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Biomedical subjects

I Herman

Publications and source records attributed to I Herman.

16 recordsLinked to original sources
PubMed2006

Elevated platelet vesicular monoamine transporter 2 in former heroin addicts maintained on methadone.

The brain vesicular monoamine transporter (VMAT2) is essential for neuronal monoamine storage and regulation of monoaminergic neurotransmission. We demonstrated previously a high degree of similarity between the pharmacodynamic characteristics of platelet and brain VMAT2. Opioids induce increase of dopamine release in limbic structures. In the present study we assessed the VMAT2 pharmacodynamic characteristics using high affinity [(3)H]dihydrotetrabenazine (TBZOH) binding to platelets of former male heroin addicts maintained on methadone (n = 12) compared to age-matched healthy controls (n = 13). A significant increase (19%, p < 0.05) in platelet VMAT2 density (Bmax) was observed in the methadone treated patients compared to controls. There was no significant difference in the affinity of [(3)H]TBZOH to its platelet binding site. The increased VMAT2 density may reflect a compensatory attempt to prevent vesicular depletion due to chronic methadone exposure.

Blood Platelets↗
PubMed2005

The effect of mianserin add-on, on the intensity of opioid withdrawal symptoms during detoxification program--a randomized, double blind, placebo controlled, prospective study.

BACKGROUND: Based on pre-clinical studies regarding the interaction of various antidepressant drugs with the opioid system, we designed a clinical study to be carried out in the 'in-patient detoxification unit' within a large community centre for treatment of drugs dependent people. We evaluated the effect of mianserin add-on, on the intensity of opioid withdrawal symptoms in opiate dependent subjects undergoing medication-supported physical detoxification and integrated psychosocial and psychotherapeutic intervention for the treatment of dependence. METHODS: Mianserin (or placebo) was added to the routine medication protocol, during the 3-week in-patient phase of detoxification in a prospective, randomized, double blind, placebo controlled study. Mianserin (or placebo) was continued after discharge and patients were followed up for 3 months in order to evaluate relapse rates. Opiate withdrawal symptoms were assessed during the first 10 days, while depression and anxiety were assessed throughout the 3 months of study. RESULTS: From day 2 onward, patients in the study group showed significantly lower withdrawal symptoms than the control group patients and reached this peak faster (study group 2.8 days, control group 3.2 days, p<0.001). However, drop out rates were higher in the study group throughout the study period and only 13% of the study group patients, compared to 30% of the control group patients reached the end point. CONCLUSION: Though adding mianserin to the medication treatment during detoxification of opiate-dependent persons attenuated significantly both the intensity and the duration of withdrawal symptoms, the overall drop out rate was negatively influenced in the study group compared to the control group and fewer patients completed the study. Further study is needed in order to establish the origin of the paradox of higher drop out rates in the presence of attenuated intensity and duration of opiate withdrawal symptoms in the study group, and the clinical implications that should be drown.

Analysis of Variance↗
PubMed2003

Mianserin and trazodone significantly attenuate the intensity of opioid withdrawal symptoms in mice.

The aims of this study were to evaluate the effects of trazodone and mianserin on opioid-withdrawal symptoms in morphine-dependent mice. We used a comparative study of the effect of each drug on withdrawal symptoms in one model of acutely high-dose morphine-dependent mice, and two models (high-dose and lu-dose) of chronically morphine-dependent mice at the Tel Aviv University Sackler School of Medicine's laboratory.Trazodone, mianserin or both were given to the morphine-dependent mice together with a high dose of naloxone. Intensity of withdrawal symptoms was evaluated by tail-flick assay latencies and three behavioural measurements (rearing, jumping and grooming) in each group. Trazodone and mianserin, each separately,significantly attenuated withdrawal symptoms in all three models. However, the combined treatment of trazodone together with mianserin was not superior to each drug alone. The combination of trazodone and mianserin has no additive value to each drug alone in the control of withdrawal symptoms in opiate-dependent mice undergoing detoxification. When used in clinical settings, caution is needed in order to prevent the unknown influence of opioid-like drugs in medication-assisted detoxification programmes if complete opiate detoxification is the aim.

Adrenergic alpha-Antagonists↗
PubMed2000

The antinociceptive effect of trazodone in mice is mediated through both mu-opioid and serotonergic mechanisms.

The antinociceptive effects of trazodone (a triazolopyridine derivative with antidepressant activity) and its interaction with various opioid, noradrenaline and serotonin receptor subtypes were evaluated. Mice were tested with a hotplate analgesia meter. Trazodone induced a dose-dependent antinociceptive effect following i.p. administration. The ED(50) for mice in the hotplate assay for trazodone was 24.8 mg/kg (9.8; 67.4; 95% CL). The effect of opioid, adrenergic and serotonergic receptor antagonists was examined as to their ability to block trazodone antinociception. Trazodone-induced antinociception was significantly inhibited by naloxone, beta-FNA and naloxonazine, but not by nor-BNI or naltrindole, implying involvement of mu1- and mu2-opioid mechanisms. When adrenergic and serotonergic antagonists were used, metergoline (p<0.05) but not phentolamine or yohimbine, decreased antinociception elicited by trazodone, implying a clear 5-HT mechanism of antinociception. When trazodone was administered together with various agonists of the opioid receptor subtypes, it significantly potentiated antinociception mediated by mu1- and mu2- opioid receptor subtypes. Summing up these results, we conclude that the antinociceptive effect of trazodone is mainly influenced by the mu1- +mu2-opioid receptor subtype combined with the serotonergic receptor. These results explain the diffuse clinical use of trazodone in the management of some pain syndromes, and in opioid- and alcohol-detoxification programs, but raise questions regarding a possible 'indirect' opioid-dependence induced by trazodone itself.

