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Biomedical subjects

R Elie

Publications and source records attributed to R Elie.

At least 37 records · Page 2Linked to original sources
PubMed1992

Effect of trimipramine on depolarization-induced and Na(+)-Ca2+ exchange-induced 45calcium uptake in synaptosomes from the cortex of the rat brain.

The present study examined the inhibition of synaptosomal uptake of 45calcium by racemic trimipramine and nortrimipramine and by enantiomers of trimipramine. Trimipramine, nortrimipramine, (+)-trimipramine and (-)-trimipramine inhibited the net K(+)-induced uptake of 45calcium with IC50 values of 31, 39, 17 and 95 microM, respectively. No significant difference could be detected between the parent compound trimipramine and the metabolite nortrimipramine; however, the levorotatory isomer had an IC50 value significantly larger than the dextrorotatory isomer. At normal therapeutic doses, a 25-40% inhibition of net K(+)-induced uptake of 45calcium, could be expected with trimipramine or 30-50% inhibition for trimipramine and nortrimipramine combined; these data, therefore, do not exclude the possibility that inhibition of voltage-dependent calcium channels could contribute to the therapeutic effect of trimipramine. The order of potency of stereoisomers of trimipramine, for inhibition of calcium channels, was the same as their reported order of potency in the clinic; this parallelism adds support to the possible involvement of blockade of calcium channels in the antidepressant effect. With respect to uptake of 45calcium induced by the Na(+)-Ca2+ exchange process, all drugs inhibited this mechanism with a similar potency (IC50 74-91 microM); the drugs are not expected to have a significant effect on this exchange process, at therapeutic antidepressant doses.

Animals↗
PubMed1991

Muscular response to the therapist and symptomatic improvement during biofeedback for tension headache.

The relationship between muscular response to the therapist's presence and symptomatic improvement was studied during biofeedback. Thirty-two patients suffering from tension headaches received muscular biofeedback training of six sessions plus a follow-up session two months later. Patients' electro-myographic frontal response was measured prior to treatment both with and without the therapist present. A relationship was found between symptomatic improvement at follow-up and muscular response to the therapist's presence before treatment: patients showing a decrease of at least 10% in muscular tension response to the presence of their future therapist improved more regarding headache intensity than the patients showing increase or smaller variation of their EMG. A significant correlation of .59 was found between the frontal EMG response to therapist presence during the evaluation session and headache improvement at follow-up. The results suggest that the decrease of muscular tension during the first contact with the therapist could be an indicator of good prognosis, possibly because of an immediate positive therapeutic relationship and/or favorable expectancies concerning future benefit of treatment.

Adult↗
PubMed1991

Probable interaction of sodium divalproex with benzodiazepines.

1. After drug discontinuation and 1 week placebo washout, 12 patients with panic disorders received, for 6 weeks, either placebo or sodium divalproex. During 6 consecutive weeks, alternate medication was given. 2. Severity of panic and anxiety attacks was improved only in patients receiving sodium divalproex as a first medication. 3. Protracted benzodiazepine effects may occur in the dichotomous antipanic activity of sodium divalproex.

Adult↗
PubMed1991

Refractory depression: the addition of lithium to fluoxetine or desipramine.

We carried out an open clinical study with 60 consecutive patients suffering from major depression with melancholia who were resistant to anti-depressants. After at least 6 weeks of desipramine (DMI) or fluoxetine (FX) without improvement, lithium carbonate was added to the anti-depressant. Semistructured clinical interviews using the 7-point Clinical Global Impression Scale and 90-item Symptom Checklist were done at baseline and weeks 1, 6 and 14. Following the addition of lithium, more patients on FX improved within the first week than those on DMI. However, with FX, 6 relapses occurred during the 2 months of follow-up and none with DMI. The unified serotonergic and noradrenergic hypothesis for the antidepressant action could be relevant in drug-refractory depression and should be studied further.

Adult↗
PubMed1991

Clinical evaluation of a sustained release compared to a standard formulation of tiaprofenic acid (Surgam) in rheumatoid arthritis: a Canadian multicenter study.

