PubMed Health⌕ Search

Biomedical subjects

D G Spiker

Publications and source records attributed to D G Spiker.

At least 55 records · Page 3Linked to original sources
PubMed1980

RBC and plasma choline levels in control and depressed individuals: a critical evaluation.

Red blood cell (RBC) and plasma choline (Ch) were measured in 78 depressed, drug-free patients and in 23 normal, drug-free control subjects. RBC Ch levels displayed a huge variability among the patients, in contrast to those measured in normal controls. Plasma Ch levels, on the other hand, were more consistent within each group, and were correlated with age among the two populations studied. RBC Ch levels would appear to be independent of plasma Ch levels, and to be highly individualized and reproducible within each subject. A segment of the depressed population exhibited significantly higher RBC Ch levels than those seen in the normal control population. A clinical correlation of RBC and plasma Ch levels within the depressed population indicated that the patients with RBC Ch levels exceeding 35 nmole/ml might represent a diagnostically distinct subpopulation with specific clinical characteristics. Results presented here, although preliminary, suggest a role for RBC Ch as a biological marker in certain categories of depressive illness.

Adolescent↗
PubMed1980

Urinary MHPG and clinical response to amitriptyline in depressed patients.

The authors treated 18 rigorously diagnosed depressed patients with amitriptyline after baseline urine samples were collected for the measurement of 3-methoxy-4-hydroxphenylglycol (MHPG). Neither age nor severity of depression before treatment correlated with MHPG excretion. There was also no significant correlation between baseline MHPG excretion and clinical response at the end of at least 25 days' treatment with amitriptyline. The authors discuss the relevance of amitriptyline and nortriptyline plasma levels to MHPG and the noradrenergic/serotonergic theories of depression.

Adolescent↗
PubMed1980

EEG sleep alterations in olivopontocerebellar degeneration.

All-night polygraphic recordings of the electroencephalogram, horizontal electrooculogram, and submental electromyogram were performed in two patients with familial olivopontocerebellar degeneration. Sleep was characterized by subnormal measurements of both rapid eye movement (REM) and delta (slow-wave) sleep. Phasic eye movements were reduced out of proportion to tonic components of REM sleep. These findings lend further support to theories linking the pontine nuclei to the primary regulation of sleep in both experimental animals and humans.

Adolescent↗
PubMed1979

EEG sleep in primary depression. A longitudinal placebo study.

Characteristic EEG sleep changes in depression are highlighted by a sleep continuity disturbance, delta sleep reduction, and a shortened REM latency. Since these findings have been derived primarily from only a few baseline recordings, questions regarding their persistence and/or variability have not been previously addressed. As part of an extensive set of investigations of EEG sleep in depression, we examined nightly the sleep of 12 hospitalized, non-delusional, primary depressives who were involved in a program of active psychosocial treatment intervention and received only placebo during a 5-week study period. EEG sleep findings revealed a relative lack of change across time, particularly in those parameters reported to be associated with a primary or 'biologic' depressive episode. While some degree of clinical improvement was noted, the group failed to achieve a state of remission or even partial remission as determined by the Hamilton Rating Scale. It appears that the major sleep alterations associated with such disorders persist for up to at least 5 weeks in the absence of pharmacologic or other somatic intervention.

Adult↗
PubMed1979

MAO activity and EEG sleep in primary depression.

Platelet monoamine oxidase (MAO) activity and electroencephalographic (EEG) sleep measures were examined in 56 drug-free hospitalized patients with primary depression as defined by the Research Diagnostic Criteria. The group included 35 females and 21 males with a mean age of 42.6 +/- 1.4 years. Platelet MAO and EEG sleep data were compared for the group as a whole and separately for the unipolar, bipolar, male, and female subgroups. No significant relationships could be demonstrated for the entire group or for the unipolar, male, or female subgroups. However, an inverse relationship between MAO activity and REM sleep percent was noted in the bipolar subgroup (p < 0.02). While changes in REM sleep have been relatively firmly established in primary depression, the relationship of MAO to depression and to REM sleep remains unclear.

Adult↗
PubMed1979

EEG sleep and affective psychoses: I. Schizoaffective disorders.

The sleep electroencephalogram (EEG) was studied in 41 depressed inpatients. EEG sleep records were compared for two diagnostic subgroups; patients with psychotic depression (n = 29) or with schizoaffective disorders (n = 12). As was true in the previous pilot study, no major EEG sleep variables distinguished the patients with psychotic depression from those with schizoaffective disorders. These data are consistent with the theory that all psychotic depressive states may have certain common psychobiologic features such as shortened rapid eye movement (REM) sleep latency.

Depressive Disorder↗
PubMed1979

An automated analysis of REM sleep in primary depression.

The REM sleep of 23 nonpsychotic patients with primary depression was studied by means of an automated REM analyzer during a drug-free period and again during amitriptyline administration. Initial drug administration (50 mg) was associated with an immediate reduction in the number, average frequency, and average size of the rapid eye movements. The average REM size remained suppressed with continued drug administration while the average REM frequency showed a rebound which was responsible for a partial recovery of the number of REMs and total REM intensity to predrug levels. With regard to individual REM periods, REM frequency and REM intensity were redistributed during tricyclic administration so that the second REM period became more "intense" than the first REM period. This automated REM analysis technique provides an objective set of measures for characterizing discrete aspects of REM sleep during a depressive episode and for evaluating the changes in REM sleep during psychotropic trials.

