Interest in biogenic amine function in affective disorders has stimulated a variety of research s... more Interest in biogenic amine function in affective disorders has stimulated a variety of research strategies including the measurement of hormonal response to a variety of stimuli as an indirect method of investigating the integrity of aminergic function in clinically depressed patients. Apomorphine and levodopa are known to stimulate growth hormone release via a dopaminergic pathway in median eminence. Administration of
The author reviews the studies of lithium as an antidepressant, evaluates the evidence that there... more The author reviews the studies of lithium as an antidepressant, evaluates the evidence that there might be specific subgroup of patients for whom it is effective, and reports a study he and his associates conducted that found lithium to be effective for 13 of 21 depressed patients. He concludes that there is convincing, although not conclusive, evidence for an antidepressant effect of lithium and that only by identifying the subgroup of patients for whom it is effective can the continuing uncertainty surrounding lithium's role in affective disorder be resolved. He also calls for a reevaluation of the relationship between mania and depression.
N ONCOMPLIANCE WITH MEDICATION regimens not only reduces the benefits of proper therapy to the pa... more N ONCOMPLIANCE WITH MEDICATION regimens not only reduces the benefits of proper therapy to the patient, but also complicates the clinician's appraisal of response to therapy. The magnitude of this problem is evident from a review of 50 compliance studies. One-quarter to one-half of all patients failed to comply adequately with medication orders.' Noncompliance is not inherent in any particular personality, ethnic, or socioeconomic group.2 Psychiatric patients may pose a particular problem because their illness itself may interfere with their capacity to cooperate with pharmacotherapy. This makes medication compliance a major variable in assessing the response to psychoactive drugs such as the lithium ion (Li+). With regard to Li+, a partial solution to this problem has been the ability to measure the plasma concentration of the cation. However, because absorption of Li+ from the gastrointestinal tract is rapid, a patient who takes only a few doses of lithium prior to seeing his physician may appear to have "therapeutic" plasma concentrations of Li+ while still being noncompliant. For this reason, measurement of plasma Li+ concentration may not always give an accurate assessment of whether or not a patient has adhered to the prescribed regimen. The present investigation was designed to determine if the measurement of Li+ in another body compartment might provide the physician with a parameter that would enable him to more accurately assess the compliance of his patients. Since the erythrocyte (RBC) behaves pharmacokinetically as a tissue compartment separate from plasma,3 we examined whether the erythrocyte concentration of Li+ might be used as an indicator of patient compliance. MATERIALS AND METHODS Male bipolar or unipolar depressive patients, age 29-66 yr, were studied. Informed consent was obtained from all subjects studied. Creatinine clearance, serum electrolytes, and hematological indices were measured at the time of study and all were within normal ranges. At the time of study, all patients were normothymic and had been taking Li+, as outpatients, for periods from 2 mo to 5 yr. Other medications taken by some patients at the time of study included tricyclic antidepressants, stool softeners, propranolol, benzodiazepines, or leva-dopa. If a patient was taking one of these other drugs, he continued to take them for the duration of the study.
The effects of lithium and of magnesium ions on adenosine 3',5'-monophosphate (cyclic AMP) accumu... more The effects of lithium and of magnesium ions on adenosine 3',5'-monophosphate (cyclic AMP) accumulation in isolated rat hemidiaphragms were investigated. Magnesium ions caused a small but significant increase in the basal concentration of cyclic AMP, whereas lithium ions had no effect. However, pretreatment of tissues with LiCl caused a significant dose-dependent reduction in the effect of epinephrine on the concentration of cyclic AMP. Magnesium ions enhanced the rise in tissue cyclic AMP caused by epinephrine, but this stimulatory effect of magnesium ions was reduced in tissues that had been pretreated with LiCI. It was concluded that lithium ions act at an intracellular site to inhibit hormone-induced accumulation of the cyclic nucleotide and was proposed that magnesium and lithium ions act at different cellular locations to produce their effects on hormone-induced cyclic AMP accumulation.
Electroencephalography and Clinical Neurophysiology, 1967
It is common practice to exclude the data obtained from subjects during their first night in the ... more It is common practice to exclude the data obtained from subjects during their first night in the sleep laboratory in studies of the psychophysiology of sleep. It has been suggested that the subjects' behavior is affected by the novelty of the circumstances and that the data will consequently be modified by this experience. We have studied the sleep pattern of 21 depressed patients and fifteen control subjects (Hawkins and Mendels 1966; Mendels and Hawkins 1967) and herewith report a comparison of the sleep for nights 1 and 2 for each group of subjects.
