PubMed Health⌕ Search

Biomedical subjects

T Rechlin

Publications and source records attributed to T Rechlin.

35 records · Page 2Linked to original sources
PubMed1994

Heart rate analysis in 24 patients treated with 150 mg amitriptyline per day.

Twenty-four patients treated with 150 mg amitriptyline per day for an episode of major depression underwent a standardized heart rate analysis (HRA) before therapy and after 14 days. The battery of cardiovascular reflex tests included the determination of the coefficient of variation (CV) while resting and during deep respiration, a spectral analysis of heart rate, the heart rate response to standing, and the Valsalva manoeuvre. The results of the initial HRA did not differ from a group of 24 normal control subjects matched for age and sex. On day 14 of treatment the patients showed significantly reduced values of heart rate variability in all tests (P < 0.0001), probably due to the anticholinergic side effects of amitriptyline. Heart rate increased from 78.1 to 93.6 bpm on average (P < 0.0001). Abnormal CV at rest was registered in 96% of the patients; during deep respiration 29% showed abnormal CV results. An abnormal spectral analysis was found in 100% of the cases (low frequency peak: 42%, mid-frequency peak: 100%, high frequency peak: 79%). The heart rate response to standing was abnormal in 75% and the Valsalva test in 33% of the cases. Eighty-eight percent of the patients fulfilled the criteria of a cardiovascular autonomic neuropathy under the conditions of amitriptyline therapy. As yet, the consequences of these changes for the patients have not been sufficiently elucidated.

Adult↗
PubMed1994

Are affective disorders associated with alterations of heart rate variability?

A standardized heart rate analysis was carried out in unmedicated patients with major depression, melancholic type (n = 16), panic disorder (n = 16), reactive depression with suicide attempts during the preceding 24 h (n = 16) and in 16 normal control subjects. The investigations included time- and frequency-derived measurements of heart rate variability. In the patients with reactive depression, no differences could be detected as compared with the control group. The patients with panic disorder showed a significantly increased low-frequency band of spectral analysis (P < 0.01) and a marginally significant increment of heart rate (P = 0.05), probably indicating predominance of sympathetic control of heart rate. In the patients with major depression, we found significantly lower values of heart's beat-to-beat intervals and of the high-frequency peak of spectral analysis than in the other groups (P < 0.025), indicating decreased parasympathetic activity.

Adjustment Disorders↗
PubMed1994

Heart rate variability in depressed patients and differential effects of paroxetine and amitriptyline on cardiovascular autonomic functions.

Twenty-four unmedicated patients with episodes of major depression (DSM-III-R) and an age- and sex-matched group of 24 normal subjects underwent a heart rate analysis. The battery of cardiovascular reflex tests included the coefficient of variation while resting (CVr) and during deep breathing (CVdr), a spectral analysis of heart rate variability, the Valsalva test, and the posture index. The depressed patients showed no significant abnormalities in any of the tests as compared to the healthy subjects. The 24 patients were randomly allocated for treatment with either amitriptyline or paroxetine. During treatment with 20 mg paroxetine per day, patients showed no changes in cardiovascular autonomic function tests after 14 days. However, treatment with 150 mg amitriptyline per day decreased all heart rate parameters significantly due to anticholinergic side effects, except heart rate, which increased significantly. As autonomic side effects are a potential hazard of antidepressant therapy, the data suggest that paroxetine is an appropriate antidepressant for cases with pre-existing cardiovascular autonomic neuropathy.

Adult↗
PubMed1994

The effect of amitriptyline, doxepin, fluvoxamine, and paroxetine treatment on heart rate variability.

A total of 32 unmedicated patients with episodes of major depression (DSM-III-R) and 32 normal control subjects matched for age and sex were tested for heart rate variability (R-R variation) while resting and during deep breathing. Compared with the group of healthy subjects, the depressed patients showed no abnormalities before therapy. The patients were randomly allocated for treatment with 150 mg of amitriptyline per day (N = 8), 150 mg of doxepin per day (N = 8), 150 mg of fluvoxamine per day (N = 8), and 20 mg of paroxetine per day (N = 8). During treatment with either amitriptyline or doxepin, the coefficients of variation at rest and during deep breathing, which are largely independent of heart rate, had significantly decreased after 14 days (p = 0.012), whereas patients treated with fluvoxamine or paroxetine showed no significant changes of heart rate variability parameters after 14 days. The implications of these findings are discussed.

Adult↗
PubMed1994

[Partnership status in long-term home ventilation of amyotrophic lateral sclerosis patients].

Described is the development of the intrapartnership dynamics in a case of home ventilation of a spouse having amyotrophic lateral sclerosis. Led in a heated manner until recently, the ethical discussion on the pros and cons of long-term (home) ventilation could be greatly enriched by introducing relevant systemic views and reasoning. So far, however, there are no published observations in this field.

Amyotrophic Lateral Sclerosis↗
PubMed1994

[Disorders of autonomic heart rate regulation in patients with brain stem lesions].

