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Biomedical subjects

H Raotma

Publications and source records attributed to H Raotma.

15 recordsLinked to original sources
PubMed1979

Bimodal distribution of serum trypotphan level.

Serum levels of total L-tryptophan (L-TP) were determined before and during treatment in patients suffering from endogenous depression, who were treated with L-TP, 6 g daily, and unilateral electroconvulsive therapy (ECT). The gaussian curve of initial L-TP concentrations changed into a bimodal distribution during treatment. The patients with initially lower L-TP levels also had lower L-TP levels during the treatment, thus forming the low-concentration group within the bimodal distribution. In the patients with higher initial concentrations, the L-TP levels increased to a much greater degree, forming the high-concentration group. Patients in this group needed a larger number of ECT's, probably owing to L-TP's property of shortening the seizure duration. No other background data or clinical variables showed significant differences between the groups. It is suggested that the bimodality of L-TP levels is genetically determined.

Adult↗
PubMed1978

Has tryptophan any anticonvulsive effect?

In an an intra-individual crossover trial depressed patients were treated with the 5-hydroxytryptamine (5-HT) precursor L-tryptophan (L-TP) and unilateral ECT, or with unilateral ECT alone. The oral dose of L-TP was 6 g the day before ECT and 3 g on the day of ECT, 4 hours before the treatment. The seizure duration was measured on EEG records. The time of the electrical stimulation needed to induce generalized seizures was similar for both treatment alternatives. Thus L-TP seems not to elevate the threshold to ECT-induced convulsions. The mean duration of a seizure was significantly shorter when the patients were treated with L-TP + ECT than when treated with ECT alone. It is suggested that L-TP exerts an inhibitory influence on the ability to sustain epileptic activity.

Administration, Oral↗
PubMed1977

Memory impairment after convulsive therapy. Influence of age and number of treatments.

The influence of age and number of treatments on memory impairment was studied in depressed patients after a series of convulsive treatments: bilateral ECT, unilateral ECT on the nondominant hemisphere, and fluorothyl convulsive therapy. Before and after the completed convulsive therapy course the patients were tested with a memory test battery and the symptoms rated with a depression scale. Before treatment older age-groups had decreased ability to learn, but their post-treatment forgetting score was not significantly higher than in other age-groups. An increase in the number of ECTs did not seem to correlate with the degree of memory impairment. The conclusion of the present study is that age (up to 65) and the number of ECTs (up to 10) have no apparent influence on memory impairment after electroconvulsive therapy.

Adolescent↗
PubMed1977

Comparative clinical evaluation of lofepramine and imipramine. Psychiatric aspects.

Lofepramine, an imipramine analogue, was compared with imipramine in a multicentre, double-blind clinical trial. The 62 patients (31 in each of two treatment groups) had a depressive syndrome that normally would have been treated with a tricyclic antidepressant. These patients had not received any adequate treatment for this present depressive episode. After a wash-out period and once a week during treatment (up to 5 weeks), routine laboratory tests and electrocardiograms was done. The dosage was 50 mg t.i.d. for imipramine and 70 mg t.i.d. for lofepramine. Depression ratings with the Cronholm-Ottosson depression rating scale were performed before treatment and once weekly for 3 weeks and then in the 5th week. The last four ratings were combined with rating of side-effects. In the 5th week of treatment 15 out of 31 in the lofepramine group and 18 out of 31 in the imipramine group had recovered. This difference was not significant, nor did the median values of individual symptoms differ between the groups. The side-effects were moderate and the two groups only differed significantly in the items "dry mouth" and accommodation disturbances in favour of lofepramine. The drug compliance was checked by plasma levels of desmethylimipramine in the imipramine group, parent compound, and "apparent" desmethylimipramine in the lofepramine group. The relationship between plasma drug levels, the effect on noradrenaline uptake in vitro and amelioration discussed in Siwers et al. (1977) in this issue. The clinical outcome in the two groups did not differ significantly; interpretation of this result is discussed in relation to the reliability and selection of patients.

Adult↗
PubMed1977

Comparative clinical evaluation of lofepramine and imipramine. Pharmacological aspects.

