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Biomedical subjects

L Tanum

Publications and source records attributed to L Tanum.

10 recordsLinked to original sources

Serum concentrations of risperidone and 9-OH risperidone following intramuscular injection of long-acting risperidone compared with oral risperidone medication.

OBJECTIVE: To compare serum concentrations of risperidone, 9-hydroxy (OH) risperidone and risperidone plus 9-OH risperidone, as well as the 9-OH risperidone/risperidone ratio in patients receiving depot and oral risperidone. METHOD: Serum concentrations from 78 patients receiving three different doses of risperidone depot were measured and compared with serum concentrations from 82 patients taking three different doses of oral risperidone. RESULTS: Patients receiving risperidone depot had significantly lower serum concentrations of risperidone plus 9-OH risperidone than patients taking oral risperidone. More interestingly, the 9-OH risperidone/risperidone ratio was also significantly lower in patients receiving risperidone depot than in patients taking oral risperidone. CONCLUSION: Serum concentrations of risperidone plus 9-OH risperidone may be a rather poor indication of the antipsychotic efficacy of risperidone unless their ratio is also considered.

Administration, Oral↗

Personality and physical symptoms in nonpsychiatric patients with functional gastrointestinal disorder.

OBJECTIVE: We investigated the relationship between personality and reported pain and somatic distress in patients with functional gastrointestinal disorder (FGD) without psychopathology. METHODS: Fifty-six patients and 55 controls completed Buss-Durkee Hostility Inventory (BDHI), NEO Personality Inventory (NEO-PI), Eysenck Personality Questionnaire (EPQ: N+L scales), and Giessener Physical Complaints Checklist (GBB). Patients also completed McGill Pain Questionnaire (MPQ) and Visual Analogue Scale (VAS) for abdominal pain and target symptom (abdominal distress). RESULTS: Patients displayed significantly higher levels of neuroticism and covert aggression than controls. Number of words chosen (NWC) to describe pain and sensory pain index (MPQ), but not pain intensity on VAS, were predicted by indirect aggression -- and less so by neuroticism -- in females and covert aggression in males (stepwise regression model). Patients reported far more extraintestinal somatic complaints than controls. CONCLUSION: Out of nine dimensions of hostility and five dimensions of personality, only neuroticism and concealed aggression are increased in FGD patients without psychiatric comorbidity compared with healthy controls. These personality traits influence pain reports and should be taken into account when evaluating and treating patients with FGD. Neuroticism and concealed aggression are most likely markers of vulnerability to FGD and not merely reflections of being chronic ill or explained by sample bias secondary to illness behavior.

Abdominal Pain↗

Reboxetine: tolerability and safety profile in patients with major depression.

Since reboxetine acts selectively on the reuptake of noradrenaline, it has a different side-effects profile than drugs acting predominantly on the serotonin reuptake mechanism. Data from patients treated with reboxetine (n = 1503) or placebo/comparator drugs (n = 1027) show that reboxetine has no significant cardiovascular effects, a low potential for drug interactions, causes no significant impairment of cognitive or motor function and no increase in suicidal ideation. In contrast to certain serotonergic drugs, there is no evidence of any withdrawal syndrome upon abrupt discontinuation or tapering of reboxetine treatment. Sexual dysfunction appears in only a small fraction of the patients and mainly with doses higher than 8 mg daily. The rate of discontinuation due to adverse effects with reboxetine was not significantly different from that observed with placebo in short-term studies. The level of efficacy and apparently favourable tolerability profile makes reboxetine an important alternative in the medical treatment of depressive illness.

Adrenergic Uptake Inhibitors↗

Personality traits predict treatment outcome with an antidepressant in patients with functional gastrointestinal disorder.

