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D P Devanand

Publications and source records attributed to D P Devanand.

99 records · Page 6Linked to original sources
PubMed1987

Serial dexamethasone suppression tests in initial suppressors and nonsuppressors treated with electroconvulsive therapy.

Four different methods of quantifying the 1-mg Dexamethasone Suppression Test (DST) were contrasted with serial testing in endogenous depressives receiving electroconvulsive therapy (ECT). Of three continuous measures in 38 patients with pretreatment DSTs, only the log-transformed value for plasma cortisol was normally distributed, indicating that it possessed superior psychometric properties. Pretreatment Hamilton Depression Rating Scores (HAM-D) correlated positively with pretreatment DST status, with a similar association noted between posttreatment DST status and HAM-D scores. There was no uniform effect of ECT on the DST. Although pretreatment nonsuppressors showed a trend toward decreased postdexamethasone cortisol values, initial suppressors (cutoff: 5 micrograms/dl) evidenced a significant increase in these values, and 35.3% of initial suppressors were nonsuppressors at final DST assessment. These trends were noted in the DST assessment done following the third ECT treatment, suggesting an effect of regression to the mean. The findings highlight the importance of following initial DST suppressors in studies of this type.

Depressive Disorder↗
PubMed1985

Elevated plasma homovanillic acid in depressed females with melancholia and psychosis.

Plasma free homovanillic acid (HVA) and 3-methoxy-4-hydroxyphenylglycol (MHPG) were measured before drug treatment in 29 patients diagnosed as having major depression with melancholia and in 18 control subjects. Plasma HVA was significantly elevated in the total group of female melancholic patients when compared with female controls or male melancholics. Most female patients with psychotic melancholia had elevated HVA levels. These differences were not found in male patients. No significant differences were found for plasma MHPG.

Adult↗
PubMed1985

Concurrent depression and dementia: implications for diagnosis and treatment.

The need to distinguish between depression and dementia is well recognized and has been much discussed, but the coexistence of the two illnesses has received less attention. Three cases are presented which corroborate previous reports of the coexistence of dementia and depression but also raise other issues. It is suggested that this diagnosis should not be viewed as an "either/or" decision, but that each diagnosis should be considered independently. The cases illustrate that the type of depression present may vary and that an accurate assessment of dementia may be possible only after depressive symptoms have abated. Other issues encountered in this clinical situation are discussed.

Aged↗
PubMed1984

False-positive dexamethasone suppression test results related to antipsychotic drug withdrawal: case report.

A nonmelancholic schizophrenic patient showed a positive dexamethasone suppression test (DST) 3 days after antipsychotic drug withdrawal. The patient was then put on a stable dose of the antipsychotic and a repeat DST showed normal suppression. The drug was again stopped, and 3 days later a DST was positive. This indicates that antipsychotic withdrawal may lead to false-positive DST results. The theoretical implications and clinical relevance of this finding are discussed.

Adult↗
PubMed1982

Differential liabilities of haloperidol and thioridazine for inducing apomorphine hypersensitivity.

In an animal model of tardive dyskinesia, sensitivity to apomorphine-induced stereotyped behavior reflects increased dopamine receptor activity induced by chronic neuroleptic treatment. Four groups of Sprague-Dawley rats received haloperidol (H) 0.5 mg/kg, haloperidol 0.5 mg/kg + benztropine 2.0 mg/kg (H + B), thioridazine (T) 25 mg/kg, or saline (S) ip daily for 18 days, were withdrawn for 21 days, and then received another 10 days of drug. Drug-induced catalepsy was measured daily during the second phase of drug treatment. Sensitivity to apomorphine 0.125 mg/kg and 0.250 mg/kg was assessed during the first and second weeks of withdrawal from each phase of drug treatment. Catalepsy scores for H, H + B, and T groups showed an unexpected progressive increase over treatment days. Following withdrawal from the first drug phase, only H and H + B rats showed enhanced apomorphine stereotypy. H rats were hypersensitive for both weeks of testing while H + B rats were only hypersensitive for the first week. All rats showed changes in apomorphine sensitivity after withdrawal from the second drug phase. H and H + B rats showed significant enhancement of stereotypy at both apomorphine dose levels and at both weeks of testing. T rats showed a significant enhancement but only at the higher apomorphine dose level and only during the first withdrawal week. S rats had a significant enhancement of apomorphine-induced stereotypy during the second withdrawal week. We conclude that H, H + B, and T have differential liability for inducing dopamine receptor hypersensitivity, with haloperidol being most effective and thioridazine being least effective.

Animals↗
PubMedDate not supplied

Psychosis, behavioral disturbance, and the use of neuroleptics in dementia.

Despite the widespread use of psychotropic agents in patients with dementia, there is little available research on the nature and prevalence of psychiatric disturbance and behavioral syndromes requiring this treatment, and the results of such therapy. The authors suggest strategies to overcome difficulties inherent in attempting to obtain symptom profiles in demented patients. There is weak evidence to support the use of neuroleptics in the treatment of symptoms like suspiciousness, hallucinations, sleeplessness, agitation, emotional liability, and aggressiveness; no individual neuroleptic can be considered superior to any other for this purpose. Few studies have evaluated the effect of neuroleptics on activities of daily life (ADL), and no study has used detailed neurophsychological evaluation to examine their effects on cognitive function in dementia.

Activities of Daily Living↗
PubMedDate not supplied

Relative response of endogenous and non-endogenous symptoms to electroconvulsive therapy.

A sample of patients with endogenous depression (RDC), who had only a partial response to electroconvulsive therapy (ECT), was identified from a larger group of patients participating in a study of the affective and cognitive effects of low-dose titrated ECT. Using symptom scores on the Hamilton Rating Scale for Depression, subscales were constructed to reflect Klein's formulation of endogenomorphic depression, the RDC for endogenous subtype, and the DSM-III criteria for melancholia. Regardless of the subscale used, no evidence was obtained that endogenous symptoms were more responsive to ECT than non-endogenous symptoms.

Adult↗
PubMedDate not supplied

Adverse life events in elderly patients with major depression or dysthymic disorder and in healthy-control subjects.

The authors compared elderly outpatients (> or =60 years) with major depression or dysthymic disorder and healthy-control subjects on the type and subjective impact of adverse life events. The Geriatric Adverse Life Events Scale (GALES) was developed for this purpose. Fifty patients with major depression, 79 patients with dysthymic disorder, and 40 healthy controls completed the GALES. Adverse life events during two time periods were assessed: the year before the evaluation, and the year before onset of the index episode (patients only). During the year before evaluation, patients with major depression reported more life events with greater negative impact, particularly for interpersonal conflicts, and dysthymic patients scored intermediate between patients and controls. Sum scores for perceived stress and negative impact on mood differed significantly among the groups: highest for major depression, intermediate for dysthymic disorder, and lowest for controls. During the year before onset, patients with major depression reported significantly higher sum scores for negative impact on mood than patients with dysthymic disorder. On several measures, patients with major depression perceived greater negative impact of life events than patients with dysthymic disorder and healthy controls, particularly for interpersonal conflicts. The subjective impact of adverse life events may play an important role in the expression of depressive illness in elderly patients, particularly in major depression, and it needs to be considered in clinical management.

Aged↗