Biomedical subjects

U von Bardeleben

Publications and source records attributed to U von Bardeleben.

At least 19 recordsLinked to original sources

PubMed1997

[Drug dependence--diagnostic and therapeutic aspects].

In Switzerland, dependence on these drugs reflects primarily the relationship between patient and doctor, due to the strict regulations. Drugs involved are in most cases benzodiazepines and other sedatives, less frequently stimulants including weight-control products and drugs containing opioids. Patients' characteristics and motivations include 1.) attempt for specific psychotropic effects, 2.) habituation developed during long-term treatment, 3.) overconsumption of drugs without seeking specific psychotropic effects. Clinical syndromes and therapeutic and preventive strategies are described.

Anti-Anxiety Agents↗

PubMed1994

[Substitution as a possibility for the treatment of opiate dependent patients].

The treatment of patients who are dependent on opiates has definitely been including drug substitution besides withdrawal and weaning in the Swiss urban community ("Kanton") of Basel City since 1980. After a significant increase of treatments in 1987 in connection with the spread of HIV infections, more than 800 patients were presently receiving substitution treatment according to a descentralised schedule. The type of long-term treatment is illustrated by sociodemographic and treatment data of 500 substituted individuals who are mostly being looked after always by the same persons entrusted with caring for them. This represents a flexible, economically feasible and highly individual type of care and treatment that can help to reduce illegal drug consumption and hence the undesirable events associated with it in an urban district such as Basel city.

Adult↗

PubMed1993

The sleep EEG and nocturnal hormonal secretion studies on changes during the course of depression and on effects of CNS-active drugs.

1. The sleep EEG and nocturnal hormone secretion were studied simultaneously in normal male controls and in male patients with major endogenous depression before treatment with tricyclics and after recovery and drug cessation. 2. Several studies were performed in normal male controls to investigate the effect of antidepressants (brofaromine, moclobemide, amitriptyline, clomipramine and trimipramine) and of neuropeptides (CRH and the ACTH (4-9) fragment analog ebiratide) on the sleep EEG and sleep-associated hormone secretion. 3. Elevated cortisol and blunted testosterone secretion are state markers of acute depression, whereas sleep EEG, GH and prolactin variables do not show marked differences between acute depression and recovery. Except for trimipramine, all antidepressants investigated suppress REM sleep. No systematic relationship between the sleep EEG and endocrine effects of antidepressants is detectable. Pulsatile application of CRH in controls mimicks some of the neurobiological symptoms of acute depression. More shallow sleep occurs under ebiratide, whereas hormonal secretion remains unchanged. 4. Our data demonstrate that antidepressants exert distinct effects on sleep. However, these substances do not induce changes in sleep structure which persist after their withdrawal in remitted patients. Pulsatile application of neuropeptides leads to specific effects on CNS activity which are not mediated by changes of peripheral hormone secretion. The view that CRH plays a key role in the pathophysiology of affective disorders is corroborated.

Adult↗

PubMed1993

Neuroendocrine and cardiovascular effects of MDE in healthy volunteers.

The drug 3,4-methylenedioxyethamphetamine ([MDE] also known as "Eve") is a less toxic analog of 3,4-methylenedioxymethamphetamine (also known as "Ecstasy") with similar psychotropic effects in humans. In a double-blind placebo-controlled, cross-over study we administered 140 mg of MDE or placebo orally to eight healthy male volunteers at 1:30 P.M. Serum cortisol, prolactin (PRL), and growth hormone (GH) levels, as well as blood pressure, and heart rate were measured every 20 minutes until 5:00 P.M. Administration of MDE was followed by statistically significant long-lasting increases of serum cortisol, PRL, systolic blood pressure, and heart rate, and by a trend toward blunting of GH secretion. The neuroendocrine and cardiovascular effects of MDE are comparable to those of other phenethylamines with the exception of the effect on GH secretion.

3,4-Methylenedioxyamphetamine↗

PubMed1993

[Substitute drug treatments with methadone].

Methadone maintenance treatment for patients with opiate addiction, started in the Canton of Basel in 1980, today includes more than 600 patients, with a marked increase since 1987 due to a change in inclusion criteria following the spreading of HIV infections. Data from 500 patients, gathered in 1991/92 on sociodemographic and treatment characteristics, emphasize the long-term aspect of the methadone maintenance treatment and the necessity of an intensive psychosocial treatment.