CORRESPONDENCE 524 instead of a daughter, than is the case with the parents of heterosexual women... more CORRESPONDENCE 524 instead of a daughter, than is the case with the parents of heterosexual women, was confirmed by the findings.― Again, the hypothesis only stated that lesbians would report the phenomenon to a greater degree. We do not know that the parents of homo sexual women wanted a son more frequently. I stress these points for the following reasons. The hurried professional, flooded by a sea of medical literature, finds it impossible to read all the articles he would like. Much reading is reduced to summaries of papers, or to abstracts which quote statements from the original paper succinctly summarizing the results. Furthermore, full-length papers frequently refer to the past related publications of other authors also by quoting one or two of the results. Thus it behoves all of us who publish to be ever scrupulous in the wording of our material. Dr. Bene's study was a carefully conducted one in an area which demands sophisticated research. Undoubtedly, it will be widely cited. Thus, I consider it important to emphasize its potential for overinterpretation.
This study was aimed at identifying the expressive, movement, and social behaviors associated wit... more This study was aimed at identifying the expressive, movement, and social behaviors associated with anxiety in the syndrome of major depression. The sample consisted of 97 hospitalized male and female depressed patients. Expressive and social behaviors were evaluated prior to treatment in a structured videotaped interview. Anxiety was measured using a multi-vantaged approach including doctor's rating, nurse's rating, patient self-report, and a separate video rating. Results indicate that anxiety was significantly associated with agitation, distressed facial expression, bodily discomfort, and poor social interaction in both sexes. Men and women differed in certain respects: anxiety was highly related to motor retardation in women only, and to hostility in men only. Differences in the pattern of expressive behavior between high and low anxious, depressed patients were clearly significant, and several were large enough to serve as clinical indicators. These findings help to characterize the expressive features of anxiety in the context of severe depression, and add to the growing literature on sex differences in depression.
Interest in biogenic amine function in affective disorders has stimulated a variety of research s... more Interest in biogenic amine function in affective disorders has stimulated a variety of research strategies including the measurement of hormonal response to a variety of stimuli as an indirect method of investigating the integrity of aminergic function in clinically depressed patients. Apomorphine and levodopa are known to stimulate growth hormone release via a dopaminergic pathway in median eminence. Administration of
The author reviews the studies of lithium as an antidepressant, evaluates the evidence that there... more The author reviews the studies of lithium as an antidepressant, evaluates the evidence that there might be specific subgroup of patients for whom it is effective, and reports a study he and his associates conducted that found lithium to be effective for 13 of 21 depressed patients. He concludes that there is convincing, although not conclusive, evidence for an antidepressant effect of lithium and that only by identifying the subgroup of patients for whom it is effective can the continuing uncertainty surrounding lithium's role in affective disorder be resolved. He also calls for a reevaluation of the relationship between mania and depression.
N ONCOMPLIANCE WITH MEDICATION regimens not only reduces the benefits of proper therapy to the pa... more N ONCOMPLIANCE WITH MEDICATION regimens not only reduces the benefits of proper therapy to the patient, but also complicates the clinician's appraisal of response to therapy. The magnitude of this problem is evident from a review of 50 compliance studies. One-quarter to one-half of all patients failed to comply adequately with medication orders.' Noncompliance is not inherent in any particular personality, ethnic, or socioeconomic group.2 Psychiatric patients may pose a particular problem because their illness itself may interfere with their capacity to cooperate with pharmacotherapy. This makes medication compliance a major variable in assessing the response to psychoactive drugs such as the lithium ion (Li+). With regard to Li+, a partial solution to this problem has been the ability to measure the plasma concentration of the cation. However, because absorption of Li+ from the gastrointestinal tract is rapid, a patient who takes only a few doses of lithium prior to seeing his physician may appear to have "therapeutic" plasma concentrations of Li+ while still being noncompliant. For this reason, measurement of plasma Li+ concentration may not always give an accurate assessment of whether or not a patient has adhered to the prescribed regimen. The present investigation was designed to determine if the measurement of Li+ in another body compartment might provide the physician with a parameter that would enable him to more accurately assess the compliance of his patients. Since the erythrocyte (RBC) behaves pharmacokinetically as a tissue compartment separate from plasma,3 we examined whether the erythrocyte concentration of Li+ might be used as an indicator of patient compliance. MATERIALS AND METHODS Male bipolar or unipolar depressive patients, age 29-66 yr, were studied. Informed consent was obtained from all subjects studied. Creatinine clearance, serum electrolytes, and hematological indices were measured at the time of study and all were within normal ranges. At the time of study, all patients were normothymic and had been taking Li+, as outpatients, for periods from 2 mo to 5 yr. Other medications taken by some patients at the time of study included tricyclic antidepressants, stool softeners, propranolol, benzodiazepines, or leva-dopa. If a patient was taking one of these other drugs, he continued to take them for the duration of the study.