A multicentre comparative clinical evaluation of lofepramine, an imipramine analogue, and imipramine has been made with double-blind technique and fixed dosage (lofepramine 70 mg t.i.d., imipramine 50 mg t.i.d.). Plasma was drawn after 3 weeks for determination of noradrenaline-uptake inhibitory capacity of the parent compound and/or its active metabolites. Plasma concentrations of lofepramine and desmethylimipramine (DMI) were determined in the same samples. The concentrations of lofepramine in the whole material were low (5-27 ng/ml) except for one patient who had a level of 53 ng/ml. In both groups of patients there was an almost 40-fold range in the plasma levels of DMI or apparent DMI. The patients were rated for severity of depression before treatment, then once weekly for 3 weeks and finally during the fifth week. For further information concerning the psychiatric aspects, see d'Elia et al. in this issue (1977). A significant correlation was found between the concentrations of DMI and the noradrenaline-uptake inhibitory capacity in the plasma samples. No correlations were found between uptake inhibitory capacity of plasma samples and the amelioration scores.

Adult↗
PubMed1977

Evaluation of the combination of tryptophan and ECT in the treatment of depression. I. Clinical analysis.

A double-blind evaluation of the antidepressant efficacy of treatment with a combination of orally administered L-tryptophan (L-TP) and electroconvulsive therapy (ECT) was made in patients suffering from endogenous depression. The patients were randomly assigned to two groups, one treated with L-TP (6 g daily) and unilateral ECT, the other with placebo and unilateral ECT. L-TP treatment was initiated at least 1 day before the first ECT and terminated 4 days after the last ECT. There was a good agreement between the two groups in several measures of antidepressant efficacy: doctors' and patients' ratings of depressive symptoms, and doctors' global rating of therapeutic effect 4 days and 1 month after the last ECT. In the L-TP group, however, there was a significantly better effect on retardation symptoms in the nurses' rating scale. This difference, which is not consistent with other measures of amelioration, contributes, at most, to a marginal therapeutic addition to the antidepressant effect of ECT. It is concluded that oral administration of L-TP, in the dose of 6 g daily, is not of practical value for potentiating the antidepressant efficacy of ECT.

5-Hydroxytryptophan↗
PubMed1977

Comparison of fronto-frontal and temporo-parietal unilateral ECT.

An intraindividual double-blind cross-over comparison for the anterograde effect on memory of unilateral non-dominant frontofrontal (FF) and temporo-parietal (TP) ECT was performed in connection with the second and third treatment of an ECT-series, the electrode placement being alternated at random. Treatment technique was standardized and seizure duration was measured by means of EEG. Memory functions were tested after treatments by means of four memory tests: the 30 Word-Pair Test, the 30 Figure Test, the 30 Geometrical Figure Test and the 30 Face Test. Three operationally defined memory variables, immediate memory (IMS, 3 hours after ECT), delayed memory (DMS, 3 hours after IMS), and their difference, forgetting, were scored. No differences were found in the mean time of electrical stimulation, in the amount of methohexital and suxamethonium chloride, and in seizure duration between the two treatment groups. No statistically significant differences in any of the memory tests were found. The FF electrode position did not show any advantage compared with the routine TP electrode placement.

Aged↗
PubMed1976

Comparison of unilateral dominant and non-dominant ECT on verbal and non-verbal memory.

An intraindividual, double-blind cross-over comparison of the effects of dominant (D) and non-dominant (ND) temporo-parietal unilateral electroconvulsive therapy (ECT) was performed in connection with the second and third treatment, the type of electrode placement being allocated at random. Four memory tests were used. The 30 Word-Pair Test is an audio-visual verbal recall test, the 30 Figure Test is a mainly visual recognition test with easily verbalized items. The 30 Geometrical Figure Test and the 30 Face Test are nonverbal recognition tests of visual complex and unfamiliar material. Compared with dominant ECT, non-dominant ECT has a more negative influence in the complex non-verbal visual tests, whereas dominant ECT has a more negative effect on verbal memory. In the non-verbal tests, as compared with the verbal ones, the encoding (or learning) is relatively more influenced and the retention (or storage) relatively less. An impairment either of complex apperceptive function or of memory may be responsible for the relatively lower performance in non-verbal tests after non-dominant ECT.

Adult↗