Analgesics↗
PubMed1984

Severity of psychiatric symptoms as a predictor of benefits from psychotherapy: the Veterans Administration-Penn study.

One hundred ten nonpsychotic opiate addicts were randomly assigned to receive paraprofessional drug counseling alone, counseling plus cognitive-behavioral psychotherapy, or counseling plus supportive-expressive psychotherapy. Patients were classified low-severity, mid-severity, or high-severity on the basis of the number and severity of their psychiatric symptoms. Overall, the addition of professional psychotherapy was associated with greater benefits than was drug counseling alone. Low-severity patients made considerable and approximately equal progress with added psychotherapy or with counseling alone. Mid-severity patients had better outcomes with additional psychotherapy than with counseling alone, but counseling did effect numerous significant improvements. High-severity patients made little progress with counseling alone, but with added psychotherapy made considerable progress and used both prescribed and illicit drugs less often.

Adolescent↗
PubMed1983

Psychotherapy for opiate addicts. Does it help?

Opiate addicts beginning a new treatment episode on a methadone maintenance program were offered random assignment to drug counseling alone or to counseling plus six months of either supportive-expressive psychotherapy or cognitive-behavioral psychotherapy. Sixty percent of patients meeting the study criteria expressed an interest and 60% of these actually became engaged. One hundred ten subjects completed the study intake procedure and kept three or more appointments within the first six weeks of the project. Measures including standardized psychological tests, independent observer ratings, and continuous records of licit and illicit drug use were done at baseline and seven-month follow-up. All three treatment groups showed significant improvement, but patients receiving the additional psychotherapies showed improvement in more areas and to a greater degree than those who received counseling alone, and with less use of medication. More than a third of opiate addicts in our treatment program thus both were interested in professional psychotherapy and apparently benefitted from it. Certain administrative procedures appear necessary to maximize the chances that psychotherapy can be used effectively with drug-addicted patients.

Adult↗
PubMed1983

The qualitative effects of laser irradiation on human arteriosclerotic disease.

To determine the effects of laser irradiation upon human coronary atherosclerotic disease, coronary plaques were extracted from fresh human cadaver hearts. Seventy-four diseased artery samples were sectioned either transversely or longitudinally and subjected to laser treatment from argon-ion and carbon dioxide sources. The laser beam affected vaporization and patency in fibrous, lipoid, and calcified plaques as observed histologically. Calcified blockage showed greater extent of charred remnants following controlled thermal injury than did fibrous or lipoid obstructions. The area and depth of penetration varied directly with intensity and duration of photoirradiation and inversely with the density of the atherosclerotic tissue. This study supports further research work on the use of lasers to effect relief of atherosclerotic obstructions.

Coronary Disease↗
PubMed1983

Psychotherapy for opiate addicts.

An opportunity to receive a six-month course of professional psychotherapy in addition to paraprofessional counseling was offered to opiate addicts who were beginning a new treatment episode on a methadone maintenance program. The treatments offered were drug counseling alone (DC), counseling plus supportive-expressive psychotherapy (SE), or counseling plus cognitive-behavioral psychotherapy (CB). Sixty percent of patients meeting the study criteria expressed an interest in the psychotherapy program and 60% of these actually became engaged. One hundred and ten subjects completed the study intake procedure, were randomly assigned to one of the three treatment conditions and kept three or more appointments within the first six weeks of the project. A variety of outcome measures showed that patients in all three treatment groups improved. Patients receiving the additional psychotherapies improved in more areas and to a greater degree than those who received counseling alone. The specific improvements seen appear to be related to the focus of the therapy used. Patients with antisocial personality disorder, as defined by Research Diagnostic Criteria, did not benefit significantly from therapy, but those with depression did. Patients with high levels of psychiatric symptoms made many significant gains if they received additional therapy, but improved only in drug use if they received counseling alone. Patients in all three treatment groups having low levels of psychiatric symptoms improved significantly in many areas. We conclude that more than a third of opiate addicts in our treatment program are interested in psychotherapy and many of these can benefit from it. Certain administrative procedures appear necessary to maximize the chances that psychotherapy can be used effectively with drug addicted patients.

Adult↗
PubMedDate not supplied

[Relationship between structural brain abnormalities and psychopathologic profile in patients with schizophrenia].

Aim of this study was to determine the presence of structural brain abnormalities, dynamics of psychopathology three and seven years after the first hospitalisation and correlation between them. We examined 59 first admitted schizophrenic patients. We used computed tomography to examine structural brain abnormalities and BPRS-LA to measure the psychopathology level. CT and BPRS measures were both completed 3 years after the first admission. 7 years after the first admission the psychopathology level was measured with BPRS. We observed spaces in the brain and cortical sulci widened in 55 subjects (93%). The most commonly met structural brain pathology was a widening of the IIIrd ventricle and frontal cortex pathology. Assessment of the dynamics of psychopathology shows stability of the negative syndrome and increase of the positive syndrome and general psychopathology between the third and the seventh year of the illness. Three years after first admission, structural brain pathology in the left temporal cortex and frontal cortex correlate with the overall level of psychopathology measured with BPRS-LA, but this correlation vanishes in seventh-year catch-up. Seven years after first admission subcortical cerebral pathology, especially in the subcortical frontal area correlate significantly (p < 0.01) with a lower level of positive symptoms.

Adult↗