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Biomedical subjects

F K Judd

Publications and source records attributed to F K Judd.

At least 19 recordsLinked to original sources
PubMed1992

Suicide following acute traumatic spinal cord injury.

The rate of suicide following spinal cord injury has not been extensively studied but appears to be greater than in the general population. Six patients who died by suicide, from a total of 342 patients who were treated for acute spinal cord injury over a 5 year period are described. Clinical features shared by this group of patients included being male; having schizoid, depressive or narcissistic personality traits; alcohol or drug abuse; family or significant others favouring death as a preferred option; and the development of significant depression.

Acute Disease↗
PubMed1992

New pharmacological approaches to the management of depression: from theory to clinical practice.

A review of the clinical efficacy of four structurally distinct antidepressant drugs is presented. Their antidepressant activity can be rationalised within current pharmacological hypotheses of drug action, despite markedly different effects on "in vitro" testing. Fluoxetine, a specific serotonin re-uptake inhibitor, has proven safe, effective treatment for depressive illness and may have a role to play in the treatment of obsessive-compulsive disorder and panic attacks. While it has few of the anticholinergic side effects of the tricyclic antidepressants, nausea, tremor, headache, weight loss, nervousness and sweating are side effects most frequently reported. Minaprine, a compound with weak MAO inhibiting properties and effects on serotonergic receptors, has clinical efficacy in the treatment of depression based on several comparative studies. It is claimed that minaprine lacks anticholinergic and sedative properties. Moclobemide, a specific, reversible inhibitor of MAO-A, has been extensively evaluated in depressive illness. The major advantage of this agent over other irreversible, non-specific MAO inhibitors, is the significant attenuation of the so-called "cheese effect" with doses of tyramine likely to be encountered in foodstuffs. Rolipram, a phosphodiesterase inhibitor, represents a new approach to antidepressant treatment. Limited clinical data suggest that the drug may be an effective antidepressant with few side effects. The place of these agents in therapy is yet to be established.

Antidepressive Agents↗
PubMed1992

Psychiatric consultation in a spinal injuries unit.

The function of a consultation liaison service to a spinal injuries unit is described. Within this context, a study was conducted in which sociodemographic and clinical data were collected over a 4 year period for consecutive admissions to the unit. Data are presented for 227 patients admitted during this period. Forty-seven patients were found to have discrete psychiatric disorders (DSM III) which required treatment during the course of their inpatient care. For forty-two of these patients the psychiatric disorder first developed following spinal cord injury.

Activities of Daily Living↗
PubMed1991

Depression, disease and disability: application to patients with traumatic spinal cord injury.

Depressive symptoms are common in medically ill patients. Methodological difficulties of many of the studies demonstrating this do not allow differentiation of depressive symptoms from depressive illness. This paper examines representative samples of studies in the medically ill to highlight these problems. Data from a study of patients with traumatic spinal cord injury are used to demonstrate (1) ways of overcoming some of these difficulties and (2) the means of differentiating depressive symptoms and depressive illness. Difficulties of detection and diagnosis of depression in the medically ill are discussed.

Depression↗
PubMed1991

Fenfluramine augmentation of clomipramine treatment of obsessive compulsive disorder.

Recently, much research interest has been directed to demonstrating a possible biological basis to obsessive compulsive disorder. In particular, dysregulation in brain serotonin is suggested to be important. Two cases are described in which fenfluramine, a presynaptic 5 HT-releasing agent and 5HT-reuptake inhibitor was used to augment clomipramine treatment for OCD.

Adult↗
PubMed1991

Panic disorder: a treatment update.

Panic disorder is characterized by unexpected, unprovoked attacks of cognitive symptoms (e.g., dread, fear) and physical symptoms (e.g., palpitations, trembling, shortness of breath). It is the most common anxiety disorder seen in clinical practice. Pharmacotherapy has been shown to be effective in controlling symptoms of panic disorder, although potential disadvantages (e.g., adverse drug reactions, withdrawal syndrome, dependency) must be carefully assessed and balanced against the advantages. Current data indicate that for panic disorder, benzodiazepines prescribed for more than a 6-month period are as effective as other forms of pharmacotherapy, i.e., monoamine oxidase inhibitors and tricyclic antidepressants. Generally, doses of benzodiazepines used for the treatment of panic are higher compared to those used for generalized anxiety disorder.

Alprazolam↗
PubMed1990

A family study of panic disorder: reanalysis using a regressive logistic model that incorporates a sibship environment.

Previous analysis of affection status in parents and siblings of 117 probands with panic disorder by a log-linear model for binary pedigree data found a common concordance across biological first-degree relatives and no spouse association [Hopper JL, Judd FK, Derrick PL, Burrows GD: Genet Epidemiol 4:33-41, 1987]. In this paper the data were reanalyzed using a regressive logistic model that modelled both vertical transmission and a shared sibship environment. Ascertainment correction was made by a) an "ascertainment assumption-free" procedure, following Ewens and Shute [Theor Pop Biol 30:388-412, 1986] and compared with b) complete ascertainment and c) single ascertainment. Under every scheme there was evidence for vertical transmission from parents to offspring. Inclusion of a sibship environment gave an improved fit, suggesting that vertical transmission alone may not be sufficient to explain the familial aggregation observed in these families. The effects of an affected parent, of the postulated environmental factor (present for all siblings if it was present for one sibling), and of the prevalence of the rare environmental factor were estimated and found to be roughly similar under the different schemes. Model predictions of lifetime prevalence were consistent with other population-based studies. Under the same assumption-free method, standard errors approximately doubled and computation time increased compared with the other ascertainment schemes that made specific, although not necessarily correct, assumptions. The regressive logistic model used less computation time and gave greater insight into the pattern of familial aggregation than did the previous modelling.

