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Thomas Paparrigopoulos

Publications and source records attributed to Thomas Paparrigopoulos.

8 recordsLinked to original sources

Amisulpride-induced hyperprolactinemia is reversible following discontinuation.

BACKGROUND: Although amisulpride is considered to be a prolactin-raising atypical antipsychotic drug, a limited number of studies have documented the extent of its prolactin-elevating properties. In the present study the effect of amisulpride on plasma levels of prolactin and the reversibility of this untoward side effect were investigated. METHODS: 17 patients with various diagnoses received amisulpride (50-800 mg/day) or a combination of amisulpride plus other medication as needed. Plasma prolactin was determined 26.7+/-9.4 days (range: 13-50 days) after initiation of treatment and in 3 cases after a much longer period, and 14-51 days following its withdrawal. RESULTS: All patients on amisulpride had hyperprolactinemia (mean+/-S.D. prolactin levels: 62.5+/-33.0 ng/ml) with females exhibiting considerably higher prolactin levels than males. Following amisulpride discontinuation prolactin levels were significantly (p<000) reduced (mean+/-S.D. prolactin levels: 12.3+/-6.7 ng/ml). No significant correlation was detected between prolactin levels and either amisulpride dosage or duration of administration. CONCLUSION: Amisulpride has a pronounced prolactin-elevating effect which appears to be independent of dosage and duration of administration. Hyperprolactinemia rapidly reverses following amisulpride discontinuation.

Adult↗

Short-term psychological impact on family members of intensive care unit patients.

OBJECTIVE: This study aimed to evaluate the short-term psychological impact on family members of intensive care unit (ICU) patients during their stay in the unit. METHODS: Thirty-two first-degree relatives of patients treated in the ICU of two general hospitals were investigated for symptoms of early posttraumatic stress reaction, anxiety, and depression. Patients' and relatives' sociodemographic data and information pertaining to the patients' ICU treatment were collected. Family members were assessed at intake and before discharge through the Center for Epidemiological Studies Depression Scale, the State-Trait Anxiety Inventory, and the Impact of Event Scale. RESULTS: High rates of anxiety, depressive (97%), and posttraumatic stress (81%) symptoms were recorded at the initial assessment. Although symptoms remitted significantly, 87% and 59% of the sample fulfilled the criteria for a depressive and posttraumatic stress reaction, respectively, at the second assessment. Women exhibited higher levels of distress and more persisting symptoms than men did. Trait anxiety was the most significant predictor (P<.001) of the severity of depressive symptoms and the single predictor of the development of posttraumatic stress reaction (P<.000); also, state anxiety was a predictor of the development of posttraumatic stress symptoms, especially of the female gender. CONCLUSIONS: Family members of ICU patients exhibit high levels of distress that persist throughout their relatives' hospitalization. Women and individuals with high trait anxiety are at increased risk for developing such reactions. Severe early anxiety responses predicted the development of posttraumatic stress symptoms. Early case identification and intervention may prevent the full development of posttraumatic stress disorder.

Adjustment Disorders↗

Melatonin secretion after head injury: a pilot study.

PRIMARY OBJECTIVE: To investigate the circadian rhythm of serum melatonin in patients with traumatic brain injury (TBI) during Intensive Care Unit (ICU) stay and its relationship with core body temperature fluctuations and measures of severity of their condition. METHODS AND PROCEDURES: The pilot study was conducted in the ICU of a general hospital in Athens, Greece. Blood melatonin was determined in eight patients consecutively admitted at the ICU following severe head injury, eight times per day during the first and second day following admission. Core body temperature was recorded at hourly intervals. Patients were also assessed with the Glasgow Coma Score (GCS) and the APACHE II score. RESULTS: Melatonin concentrations were lower than the normally reported values. Mean night-time melatonin levels were higher than mean daytime levels both on the first and second days, although not statistically significant. Diurnal variation of melatonin was associated with the GCS. Thus, patients with low GCS (n = 4) did not exhibit a consistent diurnal variation of melatonin, whereas those with high GCS (n = 4) retained the normally expected fluctuations. CONCLUSIONS: ICU-treated TBI patients exhibit reduced melatonin levels and a circadian secretion profile which is related to the severity of the injury. Patients with more severe head trauma exhibit a clearly disrupted pattern of melatonin secretion, whereas those with less severe trauma preserve a relatively intact diurnal rhythm. Furthermore, the diurnal secretion pattern of melatonin appeared to be dissociated from the circadian rhythm of core body temperature. These preliminary findings may have implications for the management of TBI patients.

