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Biomedical subjects

K Ghose

Publications and source records attributed to K Ghose.

At least 19 recordsLinked to original sources
PubMed1979

Pharmacokinetics and pharmacodynamics of amitriptyline in depression.

1. The therapeutic effect and pharmacokinetics of amitriptyline were assessed in thirty-five patients suffering from primary depressive illness during inpatient treatment. 2. Contrary to our previous study, no significant correlation was obtained between the plasma concentrations of amitriptyline, nortriptyline or total tricyclics with Hamilton rating score at 6 weeks or percentage improvement after 6 weeks treatment. 3. There was also no correlation with the plasma concentrations of tricyclics with the corrected subjective side-effects score. 4. A linear correlation (rs = 0.80; p less than 0.001) was observed between the plasma concentration of nortriptyline and decreased tyramine sensitivity, an index of noradrenaline reuptake blocking effect. 5. The corrected side-effect score during the trial correlated (r = 0.64; p less than 0.001) with Hamilton rating score at week 6, i.e. the patients who complained of more side-effects had less clinical benefit during amitriptyline therapy.

Amitriptyline↗
PubMed1978

[Study report on the lack of interaction between mianserine and noradrenaline in man].

Tricyclic antidepressants are known to potentiate the increase in blood pressure caused by noradrenaline. Five depressive patients were given intravenous noradrenaline before and after 2--4 weeks of treatment with Org GB 94 (Tolvin). The dose of noradrenaline was increased until a rise of 30 mmHg in systolic blood pressure occurred. No evidence of interaction between Org GB94 and noradrenaline was found. The implications of this are discussed.

Antidepressive Agents, Tricyclic↗
PubMed1978

Antidepressant activity and pharmacological interactions of ciclazindol.

Ciclazindol, a new tetracyclic compound, appears to be a potentially important antidepressant of the same order as amitriptyline, but with significantly fewer subjective side effects. Although as a group the patients treated with ciclazindol lost weight, clinical improvement was observed to be significantly correlated with the weight gain in both groups. The peripheral adrenergic interactions were studied. In the dosage used (100 mg/day) ciclazindol was observed to be a peripheral Na-reuptake blocker with no significant effect on the postsynaptic alpha-receptors. Plasma concentrations of the drug were estimated and their relationship to the therapeutic outcome, side effects, and adrenergic interaction were studied. No significant change in resting BP or ECG was observed following 4--6 weeks' treatment with ciclazindol.

Adult↗
PubMed1978

Amitriptyline plasma-concentration and clinical effect. A World Health Organisation Collaborative Study.

54 patients in five centres participated in a study of the relationship between steady-state plasma-levels of amitriptyline (AT) and its active metabolite nortriptyline (NT) and therapeutic response. The participants were inpatients who, after a 7-12 day period of assessment, were rated greater than or equal to 16 on the Hamilton rating scale for depression. They were given 75 mg of amitriptyline for 3 days and then 150 mg daily for an active-treatment period of 6 weeks. Clinical ratings and plasma-samples were obtained at baseline then at 2, 4, and 6 weeks after starting therapy. Contrary to the findings of three previous trials, no important correlations were found between steady-state plasma-levels and therapeutic outcome or corrected side-effects. Corrected side-effects correlated negatively with therapeutic outcome. There seems little advantage in routine monitoring of AT and NT, since variations in plasma-levels do not account for the considerable variation in therapeutic outcome.

Adult↗
PubMed1978

Effect of carbamazepine in polyuria associated with lithium therapy.

Ten patients, suffering from affective disorders, were treated with carbamazepine for polyuria and polydipsia associated with long-term lithium therapy. Oral carbamazepine (300--600 mg daily for six weeks) was observed to have no beneficial effect in alleviating these symptoms when compared with placebo tablets in a double blind crossover study. Plasma and urinary osmolality were observed to be within normal range in these patients and there was no antidiuretic response following subcutaneous Pitressin injection. There was 50% drop-out due to severe side-effects like ataxia, dizziness, restlessness and confusional states. It appears that lithium exacerbates carbamazepine induced CNS side-effects or vice versa, the mechanism of which is not very clear. It may be due to their mutual effect on sodium metabolism or on nervous conduction velocity. Hence, simultaneous administration of these two drugs should preferably be avoided.

Adult↗
PubMed1978

Continuation therapy with amitriptyline in depression.

Thirty-two patients who had responded to amitriptyline (150 mg daily) when suffering from a depressive illness were allocated either to receive placebo or to remain on the same medication for one year. Plasma concentrations of the drug were regularly estimated. There was no correlation between plasma concentration and subsequent residual affective morbidity. In spite of considerable encouragement, three of the patients did not take the prescribed amitriptyline and they all relapsed. Five out of sixteen patients who received placebo relapsed. None of the patients who continued to take amitriptyline relapsed. It is emphasized that the patients studied were selected, inasmuch as they were apparent responders to amitriptyline. It is concluded that this group of patients should continue to be treated with antidepressant medication for eight months after apparent recovery, and care should be taken to ensure the patients' compliance.

Adult↗
PubMed1978

Mianserin and lithium in the prophylaxis of depression.

