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Biomedical subjects

F M Quitkin

Publications and source records attributed to F M Quitkin.

At least 145 records · Page 8Linked to original sources
PubMed1984

A comparative study of the pituitary TSH response to thyrotropin in outpatient depressives.

The pituitary thyroid-stimulating hormone (TSH) response to exogenous thyrotropin-releasing hormone (TRH) has been reported abnormal in depression, chiefly in endogenous depression among inpatients. This study finds an incidence of abnormality among a group of 53 outpatients that is no greater than among controls. Among outpatients with either major depression by Research Diagnostic Criteria (RDC) or atypical depression by our criteria, blunted responses are no more common than among normal controls. A comparison group of inpatient RDC major depressives, endogenous subtype, shows a significantly higher proportion of abnormal or blunted responses. These data suggest that the test may be less useful among outpatients than among inpatients. The test does detect a significant but unexplained biologic abnormality among inpatient endogenous depressives.

Adult↗
PubMed1984

Mianserin versus amitriptyline for depression: a double-blind 6-week trial.

34 patients who met the research diagnostic criteria for major depressive disorder as defined by Spitzer et al. [Archs gen. Psychiat. 35: 773-782, 1978] completed a double-blind 6-week trial of mianserin versus amitriptyline following 1 week of single-blind placebo washout. After 2 weeks of dose build-up, patients took 150 mg/day of mianserin or 300 mg/day of amitriptyline throughout the next 4 weeks. At week 6, 63% of mianserin patients and 73% of amitriptyline patients were rated as responders; this difference is not statistically significant. No clinically meaningful differences between drugs were observed with respect to number or severity of side effects as reported by either patient or physician. Overall, mianserin was found to be equivalent to amitriptyline in terms of efficacy, patient tolerance and ease of administration.

Adolescent↗
PubMed1984

Treatment of melancholia with tranylcypromine.

Nine of 12 outpatients meeting DSM-III criteria for melancholia responded to treatment with the monoamine oxidase inhibitor (MAOI) tranylcypromine. Responders were less depressed before treatment and after treatment than were nonresponders. MAOIs appear useful in treating endogenous depressions.

Adolescent↗
PubMed1984

Defining the boundaries of atypical depression.

Psychopharacologist have had a longstanding interest in identifying a depressive subtype which selectively benefits from monoamine oxidase inhibitors (MAOIs). A superior rate of improvement with MAOI treatment might help delineate a depressive subgroup with pathophysiology different from other depressive syndromes. Research is described which indicates that patients with reactivity of mood, as well as two of four associated features (hypersomnia, overeating, lethargy, and rejection sensitivity), may have a preferential response to phenelzine as compared with imipramine or placebo. Preliminary data are presented to suggest that patients with reactive mood and only one associated feature may have a preferential response rate to phenelzine compared to imipramine and placebo. Data on patients with reactive mood but no associated features are insufficient at this point to draw any conclusions.

Clinical Trials as Topic↗
PubMed1984

Psychopharmacologic validation of atypical depression.

Sixty patients meeting specific criteria for atypical depression completed 6 weeks of double-blind, randomly assigned treatment with phenelzine, imipramine, or placebo. Patients who had a history of spontaneous panic attacks or hysteriod dysphoric features showed extremely low placebo-response rates, moderate responses to imipramine, and high rates of response to phenelzine. Conversely, patients without such features responded moderately well to all three treatments. Based on preliminary data, MAOI-specific atypical depression does appear to exist, although in more delimited forms than previously recognized.

Adolescent↗
PubMed1983

Efficacy of desipramine in depressed outpatients. Response according to research diagnosis criteria diagnoses and severity of illness.

The efficacy of desipramine for mild depression was tested in a double-blind, placebo-controlled study of outpatients with scores below 19 on the Hamilton Rating Scale for Depression (HAM-D). Of 103 such patients, 23 dropped out and 16 improved during a ten-day placebo period. Among 64 patients completing the randomized portion of the study, significantly more improved with desipramine that with placebo. The Research Diagnostic Criteria (RDC) category of major depressive disorder largely accounted for the drug-placebo response difference found for the entire sample. Patients with intermittent depressive disorder improved significantly less frequently with desipramine than patients with major depressive disorder. Independent of RDC diagnosis, severity of illness correlated with outcome. Thus, patients with pretreatment HAM-D scores at or above the median demonstrated significant drug effect, while patients with lower pretreatment HAM-D scores did not.

Adolescent↗
PubMed1982

Lithium carbonate and imipramine in the prophylaxis of unipolar and bipolar II illness: a prospective, placebo-controlled comparison.

Twenty-seven patients with recurrent unipolar depression and 22 with bipolar II illness in remission for at least six months were randomly assigned on a double-blind basis to treatment regimens using lithium carbonate, imipramine hydrochloride, lithium carbonate plus imipramine, or placebo. Lithium carbonate was found to help prevent depressive relapse among patients with unipolar disease, and relapse of any type among those with bipolar II disease. No effect or interaction of imipramine was found in either group. These results add to a growing body of data that suggest the usefulness of lithium carbonate in the prophylaxis of unipolar depressive illness. The relative usefulness of lithium carbonate and imipramine requires further study.

