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Biomedical subjects

M Trimble

Publications and source records attributed to M Trimble.

At least 55 records · Page 3Linked to original sources
PubMed1987

Bradyphrenia in Parkinson's disease and psychomotor retardation in depressive illness. An experimental study.

Thirty newly diagnosed patients with Parkinson's disease and 30 patients with primary depressive illness showed slowing of response on a computerized digit symbol substitution test when compared with 30 matched normal control subjects. Significant slowing was related, in the parkinsonian patients, to structural brain disorder and affective impairment and, in the depressed patients, to motor impairment. A second computerized test, cognitively simpler but requiring the same motor response, was also administered to each subject. Both cognitive and motor slowing seemed to contribute to slowing of response in the digit symbol test in both parkinsonian and depressed patients. The tests were repeated after about six months in 12 subjects from each group. The parkinsonian patients, on dopaminergic treatment, showed neither significant change in motor or affective impairment, nor improvement in response time for the digit symbol test, but change in response time was related to change in depression rating. The depressed patients, on conventional treatment, showed significant improvement in both affective and motor impairment and improvement in response time for the digit symbol test, due to improvement in cognitive slowing. It is proposed that bradyphrenia in Parkinson's disease and psychomotor retardation in depressive illness are closely related, and that impairment of dopaminergic systems may be involved in both.

Brain↗
PubMed1984

Abnormal illness behaviour: the nursing contribution.

Patients who suffer from physical symptoms with no apparent organic pathology often receive inappropriate care in the general hospital. Many terms have been used to describe such patients, often derogatory. More careful assessment, systematic description and treatments are required from all staff. In this study a sample (N = 79) of patients with various 'hysterical' complaints, other than pain, were interviewed, and completed a set of psychological instruments to detect any personality or mood disturbance. These data were also collected from two comparison groups from a psychiatric clinic (34) and a neurological setting (36). The main purpose of this study, to identify differences between these groups, was achieved. Patients in the main sample were found to have a high frequency of affective disturbance, being moderately anxious and depressed. Most understood that their problems may have been psychological but had an unrealistic view of their coping strategies and life problems. Nurses in both general and psychiatric settings could have an immensely important role in both identifying such patients and their needs and in providing appropriate guidance and treatments.

Adult↗
PubMed1983

Antidepressant drugs, convulsions and epilepsy.

1 Evidence concerning the convulsant effects of non-monoamine oxidase inhibitor antidepressant drugs has been reviewed. 2 Mianserin is convulsant in therapeutic doses but seizures have not been reported following overdose. 3 The convulsant effects of mianserin are probably no greater than for other non-monoamine oxidase inhibitor antidepressant drugs. 4 Enzyme-inducing anti-epileptic drugs can reduce the peak plasma concentration of mianserin and shorten its elimination half-life, probably by inducing its metabolism.

Antidepressive Agents↗
PubMed1981

Anticonvulsant drugs, behavior, and cognitive abilities.

The literature concerning the relationship of anticonvulsant drugs to disturbances of behavior and cognitive abilities has been reviewed. It is indicated that although completed studies are sparse and although many of the techniques currently used for evaluating the effects os such drugs on patients are inadequate, certain conclusions may be drawn. With regard to the effects on cognitive abilities, the drugs not only impair performance on psychological tests, but some drugs--particularly phenytoin--are associated with a progressive decline of intellectual abilities, which is often insidious and unrecognized. There is little systematic evidence to indicate which anticonvulsant drugs have adverse effects on behavior, but several studies have indicated improvements in behavior associated with carbamazepine and sulthiame. The possible reasons why anticonvulsant drugs should have those effects are discussed, and particularly the relationship of the drugs to abnormal folic acid and monoamine and metabolism are highlighted.

Animals↗
PubMed1981

Phenytoin and cognitive function: effects on normal volunteers and implications for epilepsy.

