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Biomedical subjects

S Gershon

Publications and source records attributed to S Gershon.

At least 73 records · Page 4Linked to original sources
PubMed1987

Sleep and depression.

Manifestations of sleep disturbances can potentially serve as external criteria for the diagnosis of specific subtypes of major depressive disorder (MDD). Depressed patients generally experience disturbances of sleep continuity and rapid eye movement (REM) sleep. Disturbances in nonrapid eye movement (NREM) sleep (stages III and IV) also occur. Characteristic of primary sleep disturbance in many depressed patients are shortened REM latency periods and instabilities in NREM sleep identified by increases in the number of stage shifts, decreases in the duration of stage III and IV sleep, and a shift towards lighter sleep stages (sleep efficiency disturbances). Treatment modalities for these sleep disturbances include sleep deprivation therapy and antidepressant therapy. Sleep deprivation alone has been only moderately successful, while antidepressant therapy usually results in symptomatic improvement. To restore normative sleep, REM sleep periods and stage III and IV sleep must be returned to normal. Trazodone therapy has been shown to reduce the frequency of arousals, the severity of drowsiness, and the duration of REM sleep, and increase restorative slow wave sleep and stage III and IV NREM sleep.

Depressive Disorder↗
PubMed1987

Thyroid hormone levels in panic disorder.

A history of thyroid dysfunction has been reported in patients with phobic disorders. There is also evidence of a blunted TSH response to TRH stimulation in patients with panic disorder. In this study, values of T3, T4 and T7 were compared between 26 patients with panic attacks and 20 normal controls. Patients were diagnosed according to DSM-III criteria and those with a clinical history of thyroid dysfunction were excluded. Patients were not on any medication when the blood samples were drawn. The mean values of T3, T4 and T7 did not significantly differ between the two groups, suggesting no evidence of hypo or hyperthyroidism; however, the variance of distribution of T3, T4 and T7 values was significantly different between the two groups (Fmax values for T3: 2.55, p value less than 0.05; T4: 3.15, p value less than 0.01; T7: 2.55, p value less than 0.05).

Adult↗
PubMed1987

Tiaspirone in schizophrenia.

It was predicted that tiaspirone, a novel compound, would benefit schizophrenic patients since in animal experiments it is a potent dopamine blocker. Following a placebo washout period of 1 to 2 weeks, 14 patients were treated for 28 days with the drug in a single-blind, dose ranging trial. GAS, NOSIE, and BPRS scores all showed significant improvement. No serious adverse effects were found. The absence of extrapyramidal symptoms was particularly encouraging since 10 of the 14 subjects had previously had them on other neuroleptics. Tiaspirone may represent a step forward in the search for a safer antipsychotic.

Adolescent↗
PubMed1987

Carbamazepine versus lithium in mania: a double-blind study.

Thirty-four manic patients were randomly assigned to treatment with carbamazepine or lithium. Clinical response was rated over 4 weeks. Twenty-eight patients, 14 in each group, completed the full protocol. Serum levels for both drugs were within the accepted therapeutic range. The overall response to treatment was not significantly different between the two groups. Comparison of individual Clinical Global Impressions, Brief Psychiatric Rating Scale, and Beigel-Murphy Manic State Rating Scale change scores showed a more consistent level of improvement across patients in the lithium-treated group compared to a minority of good responders in the carbamazepine-treated group. The findings suggest that carbamazepine has antimanic potential in specific bipolar patients whose clinical characteristics remain to be clearly defined.

Adult↗
PubMed1986

Chronic pain: hypothesized mechanism and rationale for treatment.

Chronic pain is refractory to most currently marketed regimens. Part of the problem in achieving satisfactory results in treatment is understanding the mechanism that causes chronic pain. One hypothesis currently being investigated explores the role of serotonin. As such, products that block the reuptake of serotonin, such as trazodone and amitriptyline, are being studied. The rationale for the current hypothesis, including psychopharmacology and the role of serotonin reuptake blockers, will be reviewed.

Antidepressive Agents↗
PubMed1986

The future of neuroleptic psychopharmacology.

Neuroleptic drugs have had a great impact on the treatment of psychotic states. The presence of acute and long-term side effects, however, has led to a reconsideration of the risks and benefits of these drugs. The need to use a minimum efficacious dose has led to the implementation of new treatment regimens and attempts to establish a relationship between clinical response and neuroleptic plasma levels. This article will review the factors influencing and conditioning the response to neuroleptic treatment and examine the predictors of good and poor response to neuroleptic drugs. Dopamine-receptor supersensitivity associated with chronic neuroleptic treatment is also considered, as well as new strategies in the treatment of psychotic states.

