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Biomedical subjects

A Coppen

Publications and source records attributed to A Coppen.

At least 37 records · Page 2Linked to original sources
PubMed1978

Decreased tryptophan excretion by depressive patients.

The concentration and 24-h urinary excretion of tryptophan has been measured in urine samples from monopolar female depressed patients and female control subjects. Female depressed patients and the control subjects excrete similar amounts of tryptophan. Patients with endogenous features of depression excrete significantly less tryptophan in 24 h than do the patients with reactive features and the control subjects. The relationship between plasma tryptophan concentration and 24-h urine tryptophan excretion in control subjects has been investigated and the results discussed in the light of abnormalities of tryptophan metabolism in depressive illness.

Antidepressive Agents, Tricyclic↗
PubMed1978

Platelet 5-hydroxytryptamine accumulation in depressive illness.

The uptake of 5-hydroxytryptamine (5-HT) by blood platelets from controls, depressed patients and recovered depressed patients has been determined using short incubation times and low substrate concentrations. The affinity of serotonin for the platelet membrane appears to be normal in acutely depressed and recovered depressed patients. The capacity of transport of 5-HT through the platelet membrane is impaired in these depressive patients and this impairment is independent of the psychiatric status of the patients and is discussed in the light of the electrolyte and enzyme disturbances that are associated with depressive illness.

Biological Transport, Active↗
PubMed1978

Antidepressant activity and pharmacological interactions of ciclazindol.

Ciclazindol, a new tetracyclic compound, appears to be a potentially important antidepressant of the same order as amitriptyline, but with significantly fewer subjective side effects. Although as a group the patients treated with ciclazindol lost weight, clinical improvement was observed to be significantly correlated with the weight gain in both groups. The peripheral adrenergic interactions were studied. In the dosage used (100 mg/day) ciclazindol was observed to be a peripheral Na-reuptake blocker with no significant effect on the postsynaptic alpha-receptors. Plasma concentrations of the drug were estimated and their relationship to the therapeutic outcome, side effects, and adrenergic interaction were studied. No significant change in resting BP or ECG was observed following 4--6 weeks' treatment with ciclazindol.

Adult↗
PubMed1978

Amitriptyline plasma-concentration and clinical effect. A World Health Organisation Collaborative Study.

54 patients in five centres participated in a study of the relationship between steady-state plasma-levels of amitriptyline (AT) and its active metabolite nortriptyline (NT) and therapeutic response. The participants were inpatients who, after a 7-12 day period of assessment, were rated greater than or equal to 16 on the Hamilton rating scale for depression. They were given 75 mg of amitriptyline for 3 days and then 150 mg daily for an active-treatment period of 6 weeks. Clinical ratings and plasma-samples were obtained at baseline then at 2, 4, and 6 weeks after starting therapy. Contrary to the findings of three previous trials, no important correlations were found between steady-state plasma-levels and therapeutic outcome or corrected side-effects. Corrected side-effects correlated negatively with therapeutic outcome. There seems little advantage in routine monitoring of AT and NT, since variations in plasma-levels do not account for the considerable variation in therapeutic outcome.

Adult↗
PubMed1978

Tryptophan and depressive illness.

Plasma free tryptophan is significantly decreased in monopolar, depressed patients. No evidence was found to suggest that poor nutritional history prior to hospital admission was responsible for these low levels. Factors known to influence tryptophan-albumin binding in plasma, e.g. concentration of plasma proteins, albumin and non-esterified fatty acids, did not account for the low levels of free tryptophan in depressed patients. A significant decrease in plasma free tryptophan levels was found in perimenopausal but not in pre- or post-menopausal female controls. This mirrors the decrease in circulating oestrogens. Although exogenously administered oestrogens do not have any therapeutic efficacy in relieving mild residual depressive symptoms of lithium treated patients, they increased the levels of plasma free tryptophan. Clofibrate also displaces tryptophan from plasma protein binding sites in both depressed patients and controls. Utilization of the increased levels of plasma free tryptophan is reduced in depressed patients. A situation therefore exists in depressed patients where the plasma free tryptophan is not only reduced but also leaves the plasma less readily than in control subjects.

Blood Proteins↗
PubMed1978

Continuation therapy with amitriptyline in depression.

