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Biomedical subjects

K Modigh

Publications and source records attributed to K Modigh.

At least 19 recordsLinked to original sources
PubMed1998

[High risk for children with DAMP/ADHD to become addicts later in life].

The prevalence of attention deficit hyperactivity disorder (ADHD) and of the overlapping condition, deficit in attention, motor control and perception (DAMP), among children of early school age is approximately 5 per cent (1.5% being severe cases). Boys are more commonly affected than girls. The symptoms continue to be disabling at 20 years of age in 50 per cent of cases, and social maladjustment is common. Half of the young boys develop oppositional defiant disorder (ODD), very often progressing to conduct disorder (CD) and antisocial personality disorder (ASPD). Low socio-economic status, parental mental disorder, and persistence of DAMP/ADHD symptoms are all predictors of the development of CD/ASPD. Prospective studies of children with DAMP/ADHD have shown them to be characterised by a high level of alcohol and/or drug abuse comorbidity, particularly the subgroup progressing to CD/ASPD. Conversely, studies of drug abuse and of alcohol abuse series have shown them to be characterised by a high level of DAMP/ADHD comorbidity. Approximately one in five alcoholics has or has had DAMP/ADHD, a comorbidity probably even more pronounced among type II alcoholics. Approximately every third substance-abuser has or has had DAMP/ADHD. The need of more persevering support and treatment efforts for the well-defined category of boys at high risk is emphasised. Better awareness, active diagnosis and treatment of adults with persisting DAMP/ADHD is also warranted.

Adolescent↗
PubMed1992

Neuroendocrine evidence for decreased function of alpha 2-adrenergic receptor after electroconvulsive therapy.

Growth hormone (GH) and hypotensive responses to clonidine (150 micrograms, i.v.) were investigated before and after electroconvulsive therapy (ECT) in 16 depressed patients. Because of high baseline serum GH concentrations, results from only 10 patients could be evaluated. The level of GH secretion induced by clonidine was significantly reduced after ECT, but the hypotensive responses to clonidine remained unchanged. The results indicate downward regulation of the sensitivity of alpha 2-adrenergic receptors in the hypothalamus after ECT.

Blood Glucose↗
PubMed1992

Clomipramine effectively reduces premenstrual irritability and dysphoria: a placebo-controlled trial.

Forty nondepressed women displaying severe premenstrual irritability and/or dysphoria and fulfilling the DSM-III-R criteria of late luteal phase dysphoric disorder were treated daily for 3 menstrual cycles with either the potent serotonin reuptake inhibitor clomipramine (25-75 mg; flexible dosage) (n = 20) or placebo (n = 20). In both treatment groups premenstrual irritability and dysphoria (as rated daily by the patients using a visual analogue scale) were significantly reduced as compared with the rating during 2 pretreatment reference cycles; however, in the placebo group this reduction was only about 40% whereas, in the clomipramine group, the symptom decrease was greater than 80%. At all 3 treatment cycles, patients on clomipramine displayed significantly lower symptom rating than controls. Also with respect to the rating of global improvement, the results obtained with clomipramine were considerably and significantly better than those obtained with placebo. It is concluded that low doses of clomipramine effectively reduce premenstrual irritability and dysphoria with a response rate close to 100%. The possible role of serotonin in the pathophysiology of the premenstrual syndrome is discussed.

Adult↗
PubMed1992

Superiority of clomipramine over imipramine in the treatment of panic disorder: a placebo-controlled trial.

A double-blind, placebo-controlled trial was undertaken to compare the effects of imipramine and clomipramine in the treatment of panic disorder with or without agoraphobia. The number of dropouts in the placebo-treated group was 7; in the imipramine-treated group, 4; and in the clomipramine treated group, 0. Ten subjects fulfilled the 12 weeks of treatment in the placebo group, 25 in the imipramine group, and 22 in the clomipramine group. To minimize dropouts because of side effects, a flexible dose regimen with a careful escalation of doses was applied. The maximal dose allowed was 250 mg/day. The mean (+/- SEM) daily doses reached were 124 +/- 9 mg (range, 50-250 mg) of imipramine and 109 +/- 8 mg (range, 25-200 mg) of clomipramine. At the end of the trial, the number of panic attacks as well as the anxiety between attacks (measured using the Hamilton Rating Scale for Anxiety) were markedly reduced in patients treated with either of the two antidepressant drugs, but only slightly decreased in patients on placebo. With respect to all major outcome parameters, i.e., full panic attacks, total number of anxiety attacks (full plus mild), and anxiety between attacks, the effect of clomipramine was clearly and significantly superior to that of imipramine (p less than 0.001, p less than 0.002, and p less than 0.002, respectively). Moderate intake of diazepam was allowed; in the clomipramine group (p less than 0.006), but neither in the imipramine group nor in the placebo group, a significant decrement in diazepam intake was observed during the course of the trial. The finding that clomipramine may have a higher potency and/or efficacy than imipramine in the treatment of panic disorder supports the concept that the antipanic effect of antidepressant drugs is due to the influence of these compounds on serotonergic rather than noradrenergic neurotransmission.

