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PubMed1975

Comparative enhancing effects of phenobarbital, amobarbital, diphenylhydantoin, and dichlorodiphenyltrichloroethane on 2-acetylaminofluorene-induced hepatic tumorigenesis in the rat.

Earlier studies showed that phenobarbital feeding enhanced hepatic tumorigenesis in rats previously fed 2-acetylaminofluorene for a brief period. As part of an investigation of the mechanism of this enhancement, the present study evaluated the relative enhancing abilities of amobarbital, diphenylhydantoin, and dichlorodiphenyltrichloroethane (DDT), agents that resemble phenobarbital to varying degrees in their effects on liver structure and metabolism. A comparison of hepatic tumor yields in rats fed 2-acetylaminofluorene, followed by the test substance (sequential treatment), showed that amobarbital and diphenylhydantoin had no enhancing activity, whereas the enhancing effect of DDT was similar to that of phenobarbital. These results show that the sequential treatment technique readily distinguishes among substances differing in enhancing ability and should prove useful in screening additional substances for this activity. The comparative biochemical effects of these substances in the liver can then be correlated with their relative enhancing abilities to provide information on the molecular events specifically associated with enhancement. Such correlations were initiated in this study by comparing the effects of the four test substances on liver weight and DNA synthesis. The results showed that the enhancers, phenobarbital and DDT, each stimulated liver DNA synthesis and increased liver weight, whereas the nonenhancers, amobarbital and diphenylhydantoin, had neither effect. Phenobarbital and DDT both increased the early tumor incidence rate and maintained an increment in tumor incidence over that in the other treatment groups throughout the experiment, although it is not clear whether this increment would persist indefinitely. In addition, although the spectrum of tumor types observed ranged from highly differentiated to poorly differentiated in all treatment groups, DDT and phenobarbital selectively increased the incidence of highly differentiated tumors throughout most of the experiment.

2-Acetylaminofluorene↗
PubMed2003

Neurobehavioral differences in superselective Wada testing with amobarbital versus lidocaine.

Four patients with cerebral arteriovenous malformations (AVMs) underwent superselective Wada testing with intraarterial amobarbital and lidocaine before embolization. In all four patients, the use of lidocaine detected clinically significant neurologic deficits that amobarbital alone did not, likely because of the pharmacodynamic differences of the two agents. The use of lidocaine with amobarbital for superselective Wada testing in patients with cerebral AVMs may improve the sensitivity and predictive value of this test in the future.

Adult↗
PubMed1983

Lormetazepam and amobarbital sodium in the outpatient treatment of insomnia: a controlled trial.

In a double-blind clinical trial, 50 psychiatric outpatients with moderate insomnia (requiring daily treatment with a hypnotic drug) were treated for two weeks with lormetazepam (1 mg) or amobarbital sodium (100 mg). In interviews before and after treatment, data were collected on the patients' demographic characteristics, sleep disturbances, concomitant organic or psychiatric disorders, and opinions of the drug taken during the two-week period. During the trial the patients took notes on their use of the drug, the quality and duration of their sleep, and any adverse effects of the drug they were using. Lormetazepam and amobarbital were equivalent in the amount of time it took patients receiving each drug to fall asleep and in the duration of the patients' sleep, but insomnia disappeared (or the condition improved) in a larger proportion of patients receiving lormetazepam, and there were fewer adverse effects (eg, hangover in the morning, sedation in the morning and during the day, and dry mouth) in patients receiving lormetazepam than in patients receiving amobarbital.

Adult↗
PubMed1978

Amobarbital treatment of multiple personality. Use of structured video tape interviews as a basis for intensive psychotherapy.

The case of a 30-year-old woman with five distinct personalities is presented. The patient was treated, using a system of structured video taped sodium amobarbital interviews, in which areas to be explored were developed in psychotherapy. Tapes were played for the patient after each session. The taped material was used as the basis for psychotherapeutic investigation. The patient evidenced many of the features previously reported in cases of multiple personality, specifically: being the product of an unwanted pregnancy in a repressively rigid family; emotional distancing by one parent; strong sibling rivalry with an adopted sib; family history of mental illness; a traumatic first sexual experience (rape); a marriage to a maladjusted individual in an attempt to escape the parental home; a high internalized standard of performance and an inability to display anger or negative feelings toward the parents. In the course of treatment, the patient's personalties fused and she was able to accept each component as part of herself. No further fragmentation has occurred during the year following discharge. The therapy technique minimized dependency, and the possiblity of addiction to amobarbital interviews permitted more active patient therapy involvement, and set clear-cut goals and expectations for improvement before further amobarbital interviews could be conducted.

