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Biomedical subjects

Y Papakostas

Publications and source records attributed to Y Papakostas.

15 recordsLinked to original sources
PubMed1996

Effects of thyrotropin-releasing hormone administration on the electroconvulsive therapy induced prolactin responses and seizure time.

The effects of thyrotropin-releasing hormone (TRH) administration on electroconvulsive therapy (ECT)-induced prolactin (PRL) secretion and the duration of the seizure were studied in 14 depressed women. In a balanced order crossover design the patients were given 0.4 mg TRH or placebo intravenously 20 min before ECT during the first two sessions. In the third ECT session TRH was given just prior to ECT. ECT elicited the expected PRL response when given alone and when given 20 min after TRH when PRL plasma levels were high. During the coadministration design (third ECT session) PRL levels were raised not as a sum of the two stimuli but even significantly more. TRH failed to modify the duration of the seizure induced by ECT. Therefore, if TRH is involved in seizure modulation during ECT, our findings suggest a postictal rather than ictal role for TRH.

Adult↗
PubMed1993

Evaluation of TSH and prolactin responses to TRH as predictors of the therapeutic effect of ECT in depression.

In a group of 42 unipolar depressed patients with melancholia the thyrotropin (TSH) and prolactin (PRL) responses to TRH were studied in relation to the clinical response to an ECT course. Patients were categorized as responders or nonresponders using as criterion a 50% reduction in the Hamilton Rating Scale for Depression score. Comparison between responders and nonresponders with respect to the TSH and PRL responses to TRH did not reveal any significant differences. Thus, TSH and PRL responses were not proved to have a predictive value for the therapeutic ECT response in melancholia.

Aging↗
PubMed1993

Prolactin and thyrotropin responses to ECT after pindolol administration. A placebo controlled study.

The effect of pindolol, a beta-receptor blocker with potent 5-HT1 receptor antagonistic properties, on the prolactin (PRL) and thyrotropin (TSH) responses to electroconvulsive therapy (ECT) was systematically studied in 12 female depressed patients. In a balanced order, crossover design, the patients were given placebo or pindolol 5 mg orally, 1 h prior to bilateral ECT. The last five patients were additionally tested with 10 mg pindolol during the third ECT. Plasma levels of PRL and TSH increased in all three trials, but no consistent effect of pindolol on these hormonal responses could be demonstrated. Pindolol tended to attenuate seizure duration, especially at the 10 mg dose. The participation of 5-HT1 receptor activity in the secretion of PRL and TSH during ECT remains uncertain.

Adult↗
PubMed1991

Thyrotropin and prolactin responses to ECT in schizophrenia and depression.

Thyroid stimulating hormone (TSH) and prolactin (PRL) plasma levels were studied during electroconvulsive therapy (ECT) in five schizophrenic patients in a simulated ECT (SECT) controlled experimental design. The data were compared to those obtained from a group of 10 depressed patients treated with ECT. In the schizophrenic group, both PRL and TSH increased significantly during ECT compared to SECT, as they did in the depressive group during ECT. Thus, the hormonal TSH and PRL profile during ECT is similar in schizophrenia and depression. It is concluded that the changes in TSH and PRL induced by ECT are specifically linked to the current or the seizure, and are not related to the type of psychopathology.

Adult↗
PubMed1990

Ritanserin, a 5-HT2 receptor antagonist, does not modify ECT-induced prolactin release.

The effect of pretreatment with ritanserin, a potent and selective serotonin-S2 (5-HT2) receptor antagonist, on the prolactin (PRL) response to electroconvulsive therapy (ECT) was studied in seven female patients suffering from major depressive disorder. They were given either ECT alone, or ECT after 10 or 20 mg ritanserin PO, and PRL was estimated in blood samples taken at times -5, 0, +5, +15, +30 and +60 min. The PRL responses after drug administration were not different from the responses after ECT alone. We conclude that, if serotonergic mechanisms are involved in the ECT-induced PRL increase, this neuroendocrine response seems to be rather a 5-HT1 than 5-HT2 receptor mediated event.

Aged↗
PubMed1987

The patterns of prolactin release by ECT and TRH compared.

The patterns of prolactin release after bilateral ECT and after 0.4 mg TRH i.v. were studied in 11 female melancholic patients in a 5-min sampling protocol. Mean prolactin peaking times were 10.2 min after ECT and 20.5 min after TRH. The elimination rate coefficients were significantly lower--and the corresponding half-lives longer--for prolactin released by TRH than by ECT. A significant positive correlation of the maximal prolactin responses by the two stimuli was also found.

Adult↗
PubMed1987

Increased prolactin response to thyrotropin releasing hormone during migraine attacks.

Prolactin (PRL) has been associated with the pathogenesis of migraine, and various approaches have been used to investigate its role. In the present study, the PRL response to thyrotropin-releasing hormone (TRH) was evaluated in eight women migraineurs during an attack-free state and during a migraine attack. PRL baseline values were not different in the two states, and the same was true for the TSH responses to TRH. The PRL responses to TRH were, however, significantly higher during the attack, a finding that indicates a latent disturbance of the PRL-regulating systems in migraine, with a higher responsiveness during migraine attacks.