BACKGROUND: We investigated the relationship between personality traits and response to treatment with the tetracyclic antidepressant mianserin or placebo in patients with functional gastrointestinal disorder (FGD) without psychopathology. METHODS: Forty-eight patients completed the Buss-Durkee Hostility Inventory, Neuroticism Extroversion Openness -Personality Inventory (NEO-PI), and Eysenck Personality Questionnaire (EPQ), neuroticism + lie subscales, before they were consecutively allocated to a 7-week double-blind treatment study with mianserin or placebo. Treatment response to pain and target symptoms were recorded daily with the Visual Analogue Scale and Clinical Global Improvement Scale at every visit. RESULTS: A low level of neuroticism and little concealed aggressiveness predicted treatment outcome with the antidepressant drug mianserin in non-psychiatric patients with FGD. Inversely, moderate to high neuroticism and marked concealed aggressiveness predicted poor response to treatment. These findings were most prominent in women. Personality traits were better predictors of treatment outcome than serotonergic sensitivity assessed with the fenfluramine test. CONCLUSION: Assessment of the personality traits negativism, irritability, aggression, and neuroticism may predict response to drug treatment of FGD even when serotonergic sensitivity is controlled for. If confirmed in future studies, the findings point towards a more differential psychopharmacologic treatment of FGD.

Adult↗

Fenfluramine challenge test predicts outcome in pharmacological treatment of patients with functional gastrointestinal disorder.

We investigated if response to the fenfluramine challenge test could predict outcome in 47 nonpsychiatric patients with chronic functional gastrointestinal disorder (FGD) treated with mianserin, a drug closely related to mirtazepine, or placebo. Sixty milligrams of fenfluramine was given orally in the morning on nonfasting basis. Serum cortisol (COR) and prolactin (PRL) were analyzed at baseline, and after 120, 180, and 240 minutes. Patients were then randomized into a 7-week double-blind treatment trial with mianserin or placebo. Response to treatment with mianserin (76% vs.18% for placebo) was closely linked to a high increase in PRL and COR following a fenfluramine challenge test (positive predictive power=72%). Adding length of illness history increased both positive and negative predictive power to 92%. Our results indicate that the fenfluramine challenge test may be a potentially useful tool to identify nonpsychiatric subjects with FGD, who will most likely respond to treatment with a combined alpha2 and 5HT-2 and -3 antagonist.

Adult↗

Fenfluramine and idiopathic pain: a serotonergic study in non-psychiatric patients with functional gastrointestinal disorder.

BACKGROUND: We investigated prolactin and cortisol response to fenfluramine in non-psychiatric patients with chronic functional gastrointestinal disorder (FGD). METHODS: Sixty milligrams fenfluramine was given orally to 55 subjects without any DSM-III axis-1 psychopathology and 29 healthy control subjects matched for sex and age. Serum cortisol and prolactin levels were analysed at base line and after 120, 180, and 240 min. RESULTS: Fenfluramine challenge induced an increase in mean prolactin and cortisol serum values in both patients and controls. Female patients showed lower base-line values of prolactin and higher delta values of cortisol than controls. Male patients and controls showed very uniform values for all variables. Length of illness history influenced delta cortisol values in both sexes. CONCLUSIONS: The cortisol and prolactin responses to fenfluramine suggest a psychobiologic gender difference with a possible stress-induced central serotonergic dysfunction in female patients but not in male patients. The close relationship between length of illness and delta cortisol may also suggest an increased state of distress in females with chronic functional gastrointestinal disorder.

Adult↗

A new pharmacologic treatment of functional gastrointestinal disorder. A double-blind placebo-controlled study with mianserin.

BACKGROUND: The efficacy of unselected monoamine reuptake inhibitors (tricyclic antidepressants) in the treatment of patients with functional gastrointestinal disorders (FGD) has not been convincingly demonstrated. We investigated the efficacy of an antidepressant (mianserin) with a different receptor profile (combined 5-hydroxytryptamine-2 + 3 and alpha-2 antagonist) in FGD. METHODS: After excluding patients with psychopathology and initial placebo responders from the study, eligible patients (n = 49) were randomized to 7 weeks of double-blind treatment with either mianserin, 120 mg/day, or placebo. Efficacy was assessed by using observer-completed ratings, the Global Improvement Scale, and patient self-ratings, Visual Analog Scale, and Disability Scales. RESULTS: Patients taking mianserin reported less abdominal pain, symptoms of abdominal distress, and functional disability than those given placebo (p < 0.001). The efficacy was significant across different lengths of illness periods and types of functional disorder. There was no major change 4 weeks after tapering. CONCLUSION: Mianserin may be an effective and well-tolerated pharmacologic short-term treatment for functional gastrointestinal disorders in patients with no clinical evidence of psychopathology.

Adolescent↗