Adult↗
PubMed1990

Short-acting versus long-acting benzodiazepines: discontinuation effects in panic disorders.

An increasing body of evidence suggests that benzodiazepines--which have long been considered the drugs of choice in the treatment of various anxiety disorders due to their relative lack of side effects, lack of adverse drug reaction, their safety, and increased efficacy over other agents--are effective in the treatment of panic disorders. Originally, the benzodiazepines were believed to be devoid of dependence-inducing properties, even at high doses. Recent evidence, however, suggests that discontinuation of both high and normal doses of both short- and long-acting benzodiazepines generally results in similar withdrawal symptoms, including anxiety and sleep and perceptual disturbances. This article presents a brief review of benzodiazepine withdrawal, with an emphasis on the discontinuation of these drugs following treatment of panic disorders. In particular, short-acting and long-acting drugs may present different features following long-term treatment and withdrawal. Preliminary results from a study comparing alprazolam and diazepam are presented to illustrate this point in contrast to expectations: the problems associated with withdrawal of both agents were comparable.

Alprazolam↗
PubMed1990

High-affinity platelet [3H]LSD binding is decreased in panic disorder.

Platelet [3H]LSD binding was measured in 15 patients with panic attacks and 15 controls. The mean (+/- SD) Bmax values of the patients (14.1 +/- 6.3 fmol/mg protein) and of the controls (18.5 +/- 4.7 fmol/mg protein) were significantly different (P less than 0.05, Mann-Whitney U-test). Mean (+/- SD) values of Kd for the patients (0.55 +/- 0.34 nM) and for the controls (0.51 +/- 0.12 nM) were not significantly different (P greater than 0.1, Mann-Whitney U-test). The results are discussed in terms of a serotonergic hypothesis of the aetiology of panic disorders.

Adult↗
PubMed1990

Plasma concentrations of melatonin in panic disorder.

Nocturnal plasma melatonin concentrations were measured in seven patients with panic disorder and eight healthy control subjects. The five patients who had never received psychotropic medication had significantly greater melatonin concentrations from 4:00 a.m. to 7:00 a.m. than the control subjects. In addition it is possible that a phase delay occurred in these unmedicated patients. The findings are discussed in terms of previous studies showing increased melatonin in manic patients and the effect of intense stress on melatonin synthesis. The two patients who had been medication free for only 1 week showed a decreased melatonin rhythm, which is consistent with previous findings in medicated patients.

Adult↗
PubMed1990

Current treatment concepts in depression.

Depression is a common disorder. While depressive symptoms are often transient and may be regarded as normal, 10 per cent of the population suffers depressive symptoms of sufficient severity and duration to be diagnosed as suffering a depressive illness.

Antidepressive Agents↗
PubMed1989

Platelet serotonin uptake in panic disorder patients: a replication study.

Platelet serotonin uptake was measured in 29 patients with DSM-III panic disorder or agoraphobia with panic attacks and compared to values obtained in 23 controls. Both the affinity constant (Km) and the maximal rate of uptake (Vmax) were determined in a buffered medium using 14C-serotonin. Patients and controls did not differ significantly with respect to age or Km values. A statistically significant difference was observed for Vmax (mean +/- SD = 65 +/- 22 pmol/10(8) platelet/min in patients vs. 44 +/- 13 pmol/10(8) platelets/min in controls). This finding suggests an overactivity of peripheral serotonergic function in panic disorder, which may also imply a similar dysfunction centrally.

Adolescent↗
PubMed1989

Serotonin in panic disorder: platelet uptake and concentration.

Platelet serotonin uptake and platelet serotonin concentrations were measured in 17 patients (5 males, 12 females) with panic attacks and 15 controls (8 males, 7 females). Higher Vmax values were found in the patient group compared with controls (65 +/- 7 vs. 47 +/- 3 pmol/10(8) platelets/min; p less than 0.05) while the affinity constant Km was not significantly different (0.6 +/- 0.1 vs. 0.5 +/- 0.1 microM). Platelet serotonin concentrations were not significantly different between the two groups (38 +/- 4 vs. 41 +/- 4 ng/10(8) platelets). These results confirm our earlier finding of increased serotonin uptake in patients with panic attacks and suggest that platelet serotonin levels are normal.

Adult↗
PubMed1989

A short term open clinical trial of clobazam in the treatment of patients with panic attacks.

Clobazam, a 1-5 benzodiazepine with anxiolytic properties, was evaluated in the treatment of patients with DSM-III panic disorder or agoraphobia with panic attacks. In this open clinical trial, 10 of the 15 patients completed 8 weeks of treatment. Six of the 10 completers (60%) were responders (75% reduction in the number of panic attacks from baseline) at the end of 8 weeks. Of the responders so defined, 5 of the 6 were panic free. At the end of week 8 the average dose for the responders to medication was 50 +/- 17 (S.D.) mg per day. Clobazam was well tolerated at the doses used with the few side-effects recorded as mild to moderate. The study suggests that further placebo-controlled studies are warranted to evaluate clobazam's potential antipanic effect.

Adolescent↗
PubMed1989

Depression following spinal cord injury. A prospective in-patient study.

In a systematic prospective study of 71 patients with acute spinal cord injury carried out in the acute and rehabilitation phases of treatment, 14 patients meeting the DSM-III criteria for major depressive disorder were identified. A further 13 patients had transient periods of depressed mood, while the majority of patients showed no clear evidence of depression. The BDI was found to be valid in this group of patients.

Adjustment Disorders↗