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Biomedical subjects

R T Joffe

Publications and source records attributed to R T Joffe.

At least 163 records · Page 9Linked to original sources
PubMed1987

Correlates of antimanic response to carbamazepine.

Nineteen acutely manic patients were studied in a double-blind trial of carbamazepine in doses averaging 1240 mg/day, achieving blood levels of 10.4 +/- 2.2 micrograms/ml. Clinical improvement in mood and psychomotor components of the manic syndrome was rapid in onset, generally parallel to that observed in previous patients treated with neuroleptics, and was associated with increases in the total hours of nighttime sleep. Compared to the seven nonresponders, the 12 patients who improved were significantly more manic during the baseline placebo period, tended to be more dysphoric, and were significantly more rapid cyclers over their entire course of illness as assessed by episodes in the year before NIMH admission (7.0 +/- 5.6 vs. 2.7 +/- 2.4 in the nonresponders). While improvement was robust in responders, it was not always complete, and some of these patients remained mildly to moderately symptomatic. All seven patients with a negative family history of affective illness in first degree relatives were responders, while those with a positive family history were equally divided. These preliminary data suggest that several predictors of poor response to lithium carbonate (manic severity, anxiety and dysphoria, rapid cycling, and negative family history) may be associated with good antimanic response to carbamazepine.

Antipsychotic Agents↗
PubMed1987

Antithyroid antibodies in major depression.

Antithyroid antibodies were measured in 58 patients with unipolar major depressive disorder. None of the patients had received prior lithium treatment. Five patients had antimicrosomal and antithyroglobulin antibodies. The prevalence rate of detectable antibody titers approximates that found in normal subjects. The presence of detectable antibody titers was not related to abnormal thyroid function tests. The implications of these findings are discussed.

Adult↗
PubMed1987

Methylphenidate in primary obsessive-compulsive disorder.

An acute methylphenidate challenge was performed on 13 patients with primary obsessive-compulsive disorder. There was no overall effect of methylphenidate on mood or obsessive-compulsive behavior. However, on various behavioral scales, four patients had an antiobsessive-compulsive response and one patient an antidepressant response to methylphenidate. The clinical and theoretical implications of these findings are discussed.

Adult↗
PubMed1987

The effect of desipramine on body weight in depression.

Twenty-six patients with major depressive disorder were treated with desipramine for 4 weeks to determine the effect of the drug on body weight. Responders to desipramine showed a weight gain only at Weeks 3 and 4; nonresponders had a nonsignificant loss of weight. The increase in body weight of the responders was independent of dosage, sex, and hospitalization status. These findings suggest that the small increase in body weight that occurs in patients taking desipramine is associated with treatment response. In addition, desipramine may be a valuable treatment alternative for those patients in whom excessive weight gain is undesirable.

Adult↗
PubMed1986

Depression and carcinoma of the pancreas.

A systematic psychiatric evaluation of 21 subjects with intraabdominal malignancy (pancreatic or gastric carcinoma) was performed. Depression was frequently associated with and often the presenting symptom complex of patients with carcinoma of the pancreas. This finding was not observed in patients with gastric carcinoma. Clinical and theoretical implications of these findings are discussed.

Adjustment Disorders↗
PubMed1986

Effects of carbamazepine on serum electrolytes in affectively ill patients.

The effects on serum electrolytes of carbamazepine, an acute and prophylactic treatment for manic-depressive illness, were assessed in subjects with primary affective disorder. Carbamazepine caused statistically significant, but clinically insubstantial, reductions in serum sodium and calcium, but not in the other electrolytes measured. Decreases in serum sodium and calcium were not related to carbamazepine dose, blood levels, or the degree of clinical improvement. The theoretical implications of these findings are discussed.

Adult↗
PubMed1986

Neuroendocrine effects of the dopamine agonist piribedil in depressed patients.

Piribedil is a relatively selective dopamine agonist with moderate antidepressant activity. Although of limited clinical use, piribedil may elucidate the mechanism of the neuroendocrine effects of treatments useful in manic-depressive illness, particularly those involving the thyroid axis. Therefore, the effect of chronic piribedil treatment on peripheral thyroid hormones, as well as the pituitary hormone responses to sequential stimuli, namely arginine, thyrotropin-releasing hormone (TRH), and luteinizing hormone releasing hormone, were studied in patients with major depression. The drug was found to decrease peripheral thyroid hormones and the thyroid stimulating hormone response to TRH, but it did not affect prolactin, growth hormone, or the gonadotropins. The advantages of the experimental design and the implication of these findings for dopaminergic mechanisms in both the regulation of pituitary hormones and the treatment response of affective illness are discussed.

Adult↗
PubMed1986

Erythrocyte sodium and potassium in affective illness.

In a preliminary study, erythrocyte sodium and potassium were measured in 24 affectively ill patients and 24 normal controls. Erythrocyte sodium was significantly lower and erythrocyte potassium was significantly higher in the euthymic and affective depressed patients as compared with controls.

Adult↗
PubMed1986

The effects of lithium on neuroendocrine function in affectively ill patients.

Lithium is the primary treatment for manic-depressive illness. The mechanism of action of lithium and its endocrine effects remain unclear. Therefore, the hormone responses to sequential stimuli, namely arginine, TRH, and LHRH, were studied in eight patients with major depression before and during treatment with lithium. The drug was found to elevate baseline TSH and prolactin and to augment both their responses to TRH. No clinically significant effect on sex hormones was noted. The advantages of the experimental design and the implications of the findings for lithium's mechanism of action are discussed.

Adult↗
PubMed1986

Antidepressant effects of carbamazepine.

Thirty-five depressed patients diagnosed by DSM-III criteria participated in a double-blind study of the acute antidepressant effects of the anticonvulsant carbamazepine, at average doses of 971 mg/day, achieving mean +/- SD blood levels of 9.3 +/- 1.9 micrograms/ml (range, 3-12.5 micrograms/ml). Twenty patients (57%) showed at least mild improvement, and 12 showed more substantial improvement. Possible clinical predictors of antidepressant response to carbamazepine are discussed. These preliminary data suggest that carbamazepine has some acute antidepressant efficacy in addition to the growing evidence that it has acute antimanic and longer-term prophylactic efficacy in both phases of manic-depressive illness.

Adult↗
PubMed1986

Effect of carbamazepine on body weight in affectively ill patients.

The effect of carbamazepine on body weight was studied in 24 patients with affective illness. Carbamazepine caused significant increases in body weight in the depressed but not the manic patients. Furthermore, the weight gain in the depressed patients seemed to be related to the response to treatment. These preliminary findings suggesting that weight gain is related to improvement in depression and not to a direct effect of the drug require further study.

Adult↗