Thirty-two patients who had responded to amitriptyline (150 mg daily) when suffering from a depressive illness were allocated either to receive placebo or to remain on the same medication for one year. Plasma concentrations of the drug were regularly estimated. There was no correlation between plasma concentration and subsequent residual affective morbidity. In spite of considerable encouragement, three of the patients did not take the prescribed amitriptyline and they all relapsed. Five out of sixteen patients who received placebo relapsed. None of the patients who continued to take amitriptyline relapsed. It is emphasized that the patients studied were selected, inasmuch as they were apparent responders to amitriptyline. It is concluded that this group of patients should continue to be treated with antidepressant medication for eight months after apparent recovery, and care should be taken to ensure the patients' compliance.

Adult↗
PubMed1978

Mianserin and lithium in the prophylaxis of depression.

Forty-one out-patients with a history of at least three attacks of depressive illness were randomly allocated to treatment on a double-blind basis for one year with either mianserin 20 mg three times daily plus placebo lithium tablets, or to lithium tablets once daily plus placebo mianserin tablets. After one year, the dosage of mianserin was increased to 30 mg t.d.s. for a further six months. All but three of the patients had previously been stabilized on prophylactic lithium therapy. Lithium was found to be significantly superior to mianserin in avoiding admission to hospital or ECT. The overall affective morbidity index, calculated from global rating, showed no significant difference between drugs, but the index of the mianserin group was higher in the second six months than in the first. The lithium group showed no such change. Lithium remains the choice for the prophylaxis of unipolar recurrent depressive illness.

Administration, Oral↗
PubMed1978

Effect of mianserin hydrochloride on peripheral uptake mechanisms for noradrenaline and 5-hydroxytryptamine in man.

1. Mianserin seems to have little effect on peripheral noradrenaline (NA) re-uptake mechanisms as shown by its lack of effects on the tyramine dose and NA dose/pressor response. 2. Mianserin has no effect on the hypotensive action of bethanidine. 3. Mianserin in vivo has a significant action on platlet transport (Vmax) of 5-hydroxytryptamine (5-HT), which changes toward normal values in depressive patients on the drug. This action is not observed in vitro. 4. It is possible that a metabolite of mianserin is responsible for this effect, and that this may be of therapeutic importance.

Antidepressive Agents↗
PubMed1977

Noradrenaline, depressive illness, and the action of amitriptyline.

The tyramine-dose/pressor response test was carried out on a series of patients suffering from primary depressive illness before and during treatment with amitriptyline. The severity of their depression was assessed during the study of the Hamilton Rating Scale (HRS). The decreased tyramine sensitivity induced by the drug, which is related to the inhibition of NA reuptake, correlated significantly with the plasma concentration of nortriptyline. However, contrary to the expectation of the noradrenaline hypothesis of depression, the decreased tyramine sensitivity, i.e., the degree of NA-reuptake blockade, did not show any correlation with clinical improvement following 6 weeks' treatment with amitriptyline.

Adult↗
PubMed1977

Intravenous tyramine response in migraine before and during treatment with indoramin.

We studied the response of 31 migraine sufferers (20 women, 11 men) to intravenous tyramine (the tyraminedose)pressor response test). Patients were treated either with pacebo tablets or indoramin, and alpha-adrenergic blocking agent, in a double-blind crrossover trial. We found that patients with migraine required significantly less tyramine to increase their cystolic blod pressure by 30 mm Hg when compared with matched controls. Indoramin significantly increased the amount of tyramine needed to raise the systolic blood pressure among migraine suffers and reduced the incidence of posttyramine migraine for m 46% while patients were on placebo tablets to 8% when they were receiveing indoramin. There was no association between tyramine sensitivity and a history of premenstrual or dietary migraine, nor was there a significant difference in the indierenence in the incidence of post-tyramine migrain between men women. We conclude that the intravenous tyramine test may be valuable in assessing migraine suffers who will respond to an alpha-advenergic blocking agent such as indoramin.

Blood Pressure↗
PubMed1977

Red cell adenylate kinase phenotypes in the affective disorders.

The red cell adenylate kinase (AK) phenotype was determined by starch gel electrophoresis in 96 adult Caucasian subjects with affective disorders (24 with bipolar illness and 72 with unipolar illness). The phenotype frequencies and the gene frequencies of the bipolar group closely resembled that of the control subjects (180 subjects drawn from the population of a large institution for the mentally retarded), the unipolar group however, showed a significant increase in the frequency of the AK2 allele. The significance of these results have been discussed in relation to the known genetic and biochemical findings in the affective disorders. It is suggested that the mechanism involved may be a reduction of the enzyme activity in the tissues of subjects with the AK 2:1 phenotype. This may present a selective disadvantage in the form of a decrease in control of energy metabolism in general, and control of adenine nucleotide levels in nervous tissue in particular.

Adenylate Kinase↗