The present study investigates the frequency of alterations of autonomic cardiac innervation in patients with brain stem lesions by testing cardio-vascular reflexes tests. In the neurological ICU, we tested 22 patients aged 19 to 78 years (mean age 54 +/- 17 years) suffering from ischemic brain stem lesions. The variability of heart rate was at first evaluated at rest. Mean heart rate, coefficient of variation (VK) and RMSSD (root mean square of successive differences) were calculated. In addition, a spectral analysis of the heart frequency was computed by a fast fourier transformation and the spectral powers in the frequency bands 0.02-0.09 Hz, 0.09-0.15 Hz and 0.20-0.30 Hz, respectively were determined. An atropine test was then carried out. 5 minutes after the beginning of injection of atropine sulfate, further rate and spectral analyses were again computed. The VK was pathologically diminished in 59% of the patients, the RMSSD in 55% and both, VK and RMSSD, in 45%. In 32% of the patients VK and RMSSD were within normal range. Spectral power was diminished in all three frequency bands in 4 out of 22 patients with pathological heart rate variability. Most abnormal results in spectral analysis could be obtained in the frequency band 0.09-0.15 Hz (73%), followed by the frequency band 0.20-0.30 Hz (45%) and the 0.02-0.09 Hz frequency band (32%). There were significant correlations between the heart rate variability; the spectral power in the 0.09-0.15 Hz and 0.20-0.30 Hz frequency bands (p < 0.05; Spearman). 88% of the patients with abnormal results at rest had diminished heart rate responses to atropine.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Neurotoxicity of solvent mixtures in spray painters. II. Neurologic, psychiatric, psychological, and neuroradiologic findings.

A multidisciplinary cross-sectional study was performed to examine the chronic neurotoxicity of organic solvents. Participating in the study were 105 persons employed as spray painters and having long-term solvent exposure (10-44 years) and a control group consisting of 58 construction workers, electricians, and plumbers without occupational contact to solvents. Samples were matched for age, preexposure intelligence level, occupation, and socioeconomic status. After controlling for potentially non occupational confounding factors (neuropsychiatric diseases, metabolic disorders, high blood pressure, alcohol intake) 83 spray painters and 42 controls were entered finally into the study. The evaluation included work history, self-rating questionnaire, neurologic investigation, psychiatric analysis using the Present State Examination (PSE), psychological testing, and computerized axial tomography (CAT) of the brain. Physical and neurologic examinations demonstrated no case of overt disorders of the central or peripheral nervous system. An important result of the psychiatric analysis was that the syndromes "special features of depression" and "loss of interest and concentration" occurred significantly more frequently among spray painters than among controls. Further analyses demonstrated an association with chronic exposure over 30 years and repeated acute neurotoxic effects during solvent exposures. Neither psychological nor performance tests demonstrated any statistically significant differences in the performance sets after adjustment according to premorbid intelligence level; this finding supports the presumption of only a low grade of mental dysfunction. Correlation analyses indicated a relationship between subjective health complaints and long-term solvent exposure; however, the effect of age cannot be completely ruled out.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[Empirical findings with arson offenders].

Forensic, psychological and psychopathological findings on 40 arsonists, who were investigated in our psychiatric department between 1980 and 1990, are presented. The findings indicate that arsonists represent a diagnostically heterogeneous group of offenders. On the other hand, some common psychodynamic patterns can be seen; in particular, a high degree of suicidal and autoaggressive behaviour. As reported by other authors, arsonists appear to suffer from a disorder of impulse control. A historical review illustrates that since the mid-19th century a purely psychopathological model of pyromania has been found unsatisfactory, and suggests that psychodynamic aspects should not be over-emphasized. Analysis of the different motivation and abnormalities of arsonists could render the term pyromania obsolete. This requires however a radical reappraisal of the significance of psychiatric diagnosis within an anthropological framework.

Alcoholism↗
PubMed1991

Benzodiazepine dependence: detoxification under standardized conditions.

In an analysis of the withdrawal syndrome of 12 patients dependent on benzodiazepines (BZD), important factors such as underlying psychiatric disease, precipitating life events, complaints leading to BZD use, and also positive and negative psychological and social consequences, duration of intake, dose and type of BZD dependence are discussed. Withdrawal was completed under standardized inpatient conditions reducing the BZD dose to 50% of the previous dose once every 5 days and maintaining control through regular measurements of the BZD urine concentrations. The course of the somatic, psychological and perceptual withdrawal phenomena was documented according to Lader's BZD withdrawal symptom checklist (Lader, M. (1983) J. Clin. Psychiatry 44, 121-127). The reduction scheme proved to be safe and efficient; no major withdrawal syndromes developed. Abstinence phenomena largely disappeared within 10 days of discontinuation.

Adult↗
PubMed1991

[Successful treatment of the neuroleptic malignant syndrome using i.v. dantrolene sodium in the neurologic intensive care station].

The neuroleptic malignant syndrome (NMS) is one of the most dramatic psychiatric disorders every doctor in intensive care medicine can be confronted with. Two cases of successful treatment of NMS with intravenous application of dantrolene are presented. Although we used two very different doses, the treatment results were the same. Further studies will therefore be necessary to assess the optimal doses for this therapy.

Adult↗
PubMed1990

[Self-administration of drugs in an open psychiatric unit].

In 65% of the rehabilitation wards on Bavarian psychiatric hospitals, medication is not distributed by nurses but is collected by the patients in the nurses' room. For 159 patients, data on their reliability in this procedure were obtained. Patients generally come for their medication with considerable reliability. Patients suffering from schizophrenia were unreliable during the first week of treatment. During the last week of treatment, however, their reliability improved. The improvement of reliability was high for patients of higher education, productive psychotic symptoms at the beginning of the treatment, good response to neuroleptic medication, or first manifestation of the disease. The system of patients coming for their medication is a method of training self-responsible medication intake. The reliability of the patients' participation can be interpreted as a measure of their compliance.

Humans↗