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Biomedical subjects

M Fava

Publications and source records attributed to M Fava.

At least 163 records · Page 9Linked to original sources

Neuroendocrine effects of S-adenosyl-L-methionine, a novel putative antidepressant.

S-adenosyl-L-methionine (SAMe), a putative antidepressant, is a naturally occurring substance whose mechanism of action is still a matter of speculation. It has been recently postulated that SAMe may increase the dopaminergic tone in depressed patients. Since dopamine inhibits both thyrotropin (TSH) and prolactin secretion, we investigated the effects of treatment with SAMe on the TSH and prolactin response to thyrotropin-releasing-hormone (TRH) stimulation in 7 depressed outpatient women (mean age: 46.1 +/- 7.2 years) and 10 depressed outpatient men (mean age: 38.0 +/- 10.0 years) participating in a six-week open study of oral SAMe in the treatment of major depression. At the end of the study, there was a significant reduction after treatment with SAMe in the response of both prolactin and TSH to TRH stimulation in the group of depressed men compared to pre-treatment values. On the other hand, in the group of depressed women, the posttreatment prolactin response to TRH did not appear to change when compared to pre-treatment and the TSH response to TRH challenge tended even to augment slightly after treatment with SAMe. Our results, at least in depressed men, seem to support the hypothesis of a stimulating effect of SAMe on the dopaminergic system.

Administration, Oral↗

The antidepressant potential of oral S-adenosyl-l-methionine.

S-adenosyl-l-methionine (SAMe), a naturally occurring brain metabolite, has previously been found to be effective and tolerated well in parenteral form as a treatment of major depression. To explore the antidepressant potential of oral SAMe, we conducted an open trial in 20 outpatients with major depression, including those with (n = 9) and without (n = 11) prior history of antidepressant nonresponse. The group as a whole significantly improved with oral SAMe: 7 of 11 non-treatment-resistant and 2 of 9 treatment-resistant patients experienced full antidepressant response. Side effects were mild and transient.

Administration, Oral↗

"Anger attacks": possible variants of panic and major depressive disorders.

The authors report a series of illustrative cases in which patients presented with sudden "spells" of anger with physical features that resembled panic attacks but lacked the affects of fear and anxiety. These spells or "attacks" of anger were experienced as uncharacteristic and were inappropriate to the situations in which they occurred. Since treatment of these attacks with antidepressants produced in each case marked improvements in behavior, the authors also formulate some hypotheses as to the nature of these episodes.

Adult↗

Dehydroepiandrosterone-sulfate/cortisol ratio in panic disorder.

We hypothesized that the dehydroepiandrosterone-sulfate (DHEA-S)/cortisol ratio, which has been used as an index of adrenocortical function, would be altered in panic disorder patients and would change after treatment. We evaluated 10 male and 14 female outpatients meeting DSM-III-R criteria for panic disorder. Of these 24 subjects, 13 were treated with clonazepam, 8 were treated with alprazolam, and 3 were treated with placebo as part of a double-blind study. The DHEA-S/cortisol ratio values in the 24 patients with panic disorder (mean = 20.5, SD = 11.6) were significantly higher than those of a group of 60 normal controls (mean = 11.5, SD = 6.01) and were also significantly higher than those of a group of 22 depressed patients (mean = 10.6, SD = 6.33). Although there was no significant difference in the pretreatment DHEA-S/cortisol ratio values between male (mean = 23.6, SD = 11.8) and female (mean = 18.2, SD = 11.3) panic disorder patients, the effects of treatment on this ratio differed between the two sexes. In fact, in the female patients there was a significant decrease in the DHEA-S/cortisol ratio at the end of the study (mean = 15.1, SD = 7.9), while in the male patients there was no significant change in this ratio at the end of the study (mean = 30.2, SD = 21.4). No significant differences were noted between pretreatment and posttreatment DHEA-S/cortisol ratio values in patients treated with alprazolam (n = 8), in patients treated with clonazepam (n = 13), or in patients treated with placebo (n = 3).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Neurochemical abnormalities of anorexia nervosa and bulimia nervosa.

The authors review the research on anorexia nervosa and bulimia nervosa, emphasizing the neurotransmitters and neuromodulators that regulate eating behavior. Anorexia nervosa is associated with changes in the noradrenergic, serotonergic, and opioid systems; bulimia nervosa is accompanied by marked alterations in serotonin and norepinephrine activity. These neurochemical changes may perpetuate pathological eating behavior and may be responsible for several associated psychiatric symptoms, including anxiety and depression. The authors also summarize studies of several drugs that are used in the treatment of eating disorders and are known to modify neurotransmitter activity. Understanding the neurochemistry of eating disorders seems crucial for the rational development of both psychopharmacological and behavioral treatments.

Anorexia Nervosa↗

Childhood's enuresis in the history of women with hyperprolactinemic amenorrhea.

