PubMed Health⌕ Search

Biomedical subjects

F M Quitkin

Publications and source records attributed to F M Quitkin.

At least 127 records · Page 7Linked to original sources
PubMed1986

Phenelzine treatment of melancholia.

Monoamine oxidase (MAO) inhibitor antidepressants are widely thought by clinicians and researchers to be ineffective in the treatment of endogenous depression. This study reports an open clinical trial in which seven of eight outpatients (88%) with melancholia responded to phenelzine treatment. This response rate is comparable to the response to tranylcypromine in a previous study at our clinic. These results suggest that MAO inhibitors are effective for outpatients with endogenous depressive syndromes. The use of MAO inhibitors may be an alternative treatment for patients who cannot tolerate or who have not responded to tricyclic antidepressants.

Adult↗
PubMed1986

Effects of antidepressant medication on sexual function: a controlled study.

There has been little systematic study of the types of sexual dysfunction produced by antidepressant medication or of the frequency with which this type of adverse effect occurs. The authors report results of a double-blind study in which the effects of imipramine, phenelzine, and placebo on specific aspects of sexual function were assessed in depressed outpatients before and after 6 weeks of treatment. Both active treatments were associated with a high incidence of adverse changes in sexual function and produced significantly more adverse effects on sexual function than placebo. Orgasm and ejaculation were impaired to a greater extent than erection. Adverse sexual function changes secondary to antidepressant medication occurred frequently in both men and women, although men reported a higher incidence. Antidepressant-related sexual dysfunction may be of clinical importance for medication compliance in view of current recommendations that antidepressants be administered for longer periods as maintenance therapy or for prophylaxis.

Adult↗
PubMed1986

Bipolar disorder: are there manic-prone and depressive-prone forms?

Descriptive studies from the prelithium era and lithium prophylactic studies were reviewed to look for evidence that there are manic-prone and depressive-prone subtypes of bipolar illness. The manic-prone subtype has a high ratio of manic to depressive episodes, and a depressive-prone subtype has the reverse. Although data from the prelithium era are suggestive, the evidence is insufficient to accept or reject the relevance of this hypothesis. Data from the lithium era suggest that there is a relationship between the type of index episode and future episode on placebo as well as drug. The clinical and heuristic implications of the relationship of index to subsequent episode and manic proneness and depressive proneness are discussed. Its relevance for planning prophylactic drug studies is also examined. The suggestive evidence presented here will hopefully encourage other investigators to collect the data necessary to test the possibility that manic-prone and depressive-prone subtypes of bipolar illness exist.

Bipolar Disorder↗
PubMed1985

Biochemical effects of L-deprenyl in atypical depressives.

To examine the biochemical effects of 10-30 mg/day L-deprenyl, measurement of 24-hr urinary output of phenylethylamine (PEA), 3-methoxy 4-hydroxy phenylethyleneglycol (MHPG), and L-deprenyl's amphetamine metabolites were carried out before and during the treatment of atypical depressives. Platelet monoamine oxidase (MAO) activity was also assessed. With L-deprenyl 10-30 mg/day, the expected MAO B inhibition occurred, as indicated by significant increase in urinary PEA excretion and virtual disappearance of platelet MAO activity. Twenty-five to 33% of the daily dose of L-deprenyl was recovered as urinary methamphetamine or amphetamine. Excretion of MHPG was significantly decreased with L-deprenyl 10-20 mg/day. Overall, the results suggest that L-deprenyl's antidepressant effects are mediated by some mechanism other than, or in addition to, MAO B inhibition.

Adult↗
PubMed1985

Placebo-controlled study of mianserin in depressed outpatients.

Ninety-two outpatients with depressive disorders which met Research Diagnostic Criteria were treated either with mianserin or placebo in a 6-week controlled trial. Twenty-four of 42 (57%) mianserin-treated patients were rated responders to mianserin treatment while 15 of 50 (30%) were rated responders to placebo treatment (chi 2 = 6.89, p less than 0.01). This rate of drug response was comparable to that achieved with a tricyclic antidepressant in a similar study done in our clinic, supporting the use of mianserin in mildly depressed outpatients.

Adolescent↗
PubMed1985

The importance of dosage in prescribing antidepressants.

The treatment of depressive disorders was significantly altered by the introduction of the tricyclic antidepressants and the monoamine oxidase inhibitors. One salient factor in determining efficacy is the dose prescribed. The few good dose response studies which are available indicate that patients should receive 300 mg of imipramine or equivalent, and a separate trial of 90 mg of phenelzine or equivalent, before concluding they are treatment refractory. Data are reviewed which suggest many patients receive inadequate doses.

Antidepressive Agents, Tricyclic↗
PubMed1985

Adverse reactions to monoamine oxidase inhibitors. Part II. Treatment correlates and clinical management.

