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Biomedical subjects

R R Monroe

Publications and source records attributed to R R Monroe.

11 recordsLinked to original sources
PubMed1991

TV and ECT.

Explore the source record for details and available documents.

Depressive Disorder↗
PubMed1991

Maintenance electroconvulsive therapy.

Maintenance electroconvulsive therapy remains an infrequently used and insufficiently researched treatment for the prevention of relapse and recurrence of affective illnesses. The foundation for this treatment is examined by reviewing the relevant scientific literature, with particular attention to identifying those patients who may benefit most from this form of therapy, as well as establishing standard techniques of application. A critical assessment of current research is made, and areas for future investigation are proposed.

Electroconvulsive Therapy↗
PubMed1975

Anticonvulsants in the treatment of aggression.

A significant number of violent acts are committed by individuals in whom central nervous system instability can be demonstrated by special electroencephalographic (EEG) activation procedures utilizing alpha-chloralose as the activating agent. Furthermore, subcortical electrograms suggest that this instability is related to a circumscribed ictal phenomenon in the limbic system. The abruptness of the aggressive act, the fact that the behavior is so often out of character for the individual and inappropriate for the situation, as well as the confusion and partial amnesia which accompany these episodes lend clinical support for the ictal hypothesis. Some anticonvulsants not only block the activated abnormalities on the EEG but also lead to dramatic clinical improvement in those individuals showing repeated and frequent aggressive behavior. For instance, in one study 46.7 percent and 53.3 per cent of the patients demonstrated activated abnormalities on no drug and placebo, respectively. When these same patients were receiving chlorpormazine or trifluoperazine, the activation rates were 60.0 per cent and 73.3 per cent, respectively. On the other hand, when these same patients were placed on a regimen of chlordiazepoxide the activation rate was reduced to 20 per cent (p smaller than or equal to .01). Another study involved severely distrubed chronically hospitalized psychotic patients whose aggressive uncontrolled outbursts relegated then not only to a locked ward, but often to isolation rooms despite high doses of phenothiazines. A regimen of chlordiazepoxide and

Adult↗
PubMedDate not supplied

Dyscontrol syndrome: long-term follow-up.

This is a 38- to 57-month follow-up of 50 patients referred for drug-activated electroencephalograms (EEG) because of the suspicion that a limbic complex partial seizure was a crucial mechanism behind their episodic behavior. Hence, an anticonvulsant regimen might be an effective therapeutic option. The primary referral diagnoses were intermittent explosive disorder (N = 33) panic disorder (N = 6), or formes frustes of epilepsy (N = 11). None of the patients had a significant history of typical seizures and previous routine EEGs had all been normal. Twenty nine patients also had a second axis I and three a second axis II diagnosis. On the basis of EEG findings, as well as a symptom checklist of dyscontrol behavior and a history of episodic disorders, I recommended an anticonvulsant regimen in 39 patients; this was initiated by the referring psychiatrist in 25. Of the 11 patients for whom no anticonvulsant was recommended, three were nevertheless placed on such a regimen. At the end of the follow-up period, 12 patients were still on this regimen, eight were on other regimens that probably raised seizural thresholds, and 10 were treated with antidepressants, antimanic, antipsychotic, or anti-anxiety medications. Twenty were not receiving any medication. An analysis of the diagnostic procedure and the response to the various regimens, including psychotherapy, did not demonstrate any reliable data that would aid the clinician in selecting the appropriate regimen. However, of the 20 patients on regimens that raised seizural threshold, 10 reported marked and six reported moderate improvement.

Adult↗