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Biomedical subjects

A J Gelenberg

Publications and source records attributed to A J Gelenberg.

At least 73 records · Page 4Linked to original sources
PubMed1988

Lithium efficacy and adverse effects.

The primary use of lithium is as maintenance treatment of bipolar disorders to prevent relapse. Although it effectively treats acute mania, lithium must often be used in conjunction with neuroleptics. Once-daily lithium therapy may help avoid some side effects and long-term renal damage. Neurotoxicity can be a problem for a small number of sensitive patients when neuroleptics and lithium are combined. Whenever possible, lithium should be avoided in the first trimester of pregnancy because of its potential for inducing cardiovascular abnormalities in the fetus.

Adult↗
PubMed1987

Alpha 2-adrenergic receptors in platelet membranes of depressed patients: increased affinity for 3H-yohimbine.

Specific binding to alpha 2-adrenergic receptors was studied in the platelets of 31 patients with major depressive disorder and 18 normal controls using the selective antagonist 3H-yohimbine. Receptor density for depressed patients (Bmax = 88 +/- SD 45.1 fmoles/mg) was not significantly lower than that for controls (124 +/- SD 78.1 fmoles/mg). The affinity of the receptor for yohimbine was significantly greater in depressed patients (Kd = 1.05 +/- SD 0.47 nM) than in controls (Kd = 1.47 +/- SD 0.63 nM). This is consistent with the hypothesis of increased alpha 2-adrenergic receptor sensitivity in depressive disorders. Past studies of alpha 2-adrenergic receptors on platelets are reviewed, and the importance of designing studies with sufficient statistical power is discussed.

Adult↗
PubMed1987

Effects of lithium on the kidney.

We tested kidney function in 268 patients given lithium treatment for an average period of 37.6 months and in 59 manic-depressive patients never given lithium. No patients suffered serious renal damage during the course of our observations. Maximum concentration capacity was lower and serum creatinine concentration higher in the lithium treated patients than in the controls, but the differences did not achieve statistical significance. Females had poorer concentrating ability than males, both among the control subjects and during lithium treatment. Concomitant antipsychotic drug therapy may affect concentrating ability and possibly glomerular function adversely.

Adult↗
PubMed1987

Treating extrapyramidal reactions: some current issues.

"Extrapyramidal" reactions to antipsychotic drugs include acute dystonias, akathisia, Parkinson's syndrome, and tardive dyskinesia. Recent research suggests efficacy of prophylactic antiparkinson drugs in diminishing the incidence of acute dystonia in high-risk patients, although the use of lower neuroleptic doses also might lower the risk and cause fewer unwanted effects. New in the treatment of akathisia is the use of beta-blockers, specifically propranolol (Inderal and others). Many patients require maintenance antiparkinson drug therapy during prolonged antipsychotic drug treatment. There is no effective treatment for tardive dyskinesia, the prevalence of which may be growing, with an estimated annual incidence of new cases of 3%-4%; the elderly and patients with affective illness may be at greatest risk. Clinicians are also attending to the related syndrome of tardive dystonia.

Antiparkinson Agents↗
PubMed1986

Enhancement of ECT benefit by yohimbine.

Three patients with major depression who were pretreated with yohimbine 10 mg p.o. showed a dramatic response without major adverse effects following two electroconvulsive treatments (ECT). The hypothesis that the alpha 2-adrenergic antagonist yohimbine accelerates ECT-induced postsynaptic beta-adrenergic receptor down-regulation is discussed.

Administration, Oral↗
PubMed1986

Verapamil treatment of acute mania.

Six acutely manic patients were openly treated with verapamil, a calcium channel blocker, as part of their medication regimen in an inpatient setting. All patients had a prompt reduction in their manic symptoms and have been maintained on this medication. Further controlled trials of verapamil in acute mania seem warranted.

Acute Disease↗
PubMed1985

Amoxapine for the treatment of psychotically depressed subjects. A pilot study.

The treatment of psychotic depression remains controversial, although most studies suggest that the combination of an antipsychotic and an antidepressant agent is most beneficial. The authors describe an open-label study of the treatment of psychotic depression using amoxapine, an agent with both antidepressant and antipsychotic properties. Of the six patients treated, two improved dramatically within the first week of treatment, whereas for the remaining four treatment had to be discontinued due to lack of efficacy or side effects. Amoxapine appears to be effective in some cases of psychotic depression, but side effects and known risks of treatment diminish its usefulness.

Adolescent↗
PubMed1985

A double-blind comparison of clovoxamine and amitriptyline in the treatment of depressed outpatients.

Forty-two outpatients with major depression were treated in a 4-week double-blind parallel-group comparison of the new antidepressant clovoxamine--a member of oximethers of aralkylketones--with amitriptyline. The two drugs were comparable in efficacy, although because of the small sample size a moderate clinical difference between treatments may not have been detected. The magnitude of unwanted effects also was comparable, but clovoxamine produced fewer "anticholinergic" effects; this was determined by patient complaints of typical anticholinergic symptoms, by decreased salivary flow, and by a new signal detection memory test.

Adolescent↗
PubMed1984

Effects of two antidepressants on memory performance in depressed outpatients: a double-blind study.

Forty outpatients with primary depression were randomly assigned on a double-blind basis to treatment with amitriptyline (a tricyclic antidepressant) or clovoxamine (a nontricyclic, experimental antidepressant). Memory and depression were assessed during a pretreatment baseline period and at the end of days 4, 7, and 28 of drug treatment. A signal detection recognition memory task and conventional memory measures (including the Benton Visual Retention, Wechsler Logical Memory, and verbal learning tests) were used to assess memory. Although both drugs led to comparable clinical improvement in depression, they affected memory performance differently. The signal detection recognition memory task detected an impairment in memory after chronic amitriptyline administration, as contrasted with an improvement in memory after chronic administration of clovoxamine. The memory impairment in the amitriptyline group and improvement in the clovoxamine group were the result of changes in sensitivity [P(A)]. No changes in response bias (B) were detected. Conventional memory tests failed to detect drug-related differences in memory between the two groups. On the Benton, errors decreased over time within both drug treatment groups, whereas correct reproductions increased within the amitriptyline group only. However, between-group differences on the Benton did not reach significance. Results from the signal detection task suggest an amitriptyline-associated memory impairment. However, this interpretation is tempered by the finding that conventional memory measures failed to detect differences in memory performance between the two groups. We discuss the limitations of traditional memory measures and the utility of a signal detection approach in studies of psychopharmacologic influences on memory.

Adult↗