A double blind, randomized, parallel group clinical therapeutic trial, comparing a sustained release formulation with a standard preparation of tiaprofenic acid (Surgam), was performed in 119 patients with rheumatoid arthritis. The sustained release preparation was prescribed as two 300 mg capsules taken once a day, and the standard formulation as one tablet of 300 mg taken twice a day. From baseline up to the 3rd and 6th week of treatment, a statistically significant difference (p less than 0.001) was observed in both treatment groups for all the variables, indicating objective or subjective changes in the clinical signs and symptoms of the patients. For most of these variables, no significant differences were observed between the sustained release and the standard formulations. Also, no significant differences were observed between the 2 formulations in the incidence of side effects and abnormal laboratory findings.

Adult↗
PubMed1991

Panic disorder: vascular evaluation with transcranial Doppler ultrasonography.

Several recent studies have shown neurophysiologic and neuroanatomic abnormalities in panic disorder. This study aimed to assess by transcranial Doppler (TCD) ultrasonography the magnitude of the changes in blood flow during panic attacks induced by intravenous sodium lactate infusion. The subjects consisted of 30 patients with panic disorder (DSM-III-R) and 25 controls; all were between the ages of 18 and 40 years and were right-handed. The flow in the middle cerebral artery was recorded bilaterally before the infusion began (to provide baseline readings) and at 3-minute intervals during the infusion. The patients showed a more rapid acceleration of flow (p less than 0.05) than the controls. Higher maximal velocity and higher variations in velocity (p less than 0.05) were observed in the patients sensitive to lactate but only in the right middle cerebral artery. These results suggest that abnormalities of local cerebrovascular autoregulation occurred in the patients with panic disorder during attacks induced by sodium lactate.

Adult↗
PubMed1990

Temporal lobe abnormalities in panic disorder: an MRI study.

Brain mapping studies have shown abnormal changes in cerebral blood volume and oxygen consumption, or other neurophysiological abnormalities, in panic disorder (PD) patients. Because of these intriguing reports, we decided to assess the neuroanatomical aspects of patients with PD using magnetic resonance imaging (MRI). We included 31 consecutive cases with a diagnosis of PD according to the DSM-III criteria, and 20 controls. All subjects had to be right-handed and between 20 and 40 years of age. The usual exclusion criteria were applied. We carried out the MRI tests with a General Electric Signa Machine operating at 1.5 Tesla. Over 100 images were obtained per patient with an emphasis on assessing temporal lobe. There were no significant differences in age, gender, or weight between the patients and controls. We found a statistically significant higher number of abnormalities in PD patients (40%), as compared with the controls (10%). The most striking findings were focal abnormalities in the temporal lobes: areas of abnormal signal activity, and asymmetric atrophy of the temporal lobe occurred mostly on the right side. These results implicated the limbic system and may prove to be of particular relevance in panic and phobic disorders. However, the significance of our findings remains unknown and challenging. Further MRI studies in PD will be required for a better understanding of the illness.

Adult↗
PubMed1990

The effects of RU-38486 on cervical ripening. Clinical studies.

One hundred eighty pregnant patients, 17 to 39 years old (mean (+)/- SEM: 25.1 (+)/- 0.39), with an amenorrhea of 7 to 12 weeks (mean (+)/- SEM: 9.4 (+)/- 0.10), and requesting a therapeutic abortion, were selected according to general good health and gave their informed consent to the study. Mifepristone (RU-486; Roussel UCLAF, Paris, France) an antiprogestin steroid, was administered at random in doses of 0, 50, 100, 200, 400, or 600 mg. Clinical evaluations and measurements of cervical dilatation were done before the study and repeated at 24 hours after administration of Mifepristone and at 48 hours, at which time the aspiration was performed. Significant increases in cervical dilatation were observed at 48 hours with all doses of Mifepristone above 50 mg. The increases were significantly greater in patients with a gestational age greater than 10 weeks than in those less than 10 weeks' gestational age. Parity had no influence on cervical dilatation at 48 hours. Bleeding was observed significantly more often with 100 to 600 mg doses of Mifepristone than with 0 to 50 mg. No influence of gestational age or parity on bleeding could be detected. Abdominal cramps were reported more frequently with 200, 400, and 600 mg of Mifepristone at 48 hours and their occurrence appeared to parallel cervical dilatation.

