Biomedical subjects
Publications and source records attributed to K L Wisner.
The nortriptyline levels of seven depressed mothers and their breast-fed infants were obtained. Nortriptyline was not detected in the infants' sera. However, two of four infants evaluated developed low concentrations of 10-hydroxynortriptyline. No adverse effects were observed.
A 12-year-old girl, hospitalized on a psychiatric intensive care unit, was treated for phobias of school and unfamiliar males. Treatment focused on decreasing several avoidance responses and increasing prosocial approach responses. Treatment consisted of instruction, performance feedback, participant modeling and social reinforcement. Marked changes were evident when treatment was introduced in a multiple-baseline design across several phobic and prosocial behaviors. Treatment effects generalized beyond the persons and situation included in training, were reflected in overall global ratings by persons unfamiliar with the treatment, and were maintained up to a 7-week follow-up when the child returned to the hospital for reassessment. Contact with the child 21 weeks after discharge indicated that the gains were reflected in school attendance and social interaction in everyday situations.
UNLABELLED: Increased interest in the complex interplay between gonadal steroids and neurotransmitter systems involved in mood has led investigators to question the role of gonadal steroids in the treatment of affective disorders, especially in women. OBJECTIVES: The purpose of this article is to provide a rationale for using gonadal hormones in the treatment of depression in women. METHODS: The literature is reviewed regarding 1) sex-specific phenomenologic and epidemiologic differences in the manifestation of psychiatric illness, 2) sex-specific differences in the therapeutic and adverse effects of psychotropic medications, 3) the complex interplay between gonadal steroids and neurotransmitter systems implicated in psychiatric disorders, and 4) the growing literature regarding the use of estrogen and progesterone in the treatment of mood disorders in women and androgens in the treatment of depression and sexual dysfunction in both men and women. RESULTS: Findings from pharmacologic trials of estrogen and androgens are encouraging, albeit mixed, in the treatment of mood disorders and decreased libido in women, respectively. Controlled studies have failed to confirm early open-label reports of the effectiveness of progesterone in the treatment of premenstrual syndrome. CONCLUSIONS: Pending replication, estrogen may become an important pharmacologic agent in the treatment of postnatal and perimenopausal depression, whereas androgens have been shown to improve libido in postmenopausal women and hypogonadal men. Progesterone cannot be recommended as a treatment for premenstrual syndrome or postnatal depression.