Adult↗

PubMed1993

[The Basel dependence study].

In a survey of 177 patients of several outpatient departments and private practices in the area of Basel there were 23% with a dependence syndrome according to the diagnostic guidelines of ICD-10. Sedatives and hypnotics were the mostly mentioned psychotropic substances in this group. In a second survey six to twelve months later 80% of the initial study group were reassessed, focusing on referrals of the patients with a dependence syndrome to institutions specialized for the treatment of addiction. In most cases these patients were still treated at the previous institution; there were only a few referrals. Improvements concerning the increase of the referral rate to competent specialized institutions for patients with addiction seems possible by implementation of a decentralized consultation liaison service for outpatient departments, hospitals and also private practitioners in a mobile form.

Adaptation, Psychological↗

PubMed1991

Effect of age on the cortisol response to human corticotropin-releasing hormone in depressed patients pretreated with dexamethasone.

A combined dexamethasone-human corticotropin-releasing hormone (hCRH) test was applied to 63 individuals--44 patients with major depressive episode (22 male, age 49.5 +/- 13.4 years, and 22 female, 44.6 +/- 11.9 years) and 19 normal male controls (age 42.0 +/- 16.8 years). In normal controls, premedication with 1.5 mg dexamethasone at 11:00 PM substantially inhibited the stimulated release (expressed as area under the time course curve) of cortisol on the day after 100 micrograms hCRH was administered at 3:00 PM. In contrast, depressives responded with significant rises in cortisol (normal controls, 4.1 +/- 4.0 x 10(3) ng/ml/min; depressives, 12.7 +/- 8.3 x 10(3) ng/ml/min; p less than 0.01). Multiple stepwise regression analysis disclosed significant effects of age (T = 3.55, p less than 0.01) and severity of depression (T = 5.42, p less than 0.01) on cortisol release in patients. Such an influence of age upon pituitary-adrenocortical regulation was absent among healthy controls. We postulate that the underlying mechanisms involve changes in corticosteroid receptors in the brain of depressives, impairing the sensitivity with which the brain-pituitary system can detect the dexamethasone feedback signal. Altered glucocorticoid neuroregulation in depression is apparently accelerated by the aging process.

Adult↗

PubMed1991

Myoclonic epileptic seizures during clozapine treatment: a report of three cases.

Three adult schizophrenic patients without a previous history of epilepsy are reported who, during clozapine treatment, developed paroxysmal EEG patterns and generalized myoclonic jerks without alteration of consciousness. These seizures were phenomenologically identical to those occurring in juvenile myoclonic epilepsy and were classified as generalized epileptic seizures. We tentatively conclude that generalized myoclonic epileptic seizures may be induced by clozapine.

Adult↗

PubMed1991

Sleep EEG and nocturnal secretion of testosterone and cortisol in patients with major endogenous depression during acute phase and after remission.

Sleep EEG and the nocturnal secretion of cortisol and testosterone in 12 male patients (mean age 46.4 +/- 11.26 years) with major endogenous depression were investigated concomitantly during acute depression, before treatment and after recovery and drug cessation. Testosterone concentration increased after remission, while cortisol secretion decreased. Sleep EEG disturbances remained unchanged in remitted patients. The data suggest that a blunted testosterone and an elevated cortisol secretion are state markers of acute depression, which normalize independently from sleep structure. An interaction between the hypothalamic-pituitary-gonadal axis and the limbic-hypothalamic-pituitary-adrenocortical axis appears likely.

Adult↗

PubMed1991

[Zotepine versus perazine in patients with paranoid schizophrenia: a double-blind controlled trial of its effectiveness].

