Respiratory disorders associated with sleep.
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Performance maintained by differential-reinforcement-of-low-rate operant schedules has been found to be sensitive to antidepressant drugs. Tricyclic antidepressants, monoamine oxidase inhibitors and atypical antidepressants reduce response rate and increase reinforcement rate under long differential-reinforcement-of-low-rate schedules. In order to study the neurochemical mechanism by which the tricyclic antidepressant desipramine alters differential-reinforcement-of-low-rate performance, the effect of desipramine was determined before and after brain catecholamine depletion was induced by 6-hydroxydopamine administration. Before lesioning, desipramine reduced response rate and increased reinforcement rate in a dose-dependent manner. Brain norepinephrine depletion (produced by 6-hydroxydopamine injection into the dorsal noradrenergic bundle) attenuated the ability of desipramine to reduce response rate, but did not alter its ability to increase reinforcement rate, but did not alter its ability to increase reinforcement rate. Brain dopamine depletion, (produced by i.c.v. 6-hydroxydopamine administration after pargyline and desipramine pretreatment) attenuated the ability of desipramine to increase reinforcement rate. These results suggest that the sedative effect of desipramine could be mediated by its interaction with central norepinephrine neurons and that the reinforcement rate-increasing effect may involve central dopamine neurons.
In this novel method for quantifying bethanidine in plasma, after a multi-step extraction of bethanidine and internal standard from 2.0 mL of plasma, the drugs are separated on a "microbore" C18 reversed-phase column and quantified by their ultraviolet absorbance at 210 nm. The isocratic chromatographic separation takes about 15 min with use of an ion-pairing regent in the mobile phase (acetate buffer/acetonitrile, 9/1 by vol) and a flow rate of 0.25 mL/min. Sensitivity is increased relative to conventional columns, and solvent consumption is reduced by 90%. The standard curve is linear to at least 5 mg/L, and the detection limit is 0.02 mg/L. The within-run precision of the method is excellent (CV 4%) at a midrange concentration of 1.25 mg/L.
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Some patients who take tricyclic antidepressants (TCAs) develop delirium. Charts were reviewed of 125 inpatients whose TCA plasma levels had been assayed. Delirium was documented in 10 cases. The occurrence of delirium was statistically related to age, race, and loge plasma TCA levels.
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Improvements of individual depressive symptoms in patients with depression was compared between those treated with tricyclic antidepressants (TAD) and those treated with other psychoactive drugs or placebo. In the majority of comparisons, patients did not improve significantly more with TAD than with other drugs or placebo. These findings indicated that tricyclic antidepressants are not useful in the treatment of most patients with depression. Despite our findings, it is realized that a minority of patients with depression may benefit by treatment with tricyclic antidepressants.
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