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Biomedical subjects

R Narendran

Publications and source records attributed to R Narendran.

12 recordsLinked to original sources
PubMed2001

Olanzapine therapy in treatment-resistant psychotic mood disorders: a long-term follow-up study.

BACKGROUND: Recent studies suggest a role for the atypical antipsychotic olanzapine in the acute treatment of psychotic mood disorders, but long-term data are unavailable. The purpose of this naturalistic study was to determine the long-term effectiveness and tolerability of olanzapine as add-on therapy in psychotic mood disorders. METHOD: Hospital records were reviewed for 125 inpatients at the state psychiatric hospital in Buffalo, N.Y., who received at least 6 weeks of add-on olanzapine treatment for psychotic mood disorders (schizoaffective disorders [bipolar and depressive type], bipolar disorders [I, II, and NOS], and major depressive disorder). A group of schizophrenic patients served as a control group (N = 50). Baseline measures, including age, gender, number of hospitalizations in the 2 years prior to olanzapine treatment, concomitant medications, the Clinical Global Impressions scale (CGI), and the Global Assessment of Functioning-Equivalent (GAF-EQ) and Kennedy Axis V psychological impairment, violence, social skills, and activities of daily living subscale scores, were obtained. Follow-up information was obtained from the patients at least 6 months after initiation of olanzapine or by chart review and discussion with the treating psychiatrist. Patients with a diagnosis of psychotic mood disorders were compared with patients with the non-affective psychotic disorder (schizophrenia) on a variety of outcome measures. RESULTS: Follow-up information was available on 102 patients (82%). Mean follow-up was 15 months; 50 (49%) of the 102 patients remained on olanzapine treatment at follow-up (32 psychotic mood disorder, 18 schizophrenic). The primary reason for discontinuation in both groups was lack of response. Both the psychotic mood disorder and schizophrenic groups had comparable outcomes on the CGI and GAF-EQ. Improvement on the Kennedy Axis V psychological impairment and social skills subscales was seen only in the psychotic mood disorders group (p < .01); both groups showed significant (p < .02) improvement in the violence subscale. Sustained mood-stabilizing effect was evident in only 7/27 (26%) of the psychotic mood disorders patients continuing on add-on olanzapine treatment at follow-up. CONCLUSION: Lack of response was the primary reason for discontinuation of add-on olanzapine in both groups. Mood symptoms predicted a better response to add-on olanzapine in patients with psychotic mood disorders on selective outcome measures. However, only 26% of the patients with psychotic mood disorders sustained a clinically meaningful mood-stabilizing effect with add-on olanzapine treatment at follow-up.

Adult↗
PubMed2000

Methadone detoxification of tramadol dependence.

Tramadol hydrochloride is a centrally acting analgesic with a partial affinity for the opiate receptor (mu), having an analgesic potency estimated to be one tenth that of morphine. While preclinical investigations suggested that abuse liability associated with tramadol use is low, there are increasing numbers of cases reported to the U.S. Food and Drug Administration of abuse, dependence, and withdrawal associated with tramadol use. A case of a patient with tramadol dependence requiring detoxification with methadone is presented. Acute management of significant tramadol dependence has not yet been reported in the literature. Long-term treatment issues are also discussed.

Acute Disease↗
PubMed1999

The adverse effect profile and efficacy of divalproex sodium compared with valproic acid: a pharmacoepidemiology study.

BACKGROUND: Divalproex sodium has been reported to be better tolerated than valproic acid. To our knowledge, no study has examined whether significant differences in the tolerability and efficacy exist between these preparations in psychiatric patients. The objective of the present study was to compare the tolerability and efficacy of divalproex sodium with those of valproic acid in psychiatric inpatients. METHOD: Information gathered retrospectively from the medical records of 150 patients treated with divalproex sodium was compared with that of 150 patients treated with valproic acid. These medical records were photocopied, and any mention of divalproex sodium or valproic acid treatment was concealed. A series of demographic and clinical characteristics were compared. RESULTS: Patients treated with divalproex sodium compared with patients treated with valproic acid were less likely to have gastrointestinal side effects (14.7% vs. 28.7%, p = .003), specifically anorexia (6.0% vs. 14.7%, p = .012), nausea or vomiting (6.7% vs. 16.7%, p = .007), and dyspepsia (11.3% vs. 22.0%, p = .013). Divalproex sodium-treated patients compared with valproic acid-treated patients were less likely to have discontinued their medication because of side effects (4.0% vs. 12.7%, p = .0066). Twelve (63.2%) of 19 patients who discontinued valproic acid because of gastrointestinal side effects were subsequently treated with divalproex sodium, of whom only 2 continued to have gastrointestinal side effects. There were no differences in efficacy between the 2 drugs. CONCLUSION: Divalproex sodium was better tolerated than valproic acid in inpatients with a variety of diagnoses and taking concomitant medications. Patients treated with divalproex sodium compared with patients treated with valproic acid were less likely to experience gastrointestinal side effects and to have discontinued their medication because of an adverse event.

Adolescent↗
PubMed1998

Clinical predictors of acute response with olanzapine in psychotic mood disorders.

