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Biomedical subjects

S C Dilsaver

Publications and source records attributed to S C Dilsaver.

154 records · Page 9Linked to original sources
PubMed1983

Antidepressant withdrawal syndromes: evidence supporting the cholinergic overdrive hypothesis.

The authors present case examples of the various antidepressant withdrawal syndromes. Substantial evidence supports the contention that these syndromes result from cholinergic overdrive; thus, they may have a common pathophysiological basis. Even paradoxical reactions on antidepressant withdrawal, such as mania, are consistent with the cholinergic overdrive hypothesis. If the cholinergic overdrive hypothesis of affective illness. The cholinergic overdrive hypothesis is both of considerable heuristic value and is further testable by the study of the tonic and phasic aspects of sleep and neuroendocrine parameters in the withdrawal state.

Acetylcholine↗
PubMedDate not supplied

Neurobiologic effects of bright artificial light.

Bright light is an effective treatment of winter depression. Study of the effects of this treatment on mechanisms thought to be involved in the pathophysiology of depressive disorders is reviewed. Measurement of a physiological parameter, namely the change in core temperature using an intraperitoneally implanted radio transmitter sensitive to temperature in freely moving rats, indicates that treatment with bright light under various experimental conditions tends to powerfully subsensitize muscarinic and nicotinic mechanisms. Pulses of bright light during the phase delay portions of the PRC blunt sensitivity to clonidine. Our studies with bright light are consistent with those indicating that heterocyclic antidepressants and a monoamine oxidase inhibitor produce subsensitivity to the thermic effects of nicotine. Reports of the influences of full-spectrum bright light and its impact on targeted neurotransmitter mechanisms call attention to the anatomical substratum mediating its effects. Possible receptor changes are measurable using receptor binding techniques and quantitative autoradiography. The physiological effects of this interesting treatment raises questions of its impact on coupling mechanisms and second messengers.

Amitriptyline↗
PubMedDate not supplied

Efficacy of divalproex vs lithium and placebo in the treatment of mania. The Depakote Mania Study Group.

OBJECTIVE: To compare the effectiveness of divalproex sodium with that of lithium and placebo in patients with acute mania. DESIGN: Randomized, double-blind, parallel-group study of treatment outcomes in patients with manic-depressive illness. PATIENTS: A total of 179 hospitalized, acutely manic patients meeting the Research Diagnostic Criteria for manic disorder, approximately half of whom had been nonresponsive to lithium previously, were studied at nine university-affiliated hospitals. INTERVENTIONS: After a minimum 3-day washout period, random assignment for 21 days to divalproex, lithium, or placebo in a 2:1:2 ratio. Dosage of divalproex and lithium was increased if tolerated to a target concentration of 1041 mumol/L (150 micrograms/mL) or 1.5 mmol/L (conventionally expressed as milliequivalents per liter), respectively. MAIN OUTCOME MEASURES: Primary outcome measures were changes in the Mania Rating scale derived from the Schedule for Affective Disorders and Schizophrenia. RESULTS: Intent-to-treat analysis for efficacy was based on data from 68, 35, and 73 patients in the divalproex, lithium, and placebo groups, respectively. Groups were initially comparable except that all eight patients with four or more manic episodes in the previous year were in the divalproex group. In 30%, 33%, and 51% of the above groups, treatment was prematurely terminated due to lack of efficacy, with fewer premature terminations from divalproex than placebo (P = .017). The proportions of patients improving at least 50% were higher for divalproex and lithium groups than for the placebo group: 48% for divalproex (P = .004) and 49% for lithium (P = .025) vs 25% for placebo. Divalproex was as effective in rapid-cycling manic patients as in other patients. CONCLUSIONS: Both divalproex and lithium were significantly more effective than placebo in reducing the symptoms of acute mania. The efficacy of divalproex appears to be independent of prior responsiveness to lithium.

Acute Disease↗
PubMedDate not supplied

Droperidol in the interim management of severe mania: case reports and literature review.

There is little information in the literature concerning the use of droperidol in psychiatry. This article presents three cases in which extremely agitated and treatment-refractory persons with mixed mania derived benefit from droperidol administered orally. Symptomatic improvement, including decreased agitation and intrusiveness, improved sleep, and decreased rates of sleep, was observed with the use of oral droperidol at doses ranging from 10-80 mg daily. The only adverse reaction was a dystonia in one patient. This article also reviews the limited available literature on the use of droperidol in psychiatry. Only eight English language articles describing the use of droperidol for psychosis or agitation were found. Future controlled studies to examine the usefulness of oral dosing of droperidol in mania are suggested.

Administration, Oral↗