Adult↗
PubMed1993

[The intracarotid amobarbital test. Neuroradiologic and neuropsychologic aspects].

In presurgical evaluation of epilepsy, unilateral cerebral inactivation by means of intracarotid injection of amobarbital is used for the determination of cerebral dominance for language and memory functions. This intracarotid amobarbital test (IAT) is intended to yield prognoses concerning postsurgical neuropsychological and neurological deficits. In the present review, neuroradiological and neuropsychological aspects of the procedure are discussed. Each IAT is preceded by a cerebral angiography to exclude or detect vascular anomalies that might be relevant to the interpretation of neuropsychological test data. The main methodological problems of the IAT are interference of various cognitive deficits and monitoring of the course of amobarbital action. Alternative procedures of determination of hemispheric asymmetries--positron emission tomography, electrical stimulation mapping, and noninvasive methods like tachistoscopy--mainly yield data complementary to the results of the IAT and hence are not taken as substitutes of that technique.

Amobarbital↗
PubMed1999

Death attributed to amobarbital and levomepromazine intoxication.

A 29-year-old man, possibly a schizophrenic patient, was found dead 9 h after admission to a hospital. Autopsy revealed neither significant injuries nor diseases except for congestion of all organs. Microscopic examination revealed severe edema in the lung and slight centrilobular necrosis in the liver. Since amobarbital and levomepromazine were detected by drug screening, the concentrations of these drugs in the victim's body fluids and tissues were determined using gas chromatography-mass spectrometry. The whole blood concentrations of amobarbital and levomepromazine were 9.02 microg/ml and 231 ng/ml, respectively. These levels exceeded therapeutic ranges, but are not so toxic or fatal. However, on the basis of the findings in the literature and of the severe lung edema and centrilobular necrosis in the liver, the cause of his death was judged to be amobarbital and levomepromazine intoxication.

Journal Article↗
PubMed1993

The association of multiple personality and temporolimbic epilepsy. Intracarotid amobarbital test observations.

OBJECTIVE: What is the relationship of "multiple personality disorder" in patients with temporolimbic epilepsy to certain types of hemispheric interaction? DESIGN: Case series. SETTING: Tertiary care referral center. PATIENTS: Two patients with temporolimbic epilepsy considered to be surgical candidates referred for the intracarotid amobarbital sodium procedure (IAP). Each individual had presented with different "personalities" in a characteristic temporal relationship to their seizures. INTERVENTIONS: Intracarotid amobarbital sodium procedure, Wada test, and electroencephalogram. MAIN OUTCOME MEASURES: Behavioral observations made during the performance of the IAP. RESULTS: During the IAP, each patient's peri-ictal "personality" changes were precisely replicated. No seizure activity was noted during the IAPs. CONCLUSIONS: These observations suggest that the association of multiple personality and temporolimbic epilepsy is not dependent on seizure discharges per se, but rather may be related to certain types of hemispheric interaction.

Adolescent↗
PubMed1979

Clinical usefulness of sodium amobarbital interviewing.

We report a double-blind, randomized, placebo-controlled study utilizing a within-subjects design on 20 hospitalized, psychiatric patients who participated in sodium amobarbital interviews to determine if the drug has a specific effect in eliciting clinically useful information. The patients selected had difficulty communicating with their primary therapists during the postadmission, diagnostic interviews. Two raters completed a Hamilton Depression Scale, a New Haven Schizophrenia Index, and a Brief Psychiatric Rating Scale after each interview. Although both the amobarbital and saline interviews were moderately useful in obtaining new information, we found no significant difference in the primary therapists' assessments of clinical usefulness. In addition, the drug interview did not uncover material that would aid in the differential diagnosis between depression and schizophrenia. There was, however, a significant negative correlation between the assessment of general usefulness and the time interval between admission and interviewing. We report our only exception, a case of catatonic schizophrenia, in which the patient responded specifically to the drug.

Adult↗
PubMed1977

UV spectrophotometric determination of aminophylline, amobarbital, and ephedrine hydrochloride in an antiasthma capsule preparation.

A simple and rapid procedure for the determination of aminophylline, amobarbital, and ephedrine hydrochloride in a capsule preparation is described. Aminophylline and amobarbital are determined simultaneously using differential UV spectrophotometry; ephedrine hydrochloride is determined separately after elution from an alginic acid column with 0.1 N hydrochloric acid.

Aminophylline↗
PubMed1997

Assessment of the functional effect of the intracarotid sodium amobarbital procedure using co-registered MRI/HMPAO-SPECT and SEEG.

