Biomedical subjects

K I Shulman

Publications and source records attributed to K I Shulman.

42 records · Page 3Linked to original sources

PubMed1986

Electrocardiogram changes and therapeutic desipramine and 2-hydroxy-desipramine concentrations in elderly depressives.

ECG parameters in elderly depressed in-patients were assessed during routine desipramine treatment. Significant changes (prolonged PR and PRS intervals and a decreased QTc interval) were found, related only to steady state concentrations of desipramine's major metabolite--2-hydroxy-desipramine. Potentially clinically significant changes developed in 40% of the patients. All serum drug concentrations were within therapeutic limits. Previous assurances about desipramines's cardiac safety in the elderly may need to be re-evaluated.

Aged↗

PubMed1985

Hysterical seizures as a manifestation of "depression" in old age.

A case of hysterical seizures is presented which is ultimately diagnosed as depression and treated successfully with tricyclic antidepressants. The need to re-examine our understanding of illness and the effect of classification on treatment decisions is emphasized.

Aged↗

PubMed1985

Desipramine-induced delirium at "subtherapeutic" concentrations: a case report.

An elderly patient treated with low dose Desipramine developed a delirium while her plasma level was in the "subtherapeutic" range. Delirium, which may be induced by tricyclic drug therapy in the elderly, can be caused by tricyclics with low anticholinergic potency. Therapeutic ranges for antidepressants that have been derived from general adult population studies may not be appropriate for the elderly. Further studies of specifically elderly patients are now required to establish safer and more appropriate guidelines for drug therapy.

Age Factors↗

PubMed1984

The clinical use of electroconvulsive therapy in old age.

A retrospective review was conducted on the charts of 33 elderly inpatients (age range, 62-85 years) who received electroconvulsive therapy (ECT) in a geriatric psychiatry unit of a general hospital. Electroconvulsive therapy was found to be safe but not uniformly effective; only 42.4 per cent of patients obtained an immediate good outcome. The implications of these findings for further evaluations of the indications and efficacy of ECT in old age are discussed.

Age Factors↗

PubMed1984

Diet and monoamine oxidase inhibitors: a re-examination.

Monoamine oxidase inhibitors (MAOIs) are attracting renewed attention as effective antidepressants for refractory depressions, particularly among the elderly. However, widespread fears concerning the interactions of MAOIs with tyramine-containing foods have led to the development of long and complicated diets. These diets have served as an obstacle to the ready use of MAOIs, yet very little systematic or critical review of the basis for food restriction has been undertaken. An international survey of MAOI diets was conducted and from the diets collected, foods were categorized according to frequency of restriction on the diet lists. On the basis of this survey and a critical review of the literature it was determined that only four foods clearly warrant absolute prohibition: aged cheese, pickled fish (herring), concentrated yeast extracts and broad bean pods. While there is insufficient evidence to prohibit alcohol completely (even chianti wine) true moderation must apply. It is suggested that a radically simplified diet should be investigated on a prospective basis.

Animals↗

PubMedDate not supplied

The use of clock tests in schizophrenia.

Though clock drawing tests are well recognized as measures of cognitive function, there is little data on the performance of patients with schizophrenia. We compared 24 patients with schizophrenia to 24 healthy, age-matched controls on clock drawing, copying, and reading. Patients with schizophrenia performed significantly worse on clock drawing and copying despite the fact that the groups had similar scores on the MMSE. Worse performance was associated with higher scores on the BPRS. Clock drawing and copying may be useful for the assessment of cognition in schizophrenia, and the monitoring of cognitive changes associated with antipsychotic medication.

Adult↗