Cardiorespiratory problems with clozapine.
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
D Kalunian
Publications and source records attributed to D Kalunian.
Mania compared with unipolar depression in old age.
OBJECTIVE: The goal of this study was to clarify the meaning and importance of mania in old age. METHOD: The authors conducted a retrospective study of 50 elderly patients consecutively admitted to a private mental hospital with an index episode of mania. As a comparison group, they used 50 age- and sex-matched patients with unipolar depression. They reviewed the charts of the 100 patients for family history, clinical course, and neurological disorders. Outcome was determined by contacting patients, families, physicians, institutional settings, and vital statistics records. Survival analysis compared mortality rates. RESULTS: The manic patients had a greater familial predisposition to affective disorder and were younger at first psychiatric hospitalization. For the 20 manic patients whose first affective episode was depression, an average of 15 years elapsed before mania became manifest. Eighteen of the manic patients, compared with only four of the depressed patients, had neurological disorders. The manic patients had a significantly higher mortality rate than the depressed patients; by the end of the follow-up, 25 of the manic patients, compared with 10 of the depressed patients, had died. CONCLUSIONS: Mania appears to have a poorer prognosis and to be a more severe form of affective illness than unipolar depression. The 18 manic patients with neurological disorders seemed to have "secondary mania." Subtle cerebral changes due to aging may have been responsible for the conversion to mania in the 20 patients who experienced a long latency from first depression to onset of mania. The low frequency of early-onset mania in this study group highlights the need to differentiate early- from late-onset mania.
Adult↗
Function and fidelity of aging tRNA: in vivo acylation, analog discrimination, synthetase binding, and in vitro translation.
The liver transfer RNAs for valine and lysine were completely acylated in vivo, as judged by periodate oxidation, at 4 and 24 months of age in male Sprague-Dawley rats. In vitro acylation capacity for whole tRNA populations from rat livers is decreased, but this is evidently not deleterious in vivo. Several halogenated phenylalanines were synthesized and their effects upon acylation capacity for phenylalanine were examined. Synthetases bound to young (3 month) and old (24 month) tRNAs discriminated differently between p-chlorophenylalanine and authentic phenylalanine; synthetase with young tRNA was less able to discriminate than with old tRNA. Purified tRNAphe from old rats did not form ultraviolet-induced crosslinks to purified phenylalanyl tRNA synthetase as well as young tRNAphe. In vitro translation of encephalomyocarditis virus, hemoglobin, and ovalbumin mRNAs was effective, using tRNAs of young or old Sprague-Dawley or Fischer 344 rat livers, although, when the old tRNA was supplied, the product synthesized per unit tRNA was reduced. All of the protein products were synthesized with all tRNAs, as shown by sodium dodecyl sulfate polyacrylamide gel electrophoresis. We conclude that tRNA is capable of normal functions in livers of aging rats, is probably modification deficient, and is unlikely to produce protein errors.
Acylation↗
Clozapine in the elderly.
The authors reviewed the use of clozapine in eight patients over age 65 years with treatment-resistant psychoses. Six patients improved. Two patients became more confused. The authors suggest that clozapine be considered in treating elderly psychotic patients, and that its use need not be restricted to schizophrenic patients.
Aged↗