Adult↗
PubMed1978

Platelet monoamine oxidase in affective disorders.

Platelet monoamine oxidase (MAO) activity was determined with tryptamine as substrate for 61 drug-free patients who had a primary major depressive disorder and for 32 normal controls. Although there were no significant differences between the mean platelet MAO activity of 19 bipolar patients (4.94 nmoles/hr/mg of protein), 42 unipolar patients (4.97 nmoles), and the controls (4.78 nmoles), an analysis of variance indicated that the variance of the bipolar group was significantly greater than that of the other groups. This suggests that there may be subgroups of bipolar patients that differ in their platelet MAO activity but that appear to be distinct from the bipolar I vs bipolar II classification.

Adult↗
PubMed1978

Electroencephalographic sleep recordings and depression in the elderly.

Eighteen patients over the age of 60 who were experiencing a major depressive episode were studied on a Clinical Research Unit after they had been drug-free for at least two weeks. All-night electroencephalographic (EEG) recordings revealed considerable fragmentation of sleep, a mean sleep efficiency of 58 percent, and very little delta sleep. The findings of reduced sleep time, shortened REM latency, and high REM density were similar to those in depressed patients under the age of 60. These preliminary findings support the application of EEG sleep recordings as a tool for the differential diagnosis of depression in the elderly.

Aged↗
PubMed1978

Amitriptyline and EEG sleep in depressed patients: I. Drug effect.

The paucity of studies on the tricyclic antidepressants led us to conduct an investigation on 30 drug-free patients treated with amitryptyline in a double-blind protocol over a 4-week period. Consistent with previous reports, there was an immediate REM suppression on 50 mg, which was more pronounced at the 100-mg level. However, no significant incremental changes were noticed on 150 or 200 mg with regard to REM sleep suppression. Drug administration was associated with changes in other sleep variables such as stage 1 percent, stage 2 percent, and various measures of sleep continuity. The incomplete tolerance of the drug on certain REM sleep variables enhances our understanding of amitryptyline effects on the EEG sleep of depressed patients.

Adult↗
PubMed1977

Tricyclic antidepressant overdose: incidence of symptoms.

Forty consecutively hospitalized patients who had overdosed primarily with a tricyclic antidepressant (TCA) were observed until discharge. The severity of the overdose was documented by serial measurements of plasma TCA levels. Nineteen of the patients became comatose, 16 required supportive respiration, and 2 died. Individual symptoms in the 13 patients having plasma TCA levels greater than 1,000 ng/ml are shown. Plasma TCA measurements more reliably define patients who are at risk for major medical complications following overdose than does the amount of drug ingested by history. In the absence of plasma measurements, a QRS duration of 100 msec or more on a routine ECG within the first 24 hours defined all patients with major TCA overdoses.

Amitriptyline↗
PubMed1977

Tricyclic antidepressant plasma levels and adverse effects after overdose.

Forty patients ingesting tricyclic antidepressant (TAD) overdoses were studied as a pharmacologic model to determine whether total tricyclic antidepressant plasma levels correlated with major adverse effects and electrocardiographic findings. Maximum TAD plasma levels were higher in patients who died (p less than 0.025) or had cardiac arrest (p less than 0.02), needed respiratory support (p less than 0.005), were unconscious (p less than 0.02), had grand mal seizures (p less than 0.001), ventricular rate larger than or equal to 120/min (p less than 0.01), cardiac arrhythmia (p less than 0.05), QRS duration larger than or equal to 100 msec (p less than 0.001), or bundle branch block (p less than 0.05). TAD plasma levels correlated with the dose ingested by history (N = 29, r = 0.58, p less than 0.001). Measurement of total TAD (free and protein-bound) appears to correlate well with biologic response.

Antidepressive Agents, Tricyclic↗
PubMed1977

Amitriptyline plasma levels and clinical response in primary depression.

Sixteen patients with primary depression were treated for 4 wk with amitriptyline. After clinical diagnoses were determined, patients entered a double-blind protocol (amitriptyline or placebo) and their clinical status was determined with the Hamilton Depression Rating Scale by raters blind to the drug type, its dosage and plasma levels. Amitriptyline (AT) and nortriptyline (NT) plasma levels were assayed twice weekly by gas chromatography-mass spectrometry. In the 16 patients, a negative correlation between the Hamilton Score and the mean total tricyclic level (p less than 0.01), as well as with individual plasma levels, was found at the end of the treatment period. When the group was divided into clinical responders and nonresponders, the mean total tricyclic (AT + NT) levels discriminated the two groups by day 12 (p less than 0.001) as well as at the end of the protocol (day 26, 88% of the patients were classified correctly if an arbitrary level of 200 ng/ml total tricyclic plasma level was chosen). These results strongly suggest the presence of a positive correlation between plasma levels and clinical improvement in patients with primary depression.

Adult↗
PubMed1977

EEG sleep diagnosis of medical disease in depression.

The diagnosis of medical disease in the context of a depressive syndrome which may mimic medical illness has traditionally relied on a combination of exhaustive medical screening and neuropsychological testing. When 10 patients with primary depression were compared to 10 patients whose depression occurred in the context of concurrent medical disease, a single EEG sleep variable, total phasic REM activity (RA), correctly identified 95% of all 20 patients as either primary depressives or medical patients with depression. Conventional psychiatric assessment and neuropsychological testing were significantly less powerful discriminators among this sample.

Adolescent↗