BACKGROUND: In controlled studies of patients with schizophrenia, the atypical antipsychotic olanzapine has been shown to be more effective in the treatment of positive and negative symptoms compared with haloperidol at doses of 10 mg/day. However, little is known about the efficacy of olanzapine in patients with psychotic mood disorders. The purpose of this study was to assess the efficacy of olanzapine in the treatment of these psychotic mood disorders in comparison with nonaffective psychotic disorders and to identify clinical factors associated with olanzapine response. METHOD: In a naturalistic setting, by reviewing medical records, we assessed response to olanzapine and factors associated with response to olanzapine in 150 consecutive patients newly treated with the drug at a nonprofit academic psychiatric hospital. RESULTS: Patients displaying a moderate-to-marked response to olanzapine were more likely to be younger; be female; receive a diagnosis of bipolar disorder; and have a shorter duration of illness, shorter length of stay prior to olanzapine, and longer duration of trial. CONCLUSION: Olanzapine may be a useful alternative or adjunctive treatment for patients with bipolar disorder.

Adolescent↗
PubMed1980

5alpha-Androstenone concentrations in sow plasma during the estrous cycle.

Plasma concentrations of 5alpha-androst-16-en-3-one (5alpha-androstenone), the steroid responsible for boar taint, were measured by radioimmuno-assay in eight sows during the estrous cycle. The steroid concentrations ranged from a low of approximately 500 pg/ml to a high of 2.2 ng/ml during the estrous cycle. Noticeable features in the hormone profile of sows sampled, were the decline in the period preceding estrus, comparatively low levels at estrus and an increase post-estrous. Changes in hormone concentrations over the estrous cycle were significant (P<.05). The timing of the changes in 5alpha-androstenone concentrations during the period preceding estrus among the sows studied was not consistent. The physiological significance of the changes in 5alpha-androstenone concentrations during the period preceding estrus among the sows studied was not consistent. The physiological significance of these changes in 5alpha-androstenone concentration seen during the estrous cycle is not clear. Any bearing these changes may have on the malefemale sexual relationship in pigs needs to be further investigated in view of the known pheromonal function of 5alpha-androstenone.

Journal Article↗
PubMed1979

Estrogen and progesterone concentrations in bovine milk during the estrous cycle.

Estrogen and progesterone concentrations in milk during the estrous cycle were estimated in 18 normally cycling Holstein dairy cows. The estrogen and progesterone concentrations in milk during the estrous cycle followed the pattern described for them in blood in the corresponding period. During most of the estrous cycle, estrogen concentration remained at approximately 200 pg/ml and reached a proestrous peak of 360 +/- 127 pg/ml on day 19. The progesterone concentration in milk during the estrous cycle increased to a peak on day 13 (45.5 +/- 6.6 ng/ml) and thereafter declined towards estrus. Estrus detection/prediction based on milk progesterone concentrations appears feasible in view of the significant differences in milk progesterone concentrations between the early luteal (post-ovulatory), luteal and rapid follicular growth periods of the estrous cycle.

Journal Article↗
PubMed1979

Plasma oestrogen, progesterone and other reproductive responses of gilts to photoperiods.

Yorkshire gilts in 18 cool-white fluorescent light with 6 h dark daily and those in 9.0-10.8 h natural light exhibited puberty earlier (165 and 175 days: P less than 0.05) and had more corpora lutea (13.5 and 12.6: P less than 0.05) than those reared in complete darkness (200 days and 11.3 respectively). Weekly samples of plasma showed significant fluctuations of progesterone which confirmed the different times of the first over oestrus (puberty). In all 3 groups total oestrogen concentrations showed a peak at about 135 days. The correlation between oestrogen and progesterone values changed from a positive to a negative value at about 135 days of age. It is suggested that the oestrogen peak marks a time of change in sensitivity of the reproductive system to hormonal feedback.

Animals↗
PubMed1979

Hormonal induction of lactation: estrogen and progesterone in milk.

Estrogen and progesterone in milk during the first 21 days of induced and postpartum lactation in Holstein cows and heifers were estimated by assay procedures. Lactation was induced with estradiol-17 beta and progesterone treatment for 7 days. Estrogen and progesterone in induced lactations differed from concentrations in postpartum lactations. In early lactation estrogen was higher in postpartum milk (521 +/- 103 pg/ml on day 1) than in induced milk (336 +/- 46 pg/ml on day 1), but after day 7 the reverse was true (192 +/- 33 pg/ml and 233 +/- 32 pg/ml on day 7). Progesterone remained higher in induced lactation through the first 21 days than in postpartum lactation with the exception of day 19. Progesterone in postpartum milk increased from 4 +/- 1 ng/ml on day 1 to 11 +/- 2 ng/ml on day 21. Progesterone in induced milk showed greater fluctuation (11 +/- 3 ng/ml on day 1 and 22 +/- 9 ng/ml on day 3) but gradually decreased to 12 +/- 2 ng/ml on day 21 (11 +/- 2 ng/ml on day 21 of postpartum lactation).

Animals↗