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Biomedical subjects

O J Rafaelsen

Publications and source records attributed to O J Rafaelsen.

At least 55 records · Page 3Linked to original sources
PubMed1982

Long-term lithium treatment and psychological functions.

A group of 50 long-term lithium-treated outpatients were investigated with psychological examinations in order to study cognitive and emotional functions (memory, attention, speed, loss of effort, level of processing, productivity, and reactivity). The test results were compared with the general norms for the test applied. In average the test results were within the normal range. The inter-test variations which quantitatively and qualitatively characterize the performance of the lithium-treated patients indicate a relative lowering of the level of memory and perceptual processing as well as loss of effort when compared to the level of attention, productivity, and emotional reactivity. These findings support the hypothesis of a lithium-determined delay of the rate of information processing, a hypothesis which may be related to neuropsychological model of the level of arousal.

Adult↗
PubMed1982

Lithium treatment: does the kidney prefer one daily dose instead of two?

Renal structure and function were investigated in two groups of long-term lithium treated patients. Lithium was administered in two different ways either in a one-dose per day schedule where the whole dose of lithium was given between 8 and 10 p.m. or in a schedule where the lithium dose was given, divided into two or three doses, during the day. Kidney biopsy was performed, and structural changes in the kidney tissue were determined together with 24-h urine volume in the individual patients. The functional as well as the structural changes were most pronounced in patients given their lithium in divided doses during the day. Lithium may be more harmful to the kidney when the lithium administration gives a relatively constant serum lithium level than when the administration causes greater variations including peak values and low minimum levels in serum lithium. The reason for this might be that a number of regenerative processes only occur in periods with low lithium concentrations.

Adult↗
PubMed1982

Lithium effects on calcium, magnesium and phosphate in man: effects on balance, bone mineral content, faecal and urinary excretion.

Calcium, magnesium and phosphate metabolism was studied in lithium-treated patients, using a metabolic balance technique. Two groups of patients participated in the study: 1) Patients who were to start on a prophylactic lithium treatment, and 2) Long-term lithium-treated patients whose treatment was to be terminated. Lithium treatment produced a positive balance in both calcium, phosphate and magnesium. By continuous lithium treatment the effect on magnesium wore off, whereas the effect on calcium and phosphate persisted. In urine, lithium induced a decrease in both calcium and phosphate excretion, whereas the excretion of magnesium was increased. Bone mineral content was measured by photon absorption, and lithium treatment resulted in a decrease in bone mineral content occurring within the first 6 months of lithium treatment. In the patients, bioavailability of the Li2CO3 preparation was found to be about 95%, and the patients contained about one 24-h dose of lithium just before the next dose of lithium was administered.

Biological Availability↗
PubMed1981

Effect of lithium on reaction time--a study of diurnal variations.

Continuous reaction time performance was measured in groups of normal controls, psychiatric controls and patients treated with lithium. The reaction times were slower for the patients treated with lithium compared to both groups of controls, but the performance was not impaired to the same degree as in patients with various forms of cerebral dysfunction. For all groups reaction times were slower in the morning than in the evening or at night. Slow reaction times at the first investigation in the groups of normal and psychiatric controls were positively correlated with larger variations in the 24 h course. However, this correlation could not be demonstrated for patients on lithium treatment, probably because these patients do not approach their limit of speed as often as other patients or controls.

Adolescent↗
PubMed1981

Depression and cerebrospinal fluid citrate.

In relation to studies of calcium metabolism in manic-melancholic patients, the calcium binding metabolite citrate was analyzed in cerebrospinal fluid from 163 psychiatric and non-psychiatric patients. Patients with symptoms of depression, irrespective of whether the origin of the depression was endogenous or exogenous, had significantly higher cerebrospinal fluid citrate concentrations than non-psychiatric patients. Manic patients and other psychiatric patients without symptoms of depression were not significantly different from the non-psychiatric patients. When the mood was normalized after various treatments, cerebrospinal fluid citrate decreased in all groups of depressed patients.

Adult↗
PubMed1981

Saliva secretion following long-term antidepressant treatment with nortriptyline controlled by plasma levels.

Eight patients undergoing antidepressant therapy with nortriptyline for 1--4 years were investigated. The period of the investigation was 7 weeks and included a 2-week placebo period, blind for the patients. Total saliva secretion measurement, the nortriptyline plasma level, and signs and symptoms of depression and side effects were obtained once a week during the study. The results of the investigation were: (1) long-term treatment with nortriptyline is followed by hyposecretion or xerostomia, (2) the reduction of the secretion is reversible, (3) re-establishment of treatment with dosage leading to the same serum level of nortriptyline is immediately followed by a drop in saliva secretion, and (4) the changes in salivary secretion are useful as an indicator of side effects. The practical importance of the investigation is discussed.

Aged↗
PubMed1981

Comparison of peripheral anticholinergic effects of antidepressants: dry mouth.

Twenty-one healthy volunteers were given single doses of placebo or antidepressants corresponding to average daily doses of patient medications. Spontaneous whole mouth and parotid salivation was measured two, six, and ten hours after drug administration in session 1; in session 2 after ten hours. The results indicate that a subdivision of antidepressants into four groups can be made according to inhibitory effect on salivation: (a) isocarboxazide and lithium citrate with no effect, (b) zimelidine and nomifensine with slight effect, (c) imipramine oxide and mianserin with moderate effect and (d) maprotiline, nortriptyline, clomipramine, imipramine, and amitriptyline with pronounced effect. Research implications and predictive value for new antidepressants are discussed.