Abortion, Induced↗
PubMed1990

Zopiclone versus flurazepam in insomnia: prolonged administration and withdrawal.

Zopiclone (7.5 mg), a cyclopyrrolone derivative with a 6.5 h half-life, and flurazepam (30 mg) were compared to placebo in a randomized double-blind study involving 36 adult patients suffering from insomnia. All previous psychotropic drugs were discontinued 1 week prior to the study. During 4 weeks, 12 patients received zopiclone, 12 flurazepam and the others placebo. Thereafter, all patients received single-blind placebo for 3 nights. Rapidity of sleep onset, sleep duration, frequency of nocturnal awakenings, psychomotor coordination and side-effects were assessed daily with a questionnaire and a symptom checklist. The results of the study suggest that zopiclone 7.5 mg was at least as potent as flurazepam 30 mg in inducing and maintaining sleep. Both drugs maintained their efficacy during the 4 weeks of treatment. However, the two drugs differed in that flurazepam impaired psychomotor coordination whereas zopiclone did not demonstrate daytime protracted effects on psychomotor performance. Upon discontinuation of drug treatment, score values of the different sleep parameters under study returned to the baseline values. Side-effects were mild and consistent with earlier studies.

Adult↗
PubMed1990

Tricyclic antidepressants inhibit voltage-dependent calcium channels and Na(+)-Ca2+ exchange in rat brain cortex synaptosomes.

We have used a resting (5 mM K+) or depolarizing (60 mM K+) choline-based medium, and a nondepolarizing sodium-based or choline-based medium, to characterize the inhibitory potential of tricyclic antidepressants against the voltage-dependent calcium channels or the Na(+)-Ca2+ exchange process, respectively, in synaptosomes from rat brain cortex. Imipramine, desipramine, amitriptyline, and clomipramine inhibited net K(+)-induced 45Ca uptake with similar IC50 values (26-31 microM), and this uptake was also inhibited by diltiazem with an IC50 of 36 microM; these results indicate an inhibition of voltage-dependent calcium channels by tricyclic antidepressants. The net uptake of 45Ca induced by Na(+)-Ca2+ exchange was also inhibited by the four tricyclic antidepressants tested, but not by diltiazem; imipramine (IC50 = 94 microM) was a more potent inhibitor of this process than desipramine (IC50 = 151 microM), and the IC50 values of amitriptyline (107 microM) and clomipramine (97 microM) were similar to that of imipramine. Some degree (approximately 25%) of brain calcium channel blockade could be present at the steady-state concentrations of tricyclic antidepressants expected to occur therapeutic use of these compounds to treat depression or panic disorder.

Animals↗
PubMed1990

Lithium carbonate augmentation of desipramine in refractory depression.

An open clinical study with 20 consecutive outpatients suffering from major depression with melancholia (DSM-III) was carried out. All patients were resistant to desipramine after at least six weeks of treatment. A significant improvement was found in 13 of the 20 patients when lithium carbonate was added. Among the responder patients, five improved in the first week of lithium augmentation, while eight others improved after one week of lithium. The mechanism of action of the lithium augmentation effect in tricyclic-resistant depressed patients is discussed in view of our findings. We suggest that the unified 5-HT/NE hypothesis used in affective disorder could be applied in drug refractory depression.

Depressive Disorder↗
PubMed1990

Efficacy and safety of zopiclone and triazolam in the treatment of geriatric insomniacs.