The dibenzothiepine zotepine is a new potential "atypical" neuroleptic exhibiting powerful antiserotonergic and antidopaminergic properties. The efficacy of zotepine was evaluated in a double-blind controlled trial versus the tricyclic neuroleptic perazine in 41 patients suffering mainly from the paranoid-hallucinatory type of schizophrenia. The key outcome variable was the extent of mental disturbance as defined by the total score of the BPRS. Additional outcome variables were GAS and CGI. In addition, adverse reactions and extrapyramidal side effects were assessed according to the FSUCL scale and the Gerlach and AIMS rating scale, respectively. Additional variables recorded were blood pressure, heart rate and routine laboratory parameters as well as electrocardiogram and electroencephalogram. In the first two days, standard equivalent doses of both drugs were administered. Thereafter, doses were administered as required. The efficacy of both substances was compared after 7, 14 and 28 days of treatment. Both drugs showed a similar antipsychotic efficacy. Under zotepine treatment a 55% improvement of the BPRS total score was observed while perazine led to a 41% BPRS score reduction. After 7 days the zotepine group was significantly more improved than the perazine group, possibly due to a dosing effect in the perazine group. In the zotepine group, fewer adverse reactions and a better benefit/risk index were observed although the differences between the two treatment groups did not reach levels of statistical significance. There were no drug-specific abnormal laboratory findings. Thus, in the present study there was no significant difference between zotepine and perazine with respect to antipsychotic efficacy and side-effect rates. However, zotepine showed a trend to a better benefit/risk index at the end of treatment.

Adult↗

PubMed1991

Influence of human corticotropin-releasing hormone and adrenocorticotropin upon spontaneous growth hormone secretion.

Hormones of the hypothalamo-pituitary-adrenocortical (HPA-) axis are considered to be of physiological and clinical relevance in regulating spontaneous growth hormone (GH) secretion. To further investigate interdependencies between both systems, we studied the effects of adrenocorticotropin [ACTH(1-24)] and human corticotropin-releasing hormone (h-CRH) upon spontaneous GH secretion in 10 male volunteers. Administration of 1 microgram ACTH (1-24), 10 micrograms h-CRH or saline (control: CTL) every hour from 9.00 to 6.00 p.m. resulted in significant differences of cortisol secretion during the entire observation period (8.00 a.m.-3.00 a.m.) between the three groups (p less than 0.001, Friedman two-way ANOVA). Mean area under the time course curve (AUC) values (+/- SEM) for cortisol expressed as ng x 1,000 x min/ml showed also significant differences between the three treatments from 8.00 a.m. to 3.00 a.m.: CTL 64.0 +/- 6.4, ACTH(1-24) 178.5 +/- 9.4 (p less than 0.01, Wilcoxon test), h-CRH 88.5 +/- 5.6 (p less than 0.01). The main portion of cortisol was released during daytime from 8.00 a.m. to 11.00 p.m., where the most significant differences in the AUC values emerged: CTL 59.6 +/- 5.8, ACTH(1-24) 171.5 +/- 8.8 (p less than 0.01, Wilcoxon test), h-CRH 80.2 +/- 5.1 (p less than 0.01). With regard to GH secretion, significant differences became obvious between the three treatments during daytime from 8.00 a.m. to 11.00 p.m. and the sleep-related period from 11.00 p.m. to 3.00 a.m. (p less than 0.01 and p less than 0.02, Friedman two-way ANOVA).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1990

Psychometric, polysomnographic, and neuroendocrine measures in subjects at high risk for psychiatric disorders: preliminary results.

We report on the psychometric, polysomnographic, and neuroendocrine status of 12 subjects at high familial risk for psychiatric disorders and of 10 healthy subjects not at high risk. The psychometric measurements in the high-risk probands revealed an accentuated 'stress personality' pattern and an increased neuroticism score. Their all-night EEG sleep tended to be shallower than that of the control subjects (i.e., decreased sleep efficiency, more frequent awakenings, less slow-wave sleep), whereas they did not differ on REM sleep parameters. The challenge of the limbic-hypothalamic-pituitary-adrenocortical system with corticotropin-releasing hormone after pretreatment with dexamethasone yielded no differences in cortisol secretion between the groups. On an intraindividual level, however, all subjects at high risk except one were found to be conspicuous in at least one of the three states examined.

Adult↗

PubMed1989

Computerized brain tomography measures compared with spontaneous and suppressed plasma cortisol levels in major depression.

We determined brain density and ventricular measurements with computerized tomography (CT) in 33 depressed patients and compared the results with basal plasma cortisol and its suppressibility by dexamethasone. Mean plasma cortisol was positively related to elevated ventricular brain ratio (VBR). No association could be found between dexamethasone suppression test (DST) status and VBR or any other CT parameter. Elevated plasma cortisol levels and increased VBRs were positively correlated with total scores on the Brief Psychiatric Rating Scale, the Global Assessment Scale and the Bech-Rafaelsen Melancholia Scale, but they were not significantly correlated with total score on the Hamilton Anxiety Scale.

