggestion that the depressive attacks that occurred during treatment with lithium carbonate might be less severe than with placebo treatment.
Adult↗
Lithium carbonate prophylaxis of depression in three subtypes in primary affective disorder.
Multiple indices of depression were used to evaluate the prophylactic efficacy of lithium carbonate versus placebo in a 4-year, double-blind study of unipolar, bipolar I, and bipolar II patients diagnosed according to strict criteria. Our data indicate lithium prophylaxis of depression on several indices in all three subtypes of affective illness. Additional studies are needed, comparing tricyclic antidepressants alone, monoamine oxidase inhibitors alone, or either drug combination with lithium carbonate for prophylaxis in clearly defined depressive subtypes.
Adult↗
The course of development of mania in patients with recurrent depression.
The authors attempted to assess the extent to which bipolar patients are misdiagnosed as unipolar by evaluating the development of mania in patients who had recognized bipolar illness and by means of follow-up data on patients who had recurrent depressions. Mania occurred early in the course of bipolar illness: almost 80% of the bipolar patients were initially hospitalized for mania. Follow-up data and theoretically based calculations suggest that the chance of a patient with recurrent depressions becoming bipolar is about 5%. Based on these findings, the authors make suggestions for the classification of unipolar patients.
Bipolar Disorder↗
Lithium prophylaxis of depression in bipolar I, bipolar II, and unipolar patients.
The authors investigated lithium prophylaxis of depression in bipolar I (N=35), bipolar II (N=18), and unipolar I (N=28) outpatients. Depression indices included frequency of depressive episodes, three measures of severity, dropouts due to depression, and time in study. There were significantly fewer episodes and dropouts due to depression in the lithium-treated than in the placebo-treated bipolar I patients. Lithium was superior to placebo on all indices in the bipolar II group (although the sample size did not permit statistical analysis) and on 3 indices in the unipolar group. The authors believe that lithium prophylaxis of depression has been demonstrated in these three subtypes but note the need for further research particularly in the use of tricyclic antidepressants.
Bipolar Disorder↗
Treatement of excessive weight gain in patients taking lithium.
Six female primary affective disorder patients who had gained an average of 9.5 kg while taking lithium lost an average of 2.9 kg on a 10-day 900 calorie a day hospital diet containing 100 mEq of sodium per day. No evidence of lithium toxicity was observed on this regimen. There was no evidence that fluid retention played a major role in the weight gain.
Bipolar Disorder↗
The use of autocorrelation analysis in the longitudinal study of mood patterns in depressed patients.
The statistical method of autocorrelation, commonly used in econometrics and engineering, was applied to the daily mood scores of ten depressive hospital in-patients. The analyses made possible the quantification of two aspects of the longitudinal course of individual patients' psychopathology, the degree of day-to-day stability and the degree of periodicity in mood. Quantification of the degree of day-to-day mood stability yielded wide variations between patients and suggested that patients might be usefully categorized in terms of this characteristic. Mood stability during periods of severe depression was found to be less pronounced than during periods of relatively moderate depression. Furthermore, the existence of 'mini-cycles', cyclical fluctuations in mood of one to two weeks' duration occurring during the course of depressive episodes, was demonstrated in three cases.
Adult↗
Lithium carbonate prophylaxis failure.
Data from non-rapid-cycling bipolar (manic-depressive) patients who were receiving long-term treatment with lithium carbonate were analysed by the life table method to determine when lithium carbonate prophylaxis failures occurred. Forty-four of 96 patients failed to keep well in spite of maintenance lithium therapy. The analysis revealed an early, rapid failure rate during the first six months of treatment, which was followed by a slower rate of failure. Several clinical factors were assessed to determine if any of them predicted which patient would experience their initial failure in the early or late interval, but none of these factors, which included age, sex, age of onset, rate of affective attacks, family history, and the nature of the preceding episode, were found to have any predictive value regarding lithium prophylaxis failure. We found, however, that patients who had early failures tended to have a subsequent early failure in spite of continued maintenance with lithium carbonate.
Adult↗
Assortative mating in primary affective disorder.
Psychiatric illness in spouses of patients with primary affective disorder was determined and compared to psychiatric illness in spouses of a nonpsychiatrically ill control group. An increase in affective illness in wives of bipolar male patients with affective disorder was found. There was no increase in affective illness among husbands of female patients. Marital status of these patients was evaluated and the percentages of patients who had never married or who had married but had ever been divorced or separated were similar to control data. Several of the marriages were quite stable over long time periods in spite of the severe recurrent affective illness experienced by these patients.
