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Biomedical subjects

G D Tollefson

Publications and source records attributed to G D Tollefson.

At least 91 records · Page 5Linked to original sources
PubMed1989

Lymphopenia in primary degenerative dementia.

The central nervous and immune systems share a number of common properties, e.g. neurotransmitter receptors. In contrast to age matched healthy and/or hypertensive controls, the total lymphocyte count in 25 carefully diagnosed and staged patients with primary degenerative dementia were significantly reduced and also correlated with the severity of their dementia. Subjects' age, age of dementia onset, or duration of illness were unrelated. Total leukocyte counts were similar between groups. Nutritional status, ACTH, or plasma cortisol in dementia cohort were also not explanatory of their lymphopenia. These results are potentially significant in light of an immune hypothesis for primary degenerative dementia: Alzheimer's type and/or that population's high concomitant risk of infection.

Adrenocorticotropic Hormone↗
PubMed1989

Buspirone: effects on prolactin and growth hormone as a function of drug level in generalized anxiety.

Certain evidence suggests that buspirone, a novel nonbenzodiazepine anxiolytic, may be a 5-HT1A serotonergic agonist and may antagonize postsynaptic dopaminergic receptors. The latter property raises questions regarding a dyskinesia- or extrapyramidal symptom-inducing potential. We monitored serum prolactin and growth hormone in 10 subjects with generalized anxiety disorder and 10 matched controls before and after 4 weeks of pharmacotherapy. A drug effect upon serotonin-modulated prolactin release or on the tubero-infundibular dopamine axis (prolactin; growth hormone) was negligible at clinically effective dosages of buspirone. Concomitant buspirone levels also failed to demonstrate any significant relationships.

Adult↗
PubMed1989

Serotonin and alcohol: interrelationships.

Alcoholism is a multifaceted medicosocial problem. Recent literature discusses a common dyad, alcoholism and anxiety. Both disorders are interdigitated with the brain amine serotonin (5-hydroxytryptamine, 5-HT). Direct 5-HT activation reportedly attenuates alcohol consumption, whereas depletion enhances use patterns. Acute alcohol consumption has also been associated with a transient rise, albeit eventual diminished 5-HT turnover. A variety of 5-HT models have confirmed this observation, e.g., reduced platelet 5-HT content, uptake, and cerebrospinal fluid (CSF) 5-hydroxyindoleacetic acid. Such altered characteristics of 5-HT secondary to chronic alcohol use may explain the frequent morbidity of anxiety and/or depression. Acute alcohol consumption is also associated with accumulation of the 5-HT aldehyde derivative 5-hydroxymethtryptoline. Thus, alcohol may induce the in vivo formation of aldehydes, e.g., beta-carbolines, that themselves possess high lipophilicity and psychotropic activity. Future investigation into 5-HT-specific pharmacologic probes in alcoholism will be interesting. Preliminary research has consistently demonstrated that 5-HT-enhancing agents (e.g., zimelidine or fluvoxamine) decrease alcohol consumption, preference, and short-term memory decrements. Thus, 5-HT appears to represent at least one common denominator for a spectrum of behavioral disorders including anxiety and alcoholism.

Alcohol Drinking↗
PubMed1988

Use of psychiatric referral by family physicians.

The family physician occupies a critical place in the detection and management of mental health problems. Optimal case management requires an awareness of individual limitations and effective use of a psychiatric consultant. The consultant must understand the unique relationship between the patient and the family physician. Several historical biases may impede the physician's use of psychiatric consultation and the patient's acceptance of psychiatric treatment options.

Humans↗
PubMed1988

A retrospective evaluation of plasma trazodone concentrations and clinical response in a primary care clinic.

Trazodone has become a very popular second generation antidepressant. In our experience, trazodone levels are frequently obtained albeit interpretation/utility of these levels and purported normal ranges are in question. We analyzed 39 consecutive cases of major depressive disorder treated with trazodone in a primary care medical clinic. Thirty (79%) of subjects had a positive response. While a positive correlation existed between dosage and concentration of the parent drug, no dose-response correlation could be identified within this cohort. However, a minimum level of 250 ng/ml did appear necessary for a response. The overall utility/cost efficacy of second generation antidepressants, in the absence of well designed dose response studies, is questioned.

Adult↗
PubMed1987

Occurrence of myoclonus in patients treated with cyclic antidepressants.

Myoclonus associated with cyclic antidepressant therapy has been considered to be a rare phenomenon. Ninety-eight patients who were to begin receiving cyclic antidepressant therapy were prospectively evaluated for myoclonus. Thirty patients experienced clinically insignificant drug-associated myoclonus. Nine patients had clinically significant myoclonus. The myoclonus was reversible with the discontinuation of therapy but tended to persist if medication changes were not made. None of the tested clinical variables were able to predict which patients would develop myoclonus.

Adult↗
PubMed1987

Elevations of urinary MHPG in depressed patients with panic attacks.

Anxiety may be associated with increased norepinephrine activity. Urinary levels of the norepinephrine metabolite 3-methoxy-4-hydroxyphenylglycol (MHPG) were examined in depressed patients with and without panic attacks. Depressed patients with panic attacks had significant elevations of MHPG.

Adult↗
PubMed1986

Prediction of postdexamethasone cortisol levels by serum sodium levels in patients with major depression.

The authors analyzed the dexamethasone suppression test (DST) results of 54 patients with major depressive disorder in relation to their pre-DST levels of cholesterol, sodium, potassium, and blood glucose, which are thought to have adrenocorticotrophic links. Discriminant analysis revealed that sodium alone was a significant predictor of nonsuppression. Validation of the predictive power of sodium could minimize the need for DST administration.

Adult↗
PubMed1984

Hypersomnia in major depressive disorders.

Hypersomnia was experienced by 17 of 102 patients with major depressive disorder. Comparisons between hypersomnic and non-hypersomnic depressives demonstrated significant associations between hypersomnia and increased appetite, weight gain, agitation, headaches, depression in a first-degree relative, and earlier age of illness onset.

Appetite↗
PubMed1984

Migraine headaches and depression.

After taking the lifetime migraine headache histories of 116 patients with major depressive disorder, the authors compared the prevalence of migraine headaches in these depressed patients with the prevalence of migraine reported in four community surveys. There was a trend for the depressed men to experience a higher prevalence of migraine than men in the general population, but the depressed women had a migraine prevalence similar to that of women in the general population. No differences on multiple variables of depressive illness were found between depressed patients with a history of migraine and those with none.

Child↗
PubMed1984

The neuroleptic syndrome and central dopamine metabolites.

The neuroleptic malignant syndrome remains an intriguing syndrome, yet its pathogenesis is unknown. Despite numerous analogies with peripheral disorders of aberrant calcium migration in the sacroplasmic reticulum, the probable loci are striatal and hypothalamic (preoptic) dopaminergic pathways. In order to clarify the characteristics of dopamine activity, analysis of the central metabolites 3,4-dihydroxyphenylacetic acid and homovanillic acid in one case revealed marked elevations. A possible role for postsynaptic dopamine receptor inhibition is discussed. These findings further suggest that the syndrome may be similar to other extrapyramidal disorders, and they lend credence to observations of its reported drug induction and management.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1984

Postpartum depression.

Postpartum depression (PPD) occurs in 4% of women during the puerperium. Patients with a previous history of depression, especially a postpartum depression, have a much greater incidence of PPD. Those patients should be evaluated carefully during the six-week period following parturition. PPD is to be differentiated from "baby blues," which occur in more than 50% of women postpartum. Baby blues are characterized by intermittent, mild affective symptoms that remit spontaneously after several days.

Antidepressive Agents↗