Forty-one out-patients with a history of at least three attacks of depressive illness were randomly allocated to treatment on a double-blind basis for one year with either mianserin 20 mg three times daily plus placebo lithium tablets, or to lithium tablets once daily plus placebo mianserin tablets. After one year, the dosage of mianserin was increased to 30 mg t.d.s. for a further six months. All but three of the patients had previously been stabilized on prophylactic lithium therapy. Lithium was found to be significantly superior to mianserin in avoiding admission to hospital or ECT. The overall affective morbidity index, calculated from global rating, showed no significant difference between drugs, but the index of the mianserin group was higher in the second six months than in the first. The lithium group showed no such change. Lithium remains the choice for the prophylaxis of unipolar recurrent depressive illness.

Administration, Oral↗
PubMed1978

Effect of mianserin hydrochloride on peripheral uptake mechanisms for noradrenaline and 5-hydroxytryptamine in man.

1. Mianserin seems to have little effect on peripheral noradrenaline (NA) re-uptake mechanisms as shown by its lack of effects on the tyramine dose and NA dose/pressor response. 2. Mianserin has no effect on the hypotensive action of bethanidine. 3. Mianserin in vivo has a significant action on platlet transport (Vmax) of 5-hydroxytryptamine (5-HT), which changes toward normal values in depressive patients on the drug. This action is not observed in vitro. 4. It is possible that a metabolite of mianserin is responsible for this effect, and that this may be of therapeutic importance.

Antidepressive Agents↗
PubMed1977

Noradrenaline, depressive illness, and the action of amitriptyline.

The tyramine-dose/pressor response test was carried out on a series of patients suffering from primary depressive illness before and during treatment with amitriptyline. The severity of their depression was assessed during the study of the Hamilton Rating Scale (HRS). The decreased tyramine sensitivity induced by the drug, which is related to the inhibition of NA reuptake, correlated significantly with the plasma concentration of nortriptyline. However, contrary to the expectation of the noradrenaline hypothesis of depression, the decreased tyramine sensitivity, i.e., the degree of NA-reuptake blockade, did not show any correlation with clinical improvement following 6 weeks' treatment with amitriptyline.

Adult↗
PubMed1977

Intravenous tyramine response in migraine before and during treatment with indoramin.

We studied the response of 31 migraine sufferers (20 women, 11 men) to intravenous tyramine (the tyraminedose)pressor response test). Patients were treated either with pacebo tablets or indoramin, and alpha-adrenergic blocking agent, in a double-blind crrossover trial. We found that patients with migraine required significantly less tyramine to increase their cystolic blod pressure by 30 mm Hg when compared with matched controls. Indoramin significantly increased the amount of tyramine needed to raise the systolic blood pressure among migraine suffers and reduced the incidence of posttyramine migraine for m 46% while patients were on placebo tablets to 8% when they were receiveing indoramin. There was no association between tyramine sensitivity and a history of premenstrual or dietary migraine, nor was there a significant difference in the indierenence in the incidence of post-tyramine migrain between men women. We conclude that the intravenous tyramine test may be valuable in assessing migraine suffers who will respond to an alpha-advenergic blocking agent such as indoramin.

Blood Pressure↗
PubMed1977

Clinical pharmacological studies of tandamine, a potential antidepressive drug.

Tandamine hydrochloride, a thiopyranoindole, was more active than desmethylimipramine in inhibiting the tyramine pressor response after single oral doses in human volunteers. When compared with a placebo, tandamine was found to possess significant anticholinergic activity, to reduce appetite and to produce sedation. Compared with clomipramine, it caused a smaller inhibition of 5-HT but a more marked inhibition of dopamine uptake into human platelets. Further clinical and pharmacological studies with tandamine may help to elucidate the respective roles of different monoamines in depression, sedation and appetite.

Adult↗
PubMed1977

Antidepressant evaluation and the pharmacological actions of FG4963 in depressive patients.

FG4963 a phenylpiperidine derivative and potent 5-HT reuptake inhibitor at neuronal sites was investigated in a group of 10 depressive patients, and its effect was compared with that of amitryptyline in a group of 10 depressive patients treated with amitriptyline. FG4963 was found to be significantly inferior as an antidepressant compared to amitryptyline over a 6-week period. FG4963 did not appear to be anticholinergic as judged by its lack of effect on salivary flow. Its effect (in the dosage used) on the tyramine dose--pressor response and NA dose--pressor response tests were less than those of amitryptyline.

Amitriptyline↗
PubMed1977

Antinuclear antibodies, affective disorders and lithium therapy.

The prevalence of positive antinuclear antibody (ANA) was investigated in a group of patients suffering from recurrent affective disorders who had been treated for more than one year with lithium carbonate. There was no increase of ANA in these patients (8%) as compared with a group of patients suffering from affective disorders (7.5%), but untreated with lithium salts, or with the prevalence of ANA in the general population (9%) of the same age group.

Affective Symptoms↗
PubMed1977

Mianserin in the prophylactic treatment of bipolar affective illness.

Mianserin in a dosage of 20 mg 3 times daily, was given to 13 patients with bipolar affective illness, who were previously maintained on lithium. 3 patients left the trial at their own request within a few days due to drowsiness in 2 cases and insomnia in the third. Of the remaining 10 patients, 6 became manic within the 3-month trial period. This result indicates that mianserin may be capable of precipitating mania in susceptible subjects with bipolar affective illness. This may be a general property of antidepressants, since it has been previously described with other groups of antidepressants.

Adult↗