Adult↗
PubMed1987

Electrodermal responding and chlorpromazine treatment in schizophrenia.

Skin conductance level (SCL) and skin conductance responses (SCR) to a random series of tones were measured in 25 drug-free schizophrenic patients, 15 males and 10 female, before and after standard chlorpromazine treatment. The DSM-III diagnostic criteria were used for selecting subjects. Psychopathology was measured with the Brief Psychiatric Rating Scale. After treatment, patients showed an improved psychopathology and decreased SCL. There was a transition of patients to lower response categories: the number of responders decreased twice and the number of non-responders increased three times. Responders exhibited significantly higher SCL than non-responders and fast habituators were between the two groups.

Adult↗
PubMed1986

Delusional depression: phenomenology and response to treatment. A prospective study.

In a prospective study, the authors compared 22 delusional and 36 non-delusional depressive patients with respect to demographic and clinical variables, personality, and response to treatment. Delusional depressives had a higher total score than non-delusional depressives on Hamilton's Rating Scale for Depression, as well as a higher score for depressed mood and psychomotor retardation. The type of treatment failed to differentiate the two groups as to outcome at discharge. However, six of the seven delusional depressives who did not respond to tricyclic antidepressants had a full recovery with ECT. The results indicate that delusional depression represents a more severe type of major depression.

Adolescent↗
PubMed1986

Prolactin response induced by ECT and TRH.

The prolactin response after ECT in ten female melancholic patients correlated significantly to their prolactin response to i.v. TRH. These findings may suggest an underlying common mechanism between TRH and ECT regarding their PRL releasing properties.

Adult↗
PubMed1984

Increases in prolactin levels following bilateral and unilateral ECT.

Plasma prolactin levels were studied after bilateral and unilateral ECT in eight female melancholic patients. Although prolactin levels were higher after both treatments, patients who received bilateral ECT had significantly higher prolactin levels than did those who received unilateral ECT.

Adult↗
PubMed1981

Neuroendocrine measures in psychiatric patients: course and outcome with ECT.

Measures of neuroendocrine function--plasma cortisol and its response to dexamethasone, and plasma thyroid-stimulating hormone (TSH) and its response to thyrotropin-releasing hormone (TRH)--were employed in 50 hospitalized male veteran psychiatric patients with diagnoses of unipolar or bipolar melancholia, secondary depression, or schizophrenia. Of 20 cases of unipolar melancholia, 17 (85%) exhibited hypercortisolism; 14 (70%) failed to suppress plasma cortisol after dexamethasone; and 4 (31%) of 13 tested had an abnormal TSH response to intravenous TRH. Two patients with secondary depression also exhibited hypercortisolism; no other patients evinced abnormal neuroendocrine test results. These measures were repeated in 14 unipolar depressed patients after a course of electroconvulsive therapy (ECT). Improvement in psychopathology was directly related to normalization of measures of hypothalamic-pituitary-adrenal (HPA) function. The TSH response to TRH was not systematically altered. After a followup period of 1 to 9 months, there was a good correlation between the measures of HPA function and the clinical outcome. These findings encourage further study of HPA function measures as outcome criteria for depressed patients receiving ECT.

Adult↗
PubMed1979

Phenytoin: EEG effects and plasma levels in volunteers.

The electroencephalographic (EEG) and behavioral effects of oral doses of phenytoin from 100 mg to 1 g in normal male volunteers were measured. The electroencephalogram exhibited decreases in power in the slow frequencies and increases in the fast frequencies, accompanied by an increase in mean frequency. These changes are similar to those seen with psychostimulants. They occurred at average plasma levels of 8 micrograms/ml and above. The time course and the intensity of EEG effects parallel plasma levels. Drug-related EEG changes were bilaterally symmetric. EEG changes at plasma levels of 8--12 micrograms/ml were not associated with behavioral toxic signs. These findings suggest that future psychiatric studies of phenytoin as a psychostimulant should include monitoring for plasma levels, with a minimum of 8 micrograms/ml as a guide to clinical efficacy.

Behavior↗
PubMedDate not supplied

Medication response to ECT-resistant melancholic patients.

During an ongoing study on potential neurochemical and neuroendocrine predictors of recovery after ECT, it was observed that depressed patients with unfavorable response to ECT, improved consequently with antidepressants alone or in combination and in some cases with the addition of neuroleptics or lithium salts. 13 female depressed patients with melancholia (DSM-III criteria), who had proven resistant to electroconvulsive therapy (ECT) and showed marked improvement with subsequent psychopharmacologic regimens, are described. In not less than 2 months after the last ECT, remission was achieved with a heterocyclic antidepressant (HCA) alone (3 patients) combined infusion of chlorimipramine and maprotiline (3 patients) combined HCAs-antipsychotics (4 patients) and HCAs in combination with lithium (3 patients). It is worth noting that certain depressed patients improved markedly with drugs which had poor results at the same doses before ECT. Confirmation of these observations by prospective studies would provide novel therapeutic capabilities and clues about the mode of action of this controversial treatment.

Antidepressive Agents↗