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Biomedical subjects

Jerzy Landowski

Publications and source records attributed to Jerzy Landowski.

14 recordsLinked to original sources
PubMed2006

Seizure following sudden zolpidem withdrawal.

Zolpidem is a short acting hypnotic drug belonging to imidazopyridine family. It produces its hypnotic effects via the GABA-A benzodiazepine receptor complex, and binds preferentially to those receptors containing the alpha-1 subunit. In comparison with benzodiazepines this mechanism is thought to reduce liability to induce dependence. Several case reports of zolpidem abuse and dependence have been published along with a small number of cases demonstrating seizures after sudden zolpidem withdrawal. We describe a case of a 29-year-old Caucasian woman who developed a generalized seizure following sudden zolpidem withdrawal subsequent to drug dependence to 160mg of zolpidem. The clinical effects of zolpidem seem to be comparable to those of benzodiazepines and abuse, dependence and withdrawal seizures belong to the spectrum of its adverse drug reactions.

Adult↗
PubMed2006

Relationship between the prevalence of depressive symptoms and metabolic syndrome. Results of the SOPKARD Project.

INTRODUCTION: Depression is a newly recognised risk factor for ischaemic heart disease (IHD). The results of many studies show that depression may contribute to the development of components of metabolic syndrome, such as arterial hypertension, obesity and glycaemic abnormalities. Thus it may have a significant impact on IHD development and worsen the course of an already established disorder. AIM: Evaluation of the prevalence of metabolic syndrome and depression among Sopot inhabitants aged 50 or 60 years. METHODS: This study involved 795 consecutive inhabitants of Sopot (477 female and 318 male) who were invited in 2003 and 2004 to participate in screening examinations in the programme of primary prevention of arterial hypertension, diabetes and lipid abnormalities -- SOPKARD. Metabolic syndrome was diagnosed according to the NCEP ATP III guidelines. Beck's Depression Inventory was used for the assessment of depressive symptoms. RESULTS: Metabolic syndrome was recognised in 32% of participants (in 31% of women and in 33% of men). The distribution of particular elements of metabolic syndrome was as follows: elevated blood pressure was found in 63% of subjects (female -- 58%, male -- 70%), abnormal fasting glucose in 24% (female -- 21%, male -- 28%), visceral (abdominal) obesity in 33% (female -- 38%, male -- 26%), elevated triglyceride level in 34% (female - 28%, male - 42%) and decreased HDL level in 26% (female -- 28%, male -- 23%). Symptoms of depression were found in 37% of studied subjects (42% of females, 28% of males). Metabolic syndrome was observed more frequently in subjects with depressive symptoms compared to those without depressive symptoms in the whole group (35% vs 28%, p <0.05) and in males (44% vs 28%, p <.05). This difference was not statistically significant in females (31% vs 28%, ns). Visceral obesity was observed more frequently in males with depressive symptoms than in those without depressive symptoms (37% vs 21%, p <0.001). It was not observed in the whole group and in females. The studied females group with depression more often had a higher fasting serum glucose concentration when compared to those without depression (25% vs 18%, p<0.05). Such a relationship was not observed in the male group and whole group. CONCLUSIONS: In the studied group of middle-aged subjects, especially among women, a high prevalence of depression symptoms was noted. Statistically significant correlations between the prevalence of depressive symptoms and visceral obesity in men and an elevated glucose level in women were shown.

Adult↗
PubMed2004

Immune consequences of the spontaneous pro-inflammatory status in depressed elderly patients.

INTRODUCTION: The aim of the study was to describe the interrelationship between senescence, depression, and immunity. METHODS: We assessed 10 elderly patients with depression and 10 age- and sex-matched controls: before, at one and at six month intervals after the anti-influenza vaccination. Levels of TNFalpha, IL6, ACTH, and cortisol, titres of anti-hemagglutinins and anti-neuraminidases, lymphocytes secreting IFNgamma, IL2, IL4, and IL10, cytotoxicity of NK and CD3+ CD8+ IFNgamma+ cells, anti-CMV antibodies, and CD28- CD57+ lymphocytes known to be associated with the CMV carrier status were evaluated. RESULTS: Higher levels of anti-CMV, higher percentage of the CD28- CD57+ cells, and elevated levels of TNFalpha, IL6, and cortisol concomitant with decreased levels of ACTH and insufficient production of IL10 (which increased the IFNgamma+ /IL10+ ratio) were found in the patients suffering from depression, in comparison to healthy controls. The subjects with depression revealed a low NK cytotoxicity, while a level of CD3+ CD8+ IFNgamma+ cells was comparable between the groups. Although the levels of anti-hemagglutinins and anti-neuraminidases were low in the depressed patients, they reached the protective titres. The majority of these differences disappeared when CMV titres were entered into the analyses as a covariate. DISCUSSION: The results suggest that the elderly depressed patients were characterised by increased exposure to CMV in the past, which could have resulted in a pro-inflammatory profile demonstrated as elevated levels of TNFalpha, IL6 and deficiency of suppressive IL10+ cells. These changes negatively affect humoral and innate response in the depressed patients.