Despite the widespread use of phenytoin in the treatment of epilepsy, few studies have examined its effects on cognitive functioning. We report here the results of an investigation into the effects of phenytoin on the performance of non-epileptic volunteers, on a series of specially designed psychological tests. Subjects received placebo or phenytoin 300 mg per day for two weeks in a double-blind crossover design and measures were taken of phenytoin serum levels. The results demonstrate a deleterious effect of phenytoin upon several important aspects of cognition, including memory, concentration, mental and motor speed. The implications of our findings for the treatment of patients with epilepsy are discussed.

Adolescent↗
PubMed1979

Personality, sexual adjustment, and brain lesions in patients with conversion symptoms.

To clarify the interrelationships of conversion symptoms, hysterical personality, sexual adjustment, and cerebral organic disorders the authors studied 89 patients with classic motor conversion symptoms (group L) and compared a subgroup of 24 of these patients (group H) with 24 matched control patients (group C). They found hysterical personality in 19% of group L, 21% of group H, and none of group C and passive-immature-dependent personality in 19% of group L, 21% of group H, and none of group C. Forty-eight percent of group L, 50% of group H, and 58% of group C had some cerebral disorder. Patients with conversion symptoms who also had hysterical and passive-immature-dependent personalities were especially likely to have sexual abnormalities.

Adult↗
PubMed1978

Non-monoamine oxidase inhibitor antidepressants and epilepsy: a review.

The literature dealing with the convulsant effects of the antidepressant drugs of the non-monoamine oxidase inhibitor variety is reviews. It is concluded that most of these drugs do lower the seizure threshold and may precipitate seizures even at normal therapeutic doses. The pathophysiology of antidepressant-induced seizures is discussed, and attention is drawn to biochemical differences in those antideprssants that have the least epileptogenic potential or may even be anticonvulsant. The clinical difficulties regarding administration of antidepressant drugs to epileptic patients are mentioned, and some practical advice is offered.

Adult↗
PubMed1978

Manipulation of cerebral monoamines in the treatment of human epilepsy: a pilot study.

The effects of L-DOPA, L-tryptophan, monoamine oxidase inhibitor (MAOI), and MAOI plus L-tryptophan, each for 3 months, have been assessed in 10 severe, adult epileptics with placebo control. There was no overall reduction in seizure frequency, but 2 patients with minor partial seizures improved, 1 with L-DOPA, MAOI, and MAOI plus L-tryptophan, and the other with L-tryptophan and MAOI plus L-tryptophan. We have not been able to demonstrate an increased turnover of cerebral serotonin (5-HT), as measured by cerebrospinal fluid 5-hydroxyindoleacetic acid, after treatment with L-tryptophan for 3 months. This observation casts doubt on the ability of L-tryptophan to alter the long-term metabolism and functional activity of brain 5-HT. The importance of further exploration of manipulation of cerebral monoamines as a possible approach to the treatment of epilepsy is emphasized.

Adult↗
PubMed1977

Seizure activity in photosensitive baboons following antidepressant drugs and the role of serotoninergic mechanisms.

Laboratroy and clinical evidence indicates that tricyclic antidepressants lower seizure threshold and in high doses may induce generalised seizures. In baboons with photosensitive epilepsy (Papio papio) the effects of 2 tricyclic antidepressants (imipramine and chlorimipramine) and of maprotiline and Nomi fensine have been studied (i.v. dose range 1-20 mg/kg. Imipramine, chlorimipramine and maprotiline (10 mg/kg i.v.) lowered seizure threshold to a comparable extent, whereas Nomifensine (10 mg/kg i.v-) did not enhance myoclinic responses to photic stimulation. Generalised seizures were seen 15-30 min after imipramine or chlorimipramine (20 mg/kg), and these two drugs showed no difference in their epileptogenicity. Administration of 5-hydroxytryptophan (25 mg/kg i.v.) 90 min before chlorimipramine or imipramine (10 mg/kg) completely blocked the usual augmentation of photically-induced epileptic responses. It is concluded that enhancement of serotoninergic activity following blockade of 5-HT re-uptake within the brain is unlikely to be responsible for enhanced myoclonic responses and epileptogenic seizures seen after tricyclic antidepressants. Nomifensine is significantly less epileptogenic than imipramine or chlorimipramine.

5-Hydroxytryptophan↗