Adult↗

Sleep spindle detection using artificial neural networks trained with filtered time-domain EEG: a feasibility study.

An artificial neural network (ANN) based on the Multi-Layer Perceptron (MLP) architecture is used for detecting sleep spindles in band-pass filtered electroencephalograms (EEG), without feature extraction. Following optimum classification schemes, the sensitivity of the network ranges from 79.2% to 87.5%, while the false positive rate ranges from 3.8% to 15.5%. Furthermore, due to the operation of the ANN on time-domain EEG data, there is agreement with visual assessment concerning temporal resolution. Specifically, the total inter-spindle interval duration and the total duration of spindles are calculated with 99% and 92% accuracy, respectively. Therefore, the present method may be suitable for investigations of the dynamics among successive inter-spindle intervals, which could provide information on the role of spindles in the sleep process, and for studies of pharmacological effects on sleep structure, as revealed by the modification of total spindle duration.

Alpha Rhythm↗

Mirtazapine and venlafaxine in the management of collateral psychopathology during alcohol detoxification.

Symptoms of anxiety and depression are common in a large proportion of alcohol-abusing/dependent individuals during alcohol detoxification. The aim of this study was to examine the impact of a combined psychotherapeutic-psychopharmacological (either with mirtazapine or venlafaxine) treatment of these symptoms during the early withdrawal phase of alcohol compared to a group treated only with psychotherapy. A total of 60 alcohol-dependent/abusing subjects randomly assigned to three groups (psychotherapy, psychotherapy plus mirtazapine, psychotherapy plus venlafaxine) were studied. Assessment of psychopathology and global functioning throughout a 4-5-week detoxification period was done by the Hamilton Anxiety Rating Scale (HARS), the Hamilton Depression Rating Scale (HDRS), and the Global Assessment Scale (GAS). At baseline, high scores of anxiety and depression were recorded (HARS: controls: 33.1+/-7.8, mirtazapine: 33.2+/-12.6, venlafaxine: 36.6+/-5.4; HDRS: controls: 39.5+/-7.4, mirtazapine: 37.9+/-7.8, venlafaxine: 41.9+/-4.5). A marked improvement (p<0.000) was evidenced in all groups by the end of the detoxification period. However, patients on mirtazapine improved significantly more compared to the other two groups (HARS: controls: 9.6+/-7.6, mirtazapine: 4.3+/-4.4*, venlafaxine: 7.2+/-4.1, *p=0.011; HDRS: controls: 8.6+/-7.9, mirtazapine: 3.8+/-3.2*, venlafaxine: 8.2+/-3.5, *p=0.017; GAS: controls: 79.5+/-9.4, mirtazapine: 87.5+/-5.5**, venlafaxine: 83.0+/-8.0, **p=0.006). It is concluded that addition of mirtazapine, but not venlafaxine, to a standard psychotherapy-oriented alcohol detoxification treatment may facilitate the detoxification process by minimizing psychological discomfort. Consequently, it may prove to be a facilitator for the long-term abstinence from alcohol.

Adult↗

Mood disorder with mixed features due to vitamin B(12) and folate deficiency.

Vitamin B(12) and folate deficiency is often associated with affective disorders mainly of the depressive type. We report a case of a 42-year-old woman with a mood disorder with mixed depressed/manic features that was due to vitamin B(12) and folate deficiency. The psychopathology developed over a five-year period without hematologic or other overt clinical characteristics of pernicious anemia. Replacement treatment with vitamin B(12) and folate was rapidly followed by full clinical remission, electroencephalographic normalization and neuropsychological improvement. At a one-year follow-up this condition was stable. Consequently, patients who respond poorly to psychopharmacologic treatment and/or present with atypical mood symptoms would warrant determination of vitamin B(12) and folate serum levels.

Adult↗