Cerebral glucose metabolic rates in normal human females versus normal males.

Sex-related differences have been reported for some brain neuroanatomical structures and several measures of brain function. We studied the cerebral glucose metabolic rates of normal men (n = 7) and women (n = 7) with positron emission tomography and the fluorodeoxyglucose method. Women were studied between days 5 and 15 of the menstrual cycle.

Effect of interrupted sleep patterns and partial sleep deprivation on DST and mood in psychiatric house officers.

To gain further insight into clinical associations seen in depression, the authors investigated the effect of interrupted night-time sleep on the HPA axis and mood in 20 psychiatric house officers taking overnight call. Specific interest was in whether multiple awakenings could induce a positive DST. No statistically significant association emerged between number of nocturnal awakenings, number of hours of sleep deprivation or temporal occurrence of sleep deprivation and cortisol, DST or mood.

Local cerebral glucose metabolic rates in obsessive-compulsive disorder. A comparison with rates in unipolar depression and in normal controls.

We studied 14 patients with obsessive-compulsive disorder (OCD) by positron emission tomography and the fluorodeoxyglucose method, looking for abnormalities in local cerebral metabolic rates for glucose in brain structures that have been hypothesized to function abnormally in OCD. These patients were compared with 14 normal controls and 14 patients with unipolar depression. The patients with unipolar depression and OCD did not differ in levels of anxiety, tension, or depression.

Reduced cerebral glucose metabolism in asymptomatic subjects at risk for Huntington's disease.

Symptomatic patients with Huntington's disease may have reduced glucose metabolism in the caudate nuclei. We used positron emission tomography and [18F]fluorodeoxyglucose to study cerebral glucose metabolism in 95 subjects: 58 clinically asymptomatic (chorea-free) subjects at risk for Huntington's disease, 10 symptomatic patients with the disease, and 27 controls. All the symptomatic patients had marked reductions in caudate glucose metabolism.

Refractory depression treated with high doses of monoamine oxidase inhibitor.

Two treatment-refractory cases of depression were treated with doses of monoamine oxidase inhibitors (MAOIs) that exceeded the recommended therapeutic range. Both patients improved without any side effects. It appears that high doses of MAOIs when used with caution in responsible patients may be another method for treating refractory depression.

Trazodone treatment response in obsessive-compulsive disorder--correlated with shifts in glucose metabolism in the caudate nuclei.

Obsessive-compulsive disorder (OCD) is a severe psychiatric illness that is difficult to treat. The effects of trazodone hydrochloride treatment were studied, both with and without the addition of a monoamine oxidase inhibitor, in OCD patients. Changes in symptoms correlated with changes in local cerebral metabolic rates for glucose (LCMRGlc), as measured by positron emission tomography and the 18F-fluorodeoxyglucose method.

Prolongation of the antidepressant response to partial sleep deprivation by lithium.

Depressed patients given a loading dose of lithium on the first of 2 successive days of partial sleep deprivation (PSD), and kept at maintenance levels thereafter, showed significantly greater prolongation of the antidepressant effects of PSD than patients treated with PSD and placebo, even though the acute elevation in mood derived from PSD was as great on placebo as on lithium. Depression was assessed 3 days after PSD with an augmented version of the Hamilton Rating Scale for Depression. Patients on lithium alone, without PSD, did not have the acute elevation in mood seen in the two PSD groups and had significantly less improvement in depression than those who received PSD with lithium.

A possible diurnal variation in trazodone clearance.

Diurnal variations in drug metabolism that have clinical consequences have been described for several drugs used in internal medicine but have not been reported for antidepressants. The long half-lives of most antidepressants may obscure such variations. Trazodone hydrochloride has a short half-life compared with other commercially available antidepressants.

The Experience of Electroconvulsive Therapy in the 1980s: A Prospective Study of the Knowledge, Opinions, and Experience of California Electroconvulsive Therapy Patients in the Berkeley Years.

In 1982, the city of Berkeley, California voted to make the use of electroconvulsive therapy (ECT) a crime. Though later overturned, this ordinance generated much publicity and underscored the public's general negative view of ECT. In this climate, the authors surveyed first-time ECT recipients (n = 35), and a group with prior ECT (n = 20) to examine patient knowledge, experience, and opinions of ECT in California in the 1980s.

Informing Patients About Electroconvulsive Therapy: Effects of a Videotape Presentation.

Issues of information given for consent purposes are particularly problematic with electroconvulsive therapy (ECT). The authors investigated the efficacy of an informative videotape recording in this process. The videotape contained factual information about ECT, an interview with a patient before and after treatment, and the presentation of an actual treatment.

Two cases of obsessive-compulsive disorder with depression responsive to trazodone.

Two patients with severe obsessive-compulsive disorder with superimposed depression, who had failed to respond to a wide variety of antidepressants, were treated with trazodone hydrochloride. Both seemed to obtain a rapid and impressive improvement in both their depression and obsessive-compulsive disorder while receiving trazodone. One patient subsequently had a monoamine oxidase inhibitor added to his treatment and experienced some additional improvement, but most of his improvement had occurred earlier, while he was receiving trazodone only.

Cerebral metabolic rates for glucose in mood disorders. Studies with positron emission tomography and fluorodeoxyglucose F 18.

Cerebral metabolic rates for glucose were examined in patients with unipolar depression (N = 11), bipolar depression (N = 5), mania (N = 5), bipolar mixed states (N = 3), and in normal controls (N = 9) using positron emission tomography and fluorodeoxyglucose F 18. All subjects were studied supine under ambient room conditions with eyes open. Bipolar depressed and mixed patients had supratentorial whole brain glucose metabolic rates that were significantly lower than those of the other comparison groups.

Nursing Students' Perception of Electroconvulsive Therapy: Impact of Instruction with an Electroconvulsive Therapy Videotape.

There has been little study of attitudes toward and knowledge of electroconvulsive therapy (ECT). Likewise, there have been no studies of how accurate information about ECT may be communicated. The authors studied the attitudes and opinions toward ECT of thirty-five nursing students before they had received any formal instruction on its use.

Normal thyroid function in desipramine nonresponders converted to responders by the addition of L-triiodothyronine.

The results of complete thyroid function testing were normal in four desipramine nonresponders who were converted to responders by addition of L-triiodothyronine (T3). These findings suggest that the effectiveness of T3 is not due to correction of subtle thyroid deficiencies.