From a review of the clinical charts of 198 depressed outpatients, information was extracted on common major treatment emergent side effects associated with phenelzine, tranylcypromine, and imipramine. These included hypertensive reactions, severe orthostatic hypotension, hypomania, significant weight gain, sexual dysfunction, and a residual category of multiple side effects which together culminated in drug discontinuation. In this report, frequency of their occurrence for each drug, level of severity, relation to dose and treatment duration, and physician response at the time the side effect was recorded are described. In addition, procedures found useful in the clinical management of these side effects are discussed.

Adult↗
PubMed1984

Duration of antidepressant drug treatment. What is an adequate trial?

Data from three six-week placebo-controlled randomized antidepressant trials were pooled to test the hypothesis that a four-week trial is insufficient to reach a determination of drug failure in depressed patients. We compared global clinical ratings at weekly intervals for patients receiving drug and patients receiving placebo and calculated the proportion of patients whose clinical status changed over time. We predicted, and found, that a significant proportion of patients who showed no clear-cut response at four weeks would show much improvement at six weeks in drug but not placebo conditions. Baseline Research Diagnostic Criteria diagnosis, baseline illness severity, and drug dose adjustments after four weeks did not predict either late clinical improvement or relapse between four and six weeks. Additional placebo-controlled studies are needed to replicate our findings concerning the advantage of extending trials to five or six weeks in samples of patients of various depressive subtypes.

Actuarial Analysis↗
PubMed1984

Phenelzine v imipramine in atypical depression. A preliminary report.

Sixty patients meeting specific criteria for atypical depression completed six weeks of double-blind, randomly assigned treatment with phenelzine sulfate, imipramine hydrochloride, or placebo. The overall response rates were 67% with phenelzine, 43% with imipramine, and 29% with placebo. At week 6, phenelzine was superior to placebo on many measures, while the superiority of imipramine to placebo was confined to several variables. Phenelzine was superior to imipramine on the interpersonal sensitivity and paranoia factors of the 90-item Hopkins Symptom Checklist, with trends toward superiority on several other measures, while imipramine was not differentially superior on any measure. Atypical depressive patients with a history of spontaneous panic attacks and hysteroid dysphoric patients both showed extremely low rates of response to placebo and high rates of response to phenelzine. Conversely, those without panic or hysteroid dysphoric features responded equally to all three treatments. Responders to pheneizine also had greater platelet monoamine oxidase inhibition while receiving drug therapy than did nonresponders. Completion of the 120-patient sample will allow more detailed analyses.

Adolescent↗
PubMed1984

The tyramine challenge test as a marker for melancholia.

A previous study reported that unipolar depressives excrete significantly lower amounts of urinary tyramine-O-sulfate following oral administration of a tyramine hydrochloride load than do normal control subjects. This study replicates and extends those findings by showing that within the heterogeneous group of unipolar depressives, patients with melancholia and bipolar patients with a history of melancholia manifest a tyramine excretion deficit. A small subgroup of medication-free patients in remission from episodes of melancholia had abnormally low tyramine sulfate excretion levels while they were euthymic, supporting the suggestion that reduced tyramine sulfate excretion following oral tyramine loading is a trait marker for depression. Further study of the role of trace amines in affective illness is warranted. Clinical application is not warranted until further evaluation of the sensitivity, specificity, and reproducibility of this oral tyramine challenge test.

Adult↗
PubMed1984

l-Deprenyl in atypical depressives.

We investigated the antidepressant efficacy of l-deprenyl (selegiline), a selective monoamine oxidase B inhibitor (MAOI), in a six-week open trial of 17 patients with atypical depression. Such patients have previously been shown to benefit from nonselective MAOIs such as phenelzine sulfate. Ten patients (59%) responded to l-deprenyl, but nine required dosages above the 10 to 20 mg/day used in previous investigations. l-Deprenyl was superior to six weeks of placebo administered to diagnostically similar patients in a separate double-blind study. In contrast with previous findings with pheneizine, responders to l-deprenyl differed from nonresponders by having lower baseline anxiety ratings. Even at high dosages, there appeared to be fewer side effects with l-deprenyl than with nonselective MAOIs.

Adult↗
PubMed1984

Identification of true drug response to antidepressants. Use of pattern analysis.

The purpose of this study was to develop a method for differentiating specific ("true") and nonspecific antidepressant drug response for the individual patient. Patterns of clinical response, based on weekly global ratings of clinical status, were generated for each of 185 patients participating in six-week placebo-controlled drug trials. We hypothesized and found that substantially more patients receiving active than placebo medication displayed treatment response patterns characterized both by two-week or greater delay in onset of initial improvement and nonfluctuating persistence of improvement once achieved. Identification of a distinctive pattern of clinical response to an active drug has both research and clinical applications. Pattern analysis may contribute to understanding the nature of drug mechanisms of action, may clarify some ambiguous treatment study outcomes, and in the individual case, may facilitate clinical management.

Ambulatory Care↗