We studied the functional effect of injection of sodium amobarbital (SA) in 10 patients with intractable epilepsy. During the intracarotid amobarbital procedure, we measured delta activity in EEG recording from implanted electrodes and regional cerebral blood flow (rCBF) using HMPAO-SPECT co-registered with MRI. SA injection resulted in an increase in delta activity and a decrease in rCBF in all areas examined. Direct functional changes were observed in structures perfused by the carotid artery injected. In addition, we observed indirect effects, probably owing to deafferentation of neuronal pathways connecting these structures to ipsilateral and contralateral regions, including middle and posterior hippocampus.

Amobarbital↗
PubMed1997

Level of consciousness and memory during the intracarotid sodium amobarbital procedure.

Controversy exists regarding differential effects on consciousness of left/right cerebral inactivation via intracarotid amobarbital. Further, the effects of level of consciousness (LOC) on memory during the intracarotid sodium amobarbital procedure (IAP) are unclear. A modified version of the Glasgow Coma Scale altered to avoid the confounding effects of aphasia was employed to assess LOC in 97 patients during the IAP. A greater impairment in LOC occurred with left cerebral inactivation. Memory was more impaired following left hemisphere injections as well as from injections contralateral to seizure focus. Memory was correlated with LOC, and this effect was more prominent for right hemisphere injections and for injections ipsilateral to seizure focus. These findings support differential cerebral roles in consciousness and demonstrate that IAP memory performance may be affected by the patient's LOC.

Adolescent↗
PubMed1997

An exploratory comparison of three methods of memory assessment with the intracarotid amobarbital procedure.

This paper has two objectives. The first is to compare three methods of amobarbital memory assessment in 172 adults prior to epilepsy surgery. The three methods are significantly different from one another and there was only a moderate degree of concordance between them; concordance depended upon the method, the side of surgery, and the side of speech. The second objective of the paper is to evaluate the relative abilities of the methods of differentiate, prior to surgery, patients who did and who did not suffer mild to moderate postoperative losses in verbal memory following surgery. To meet this objective a subsample of patients was selected based on the presence or absence of this type of memory loss. Significant differences in the ability of the amobarbital methods to identify the patients at risk for postoperative memory loss were observed, with the method assessing recall memory during drug presence having the best prediction rate.

Adult↗
PubMed1997

Effect of focus lateralization on memory assessment during the intracarotid amobarbital procedure.

Despite the use of stimuli that can be processed by both hemispheres, a number of studies have reported lower memory scores after the left intracarotid amobarbital procedure (IAP) than after the right IAP. Because of that, failure after ipsilateral IAP is observed more often in patients with a left temporal seizure focus (LT) than in right temporal patients (RT), possibly needlessly excluding some LT patients from surgery. In order to overcome the deleterious effects of anesthetizing the dominant hemisphere, we designed an IAP protocol that did not promote verbal encoding of the stimuli. For this purpose, a large number of visual and tactile stimuli (colored pictures and real objects) were presented to be recognized later. The effect of seizure focus lateralization was examined in 82 temporal lobe epileptic patients who underwent IAP as part of their presurgical evaluation. As expected, for both RT and LT patients, long-term recognition of pictures presented under the effect of amobarbital was highly sensitive to the presence of a contralateral epileptic focus. However, contrary to what is generally reported, LT patients performed better than RT patients when their left (ipsilateral) hemisphere was anesthetized. In RT patients, although memory scores were lower after the left contralateral injection, the disparity in memory scores between the right and left injection was not as marked as in LT patients. These results are discussed in terms of the influence of type of processing required during the initial encoding on later recognition during IAP.

Amobarbital↗
PubMed1994

Quantitative and qualitative evaluation of patterns of cerebral language dominance. An amobarbital study.

