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Biomedical subjects

P Milln

Publications and source records attributed to P Milln.

10 recordsLinked to original sources
PubMed1985

Does the dexamethasone suppression test predict antidepressant treatment success?

The 1 mg dexamethasone suppression test (DST) was carried out in patients with a major depressive illness in order to establish whether the results of this test, given before antidepressant or ECT treatment, could predict eventual therapeutic outcome. No significant difference could be detected in overall therapeutic improvement between those patients with a normal or abnormal DST response respectively, based on the 50 ng/ml cortisol cut-off point. However, using 100 ng/ml as a cut-off point it was found that patients with an abnormal DST response (i.e. a post-DST plasma cortisol concentration greater than or equal to 100 ng/ml) responded significantly better than those who had a normal DST response. These observations were statistically significant for those patients receiving antidepressants and in the combined treatment groups of those patients receiving either antidepressants or ECT.

Antidepressive Agents↗
PubMed1983

Decreasing lithium dosage reduces morbidity and side-effects during prophylaxis.

In a prospective double-blind trial we examined the affective morbidity and side-effects of 72 patients who were randomly allocated either to continue with their usual dose of lithium or to receive either a 25% or 50% reduction in lithium dosage. Patients who underwent a dosage reduction with consequently lower plasma lithium levels (0.45-0.79 mmol/l) had significantly decreased affective morbidity. Thyroid stimulating hormone levels were also significantly decreased in this group. Total subjective side-effects score and tremor were also reduced. No change in affective morbidity was observed during the trial in patients whose dosage was not altered. These changes were observed in both unipolar and bipolar patients. It was concluded that a once a day dosage with a sustained release lithium preparation that maintained a 12-h plasma level of about 0.6 mmol/l is both more effective and produces less side effects than does conventional dosages.

Bipolar Disorder↗
PubMed1983

Drug plasma levels and platelet 5-HT uptake inhibition during long-term treatment with fluvoxamine or lithium in patients with affective disorders.

1 Plasma levels and platelet 5-HT uptake characteristics were determined at baseline and at various times during a long-term study comparing fluvoxamine and lithium prophylaxis. 2 In the fluvoxamine-treated patients after 12 and 24 weeks of treatment, Km was significantly increased and y, the mean overall uptake, significantly decreased compared to the patients' own baseline values and to lithium treatment. No significant change was noted for Vmax. 3 For fluvoxamine, significant negative relationships were established between the Vmax of platelet 5-HT uptake and plasma levels. 4 The trial had to be discontinued prematurely for some patients due to apparent lack of efficacy, unwanted effects or a combination of both in the fluvoxamine-treated patients. Low plasma levels of fluvoxamine may have contributed to the apparent lack of prophylactic efficacy of the drug. 5 Reference is made to the activity of receptor systems in patients receiving lithium and the consequent changes occurring after the administration of a potent 5-HT re-uptake inhibitor.

Antidepressive Agents↗
PubMed1983

Dexamethasone suppression test in depression and other psychiatric illness.

The prevalence of an abnormal response to the dexamethasone suppression test (DST) was examined in 119 in-patients suffering from a major depressive disorder and in 79 normal controls. Only 11 per cent of controls showed an abnormal DST as against 70 per cent of depressed patients. The specificity of the DST was examined by testing patients with other psychiatric disorders. Abnormal responses were found in one-fifth of a sample of schizophrenics, over one-quarter of abstinent alcoholics, two-fifths of neurotics (including neurotic depressives) and almost half of senile dements. Abnormal DST was also found in 33 per cent of patients receiving prophylactic lithium for recurrent affective disorders.

Adult↗
PubMed1981

Urinary free cortisol and clinical classification of depressive illness.

Urinary free cortisol was measured in 24 patients with primary depressive illness. The patients were classified according to their family history (Winokur's classification) and the Newcastle scale. There was a significant increase in urinary free cortisol (UFC) excretion in patients classified as endogenous on the newcastle scale, but UFC excretion was normal in patients with neurotic depression. No significant relationship between urinary free cortisol and the Winokur classification was observed.

Adult↗
PubMed1981

Lithium continuation therapy following electroconvulsive therapy.

Thirty-eight depressed patients who were treated with ECT were randomly assigned to receive lithium therapy or identical-looking placebo tablets for one year after clinical recovery in a double-blind trial. The patients who received placebo tablets spent an average of 7.8 weeks with an episode of depression (either as in-patients or day-patients) during the year. In comparison, patients who received lithium spent on average 1.7 weeks with an episode (P less than 0.02). The trial confirms the high rate of relapses after ECT and suggests that lithium considerably reduces this morbidity. It is suggested that ECT without continuation therapy is not a satisfactory treatment of depressive illness.

Adult↗