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Biomedical subjects

R Sovner

Publications and source records attributed to R Sovner.

At least 37 records · Page 2Linked to original sources

The use of valproate in the treatment of mentally retarded persons with typical and atypical bipolar disorders.

The author reports five cases of bipolar disorder in mentally retarded adults that were managed by treating the patients with divalproex sodium, a valproate derivative. Two patients had chronic mania (one of whom had Fragile X syndrome), two patients had rapid cycling illness (one of whom had an autistic disorder), and one patient had a classic bipolar disorder superimposed on an autistic disorder. Four of the patients had marked responses to valproate and the fifth patient had a moderate response. Valproate blood levels were within the usual therapeutic range of 50 micrograms/mL to 100 micrograms/mL. These results demonstrate the effectiveness of valproate in the treatment of mentally retarded patients with typical and atypical bipolar disorders.

Adult↗

Buspirone therapy for maladaptive behavior and anxiety in developmentally disabled persons.

The authors used buspirone, a new anxiolytic agent that has a low side effect profile, to treat 14 developmentally disabled individuals who demonstrated anxiety as well as aggressive and self-injurious behaviors. Nine of the 14 individuals responded favorably to the drug. The authors present case reports for 3 of the responders and discuss the clinical implications of buspirone therapy.

Adjustment Disorders↗

Anticholinergic challenge and neuroleptic withdrawal. Changes in dyskinesia and symptom measures.

Benztropine mesylate (intravenous [IV] and oral) challenge was compared with brief neuroleptic withdrawal on dyskinesia ratings and symptom measures. Thirty-six neuroleptic-treated patients underwent a placebo-controlled acute IV challenge with 2 mg benztropine and a placebo-controlled two-week trial of oral benztropine mesylate (2 mg three times a day), followed by a double-blind placebo-controlled neuroleptic withdrawal involving four weeks of dose tapering and six weeks of placebo treatment. Benztropine given IV had no significant effect. Orally administered benztropine, however, led to statistically significant increases in dyskinesia and dysphoric mood. The brief neuroleptic withdrawal significantly increased dyskinesia scores and dysphoria and resulted in early termination of therapy in 12 of 36 patients (33%) due to symptom exacerbation. There was a striking absence of correlation between dyskinesia change measures brought about by benztropine and changes following neuroleptic withdrawal. Therefore anticholinergic challenge does not appear to be a fruitful procedure for identifying patients with covert dyskinesia.

Administration, Oral↗

Do the mentally retarded suffer from affective illness?

Twenty-five published reports were reviewed regarding the occurrence of affective illness, ie, depression and mania, in mentally retarded individuals, using the DSM-III criteria to assess the validity of both diagnoses. Individuals with mental retardation (MR) were found to manifest the full range of affective disorders. Developmentally impaired social functioning and intelligence influence the clinical presentation, but not the development, of affective symptomatology. Affective disorder diagnoses can be made for patients with all levels of MR severity. In individuals with MR of mild and moderate severity, the diagnosis can be made using standard DSM-III criteria. For those with severe and profound MR, a clinically useful diagnosis can be based on changes in behavior and vegetative functioning, as well as family history of affective illness. The psychiatrically symptomatic person with MR should always be evaluated for affective symptomatology and be considered as a candidate for the full range of treatments, including psychotherapy and pharmacotherapy with antidepressants as well as lithium carbonate.

Adolescent↗

Anorgasmia associated with imipramine but not desipramine: case report.

A case of imipramine-induced orgasmic inhibition in a woman is reported. Desipramine, the metabolite of imipramine, did not produce this reaction. The ability of imipramine to block the CNS neuronal reuptake of serotonin (a property not shared by desipramine) is considered the probable pathophysiologic mechanism in the failure to achieve orgasm.

Desipramine↗

The management of chronic behavior disorders in mentally retarded adults with lithium carbonate.

The authors review the medical literature and present two case histories regarding the efficacy of lithium carbonate in the treatment of chronic behavior disorders in mentally retarded adults. They conclude that the available data lend tentative support for the use of lithium to manage behavior disorders in retarded individuals which are characterized by lifelong hyperactivity, aggressiveness, and/or self-mutilation. They recommend that, when lithium is used for this indication, a blood level of approximately 1.0 mEq/1 is necessary, and that all patients be given a drug-free trial once a therapeutic effect has been achieved in order to assess the continued need for treatment. Etiological issues, a possible mechanism of action involving lithium's effect on CNS serotonergic activity, and areas for future research are discussed.

Adult↗

Anorexia nervosa and mental retardation: a case report.

This is the first published report of a retarded individual developing anorexia nervosa. The authors discuss the interaction between subnormal intelligence and the presentation of anorexic symptomatology. They also discuss the relationship between this disorder and depression. Anorexia nervosa may not be uncommon in retarded adolescents but may go undiagnosed because of the belief that mentally retarded individuals do not develop this disorder.

Adolescent↗