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Biomedical subjects

E F Howell

Publications and source records attributed to E F Howell.

9 recordsLinked to original sources
PubMed1989

CSF prostaglandin-E in agoraphobia with panic attacks.

Prostaglandins are thought to act as neuromodulators of both central catecholamine and endocrine systems. Abnormalities of these systems have been described in affective disorders, in general, and in agoraphobia with panic attacks, in particular. This study measured basal prostaglandin-E (PGE) cerebrospinal fluid (CSF) levels in 20 patients with agoraphobia with panic attacks and 10 nonpsychiatric controls. In a subgroup of patients and controls, CSF levels of adrenocorticotrophic hormone (ACTH) and corticotropin-releasing factor (CRF) were also measured. There was no significant difference in CSF PGE levels between patients and controls. However, patients with higher depression scores had lower CSF PGE levels. CSF PGE levels tended to correlate with CSF ACTH, but not CSF CRF in the patient group, in general, and in the female patients, in particular. These findings do not support an abnormality in basal CNS PGE production in agoraphobia with panic attacks, but suggest further study of the PGE modulatory effect on the hypothalamic-pituitary-adrenal axis in this disorder.

Adrenocorticotropic Hormone↗
PubMed1989

Phenelzine treatment of panic disorder: lack of effect on pyridoxal phosphate levels.

Earlier reports indicated that phenelzine treatment may result in clinically significant reductions of vitamin B6 in some individuals. Sixteen subjects, ages 21-59 years (seven men, nine women) with panic disorder with or without agoraphobia were treated with an average of phenelzine 53.5 mg/day for an average of 10 weeks in an open treatment study. No significant effects on plasma levels of pyridoxal phosphate, the active form of vitamin B6, were discernible in this group, nor was there any clear relationship between pyridoxal phosphate levels and symptoms in the subgroup of five patients who did develop deficiency-type symptoms. Pyridoxine replacement had unclear effects in symptomatic patients.

Adult↗
PubMed1988

Alprazolam in the treatment of social phobia.

Pharmacological treatment of social phobia has not been extensively studied. Recent reports suggest that social phobia may be treated with monoamine oxidase inhibitors, tricyclic antidepressants, beta-blockers, or clonidine. The authors describe four patients with social phobia who responded moderately to markedly well when treated with the triazolobenzodiazepine alprazolam. Patients with social phobia and patients with agoraphobia with panic attacks differ in the focus of anxiety, sensitivity to lactate infusion, and the pattern of symptoms during anxiety episodes. However, there is significant overlap in the clinical features of these two patient groups. The preliminary finding that several types of pharmacological agents that are effective in treating agoraphobia with panic attacks may also be effective in treating social phobia suggests that the two disorders may share some common pathophysiology.

Adult↗
PubMed1986

Can panic disorder present as irritable bowel syndrome?

Five patients who had been diagnosed with panic disorder and irritable bowel syndrome are described. Both panic and gastrointestinal symptoms responded dramatically and rapidly to pharmacologic treatment of panic symptoms in all five patients. The frequent overlap of gastrointestinal symptoms and psychiatric (particularly anxiety) disorders suggests that some patients with functional gastrointestinal complaints may have a primary anxiety disorder.

Adult↗
PubMedDate not supplied

The argument for HIV-antibody testing in chemical dependence treatment programs.

Controversy surrounds the issue of human immunodeficiency virus (HIV) antibody testing in chemically dependent patients. However, HIV testing can be clinically and therapeutically useful in chemical dependence treatment programs. Prerequisites for HIV testing include: staff education, high-quality pre- and posttest counseling for patients, assurance of confidentiality of results, and the use of accurate screening and confirmatory tests. Reasons to offer voluntary HIV testing in chemical dependence treatment programs include: appropriate medical evaluation and treatment, prevention of the spread of HIV infection, and support for working through the crisis of a positive diagnosis. Voluntary informed consent should be obtained prior to HIV testing; involuntary testing and mass screening are not justified. Testing decisions should be individualized, with the focus on the patient's participation based on treatment- and health-related decisions.

Acquired Immunodeficiency Syndrome↗