As a part of presurgical evaluation, 173 patients received bilateral intracarotid amobarbital tests for determination of cerebral language dominance. Language testing during intracarotid amobarbital procedures (IAP) consisted of the following tasks: automatic speech, sentence comprehension, body commands, naming, repetition, reading, and spontaneous speech. Patterns of cerebral language dominance were evaluated and discussed on five levels of analysis: (1) quantification of language dominance on the basis of a lateralization index derived from the total language scores in each IAP; (2) determination of five dominance subpatterns (left or right dominant, strongly bilateral, and incomplete left or right dominant) according to quantification performed on level (1) and clinical judgement; (3) qualitative differentiation of three kinds of bilaterality (positive, negative, and general) according to total language performance in left and right IAP; (4) analysis of grouped linguistic subfunctions extracted from performance in specific IAP subtests; (5) extraordinary individual case histories. The distribution of lateralization indices revealed only partially continuous degrees of lateralization, especially between the left-dominant and bilateral subgroups. As for the clinically oriented classification, incomplete left dominance is frequent (16.2%), while incomplete right dominance does not occur at all. Atypical dominance patterns are mostly correlated to bilateral and/or extratemporal foci. Concerning grouped subfunctions, a rotated factor matrix statistic yields an analysis of clusters of IAP subtests, where functions involving expressive language capacities are separated from those that are purely receptive. Further analyses of bilaterality subpatterns suggest that there are mainly four bilaterality phenomena, namely interhemispheric dissociation, double representation, unilateral representation of subfunctions, and partial representation of subfunctions in either hemisphere. Application of these differentiations to individual cases yields additional evidence that can be used in patient selection for operation in order to avoid postoperative neuropsychological deficits, especially in candidates for extratemporal surgery. In conclusion, a multilevel analysis of IAP language data is recommended since it permits a detailed account of varieties of language dominance patterns and contributes to more adequate presurgical decision-making in planned operations in cognitively relevant brain areas.

Adolescent↗
PubMed1977

Influence of the suspension of continued treatment with flurazepam and amobarbital on two discrimination learning schedules.

The authors have studied the effect of the suspension of chronic treatment with flurazepam and amobarbital on the operant behavior of rats that for the first time were in the presence of two fixed-interval discrimination schedules. With the sound discrimination schedule, the responses emitted by the treated animals had charactistics similar to those of control animals. With the temporal discrimination schedule, though it is not possible to distinguish between learning rates, modifications in the intensity of the effect (increases in lever pressing) indicate that, considering the doses, the action of flurazepam is slight and that of amobarbital clear and statistically significant.

Acoustic Stimulation↗
PubMed1990

Brain perfusion with intracarotid injection of 99mTc-HM-PAO in partial epilepsy during amobarbital testing.

Technetium (99mTc) hexamethyl propylene amine oxime (HM-PAO) was injected into the internal carotid artery in ten epileptic patients after the end of amobarbital speech-memory tests. The cerebral perfusion as visualized from SPET was compared to cerebral angiographies, which showed unilateral filling of intracranial vessels in seven patients. SPET revealed cross-flow between the hemispheres in four of these seven patients. In three patients in whom the angiograms had shown bilateral contrast filling, SPET showed cross-flow in only two. It is concluded that 99mTc-HM-PAO SPET examinations provide valuable information for correct interpretation of amobarbital tests on cognitive hemisphere functions. The SPET technique may help to explain atypical speech and memory responses caused by unusual intracranial vascularization.

Adult↗
PubMed1990

Cerebral language lateralization: evidence from intracarotid amobarbital testing.

Cerebral language lateralization was investigated in 103 patients undergoing intracarotid amobarbital testing as part of their diagnostic work-up for epilepsy surgery. Inclusion criteria included adequate bilateral intracarotid amobarbital studies and no radiologic lesion in areas other than the temporal lobe. Language was evaluated with respect to strict presence or absence of language representation, in which a patient was considered to have bilateral language despite potentially having asymmetric language representation, and with respect to forced relative hemispheric dominance, in which a single side could be considered dominant despite bilateral language representation. Seventy-nine patients displayed exclusive left hemisphere language representation, two patients showed exclusive right hemisphere language representation, and 22 patients had language represented in each hemisphere. In the 22 patients with bilateral language, an asymmetry was present in 17 cases (13 L greater than R, 4 R greater than L). These data indicate that language restricted only to the right hemisphere is rare, and that in the absence of purely left hemisphere language, most patients exhibit bilateral representation. Previously reported incidence of exclusive right hemisphere language may be an artifact of dichotomizing a continuous variable.

Amobarbital↗
PubMed1990

Hemispheric specialization for emotional expression: a reexamination of results from intracarotid administration of sodium amobarbital.

Emotional and behavioral responses to sodium amobarbital injection were examined in 44 epilepsy surgery candidates. Thirty-three emotional reactions occurred in 26 patients, 44% of the reactions following right hemisphere injection and 32% after injection of the left hemisphere. Among all patients examined, laughter/elated mood was statistically more frequent following right hemisphere injection while crying was statistically associated with left hemisphere injections. These observed effects were not related to amobarbital dose, sex, bilateral hemispheric inactivation (angiographic crossflow), general cognitive status, or side of seizure onset. These results support differing specialization of emotional expression in the right and left cerebral hemispheres and their subcortical connections.

Adolescent↗