Adolescent↗
PubMed1982

Determination of mianserin and metabolites in plasma by liquid chromatography with electrochemical detection.

A procedure for the determination of mianserin, desmethylmianserin, and 8-hydroxymianserin in plasma at therapeutic concentrations by liquid chromatography with electrochemical detection is described. Following a multiple-step extraction from alkaline plasma into methyl-tert-butyl ether, the reconstituted extract was injected onto a reversed-phase trimethylsilyl-packed column and eluted with an acetate-acetonitrile mobile phase containing an ion-paired reagent. The method provides an absolute recovery of 71-76% and a day-to-day precision of 5.4-9.1% for each compound at 25 ng/ml. The minimum quantifiable level for all three compounds was 5 ng/ml (RSD greater than 11%), and the detector response was linear up to 500 ng/ml. Fixed-dose steady-state plasma level data for 34 patients are reported.

Biotransformation↗
PubMed1982

Metabolism of (-) deprenyl to amphetamine and methamphetamine may be responsible for deprenyl's therapeutic benefit: a biochemical assessment.

The urinary excretion of some important phenylethylamines, catecholamines, their metabolites, amphetamine, and methamphetamine were measured in parkinsonian patients on Sinemet (L-dopa plus carbidopa, a peripheral dopadecarboxylase inhibitor) and depressed patients after chronic (-) deprenyl treatment. Deprenyl was efficiently metabolized to amphetamine and methamphetamine. It increased the excretion of phenylethylamine and of m- and p-tyramine, and reduced the output of norepinephrine metabolites, but failed to alter the excretion of dopamine-deaminated metabolites. These changes were attributed more to amphetamine and methamphetamine than to inhibition of monoamine oxidase type B. Sinemet treatment alone increased the excretion of dopamine, 3-methoxytyramine, and their respective deaminated metabolites, 3, 4-dihydroxyphenylacetic acid and homovanillic acid. It is concluded that conversion of deprenyl to amphetamine and methamphetamine may contribute to some of the therapeutic benefits of deprenyl.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1981

Prophylactic lithium carbonate with and without imipramine for bipolar 1 patients. A double-blind study.

The efficacy of lithium carbonate plus imipramine hydrochloride vs lithium carbonate plus placebo in preventing relapse was assessed in a prospective, random-assignment double-blind study of 75 bipolar 1 patients. Outcome measures included type of relapse, time until relapse, and subsequent illness course. Infrequent depression relapse in either treatment group precluded any demonstration of an advantage of adding imipramine to a lithium carbonate regimen. There was little evidence that the combination of lithium carbonate and imipramine caused adverse reactions. However, interactions between type of most recent episode, treatment condition, sex, and type of relapse showed that women and mania-prone patients treated with imipramine had an increased risk of mania. Life table analysis showed that the overall probability of remaining well was the same for both treatment groups and that two thirds of all relapses occurred in the first six months.

Actuarial Analysis↗
PubMed1981

An inverse correlation between serum levels of desmethylimipramine and melatonin-like immunoreactivity in DMI-responsive depressives.

The relationship between plasma levels of the tricyclic antidepressant desmethylimipramine (DMI) and plasma levels of melatonin-like immunoreactivity was studied in 32 endogenously depressed patients. An inverse correlation between plasma levels of DMI and plasma levels of melatonin-like immunoreactivity was found in the group of clinical responders to the chronic administration of the drug. The nonresponders had higher levels of melatonin-like immunoreactivity at comparable levels of DMI. This finding is consistent with the hypothesis that chronic high plasma levels of DMI may down-regulate the beta-adrenergic receptors in man. However, some other homeostatic mechanisms may be involved in the clinical response.

Adolescent↗
PubMed1981

Monoamine oxidase inhibitors in bipolar endogenous depressives.

Clinical lore suggests that monoamine oxidase inhibitors (MAOIs) are not effective in endogenous depression. A review of previous placebo-controlled trials of MAOI in patients with endogenous depression neither refutes nor confirms their utility in this patient group. We present patients in the depressive phase of bipolar illness refractory to treatment with tricyclics who have responded to MAOI. These open trials require confirmation in controlled studies. Bipolar illness may be a heterogeneous disorder. Presence or absence of X-linkage, low platelet MAO, or response to MAOI may indicate different forms of the disorder.

Bipolar Disorder↗
PubMed1981

Methodological problems in studies of depressive disorder: utility of the discontinuation design.

In evaluation of new drugs, even when a random assignment, double-blind, controlled clinical trial design is used, an array of methodological problems associated with treatment of those who do not respond (treatment nonresponders) can lead to unclear or misleading conclusion. Four such problems are reviewed and illustrated: unwitting diagnostic heterogeneity of depressive subtypes in study samples, inadequate dose and duration of medication, selection of inappropriate criteria for determination of efficacy, and nonreporting of global outcome measures for individual patients. The solutions offered to these problems are not novel. However, the frequent occurrence of these errors in recent reports of antidepressant trials suggests that a review of these problems and possible solutions would be timely. In addition, the authors describe an alternate, comparatively underutilized strategy, the discontinuation design, that is particularly suitable for new drug trials and that circumvents the problem of treatment nonresponders.

Antidepressive Agents↗