Acute Disease↗
PubMed1986

[Tolerance and pharmacovigilance of trazodone].

Trazodone has been approved for marketing in the United States over three years ago. During this period, over two million patients have been exposed to the compound. It is also estimated that world wide another four million individuals have been treated with the compound. This provides a fairly large clinical experience for us to draw conclusions about safety and tolerance data, both from the initial control studies and from the extensive post-marketing surveillance available as a result of this extensive clinical experience. Trazodone, "this second generation" antidepressant and its clinical efficacy and safety data, can be reviewed against the background of tricyclic antidepressants and monoamine oxidase inhibitors. These previously established therapeutic agents have been available for many years and can be used as a major reference point in making these assessments. The special areas of side effect experience with the tricyclic antidepressants have been the occurrence of significant anticholinergic side effects and the particular problems that these induce in an elderly population. In addition, the tricyclic antidepressants have been associated with a variety of cardiac effects. The other major area of concern in clinical practice is the drug interactions that may occur with the newly introduced compound. A considerable experience has been obtained with such exposure and this material will also be reviewed and presented.(ABSTRACT TRUNCATED AT 250 WORDS)

Drug Tolerance↗
PubMed1986

Response of tricyclic-induced jitteriness to a phenothiazine in two patients.

Some patients with panic attacks are extremely sensitive to tricyclic antidepressants and develop jitteriness, shakiness, and insomnia when given very low doses. Two patients who developed this "jitteriness syndrome" while taking tricyclic antidepressants are described. The side effects in these patients were markedly relieved by the addition of perphenazine.

Adult↗
PubMed1985

Methylphenidate infusion in euthymic bipolars: effect of carbamazepine pretreatment.

A number of studies have reported attenuation by lithium (Li) pretreatment of the activating and euphoriant effects of psychostimulants. In view of increasing interest in the therapeutic potential of carbamazepine (CBZ) in bipolar disorder, we examined the effect of CBZ pretreatment on methylphenidate-induced behavioral activation and euphoria. Seven euthymic bipolar subjects received 2 weeks of pretreatment with CBZ or placebo in a double-blind crossover design. After each pretreatment period, the subjects received methylphenidate, 30 mg i.v.; mood and behavior changes were monitored for a period of 5 hours after each infusion. Methylphenidate induced a striking psychostimulant effect that was not attenuated by CBZ pretreatment. Possible implications of this finding for the antimanic efficacy of CBZ and for mechanisms of action are discussed.

Adult↗
PubMed1985

Multiple, single-dose naltrexone administrations fail to effect overall cognitive functioning and plasma cortisol in individuals with probable Alzheimer's disease.

A double-blind placebo-controlled study was conducted in 10 individuals with probable Alzheimer's disease to assess the effects of varying doses of Naltrexone (0, 25, 50 and 100 mg) on cognitive functioning and on plasma cortisol. Each individual participated in four separate sessions at least three days apart. Naltrexone was found to improve performance in only one of the six psychometric tasks employed (Token Test). However, enhancement of Token Test performance was limited to the 25 mg Naltrexone dose and was mainly the result of an improvement on the part of the two most severely impaired patients. In contrast to the previous reports of elevations of plasma cortisol following administration of opiate antagonists to younger, non-demented subjects, Naltrexone administration failed to produce any significant increase in plasma cortisol in Alzheimer's patients.

Aged↗
PubMed1985

Three cases of carbamazepine toxicity.

The growing number of psychiatrists who prescribe carbamazepine therapy should be alert to the drug's potential complications. The authors report three such cases: one of hepatitis, one of a fatality due to aplastic anemia, and one of a severe dermatological reaction.

Adult↗
PubMed1985

Event-related potential in Alzheimer disease.

Auditory event - related potentials were studied in 20 patients with SDAT and 20 age and sex matched normal controls. Patients with SDAT showed prolonged latencies of N200 and P300 components. The mean amplitudes of N200 and P300 were lower in the SDAT group. This reflects the impairment of the speed of neural processing in patients with SDAT. There were no significant correlations of the progression of P300 latencies from mild to severe dementia according to global dementia scales.

Aged↗
PubMed1985

Interpatient variations in antipsychotic therapy.

There is wide interpatient variability not only in therapeutic response to a given dose of antipsychotic drug but also in steady-state plasma levels and the presence and degree of unwanted pharmacologic effects. Such variations have been attributed to individual metabolism, pharmacologic differences, and age--all of which may need careful consideration in prescribing an appropriate dosage regimen for a given patient.

Age Factors↗