Electroconvulsive Therapy and Prolactin Release: Relation to Treatment Response in Melancholia.

Serum prolactin levels 15 min after each of four consecutive electroconvulsive treatments (ECTs) in 16 male melancholics fell from the first to the fourth treatment. A larger mean prolactin response to ECT correlated with a slower treatment response, as measured by global outcome ratings after six ECTs and the total number of ECTs administered, both blind to prolactin levels. These findings were independent of baseline prolactin levels or treatment electrode placement; they are consistent with the hypothesis that ECT increases postsynaptic dopamine receptor sensitivity.

Electroconvulsive Therapy-Induced Cortisol Release: Changes with Depressive State.

With administration of 2 mg of dexamethasone 9 h before, serum cortisol levels were determined for the times just before and 30 min after the first and last electroconvulsive therapies (ECTs) of a series of at least six sessions. Twelve drug-free patients with melancholic or psychotic depression completed the study. Response to treatment was taken as a fall in the value of the Carroll rating scale.

The treatment of tricyclic antidepressant overdose with repeated charcoal.

Activated charcoal given repeatedly through a nasogastric tube to three patients in coma from amitriptyline overdose greatly accelerated tricyclic elimination: the apparent half-life fell below 10 hours for each patient to as low as 4 hours. This contrasts with extended half-lives for amitriptyline elimination averaging 36.8 hours and regularly over 60 hours previously reported for overdoses treated without repeated charcoal.

Characterization and prediction of lithium blood levels and clearances.

Mathematical simulations and nonlinear numerical methods for characterizing the serum elimination half-life, volume of distribution, and renal clearance of lithium after multiple oral doses of lithium carbonate and two or more blood level determinations were constructed and adapted for clinical use. These characteristics were measured for 24 inpatients; predictions were made with the simulation and compared with actual succeeding blood levels. The average elimination half-life of 25.

Duration of ECT-induced tachycardia as a measure of seizure length.

The duration of ECT-induced tachycardia in 203 seizures of 28 patients was measured. Tachycardia duration was easily determined; it correlated highly with both motor (cuffed arm) and EEG seizure estimates.

Prolactin levels after bilateral and unilateral ECT.

Serial post-ictal serum prolactin levels were obtained over a period of one hour after bilateral or unilateral electroconvulsive therapy (ECT) in six patients. Bilateral ECT yielded significantly higher mean post-ictal prolactin levels than unilateral ECT at the 15, 20, 30 and 60 minute sampling times. These findings demonstrate a greater hypothalamic-stimulating effect of bilateral than unilateral ECT, and may explain the reported therapeutic advantage of bilateral over unilateral ECT in the treatment of patients with melancholia.

Predicting success of intensive dialysis in the treatment of uremic pericarditis.

To identify predictors of the success or failure of daily intensive dialysis in uremic pericarditis, a retrospective examination was made of initial clinical, laboratory, and echocardiographic data in 97 patients using univariate and multivariate statistical analysis. In this group, 67 patients showed response to intensive dialysis, and 30 patients did not (22 required surgery and eight died). By univariate analysis, nine factors correlated with intensive dialysis failure (p less than 0.

Postictal prolactin elevations in rats.

Electrically induced seizures were followed by temporary elevations in serum prolactin over baseline in rats, while electrical irritation made no change. Naloxone 4 mg/kg i.p.

Dexamethasone suppression testing of alcoholics.

Fourteen (33%) of 43 men hospitalized for alcohol abuse showed abnormal cortisol levels at 4 pm, 17 hours after administration of 1 mg of dexamethasone (median, five days after admission). Most (but not all) of these nonsuppressors showed multiple signs of alcoholic physical deterioration; there may be more than one mechanism by which alcohol abuse can lead to an abnormal result of this test. Suppressors and nonsuppressors reported similar alcohol consumption, symptoms of depression, and occurrence of depression among close relatives.

Dependency of tricyclic antidepressant efficacy on thyroid hormone potentiation: case studies.

Two patients are described who depended on potentiation of tricyclic antidepressant effectiveness by thyroid superfunction for remission of an episode of unipolar depression. In one case, the excess thyroid hormone was the product of hyperthyroidism; whenever the hyperthyroidism was treated, the remission induced by imipramine was negated. In the other case, triiodothyronine was exogenously administered.

Reversible nephrotic range proteinuria with renal artery stenosis: a clinical example of renin-associated proteinuria.

Nephrotic range proteinuria occurred in a 60-year-old woman with renal artery stenosis and marked hyperreninemia. Treatment by nephrectomy produced resolution of both proteinuria and hypertension. The gradual resolution of the proteinuria postoperatively suggested the proteinuria, at least in part, came from the contralateral kidney.

Managing desperate emotional behaviour with hypnosis.

When no other psychotherapy or pharmacotherapy could prevent debilitation or institutionalization consequent to longstanding frequent repeated maladaptive behaviour, hypnosis has been observed to be effective in suitable patients. A documentation, three cases of such chronic severe behaviour which have been encountered by the author are described; each had been regarded as hopelessly unmanageable by the primary physician at the time of referral for hypnotherapy. Relevant to their suitability for hypnosis, all three patients were able to understand normal speech with difficulty, were able to concentrate well, and were agreeable to using hypnosis.

Body fluid volumes in the spontaneously hypertensive rat.

1. Plasma volume, packed cell volume (PCV), blood pressure, extracellular fluid volume (ECFV) and evans blue disappearance rate were measured in conscious spontaneously hypertensive rats and in weight-matched Wistar normotensive rats. 2.

A learning aid for DSM-III: computerized prompting of diagnostic criteria.

To help overcome many of the difficulties of learning and using the new Diagnostic and Statistical Manual of Psychiatry, a system was developed for reviewing its contents as appropriate to individual clinical cases. It is faithful in format and contents to this Manual. This system is now being regularly used by medical students, residents, and psychiatrists on a voluntary basis, as a teaching aid.

The Holtzman Inkblot Technique is not the Rorschach: a reply to Lockwood, Roll, and Mathews.

A previous article by Lockwood, Roll, and Matthews (1981) reported dramatic differences between the Movement scores obtained by 6-year-old children on the Holtzman Inkblot Technique (HIT) and previously reported normative data for this variable. The Lockwood et al. data were rescored by experienced HIT scorers; their findings-and other possible reasons for the high HIT Movement scores reported by Lockwood et al.

Haemodynamics of stable renal transplant recipients.

1. Haemodynamics, blood volume, plasma renin concentration and creatinine clearance were evaluated in 24 stable renal transplant recipients. 2.

Interrelation of the renin system and erythropoietin in rats.

Evidence is presented implicating the renin-angiotensin system in the regulation of plasma erythropoietin concentration. Male and female rats were exposed to hypoxia at 0.43 atm for 8 hr.