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Biomedical subjects

D L Keegan

Publications and source records attributed to D L Keegan.

At least 19 recordsLinked to original sources
PubMed1991

Longitudinal effect of amitriptyline and fluoxetine treatment on plasma phenylacetic acid concentrations in depression.

Unconjugated (U-PAA), conjugated (C-PAA), and total phenylacetic acid (T-PAA) concentrations in blood plasma and monoamine oxidase (MAO) activity in platelets towards phenylethylamine (PE) were determined in 40 drug-free, depressed patients (23 melancholic, 17 nonmelancholic) from five psychiatric treatment centers, and in 34 normal healthy volunteers. No significant differences were found between controls and all depressed patients or between melancholic and nonmelancholic depressed patients. Treatment of the depressed patients with amitriptyline or fluoxetine over a 6-week period resulted in clinical improvement and in a significant increase in plasma PAA concentrations. A decline in the Beck and Hamilton rating scores during treatment correlated significantly with increases in the concentrations of unconjugated, conjugated, and total phenylacetic acid but not with MAO activity, which did not change during treatment. At each of the three assessment times, however, plasma PAA concentrations and psychiatric rating scores were not significantly correlated. Except for higher end-of-study T-PAA concentrations in the amitriptyline-treated subjects, no significant differences were found between the effects of the two drugs with regard to plasma phenylacetic acid levels, MAO activity, or rating scores.

Adult↗
PubMed1991

Deuterium-labelled p-tyramine challenge test and phenolsulfotransferase activity in depressed patients--failure to replicate decreased p-tyramine conjugation in depression.

1. Depressed and normal subjects were challenged with deuterium-labelled p-tyramine and urine was collected for 3 h. 2. Urinary excretion of conjugated p-tyramine was not significantly different between normal, melancholic and non-melancholic depressed subjects. 3. Platelet phenolsulfotransferase activity to p-tyramine (p less than 0.05) and to phenol (p less than 0.005) were significantly lower in the depressed patients.

Amitriptyline↗
PubMed1990

Defining treatment refractoriness in schizophrenia.

Addressing the need for research on the nature of refractoriness to antipsychotic drug therapy exhibited by a substantial minority of schizophrenic patients, Philip R.A. May and Sven Jonas Dencker instigated an international study group to discuss this problem, beginning with the International Congress of Neuropsychopharmacology in Göteborg, Sweden, in 1980. The study group subsequently met in Haar, Federal Republic of Germany, in 1985; in Banff, Canada, in 1986; and again in Telfs, Austria, in 1988. The study group set three objectives: (1) to clarify the concept of treatment resistance or refractoriness; (2) to suggest criteria for defining or rating the degree of treatment refractoriness; and (3) to explore the role of psychosocial and drug therapies in increasing the responsiveness of the treatment refractory patient. This position article represents a distillation of the study group's efforts to define treatment refractoriness in schizophrenia.

Activities of Daily Living↗
PubMed1989

Intersubject variation in the pharmacokinetics of haloperidol and reduced haloperidol.

Single oral doses (5 mg) of haloperidol were administered to 36 healthy men (26 black, 10 white) of whom 28 (22 black, 6 white) completed the study. Plasma samples harvested over 96 hours were analyzed for haloperidol and reduced haloperidol by means of a new high performance liquid chromatographic method. Reduced haloperidol was detectable in the plasma of only six of the 28 subjects (five blacks, one white). In these individuals reduced haloperidol plasma concentrations were generally much lower than those of the parent drug. This finding in the present single-dose study is in contrast to literature reports that have described levels of reduced haloperidol higher than those of the parent drug in some patients chronically mediated with haloperidol. There was wide intersubject variation in area under the plasma concentration versus time curve and apparent oral clearance values for haloperidol. The distributions of these pharmacokinetic parameters about their respective means were each leptokurtotic and skewed toward higher values. In each case the geometric mean gave a better estimate of central tendency than the arithmetic mean. Wide intersubject variation prevented the detection of significant differences in these pharmacokinetic parameters between black and white subjects or between smokers and nonsmokers.

Adolescent↗
PubMed1989

General management issues in depressive illness--family interventions.

