Selective serotonin reuptake inhibitor-related extrapyramidal symptoms in autistic children: a case series.

Abnormal movements occur rarely with selective serotonin reuptake inhibitors (SSRIs). This report describes four consecutive autistic children who developed extrapyramidal side effects (EPS) following SSRI exposure. Videotapes, physician notes, and parental interviews were used retrospectively to rate symptoms on the Extrapyramidal Symptom Rating Scale.

Once-daily high-dose pindolol for SSRI-refractory depression.

Selective serotonin reuptake inhibitor (SSRI) augmentation with the 5-HT1A antagonist pindolol has met with mixed results. Recent studies using positron emission tomography (PET) suggest that pindolol doses used in these studies were too low to effect 5-HT1A autoreceptor blockade. To test the hypothesis that a single higher dose of pindolol would effectively augment antidepressant responses in SSRI-refractory patients, nine subjects with major depression unresponsive to paroxetine 40 mg/day given for 2 months or more were randomized to AM pindolol 7.

Localization of adenosine A2A-receptors in rat brain with [3H]ZM-241385.

Adenosine plays a key role in the regulation of tissue oxygenation, neuronal firing, and neurotransmitter release. Four receptor subtypes have been identified and cloned: A(1), A(2A), A(2B), and A(3), although only A(1) and A(2A) receptors are prominent in rat brain. Much evidence now indicates that A(2A) receptors (A(2A)R) are highly enriched within striatal medium-sized spiny GABAergic neurons where they are closely associated with, and modulate, D(2)-dopaminergic receptors involved in motor control and reward behaviors.

Cholinergic sensitivity predicts severity of mania.

Our laboratory and others have reported that pupillary constrictions following application of the cholinergic agonist pilocarpine are increased in depressed patients. Moreover, mood improvements in manic patients, given lithium or Depakote, are also correlated with increases in pupil sensitivity. The present report describes the relationship between symptom severity and cholinergic sensitivity in a larger group (N=20) of manic patients (bipolar I; 296.

Decreases in dilated pupil size in depressed patients with age may reflect adrenergic changes.

Some studies have suggested that noradrenergic activity may decrease with age in depressed patients. Pupil size is regulated by a balance between norepinephrine and acetylcholine. The present study compares pupil size in 10 unmedicated patients with unipolar depression (296.

Gabapentin as an adjunct to standard mood stabilizers in outpatients with mixed bipolar symptomatology.

Gabapentin is a new adjunctive medication to antiseizure therapies. Anecdotal evidence suggests that it may also help to alleviate mood symptoms in patients with bipolar illness. An open-label study examined the effects of adjunctive gabapentin in bipolar patients with mixed symptoms who had previously demonstrated only partial treatment responses.

Sleep deprivation therapy in depressive illness and Parkinson's disease.

1. Sleep deprivation is commonly associated with feelings of fatigue and cognitive impairment. 2.

Sodium valproate increases pupillary responsiveness to a cholinergic agonist in responders with mania.

Background: The cholinergic hypothesis of affective disorders predicts that mania is a hypocholinergic state relative to monoaminergic activity. Treatments that increase cholinergic sensitivity are expected to improve manic symptoms. Valproic acid is an effective treatment for mania.

Pupillary cholinergic sensitivity to pilocarpine increases in manic lithium responders.

Background: The cholinergic hypothesis of affective disorders predicts that mania is a hypocholinergic state relative to monoaminergic activity. Treatments that increase cholinergic sensitivity are expected to improve manic symptoms.

Methods: Ten male hypomanic or manic patients were treated with lithium carbonate (0.

Apomorphine induced alteration in corneofundal potentials in depression.

1. The role of dopamine (DA) in mood regulation remains controversial. 2.

Seasonal patterns in platelet ligand binding are related to membrane proteins.

A seasonal pattern of platelet [3H]imipramine (3H-IMI) binding was explained by a similar but inverted pattern in membrane protein levels in repeated measures of 20 normal volunteers. No seasonal pattern was evident when 3H-IMI binding was expressed on the basis of surface area rather than membrane protein. Platelet Bmax levels in 50 depressed patients were lower than those of controls when values were expressed in terms of platelet surface area.

Increased pupillary sensitivity to pilocarpine in depression.

1. The present study was undertaken to examine the hypothesis that muscarinic receptor sensitivity is increased in depression. 2.

Antidepressant responses and changes in visual adaptation after sleep deprivation.

