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T R Mareth

Publications and source records attributed to T R Mareth.

11 recordsLinked to original sources
PubMed1996

Pathophysiology and management of the serotonin syndrome.

OBJECTIVE: To review the symptoms, pathophysiology, and treatment of the serotonin syndrome (SS). DATA SOURCES: A MEDLINE search (1957-1995) of the English-language literature pertaining to the SS was performed. Additional literature was obtained from reference lists of pertinent articles identified through the search. STUDY SELECTION AND DATA EXTRACTION: All articles were considered for possible inclusion in the review. Pertinent information, as judged by the authors, was selected for discussion. DATA SYNTHESIS: The SS, an occasionally fatal disorder, is characterized by symptoms such as mental status changes, seizures, myoclonus, and blood dyscrasias. Both the central and peripheral serotonergic systems and several serotonin receptor types are involved in the symptomatology of the SS. The pathogenesis of SS may be due to endogenous as well as iatrogenic deficits in peripheral serotonin metabolism, a stimulus for release of serotonin, and interactions with other neurotransmitter systems. Lorazepam, serotonin-blockers, and nitroglycerin have been used successfully to treat SS. CONCLUSIONS: The SS is increasingly recognized and reported in the literature. Clinical and basic science research have increased our understanding of the pathophysiology, conditions, and agents that may predispose to the development of the syndrome. Newer treatment strategies are discussed.

Animals↗
PubMed1996

SSRI withdrawal.

Explore the source record for details and available documents.

Humans↗
PubMed1994

The serotonin syndrome associated with paroxetine, an over-the-counter cold remedy, and vascular disease.

There is a new, potentially fatal disorder that is infrequently reported. The apparent rareness may be because of a lack of recognition of the syndrome or its predisposing factors. Fluoxetine (Prozac, Dista Products Co, Division of Eli Lilly Co, Indianapolis, IN), sertraline (Zoloft, Roerig Division, Pfizer Inc, New York, NY), and paroxetine (Paxil, SmithKline Beecham Pharmaceuticals, Philadelphia, PA) belong to a new class of antidepressant medication: the serotonin reuptake-inhibitors (SRIs). The relative safety profile of the SRIs has led to their widespread use. However, a syndrome of excessive serotonergic activity, the "serotonin syndrome" (SS), has recently been recognized. It is characterized by changes in mental status, hypertension, restlessness, myoclonus, hyperreflexia, diaphoresis, shivering, and tremor. A high index of suspicion is required to make the diagnosis in these acutely ill patients. The most common agents implicated in SS are the monoamine oxidase inhibitors in combination with L-tryptophan or fluoxetine. A case of a patient with significant peripheral vascular disease who developed SS while taking paroxetine and an over-the-counter cold medicine is reported. There have been no prior reports of this interaction. Discontinuation of the offending agents, sedation, and supportive care are the mainstays of treatment. The interactions of serotonin with platelets and vascular endothelium are also discussed.

Acetaminophen↗
PubMed1994

Psychiatric investigation of allegations of child sexual abuse.

Allegations of child sexual abuse are commonly seen in psychiatric practices. While these must be carefully evaluated, false allegations do occur. The syndrome of child sexual abuse is reviewed, including prevalence, setting, course, and sequelae. Common techniques of clinical investigations are discussed. The uses and limitations of interviews, anatomically correct dolls, and drawings are reviewed. Providers are encouraged to make thoughtful, informed judgments and not to overstate the power of our techniques.

Child↗
PubMed1977

Normal pressure hydrocephalus: a case presentation.

There are presently no successful medical treatments available for most of the chronic dementias. For this reason it is most important to diagnose potentially reversible syndromes such as Normal Pressure Hydrocephalus and to determine if that patient is a candidate for neurosurgical treatment. A typical clinical case exemplifying the most common features of this syndrome is presented. This is followed by a discussion of the physiology, etiology, signs and symptoms, methods of diagnosis, and treatment of this illness. Material for this discussion was obtained from personal clinical experience and a review of the medical literature.

Aged↗