Most studies with zopiclone, a cyclopyrrolone derivative with a short elimination half life (5 h) have compared its hypnotic activity with that of long elimination half life molecules. In this double-blind study in geriatric patients, drugs were administered during 3 weeks and the therapeutic effects of zopiclone at optimal dosage (5 or 7.5 mg) were compared to those of triazolam (0.125 or 0.25 mg). After a 3 day single-blind washout period, placebo responders were excluded and 48 patients were thereafter treated with either placebo (Tétreault et al., 1965), zopiclone or triazolam (Pegram et al., 1980). The initial dosage was increased when indicated at the end of the first week and kept constant thereafter. At the end of the third week of double-blind treatment, a 4 day single-blind placebo washout was performed to assess drug withdrawal effects. Results confirmed the safety and efficacy of both drugs over placebo during active administration. Hypnotic activity was maximal at 7.5 mg of zopiclone and 0.25 mg of triazolam. Drug efficacy was found constant over the 3 week administration both for triazolam and zopiclone. During withdrawal, no true rebound effect was demonstrated but the active drugs were significantly worse than placebo during the first day for sleep onset duration, sleep soundness and quality of sleep. With triazolam some effects persisted up to the third day of withdrawal.

Aged↗
PubMed1989

Role of the cerebellum in complex human behavior.

Thirty-three outpatient epileptics with normal CT scans (group 1) and 31 patients with cerebellar and brain stem (CBS) atrophy (group 2) were randomly included in this study. There were no significant statistical differences between the groups with regard to age, education, and number of grand mal and other seizures. Statistical analyses showed that group 2 had a longer history of epilepsy with a consequently longer duration of phenytoin (PHT) consumption. Neuropsychological assessment revealed lower performance by this group on the following measures: full I.Q. scale, verbal I.Q. scale, performance I.Q. scale, information, arithmetic, block design, object assembly, digit symbol, Stroop test forms I and II, the B-M dexterity test, and the simple visual and auditory reaction time. No significant differences were observed between the two groups for the remaining 5 subtests from the WAIS scale, for the immediate recall and the delayed recall subtests belonging to Wechsler memory scale as well as for visual and auditory movement time. Analysis of the composite scores of neuropsychological performance showed that the cerebellum interferes with the following complex behavioral functions: (i) visuo-spatial organization for a concrete task, a function related to the cerebello-parietal loops' (ii) planning and programming of daily activities, a function related to the cerebello-frontal loops; and (iii) the speed of information processing, a mainly subcortical function.

Adult↗
PubMed1989

A test of the therapeutic mechanism in social skills training with avoidant personality disorder.

Twenty-eight patients meeting the criteria for DSM-III avoidant personality disorder were randomly assigned to two treatment groups consisting each of five sessions of social skills training plus homework and five sessions of group discussion plus homework administered in different order in accordance with a latin-square (crossover) design. Twenty-one subjects completed the study. No significant differences between the treatment groups or treatment modalities (i.e., social skills training and group discussion combined with homework each) were found. Significant improvements in time on most measures were found when data from both groups were amalgamated.

Adult↗
PubMed1989

Perception of early parenting by patients diagnosed avoidant personality disorder: a test of the overprotection hypothesis.

The perceptions of their parents by patients diagnosed avoidant personality disorder (DSM-III) and matched normal subjects were compared. The overprotection hypothesis proposed by Parker was not found to predict the perceptions of patients diagnosed avoidant personality disorder. Social introversion in patients was found to be related to perceptions of their parents as shaming, guilt-engendering and intolerant.

Adolescent↗
PubMed1989

Correlation of severity of panic disorder and neuroanatomical changes on magnetic resonance imaging.

Thirty consecutive lactate-sensitive panic disorder patients were studied with magnetic resonance imaging (MRI) to investigate the relationship between temporal lobe abnormalities and panic disorder. Neuroanatomical abnormalities, most involving the right temporal lobe, were found in 43% of patients, compared with 10% of the control subjects. Patients with temporal lobe abnormalities were significantly younger at the onset of panic disorder and had more panic attacks compared with patients with normal MRI scans (p less than .05). These results suggest that panic disorder could be secondary to temporal lobe dysfunctions and that panic disorder patients with abnormal MRIs could have a worse prognosis than those with normal MRIs and would require long-term pharmacological treatment.

Adult↗