Adaptation, Psychological↗
The effect of lithium on red blood cell cholinesterase activity in patients with affective disorders.
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Acetylcholinesterase↗
L-tryptophan in depression.
L-tryptophan, the amino acid precursor of serotonin, was administered to 16 depressive patients in a double-blind study of its potential antidepressant efficacy. Antidepressant responses were observed in one of ten unipolar patients and in three of six bipolar patients. These results are discussed in the context of possible interactions of amines with electrolyte systems in the etiology of affective illness.
Adult↗
Psychiatric illness in fathers of men with bipolar primary affective disorder.
A systematic interview regarding family history was administered to 48 men with bipolar affective illness who were attending a lithium clinic. Several families were found in which both the patient and father had affective disorders, but the mother and maternal second-degree relatives were well. Of 30 men who had histories of hospitalization for mania, three had fathers with affective disorder (all bipolar). Of 18 men who had depression and hypomania, one father had unipolar depressive disorder. The hypothesis that bipolar manic-depressive illness may be transmitted by a single dominant genetic factor on the X chromosome is discussed in relation to these ill father-ill son pairs.
Affective Symptoms↗
Lithium carbonate in affective disorders. IV. A double-blind study of prophylaxis in unipolar recurrent depression.
The prophylactic efficacy of lithium carbonate vs placebo was examined in a double-blind study in a carefully delineated group of 28 unipolar recurrent depressed patients followed up from three months to four years. Indexes of prophylactic efficacy revealed a statistically significant decrease in episode frequency, depth of global depression scores, and increased clinic attendance rate in the lithium carbonate group compared with the placebo group. Planned studies are now needed to determine which unipolar patients do best on a maintenance regimen of lithium carbonate alone, lithium carbonate plus tricyclic drugs, or tricyclic drugs alone.
Adult↗
Double-blind procedure: an assessment in a study of lithium prophylaxis.
Fifty-seven patients with primary affective disorder who were in a double-blind outpatient study to evaluate the prophylaxis of lithium were questioned as to whether they believed they were receiving lithium or placebo. Research nurses who were 'blind' to the patients' medication and a close relative living with each patient were also questioned. Nearly all patients (96%) said they beleived they were receiving lithium, ascribing this belief in 63% of the cases to a perceived improvement in condition. In only 14% of the cases on lithium was the presence of side-effects implicated in the patients' beliefs. One of the three nurses had a correct guess rate in excess of chance expectancy. All nurses tended to be more accurate in their guesses in the cases of patients who had been in prophylactic trials of over 15 months' duration than for patients with briefer periods in the study. Patients' relatives were, as a group, extremely accurate, their correct guess rate exceeding chance expectancy at the 0-001 level.
Affective Symptoms↗
Norepinephrine metabolism in mouse heart after lithium and rubidium treatment.
This report describes the effects of treatment with lithium (Li), rubidium (Rb) and sodium (Na; 1 mEq/kg/day) for 7 days on norepinephrine (NE) turnover in mouse heart. The effects of several drugs which modify the uptake and storage of NE were also studied in similarly pretreated mice. A method based on the combustion of tissue tritium to tritiated water was used to assay tritiated l-norepinephrine (l-NE-3H) concentrations in individual hearts. The rate of decline of tissue tritium concentrations in groups of pretreated mice maintained at ambient temperature (23--24 degrees C) or in the cold (4--5 degrees C) was determined. The results indicate that, compared to Na, Li and Rb did not modify the tritium turnover rate in mouse heart. Pretreatment with Li or Rb did not modify the uptake of tritiated NE in the heart. The effects of desipramine. cocaine, bretylium and chlorpromazine on NE uptake were not altered by the alkali ions. Further, pretreatment did not modify NE release by tyramine, metaraminol and guanethidine. These studies suggest that Li and Rb do not modify NE uptake, release and storage in mouse heart.
Animals↗
The lithium clinic: a new model for the delivery of psychiatric services.
Advances in the diagnosis of recurrent affective disorders and consistently high levels of lithium prophylaxis have made it possible to treat manic-depressive disorders on an outpatient basis. The author describes the experiences and organization of a lithium clinic that has operated for 15 years. Utilizing the services of trained paramedicals and a small medical staff, the clinic has efficiently served a large patient population. The author suggests that centers using this model could serve the community by increasing the availability of specialized psychiatric care.
Bipolar Disorder↗