Adult↗
PubMed1981

[Biological perturbations in affective disorders in man].

The biological evidence in affective disorders is perhaps strongest in the genetic field, where twin studies demonstrate very different concordance rates for monozygotic and dizygotic twins, 60-70 and 10-20 per cent, respectively. Physiological disturbances include low saliva production and reduced REM-latency. Biochemical findings have been many, but few have stood the test of time. In a majority of patients one or more amines or amine-metabolites are reduced in cerebrospinal fluid. The hypophyseal-hypothalamic axis is also involved in affective disorders. In depression, steroid levels are high, particularly due to continued high secretion rates at night, indicating a disturbance of diurnal rhythms. Further support for a hypothalamic dysfunction of the adrenal feedback, system comes from the finding of the lack of suppressibility of plasma steroid levels after dexamethasone in depressed patients. The reduction of growth hormone response to hypoglycemia and of thyrotrophin (TSH) response to thyrotrophin releasing hormone (TRH) lend further support to a more general theory of disturbed feedback mechanisms in affective disorders. The essential, unsolved problem is whether the physiological and biochemical disturbances are causes or consequences of the affective disorders.

Biogenic Amines↗
PubMed1980

Cerebrospinal fluid adrenaline and noradrenaline in depressed patients.

Mean adrenaline concentration in cerebrospinal fluid measured by a sensitive and specific isotope-derivative assay was significantly lower in 15 depressed patients during illness compared with 18 control subjects. At the time of recovery cerebrospinal adrenaline levels had increased markedly to normal levels. Cerebrospinal fluid noradrenaline did not differ in patients compared with controls. The present findings suggest that adrenaline as a neurotransmitter may be involved in affective disorders.

Adult↗
PubMed1980

Blood-brain barrier selectivity and synaptic turnover during delirium tremens and related clinical states. A study of brain and blood proteins in the cerebrospinal fluid.

The synaptic membrane protein D2 was measured in the cerebrospinal fluid (CSF) from patients with delirium tremens and related clinical states immediately after admission to the hospital before treatment was initiated and again after recovery. during this period of on average 5 days duration the concentration of D2 increased to double normal value possible indicating increased breakdown of old synapses during the process of readaptation to the alcohol free state. IgG, albumin and alpha 2-macroglobulin were measured in plasma and in CSF and the results indicated a decreased selectivity of blood-CSF-barrier permeability to proteins in the clinically recovered patients; this was probably due to increased micropinocytotic activity also occurring during readaptation to the alcohol free state.

Albumins↗
PubMed1980

The WHO Depression Scale. Relationship to the Newcastle Scales.

The WHO (World Health Organization) Depression Scale is a new rating scale developed to evaluate the complete clinical history and description of depression. Items of the WHO scale were transformed to cover the items of the two Newcastle scales that are designed to differentiate between endogenous and non-endogenous depressions. In 98 depressed inpatients examined prior to antidepressive therapy only moderate agreement between scores transformed to the two Newcastle scales was found. Also the distribution patterns of the scores on the two scales were different. In patients classified as endogenous on one or both scales a significant relationship between plasma levels of imipramine or clomipramine and antidepressive effect was found. In patients classified on both scales as doubtful - or non-endogenous depressions - no such correlation could be identified. The initial severity of depression, as defined by the Hamilton Depression Scale, was the same in endogenous, doubtful and non-endogenous depression according to the scores transformed to the two Newcastle scales.

Adult↗
PubMed1980

Personality in unipolar and bipolar manic-malancholic patients.

By use of standardized case-recording criteria (MULTI-CLAD) manic-melancholic patients were classified as unipolar (n = 13) and bipolar (n = 23). Personality patterns are evaluated when patients were in neutral mood (defined by low symptom rating scale scores). Results showed that the similarities in the personality patterns of unipolars and bipolars were much pronounced than the differences. In general, the score patterns of the various scales in both groups of patients were found to be within the normal score range. However, this was indirectly expressed by high Lie (or denial) score levels on the Eysenck scale. The dynamic explanations of this form of symptom-denial are discussed. Moreover, our findings are discussed in connection with lithium treatment which was the main therapy the patients had received.

Adult↗
PubMed1980

Hypnagogic and hypnopompic hallucinations during amitriptyline treatment.

Four cases of hypnagogic or hypnopompic visual hallucinations in patients during amitriptyline treatment are reported. The hallucinations were clearly delineated, projected to the outer objective space and were for a short time experienced as real. The patients rapidly realized the unreality of the "sights", probably because they regained the full criticism and coherent thinking of an unpsychotic awake individual. There may be a relation between the effects of amitriptyline in brain, the changed pattern of sleep and the clinical recovery. Patients should be informed about the benign character of this type of hallucinatory phenomena so that treatment is not terminated at an undue time.

Aged↗
PubMed1980

Long-term treatment of depression with isocarboxazide.

Isocarboxazide has been used as long-term treatment for a selected group of 20 depressive patients, of whom some 90% (17/19) were non-responders to treatment with tricyclic antidepressants. At the follow-up the median duration of illness was 162 months, and the median duration of treatment was 42 months. Side-effects and interactions were moderate thus legitimating a treatment procedure on which all the patients of the material responded better than on any other antidepressive treatment. Treatment with monoamine-oxidase-inhibitors, like isocarboxazide, should not be left untried in the case of therapy-resistant depression.

Adult↗