The effects of 1 night of total sleep deprivation on mood state and visual light-dark adaptation were studied in 15 patients with major depression and nine normal comparison subjects. Mood improvements were evident in all but one patient, although responders (n = 9) could be easily distinguished from nonresponders (n = 6). No significant group differences were found in ocular responses before treatment.

The effect of sleep deprivation on motor impairment and retinal adaptation in Parkinson's disease.

1. Sleep deprivation has previously been reported to result in a temporary improvement of motor deficits in Parkinson's disease patients. 2.

REM latency, dexamethasone suppression test, and thyroid releasing hormone stimulation test in posttraumatic stress disorder.

1. Twenty-one patients with post-traumatic stress disorder (PTSD) were included in a study utilizing baseline rapid eye movement (REM) latency measurements, the dexamethasone suppression test (DST), and the protirelin (thyroid releasing hormone; TRH) stimulation test. The DST and TRH stimulation test were repeated after double blind treatment with desipramine.

Effects of substance abuse on hallucination rates and treatment responses in chronic psychiatric patients.

Background: Few data systematically document the effects of illicit drug exposure on psychotic illness. We examined the effect of substance abuse on rates and treatment responses of hallucinations in a chronic psychiatric population.

Method: 113 cooperative patients consecutively admitted to a state psychiatric hospital were administered the Structured Clinical Diagnostic Interview for DSM-III-R, a Hallucination Interview, and an inventory of past and current substances of abuse.

Disruption of circadian MHPG rhythmicity in major depression.

Plasma concentrations of total (free plus conjugated) 3-methoxy-4-hydroxyphenylglycol (MHPG) were determined every 3 hr for a 24-hr period in 32 unipolar depressed patients, 11 bipolar depressed patients, and 12 healthy subjects. Each subject's circadian MHPG rhythmicity was modeled by a sinusoidal function. Temporal parameters were estimated by linear least squares regression with a fixed 24-hr period.

Decreased seasonal mesor of platelet 3H-imipramine binding in depression.

Seasonal cycles of platelet 3H-imipramine binding were compared in 49 endogenous unipolar depressed patients and 20 normal volunteers. A significant sinusoidal component was detected in the Bmax of binding in both patients and controls with similar amplitudes and seasonal peaks. However, the yearly average (mesor) of the patient group was significantly lower (20.

Relationship between seasonal patterns of platelet serotonin uptake and 3H-imipramine binding in depressed patients and normal controls.

1. Significant seasonal variations were found in the velocity of serotonin (Vmax) uptake and the density of 3H-imipramine binding sites (Bmax) in blood platelets from normal controls. 2.

Seasonal changes in cyanoimipramine specific platelet 3H-imipramine binding in depression.

Seasonal variations in cyanoimipramine (CNIMI) sensitive and CNIMI resistant subclasses of platelet 3H-imipramine (3H-IMI) binding sites were studied in depressed patients and normal volunteers. Sinusoidal rhythms of the binding of both subclasses were found in patients and controls with peak levels in mid-February. Patient values of CNIMI sensitive binding fluctuated about a yearly average that was 32% lower than the average of controls.

Effects of chronic imipramine treatment on subclasses of platelet 3H-imipramine binding sites and plasma cortisol.

A decreased density of platelet 3H-imipramine (3H-IMI) binding sites has been proposed as a putative trait marker of major depressive illness. However, subsequent studies have demonstrated that the number of such sites is increased so as to be more like normal controls upon chronic treatment with antidepressant drugs. In addition, there is some evidence to suggest that altered 3H-IMI binding may be secondary to elevated plasma cortisol levels which are common in depressed patients and which normalize with remission.

Subclasses of platelet 3H-imipramine binding sites.

The possible presence of multiple high affinity 3H-imipramine (3H-IMI) binding sites on blood platelets was studied using trypsin digestion and cyanoimipramine (CNIMI), a pseudo-irreversible inhibitor of 3H-IMI binding and serotonin uptake. Increasing concentrations of CNIMI resulted in a discontinuous curve with a plateau at intermediate concentrations (0.05-0.

Platelet MAO activity in personality disorders and normal controls.

Platelet monoamine oxidase (MAO) activity has been related to several psychiatric disorders and personality dimensions. The purpose of this study was to measure platelet MAO activity in personality disorders and determine its relationship to symptoms analogous to sensation seeking. Twenty-eight males admitted to a psychiatric unit with a DSM-III-R diagnosis of personality disorder were compared to normal controls.