There is a need to integrate interpersonal, spousal and family interventions into the well developed pharmacological and individual psychological therapies for depressive illness. Serious repercussions from depressive illness for the person themselves and their families, are well recognized. These include a low entrance rate to treatment programs, attrition from and poor adherence to, recognized therapies, self-harm, marital separation and divorce, family disruption and serious negative impacts on their children. A number of specific interventions, have been developed some psychoeducational, some therapeutic, and they appear to offer promise for future application. These need to be regularly applied to treatment situations in a planned fashion, and their effectiveness rigorously evaluated.

Depressive Disorder↗
PubMed1988

Association of low serum anticholinergic levels and cognitive impairment in elderly presurgical patients.

Low-dose scopolamine, given as presurgery medication, resulted in low levels of serum anticholinergic activity and caused measurable cognitive impairment in 18 psychiatrically healthy elderly patients. The degree of impairment was directly related to serum anticholinergic activity levels and, in the small subgroup of patients scheduled for spinal anesthesia, to CSF anticholinergic activity. Two of the mental status tests used, the Rey Auditory-Verbal Learning Test and the Saskatoon Delirium Checklist, were sensitive enough to detect these mild drug-induced changes, while two other tests, the Mini-Mental State and the Symbol Digit Modalities Test, were not.

Aged↗
PubMed1985

Mental dysfunction and the blockade of muscarinic receptors in the brains of the normal elderly.

Cholinergic neurons innervate many areas of the brain and the disruption of acetylcholine neurotransmission at the muscarinic receptors in these areas produces dysfunction in a wide variety of mental, emotional and physiological activities. A side effect of many psychoactive drugs is the blockade of muscarinic receptors and this can result in a marked reduction of acetylcholine neural function particularly in elderly patients receiving 2 or more such drugs, and mimic the mental impairments seen in Alzheimer's Disease. A battery of mental status and short term memory tests was given the day before and 45 minutes after the administration of 0.005 mg/kg scopolamine or saline as presurgery medication to 30 normal patients over 60 years of age scheduled for lower body surgery. Total antimuscarinic activity was determined using a competitive binding assay in a 10 ml sample of blood taken from all patients after the pretest and again at the time of surgery, and in a 2 ml sample of cerebral spinal fluid taken from patients receiving spinal anesthesia immediately prior to administering the anaesthetic. The very low dose of scopolamine given to these patients produced antimuscarinic activity equivalent to 100 pmoles atropine in serum and 74 pmoles atropine in CSF. This resulted in a significant impairment of short term memory but had no significant effect on global scores on the Mini Mental State nor on the Delirium Check List.

Aged↗
PubMed1985

Conversion mutism: case report and discussion.

Conversion mutism is an uncommon disorder that was in the past most frequently reported during wartime. Other than during wartime, young women are the most commonly affected and usually present shortly after a traumatic event. Both psychodynamic and behavioral elements are important etiologically and, thus the treatment should include both psychodynamic and behavioral methods. The patient described in this paper had underlying fears relating to sexual assault as well as behaviorally reinforced perpetuation of her symptom. She regained her speech after four weeks of combined psychodynamic and behavioral therapy.

Adult↗
PubMed1978

Psychological and social adjustment of blind subjects and the 16PF.

Determined whether individuals who adapted well or poorly to the loss of their vision could be differentiated on the basis of the Cattell 16PF. Well adjusted individuals were defined as those who displayed minimal depression and high social independence, while poorly adjusted individuals were highly depressed and socially dependent. By the use of discriminant analysis based upon the standard 16PF, 84.5% of highly depressed and 81% of the minimally depressed group were classified accurately. In a second analysis, 75% of socially independent and 73% of socially dependent individuals were classified correctly. Premorbid characteristics of well and poorly adjusted blind Ss were described.

Adaptation, Psychological↗
PubMed1978

Factors in adjustment to blindness.

We wished to explore the relationship between certain blinding eye diseases, residual vision and psychosocial adjustment, including acceptance of blindness. One hundred and fourteen patients were grouped according to level of vision, age, type of disease, general physical health and duration of blindness. Psychological symptoms were measured by the Minnesota Multiphasic Personality Inventory (M.M.P.I.) and social function by an adaptation to blindness of the Gunzberg Progress Chart of Social Function. Social adjustment was best and psychological morbidity least in those with non-diabetic retinal disorders, those who had the best vision and those who accepted their blindness. Non-acceptance of blindness was associated with the most psychological distress and the lowest scores in social adjustment. People with glaucoma and diabetic retinal disorders seemed more poorly adjusted. An attempt should be made to identify those most prone to maladjustment so as to assist them in rehabilitation.

Adaptation, Psychological↗