Adult↗
PubMed1991

Higher postdexamethasone serum cortisol levels in agoraphobic than in nonagoraphobic panic disorder patients.

The dexamethasone suppression test (DST) was performed in panic disorder (PD) patients with (n = 32) or without (n = 31) agoraphobia and in normal controls (n = 49). Postdexamethasone serum cortisol levels were significantly higher in agoraphobic PD patients (105.3 +/- 19.3 nmol/L) both when compared to PD patients without agoraphobia (47.3 +/- 7.7 nmol/L; p less than 0.01) and when compared to healthy controls (51.7 +/- 8.3 nmol/L; p less than 0.01). The rate of nonsuppressors (i.e., subjects displaying postdexamethasone cortisol levels greater than 138 nmol/L) was 28% and 3% in agoraphobic and nonagoraphobic PD patients, respectively, and 12% in controls. In patients, the postdexamethasone cortisol levels did not correlate with the number of panic attacks per week, baseline anxiety as measured using the Hamilton Anxiety Scale, depressive symptoms as measured using the Montgomery-Asberg Depression scale, or duration of illness. Data from eight patients in whom a second DST was performed after treatment with imipramine or clomipramine for three months indicate that a marked reduction of the number of anxiety attacks is not necessarily accompanied by a normalization of a pathological DST. In conclusion, it is suggested that the elevated postdexamethasone cortisol levels sometimes observed in agoraphobic PD patients are more closely related to the agoraphobic behavior than to the panic attacks per se.

Adult↗
PubMed1991

Cerebrospinal fluid levels of monoamine metabolites in panic disorder.

The cerebrospinal fluid (CSF) levels of the serotonin metabolite 5-hydroxyindoleacetic acid (5HIAA), the noradrenaline metabolite 3-methoxy-4-hydroxyphenylglycol (MHPG), and the dopamine metabolite homovanillic acid (HVA) did not differ significantly in a group of patients with panic disorder (n = 17) as compared to age- and sex-matched normal controls (n = 17). While CSF concentrations of HVA and 5HIAA were significantly correlated in both patients and controls, CSF MHPG levels were significantly correlated with the concentrations of CSF 5HIAA and HVA only in patients. In a small number of subjects (n = 5), successful reduction of anxiety attacks by administration of clomipramine or imipramine (50-150 mg/day) for at least 2 months was associated with a significant decrease in CSF concentrations of 5HIAA and MHPG, but not HVA.

Adult↗
PubMed1990

Effect of clomipramine on premenstrual syndrome.

Clomipramine (25-50 mg) was administered daily for 5 consecutive menstrual cycles to 5 nondepressed women with severe premenstrual irritability and sadness. All subjects reported a dramatic reduction in premenstrual complaints.

Adult↗
PubMed1989

Increased cerebrospinal fluid levels of endorphin immunoreactivity in panic disorder.

Cerebrospinal fluid (CSF) concentrations of beta-endorphin-like immunoreactivity (END-IR) were determined in 11 female and 6 male patients fulfilling the diagnostic criteria of panic disorder (PD) and in matched controls. Eleven of the PD patients had been taking moderate doses of benzodiazepines (BZD) irregularly without satisfactory effect against the panic attacks while six were totally drug-free. No medication was allowed for at least 24 hours before the lumbar puncture. In six patients a second lumbar puncture was performed after 2 to 3 months of treatment with imipramine or clomipramine. In PD patients, CSF levels of END-IR were significantly higher than in controls. Patients that had been taking BZD had somewhat higher concentrations of END-IR than those taking no medication; however, totally drug-free patients also displayed END-IR levels that were significantly higher than in controls. Although they effected a dramatic reduction of the panic attacks, antidepressants did not influence CSF END-IR concentrations.

Adult↗
PubMed1988

Effects of sex steroids on growth hormone responses to clonidine and GHRH in reserpine pretreated rats.

Administration of reserpine in a dose causing depletion of brain monoamines led to a complete suppression of the pulsatile secretory pattern of growth hormone (GH) in gonadectomized (GX) as well as in sham-operated male and female rats. In GX animals of both sexes treated with estradiol, but not in those treated with testosterone or dihydrotestosterone (DHT), the reserpine induced inhibition of GH release was partially antagonized. Administration of the alpha 2-adrenoceptor agonist clonidine caused secretion of GH in reserpine pretreated, sham-operated rats. In GX male rats GH responses to clonidine were blunted, while in GX males treated with testosterone or estradiol, but not in those treated with DHT, the responses were restored. In female rats gonadectomy did not significantly affect the GH releasing effect of clonidine. However, administration of estradiol to GX females led to enhanced responses to the alpha 2-agonist. Administration of the GH releasing hormone (GHRH) induced pronounced GH secretion in reserpine pretreated animals of both sexes; this effect was not significantly affected by gonadectomy. In GX males, however, GH responses to GHRH were enhanced by replacement with estradiol or testosterone, while in GX females, estradiol, but not testosterone, had the same effect.

Animals↗
PubMed1988

Growth hormone responses to the alpha 2-adrenoceptor agonist guanfacine and to growth hormone releasing hormone in depressed patients and controls.

