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Biomedical subjects

A J Gelenberg

Publications and source records attributed to A J Gelenberg.

122 records · Page 7Linked to original sources
PubMed1977

Munchausen's syndrome with a psychiatric presentation.

An unusual case of Munchausen's Syndrome is presented, in which the patient feigned a psychiatric history, complained of emotional symptoms and sought admission to a psychiatric unit. This variant of the usual somatic presentation is discussed in terms of the problem of motivation in Munchausen's Syndrome. Munchausen's Syndrome is a behavioral complex in which patients feign history and symptoms of illness and seek hospital admissions. Such an unusual pattern of behavior is clearly within the province of psychiatry, yet these patients, presenting most commonly with somatic symptoms, are often reluctant to see a psychiatrist and flee before being interviewed. Of 38 cases in one series, only 16 had a psychiatric consultation. The purpose of this paper is to describe an unusual case of Munchausen's Syndrome, a patient who, rather than fleeing from psychiatrists, sought admission to psychiatric units. While the genetic material available in this case is sparse, the phenomenon itself of psychiatric complaints and history in such a patient may further our understanding of, and spur futher interest in, a perplexing disorder.

Adult↗
PubMed1976

The catatonic syndrome.

Catatonia is often automatically assumed to be a subtype of schizophrenia. This paper proposes that it be considered as a syndrome with various possible causes. Physicians are advised to be aware of potentially serious organic illnesses which may underlie the catatonic syndrome.

Affective Symptoms↗
PubMed1976

Computerized tomography in patients with tardive dyskinesia.

The author reviews the results of computerized tomography performed on eight patients with tardive dyskinesia to determine whether there was permanent structural damage. No significant abnormalities were found. Although it may not be useful in routine workups, this new noninvasive technique might be helpful in differential diagnosis, and its increasing sophistication may suggest further research on tardive dyskinesia.

Adolescent↗
PubMedDate not supplied

Amoxapine--an antidepressant with some neuroleptic properties? A review of its chemistry, animal pharmacology and toxicology, human pharmacology, and clinical efficacy.

Amoxapine, a new antidepressant, exhibits both antidepressant and neuroleptic effects in laboratory animals and in humans. Evidence from human studies (extrapyramidal reactions, hyperprolactinemia, and galactorrhea), animal screening tests, and neurochemical experiments support the contention that amoxapine or a metabolite occasionally produces neuroleptic-like effects. Amoxapine's neuroleptic activity may derive from 7-hydroxy-amoxapine, a minor metabolite in humans, which exhibits significant dopamine receptor-blocking activity. Evidence for an early antidepressant effect of amoxapine in the treatment of depressive illness has not been consistently demonstrated. In comparable doses (roughly twice the dose of imipramine or amitriptyline), amoxapine appears to be similar to reference antidepressants in efficacy, unwanted effects, and acute toxicity.

Amitriptyline↗
PubMedDate not supplied

Chemistry, pharmacology, pharmacokinetics, adverse effects, and efficacy of the antidepressant maprotiline hydrochloride.

Maprotiline, a tetracyclic antidepressant with sedative properties, exhibits strong inhibitory effects on norepinephrine uptake across nerve cell membranes but interferes relatively little with serotoninergic mechanisms. The biological half-life of unchanged maprotiline in blood averages 43 hours. Though several studies suggest a more rapid onset of antidepressant effects with maprotiline than with amitriptyline or imipramine, this issue remains unresolved. The adverse effect profile of maprotiline is similar to that of the tricyclic antidepressants, except that rashes are about twice as frequent with maprotiline as with amitriptyline or imipramine. The most frequent adverse reactions are anticholinergic effects and sedation. Data suggest less frequent and severe anticholinergic side effects with maprotiline than with amitriptyline. Maprotiline may be less likely to induce orthostatic hypotension and tachycardia than standard tricyclic antidepressants, but clinically important differences in cardiovascular effects remain to be conclusively demonstrated. Many patients benefit from the convenience of once daily dosing. Maprotiline is comparable in antidepressant efficacy to the tricyclic antidepressants.

Anthracenes↗
PubMedDate not supplied

CDP-choline for the treatment of tardive dyskinesia: a small negative series.

Based on the cholinergic-deficiency hypothesis of tardive dyskinesia (TD), we administered cytidine diphosphoryl choline (CDP-Choline) (a naturally occurring biochemical intermediary in the synthesis of phosphatidylcholine), 500 mg twice a day orally, to four women and one man with TD for 2 to 8 weeks in a double-blind, placebo-controlled crossover trial. Although the small sample size provides only limited power to detect a treatment effect, there was no evidence of efficacy, adverse effects, or changes in psychopathology.

Adult↗
PubMedDate not supplied

Clovoxamine in the treatment of depressed outpatients: a double-blind, parallel-group comparison against amitriptyline and placebo.

In a double-blind, random-assignment, parallel-group trial, outpatients with major depression received either the new antidepressant clovoxamine, the tricyclic amitriptyline, or placebo for 6 weeks. By an "improvement" criterion of 50% or greater improvement in the Hamilton Depression Scale (HAM-D) total score, 88% of clovoxamine completers improved versus 75% with amitriptyline and 43% with placebo; however, due to small numbers, the differences failed to reach statistical significance. Diminished salivary flow was significantly greater with amitriptyline, as were complaints of dry mouth, somnolence, dizziness, and headache. Nausea and vomiting were more common in the clovoxamine-treated group. With amitriptyline, but not with clovoxamine, memory performance declined over a month. However, psychomotor performance was not affected.

Adult↗
PubMedDate not supplied

Tyrosine for depression.

The catecholamine hypothesis of affective disorders postulates that depression reflects inadequate norepinephrine activity at unspecified brain centers that regulate mood. In light of experimental data showing that the oral administration of tyrosine, precursor of the catecholamine series of neurotransmitters, can increase brain norepinephrine concentrations and activity, we have conducted preliminary trials of tyrosine in depressed outpatients. Initial results are encouraging, and we are now conducting a double-blind, parallel-group trial comparing tyrosine to the tricyclic antidepressant imipramine and to placebo in non-bipolar outpatients with major depression.

Brain Chemistry↗
PubMedDate not supplied

The Arizona Sexual Experience Scale (ASEX): reliability and validity.

Although sexual dysfunction is common in psychiatric patients, quantification of sexual dysfunction is limited by the paucity of validated, user-friendly scales. In order to address this problem, the authors have developed the Arizona Sexual Experiences Scale (ASEX), a five-item rating scale that quantifies sex drive, arousal, vaginal lubrication/penile erection, ability to reach orgasm, and satisfaction from orgasm. Possible total scores range from 5 to 30, with the higher scores indicating more sexual dysfunction. This study assesses the internal consistency, test-retest reliability, and convergent and discriminant validity of the ASEX.

Adult↗
PubMedDate not supplied

Sexual dysfunction secondary to depressive disorders.

Human sexuality has received less systematic study and is less well understood than other aspects of mental and physical health. Although depression itself, apart from medication, is generally believed to be associated with sexual dysfunction, the few existing studies report wide discrepancies with regard to frequency, gender, and quality of sexual dysfunction. Loss of libido is frequently and consistently associated with major depression. Moreover, sexual dysfunction secondary to depression or other factors is often mistaken for that caused by antidepressant medication. Although antidepressants have long been associated with sexual dysfunction, the precise nature and magnitude of sexual side effects have not been fully appreciated. This article will review the literature on sexual dysfunction associated with unmedicated depression and offer a guide for the clinician evaluating and treating depressed patients with sexual problems.

Depressive Disorder↗