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Biomedical subjects

A L Morera

Publications and source records attributed to A L Morera.

5 recordsLinked to original sources

Seasonality of psychopathology and circannual melatonin rhythm.

The association of seasonal changes in health and disease has been known for centuries. The prevalence of psychopathological symptoms with seasonal fluctuations and the use of melatonin as a biological marker of circadian and circannual rhythms is well documented. The aim of this work was to study the variability of melatonin secretion between summer and winter in our geographical area (28 degrees N, 16 degrees W) and relate the changes to the level of psychopathology. Ten drug-free, nonsmoker, healthy subjects were studied in summer (August) and winter (December). Blood samples for melatonin assays were collected every hour at night for 5 hr, from 22:00 to 02:00 hr, and next day at noon. Melatonin was assayed by an ELISA technique. Psychopathology was evaluated by means of the 28-item version of the General Health Questionnaire (GHQ-28). All subjects had a circadian rhythm of melatonin secretion in summer and winter. There was a seasonal rhythm with melatonin levels being significantly higher at night in winter than in summer. Melatonin levels at 22:00, 23:00, 24:00 and 01:00 hr and mean melatonin area under the curve (AUC) were significantly higher in winter than in summer. Melatonin AUC increased 80% in winter compared with summer. The GHQ-28 somatic and anxiety subscales and the total GHQ-28 score were significantly higher in winter than summer. Psychopathology scores were significantly and negatively correlated with melatonin production in summer and winter. Our data strongly suggest that melatonin production and psychopathology levels present seasonal fluctuations and these variations should be taken into account when conducting research in this field.

Adult↗

Risperidone and clozapine combination for the treatment of refractory schizophrenia.

Clozapine is the most widely used antipsychotic drug for the treatment of refractory schizophrenia. Here we report the case of two residual schizophrenic patients refractory to conventional antipsychotics who showed a poor response to atypical antipsychotics. The combination of risperidone and clozapine produced a noticeable improvement in the patients' clinical status and a shortening of the treatment response latency.

Adult↗

[Efficiency of melatonin in the treatment of insomnia].

UNLABELLED: The aim of this research consists of studying whether melatonin (MLT) may be considered as an alternative for the treatment of insomnia. METHODS: A 33-year period (1966-1998) of computerised search using Medline database was performed. Melatonin, pineal gland and insomnia were used as key words. RESULTS: 93 articles were elicited; 85 were excluded because they were reviews (44) or were not directly related to the research topic (41). 111 insomniac patients were treated with MLT in 8 articles. 60% of the patients reported an improvement of sleep quality. Objective sleep measures also improved; there was a decrease in the sleep latency time and the number of awakenings (62% and 50% of patients respectively) after MLT treatment. CONCLUSIONS: Melatonin may have a promising future for the treatment of insomnia. The lack of standardised criteria for diagnosing sleep disorders and the lack of structured psychiatric interviews for ruling out psychiatric pathology are clear obstacles in generalizing these results.

Adjuvants, Immunologic↗

[Safety in melatonin use].

INTRODUCTION: The interest on melatonin (MLT) as a psychiatric treatment has increased a lot in the last decade. This is mainly due to MLT safety and its lack of serious adverse reactions. The aim of this paper consists of reviewing the adverse effects to MLT consumption in humans. METHOD: A 35-year (1966-2000) bibliographic search using the Medline database was carried out. The intersection of the key word melatonin with the group of words adverse effects or side effects or adverse reactions or toxicity was the strategy of the search. RESULTS: 307 articles were elicited and 9 were related to MLT adverse effects. The range of MLT dose involved in the adverse reactions oscillated between 1 mg and 36 mg. The adverse reactions were: one patient with autoimmune hepatitis, one case of confusion due to MLT overdose, one case of optic neuropathy, four subjects with fragmented sleep, one psychotic episode, one case of nistagmus, four cases of seizures, one case of headache and two cases of skin eruptions. CONCLUSIONS: Attention should be paid on the necessity of enquiring about the drugs that patients are taking, because this product is not harmless for health.

Humans↗