Growth hormone (GH) responses to the alpha 2-adrenoceptor agonist guanfacine and to GH releasing hormone (GHRH) were measured in 13 patients fulfilling Research Diagnostic Criteria and DSM-III criteria for major depressive disorder and in 13 controls matched for age and sex. Dexamethasone suppression tests were performed in all subjects. The peak GH response to guanfacine correlated to the peak GH response to GHRH both in depressed patients and in controls. Neither the response to guanfacine nor the response to GHRH was significantly lower in depressed patients than in controls. Dexamethasone suppression tests, which were performed about 3 days before the GH stimulation tests, were abnormal in 61% (8/13) of the depressed patients but in none of the controls. No difference between dexamethasone suppressors and nonsuppressors with respect to GH response to guanfacine or GHRH was observed. The data are discussed in relation to the blunted GH response to clonidine described in depression.

Adrenergic alpha-Agonists↗
PubMed1987

Serotonergic influence on the growth hormone response to clonidine in rat.

Administration of the alpha 2-adrenoceptor agonist clonidine induces growth hormone (GH) release in rat and man. In the present study it is shown that the GH response to clonidine is weaker in rats exposed to depletion of both noradrenaline and serotonin (by means of reserpine or the combined treatment of FLA-63 and PCPA) than in animals exposed to noradrenaline depletion (by means of FLA-63) only. The possibility that an impaired serotonergic neurotransmission contributes to the blunted GH responses to clonidine observed in patients suffering from endogenous depression is discussed.

Animals↗
PubMed1987

A double-blind evaluation of electroconvulsive therapy in Parkinson's disease with "on-off" phenomena.

Eleven patients with severe Parkinson's disease and on-off-phenomena were included in a controlled double-blind study on the effect of electroconvulsive therapy (ECT). Pharmacological treatment was optimally adjusted before the trial. The severity of extrapyramidal symptoms was measured before, during and after the treatment. The patients were randomly allocated into one group, receiving active ECT and another, receiving sham treatment. The patients given active ECT showed significantly (P less than 0.05) prolonged duration of "on"-phases after ECT, in comparison to the sham-treated group. When collecting data from the controlled part of the study and the subsequent with open administration of ECT, the treatment was in addition found to significantly decrease the time and number of steps required to walk 10 meters. Moreover it reduced the severity of parkinsonian symptoms according to the Webster scale. The improvement induced by ECT was generally short-lasting. Lumbar punctures were performed before and after ECT. The concentrations of monoamine metabolites in cerebrospinal fluid were not affected by the treatment. The results indicate that ECT has an antiparkinsonian effect which probably is mediated via changed responsiveness of dopamine receptors and that further improvement is possible in patients, therapy resistant to the presently available medication.

Aged↗
PubMed1987

Antidepressant drugs in anxiety disorders.

The efficacy of tricyclic antidepressants and monoamine oxidase inhibitors (MAOI) in the treatment of panic syndromes (panic disorder and agoraphobia with panic attacks) and obsessive-compulsive disorders is reviewed. Imipramine has been reported as significantly more effective against panic attacks than placebo or other psychoactive drugs in 12 of 16 studies. Clomipramine has been found superior to placebo or other psychoactive drugs in 5 controlled studies. The effectiveness of these drugs is also reflected in a large number of open trials. The MAOI phenelzine has been reported to be effective in 5 controlled studies. Clomipramine is the best documented drug in the treatment of obsessive-compulsive disorders. Its effectiveness has been documented in 7 controlled studies. Most investigators consider the effects in panic syndromes as well as in obsessive-compulsive disorders to be unrelated to the antidepressant effect.

Antidepressive Agents↗
PubMed1983

Dopamine receptors involved in prolactin secretion pharmacologically characterized by means of 3-PPP enantiomers.

3-(3-Hydroxyphenyl)-N-n-propylpiperidine (3-PPP) is a novel compound existing in two enantiomers which, as judged by recent biochemical and behavioural studies, both have clearcut though differential effects on central dopamine (DA) receptors. Thus, while both enantiomers act in low doses as agonists preferentially on autoreceptors, in higher doses the (+)-form is an agonist also postsynaptically while the (-)-form acts as an antagonist on postsynaptic DA receptors in the striatum and in the limbic system. In the present study both enantiomers were evaluated with respect to their effects on pituitary DA receptors involved in prolactin release. In previously untreated rats, no increase in prolactin release was observed after administration of either enantiomer in low or high doses. The lack of effect of high doses of the (-)-form indicates that DA receptors on the lactotrophs are pharmacologically different from postsynaptic DA receptors in nigrostriatal and mesolimbic systems. The finding that both enantiomers exerted a dose-dependent prolactin suppressive effect in reserpine-pretreated animals suggests instead that DA receptors on the lactotrophs are pharmacologically similar to DA autoreceptors in the brain. The effect of both 3-PPP enantiomers on prolactin release in reserpine-pretreated animals was antagonized by haloperidol, sulpiride and metoclopramide while pimozide and clozapine appeared less active. This finding is discussed with respect to possible selectivity on pre- vs. postsynaptic DA receptors for various antagonists.

Animals↗