Aged↗
PubMedDate not supplied

[Intravenous clomipramine for depressive disorders].

51 patients with depressive episode (40--recurrent depressive disorder, 11--bipolar affective disorder) were treated by the clomipramine intravenous infusions. The number of infusions varied from 5 to 21 (mostly 10-16). The median of maximal dose was 150 mg. There were significant clinical improvement measured by CGI. The therapy was well tolerated.

Adult↗
PubMedDate not supplied

[Mirtazapine--an antidepressant].

The pharmacological properties and clinical value of mirtazapine has been presented, based on a literature review. It is concluded that mirtazapine has syndromolytic anti-depressive actions towards syndromes of various clinical picture and intensity. It is particularly highly recommended in the treatment of depressive disorders with insomnia, anxiety and body-weight reduction. It is a safe drug, which can be used, in long-term supportive treatment.

Antidepressive Agents, Tricyclic↗
PubMedDate not supplied

[Second generation antipsychotics: similarities and differences].

Second generation antipsychotics share some similarities but display also differences in their action. The pharmacological profile as well as the clinical efficacy and tolerability of these drugs currently on the market in Poland have been described. The analysis of their properties reveals distinct differences between the drugs. Those differences underline the value of the medications in the treatment of psychotic disorders. The differences allow tailoring the antipsychotic therapy to the individual needs of each single patient. Such a possibility to use the pharmacological agents according to the needs of the patient makes an important feature of the second generation drugs. At the same time it indicates that obvious differences in action exist inside the group.

Antipsychotic Agents↗
PubMedDate not supplied

[Safety and efficacy of olanzapine versus perphenazine in patients with schizophrenia: results of multicenter, 18-week, double-blind clinical trial].

AIM: The primary objective of the study was to evaluate the severity of extrapyramidal symptoms during treatment with olanzapine (10-20 mg) versus perphenazine (8-40 mg) using the Simpson Angus Scale (SAS). The secondary objective was to assess the safety profile and clinical efficacy of the investigated drugs. MATERIAL AND METHOD: A total of 95 patients with schizophrenia who met the criteria for DSM-IV were randomized to a double-blind, 18 week prospective comparative trail conducted in Poland. The tolerance of treatment was assessed with the use of scales: BAS, SAS and UKU. The efficacy of treatment was evaluated with BPRS, PANSS and CGOI scales. RESULTS: For olanzapine patients, the severity of extrapyramidal symptoms improved after 3 first weeks of treatment, and significantly decreased from the baseline to endpoint. Perphenazine patients showed an increase of extrapyramidal symptoms. The difference of the SAS scores change was statistically significant between olanzapine and perphenazine groups. Akathisia symptoms decreased significantly in the olanzapine group during the treatment period, whereas symptoms of akathisia increased in the perphenazine group. Statistically significant differences of mean change of BAS total score from baseline to endpoint were noted between treatment groups Treatment--emergent adverse events occurred more frequently in patients receiving perphenazine (46%), than in patients receiving olanzapine (17%). The proportion of patients complying with improvement criteria for CGI scale score was statistically greater in the olanzapine group (72.7%) than in the perphenazine group (47.9%). Results of this study showed that the tolerance profile in patients taking olanzapine is superior to perphenazine. CONCLUSIONS: Olanzapine was better tolerated than perphenazine. After olanzapine treatment more subjects fulfilled the criterion of improvement and schizophrenic symptoms were less severe than in patients treated with perphenazine.

Antipsychotic Agents↗
PubMedDate not supplied

[Serotoninergic system and limbic-hypothalamic-pituitary-adrenal axis (LHPA axis) in depression].

Depression is associated with the dysfunction in the serotoninergic (5-HT, 5-hydroxytryptamine) transmission and dysregulation of the limbic-hypothalamic-pituitary-adrenal axis (LHPA axis). In depression, the 5-HT system exhibits impaired presynaptic activity of 5-HT neurones, an increased activity of central postsynaptic 5-HT2A receptors, decreased activity of postsynaptic 5-HT1A receptors and altered synaptic 5-HT uptake. The coexistent dysregulation of the LHPA axis is predominantly linked to GR (glucocorticoid receptor) dysfunction within the limbic system along with hypercortisolemia, MR (mineralocorticoid receptor) and GR receptors imbalance which results in impaired negative feedback mechanisms in the LHPA axis loops. Several clinical and animal studies revealed the involvement of 5-HT1A system in LHPA axis regulatory mechanisms. That association seems to be dependent on the corticoid levels. The impaired GR receptor function and MR/GR receptors imbalance alter the negative feedback regulation within the LHPA axis which is followed by its dysregulation and hypercortisolemia that is further associated with the decreased activity of postsynaptic 5-HT1A receptors resulting in a serotoninergic dysfunction. The aim of this paper is to discuss and review the current data on the existence of the hypothetical relationship between the activity of the serotoninergic system, predominantly 5-HT1A receptors, and LHPA axis in depression.