Adult↗

PubMed1989

Human CRH stimulation response during acute withdrawal and after medium-term abstention from alcohol abuse.

We compared the baseline cortisol secretory pattern and ACTH and cortisol responses to hCRH (100 micrograms) in eight patients acutely withdrawn from ethanol and 12 patients who abstained from ethanol for two to six weeks. Acute withdrawal from ethanol was characterized by elevated baseline cortisol and blunted ACTH release after hCRH, while medium-term abstention was associated with normalized cortisol secretion but persistence of decreased ACTH output following stimulation. These findings support an altered corticotrophic CRH receptor function in detoxified sober alcoholics. The pathophysiology underlying the blunted ACTH response to hCRH in medium-term ethanol abstention appears to be different from that in acute alcohol withdrawal and hypercortisolemic depression.

Adrenocorticotropic Hormone↗

PubMed1989

Effects of fluoxetine upon pharmacoendocrine and sleep-EEG parameters in normal controls.

A single dose of 80 mg fluoxetine induced a slight increase in cortisol secretion when compared to placebo in an acute endocrine challenge test including assessment of prolactin, growth hormone, luteinizing hormone, follicle stimulating hormone, testosterone. This pretreatment with 80 mg fluoxetine did not change the ACTH release after blockade of the feed-back regulation of peripheral corticosteroids on ACTH secretion by metyrapone. Sleep-EEG revealed reduction of rapid-eye-movement sleep. Nocturnal penile tumescence activity was unaltered.

Adrenocorticotropic Hormone↗

PubMed1989

Mood elevating effect of fluoxetine in a diagnostically homogeneous inpatient population with major depressive disorder.

According to severity of depressive symptomatology 14 inpatients with major depressive disorder (RDC) were assigned to 2 groups of 7 patients each with 6 of them receiving fluoxetine 60-80 mg/day and 1 receiving placebo in each group in a double-blind manner. After the treatment period of 35 days clinical improvement as assessed by standardized rating scales was more pronounced in the moderately depressed patients. There were no substantial side-effects in the 2 groups. These findings corroborate previous results from outpatient studies in more heterogeneous patient samples demonstrating safety and antidepressive efficacy of fluoxetine.

Adult↗

PubMed1988

Changes of the ratio between myelin thickness and axon diameter in human developing sural, femoral, ulnar, facial, and trochlear nerves.

Previous studies on sural nerves were extended to human femoral, ulnar, facial and trochlear nerves. As asynchronous development of axon diameter and myelin sheath thickness was noted in all nerves studied. Whereas axons reach their maximal diameter by or before 5 years of age, maximal myelin sheath thickness is not attained before 16-17 years of age, i.e., more than 10 years later. The slope of the regression lines for the ratio between axon diameter and myelin thickness is significantly steeper in older than in younger individuals; it also differs if small and large fibers with more or less than 50 myelin lamellae are evaluated separately. The number of Schmidt-Lanterman incisures during later stages of development is related to myelin thickness, but the length of the spiral of the myelin lamella, thought to unrolled, in relation to its width, i.e., internodal length, varies considerably during development. The changes of the relationship between axons and myelin sheath thickness during normal human development have to be taken into account if hypomyelination is considered as a significant pathological phenomenon in peripheral neuropathies, especially in children. The implications of the present findings concerning conduction velocity of peripheral nerve fibers and other electrophysiologic parameters are discussed.

Adolescent↗

PubMed1988

Response of ACTH and cortisol to human corticotropin-releasing hormone after short-term abstention from alcohol abuse.

The authors administered 100 micrograms human corticotropin-releasing hormone (h-CRH) to alcohol-dependent subjects after short-term abstention from alcohol abuse and observed that these patients released significantly less adrenocorticotrophic hormone (ACTH) than a control group. Cortisol responses were also blunted, but this effect was less pronounced. These findings indicate that hypercortisolism in alcohol withdrawal is driven by a central neurotransmitter/receptor disturbance rather than by peripheral alterations.

Adrenocorticotropic Hormone↗