The effects of lithium and of magnesium ions on adenosine 3',5'-monophosphate (cyclic AMP) accumu... more The effects of lithium and of magnesium ions on adenosine 3',5'-monophosphate (cyclic AMP) accumulation in isolated rat hemidiaphragms were investigated. Magnesium ions caused a small but significant increase in the basal concentration of cyclic AMP, whereas lithium ions had no effect. However, pretreatment of tissues with LiCl caused a significant dose-dependent reduction in the effect of epinephrine on the concentration of cyclic AMP. Magnesium ions enhanced the rise in tissue cyclic AMP caused by epinephrine, but this stimulatory effect of magnesium ions was reduced in tissues that had been pretreated with LiCI. It was concluded that lithium ions act at an intracellular site to inhibit hormone-induced accumulation of the cyclic nucleotide and was proposed that magnesium and lithium ions act at different cellular locations to produce their effects on hormone-induced cyclic AMP accumulation.
Electroencephalography and Clinical Neurophysiology, 1967
It is common practice to exclude the data obtained from subjects during their first night in the ... more It is common practice to exclude the data obtained from subjects during their first night in the sleep laboratory in studies of the psychophysiology of sleep. It has been suggested that the subjects' behavior is affected by the novelty of the circumstances and that the data will consequently be modified by this experience. We have studied the sleep pattern of 21 depressed patients and fifteen control subjects (Hawkins and Mendels 1966; Mendels and Hawkins 1967) and herewith report a comparison of the sleep for nights 1 and 2 for each group of subjects.
CORRESPONDENCE 524 instead of a daughter, than is the case with the parents of heterosexual women... more CORRESPONDENCE 524 instead of a daughter, than is the case with the parents of heterosexual women, was confirmed by the findings.― Again, the hypothesis only stated that lesbians would report the phenomenon to a greater degree. We do not know that the parents of homo sexual women wanted a son more frequently. I stress these points for the following reasons. The hurried professional, flooded by a sea of medical literature, finds it impossible to read all the articles he would like. Much reading is reduced to summaries of papers, or to abstracts which quote statements from the original paper succinctly summarizing the results. Furthermore, full-length papers frequently refer to the past related publications of other authors also by quoting one or two of the results. Thus it behoves all of us who publish to be ever scrupulous in the wording of our material. Dr. Bene's study was a carefully conducted one in an area which demands sophisticated research. Undoubtedly, it will be widely cited. Thus, I consider it important to emphasize its potential for overinterpretation.
This study was aimed at identifying the expressive, movement, and social behaviors associated wit... more This study was aimed at identifying the expressive, movement, and social behaviors associated with anxiety in the syndrome of major depression. The sample consisted of 97 hospitalized male and female depressed patients. Expressive and social behaviors were evaluated prior to treatment in a structured videotaped interview. Anxiety was measured using a multi-vantaged approach including doctor's rating, nurse's rating, patient self-report, and a separate video rating. Results indicate that anxiety was significantly associated with agitation, distressed facial expression, bodily discomfort, and poor social interaction in both sexes. Men and women differed in certain respects: anxiety was highly related to motor retardation in women only, and to hostility in men only. Differences in the pattern of expressive behavior between high and low anxious, depressed patients were clearly significant, and several were large enough to serve as clinical indicators. These findings help to characterize the expressive features of anxiety in the context of severe depression, and add to the growing literature on sex differences in depression.
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