Hyperprolactinemia, or elevated levels of prolactin in blood, is a normal physiologic post-partum response in lactating women. Non-lactating women with hyperprolactinemia often present during the reproductive years since they may have amenorrhea, galactorrhea, or both. Hypersecretion of prolactin is most commonly due to pituitary adenomas. Women with hyperprolactinemic amenorrhea are often quite anxious, depressed and hostile. It has been hypothesized that these psychological symptoms might antecede the onset of hyperprolactinemia and that hyperprolactinemia may be associated with early developmental problems and may be psychogenic in origin. Twenty patients with hyperprolactinemic amenorrhea and twenty-one normoprolactinemic patients with amenorrhea had an interview covering psychiatric history in order to establish whether they had ever met DSM-III criteria for functional nocturnal enuresis at one time during their childhood. While seven out of twenty (35%) patients with hyperprolactinemic amenorrhea were found to have had functional enuresis during their childhood, only two out of twenty-one (9.5%) normoprolactinemic amenorrheic women reported having had functional enuresis. The difference between the two groups was statistically significant (chi-squared: 3.88; p less than 0.05). We postulate that early stress and developmental problems may present in children as psychological distress and functional enuresis and in women as psychological symptoms (e.g., anxiety and depression) and hyperprolactinemic amenorrhea.

Adult↗

Influence of legume intake on biliary lipids and cholesterol saturation in young Chilean men. Identification of a dietary risk factor for cholesterol gallstone formation in a highly prevalent area.

Chileans and North American Indians have one of the highest prevalence rates of cholesterol gallstones in the world. The most common theory to explain this has been the operation of some as yet undefined genetic risk factor in these populations. Searching for some common environmental factor for gallstones in Chileans and North American Indians, we found that beans and other legumes are common foods consumed by both populations. In this study we tested the hypothesis that legume intake may favor the production of biliary cholesterol supersaturation. We studied 20 young men subjected to a diet containing 120 g/day of legumes and a control diet without legumes for a period of 1 mo each. Both diets supplied identical quantities of energy, carbohydrates, protein, total fat, fiber, and cholesterol. Low-density lipoprotein cholesterol concentration decreased by 16% (p less than 0.001) after the legume diet. Biliary cholesterol saturation increased in 19 of the 20 subjects; the mean of the group markedly increased from 110% to 169% (p less than 0.001) after the legume diet. These results are consistent with the hypothesis that legume intake is a potential risk factor for cholesterol gallstone disease.

Adult↗

Hyperprolactinemia and psychological distress in women undergoing chronic hemodialysis.

In order to investigate the possible relationship of hyperprolactinemia to psychological distress in patients undergoing chronic hemodialysis, 19 uremic women were evaluated by a semistructured interview and administered the Kellner Symptom Questionnaire. Group A (10 uremic women with hyperprolactinemia) did not differ significantly in anxiety, depression, somatization and hostility from group B (9 normoprolactinemic uremic women). Both groups rated themselves more depressed and hostile than a normal control group of 10 women, and hyperprolactinemic patients were also significantly more anxious than the normal controls.

Anxiety Disorders↗

Prolactin, cortisol, and antidepressant treatment.

In four depressed patients with abnormal dexamethasone suppression test results before treatment, plasma prolactin levels significantly increased after successful amitriptyline therapy. Such an increase did not take place in five depressed patients with normal dexamethasone suppression test findings.

Adult↗

Neuroendocrine correlates of the type A behavior pattern: a review and new hypotheses.

Various studies have tried to identify the possible neuroendocrine correlates of the action/emotion complex defined as Type A behavior pattern. Type A subjects have been observed quite consistently to respond to laboratory stressors with a greater sympathetic nervous system response than Type B subjects. There also seems to be a trend towards a hyperactivity of the hypothalamic-pituitary-adrenocortical axis in Type A individuals. The clinical relevance of these findings lies in the fact that there is an increasing clinical and laboratory evidence of a pathogenic role of catecholamines in coronary artery disease (CAD) and that some of these neuroendocrine correlates might actually be the mediators of the risk of CAD conferred by the Type A behavior pattern. We hypothesize that dehydroepiandrosterone-sulfate (DHEA-S), an adrenal weak androgen, is inversely correlated with the degree of Type A behavior pattern and this hypothesis seems to be confirmed by the results of a preliminary investigation that we have conducted.

Arousal↗

Giant venous aneurysm associated with hypogastric arteriovenous malformation.

Venous aneurysms are extremely rare. They may be congenital or acquired in origin and occasionally related to arteriovenous communications. A 58-year-old man complained of dull left lower quadrant pain and constipation. On physical examination a soft deep mass was palpated. Ultrasonogram and CT scan revealed a cystic formation in the pelvic cavity. Angiograms disclosed an arteriovenous malformation (AVM) at the pelvic floor draining into a large cavity. The patient was successfully managed by intraoperative selective embolization of the AVM and partial resection of a 10.6 x 8 x 6.7 cm venous aneurysm. The histopathologic studies of the wall confirmed a venous structure. Venous dilatation has been reported in high flow vein grafts, blood access V fistulas and rarely, proximal to traumatic AV fistulas of the lower extremities. The etiology of the present case is probably congenital, being to the best of our knowledge, the first case affecting the hypogastric territory, reported in the English literature.

Aneurysm↗