Antidepressive Agents↗
PubMedDate not supplied

[Indicators of the persistent pro-inflammatory activation of the immune system in depression].

The aetiology of depression remains tentative. Current hypotheses on the aetiology of the depressive disorder tend to integrate monoaminoergic, neuroendocrine and immunological concepts of depression. A number of research papers emphasise the altered hormonal and immune status of patients with depression with pronounced cytokine level variations. Those studies tend to link the variable course of depression in relation to the altered proinflammatory activity of the immune system. The results of the studies on the activity of the selected elements of the immune system are ambiguous indicating both increased and decreased activities of its selected elements. However, a number of basic and psychopharmacological studies support the hypothesis of the increased proinflammatory activity of the immune system in the course of depression which is the foundation for the immunological hypothesis of depression. The aim of this paper is to review the functional abnormalities that are observed in depression focusing on the monoaminoergic deficiency and increased immune activation as well as endocrine dysregulation. This paper puts together and discusses current studies related to this subject with a detailed insight into interactions involving nervous, endocrine and immune systems.

Depression↗
PubMedDate not supplied

[The stroke variables assessment as a prognostic factor for post-stroke depression with the emphasis on the cerebral SPECT regional blood flow asymmetry].

AIM: The aim of this paper was to assess the risk for depression in a 6-month-long post stroke follow up period as related to the stroke variables (i.e. stroke localisation, haemodynamic parameters). METHOD: The stroke localisation was determined with CT and/or MRI. Subsequently all the examined individuals underwent SPECT examination. The follow up examinations were performed by the consultant psychiatrist in 6, 12 and 24 weeks subsequent to the stroke episode. The depressive episode diagnosis was established on the basis of ICD-10 diagnostic criteria. RESULTS: Only right-handed patients (43 men aged 57.3 +/- 11.6 and 17 women aged 62.5 +/- 14.4) with unilateral brain lesion were examined. 23 subjects (38%) developed depression in the follow-up period. 5 women (29%) and 18 men (ca. 42%) developed a depressive episode. Only one of the observed depressive episodes met ICD-10 criteria for severe depressive episode. 10 patients suffered from moderate depressive episode and 12 subjects exhibited a mild depressive episode. CONCLUSIONS: The results obtained with CT and/or MRI techniques revealed no correlation between the post-stroke depression and stroke lateralisation. However the localisation of the deep brain functional abnormalities revealed with SPECT correlated with the occurrence of the affective disorders as related to the asymmetry in regional blood flow measures.

Adult↗
PubMedDate not supplied

[Atypical antipsychotic-induced weight gain].

Introduction of a new group of antipsychotic drugs, called atypical because of the proprieties differing them from classical neuroleptics, gave hope for the beginning of a new era in treatment of psychoses, including schizophrenia. Different mechanisms of action not only resulted in a broader spectrum of action and high efficacy but also in a relative lack of extrapiramidal symptoms. However, atypical neuroleptics are not totally free from adverse effects. Symptoms such as sedation, metabolic changes and weight gain, often very quick and severe - present also in the case of classical drugs, but put to the background by extrapiramidal symptoms--have become prominent. Weight gain is important both from the clinical and subjective point of view--as associated with serious somatic consequences and as a source of enormous mental distress. These problems are addressed in this review, with the focus on weight gain associated with the use of specific atypical neuroleptics.

Antipsychotic Agents↗
PubMedDate not supplied

[Antipsychotic-induced weight gain--pharmacogenetic studies].

Drug-naive patients with schizophrenia often present metabolic abnormalities and obesity. Weight gain may be the side effect of treatment with many antipsychotic drugs. Genetic effects, besides many other factors, are known to influence obesity in patients with schizophrenia treated with antipsychotics. Numerous studies of several genes' polymorphisms have been performed. -759C/T polymorphism of 5HT2C gene attracted most attention. In 5 independent studies of this polymorphism the association between T allele with the lower AP-induced weight gain was detected. No associations could be detected between weight gain and other polymorphisms of serotonergic system genes as well as histaminergic system genes. Studies of adrenergic and dopaminergic system have neither produced any unambiguous results. Analysis of the newest candidate genes (SAP-25, leptin gene) confirmed the role of genetic factors in AP-induced weight gain. It is worth emphasising, that the studies have been conducted in relatively small and heterogenic groups and that various treatment strategies were used.

Antipsychotic Agents↗