RESUMEN
The ECG parameters were studied and compared in normal subjects and patients suffering from affective psychosis running bi- and monopolar course during the development of the depressive phase and after its removal. At the prodromal stage before treatment, the patients manifested sinus tachycardia, changes in the ST configuration and QRS complex. On the histograms of RR intervals distribution, the modal value was shifted to the area of short intervals, the mode amplitude was higher whereas the variation range was more narrow than in the healthy subjects. Intergroup comparisons of the changes in the ECG parameters have shown that the disturbances were more remarkable in the patients with bipolar psychosis. At the initial stage of the treatment with antidepressants, the disorders were either unchanged or got intensified. The initial positive changes in the study parameters were seen only in the presence of the initial clinical improvement. However, the intergroup differences increased at the same time. The removal or appreciable reduction of the psychopathological symptomatology revealed a reversible nature of the changes in myocardial depolarization and disorders of conduction within the system of His bundle crura, seen before treatment. Still, the patients continued manifesting sinus tachycardia and changes in the cardiointerval histograms, particularly those with monopolar depressive psychosis.
Asunto(s)
Antidepresivos/uso terapéutico , Trastorno Bipolar/fisiopatología , Trastorno Depresivo/fisiopatología , Frecuencia Cardíaca/fisiología , Contracción Miocárdica/fisiología , Adolescente , Adulto , Trastorno Bipolar/tratamiento farmacológico , Trastorno Depresivo/tratamiento farmacológico , Electrocardiografía , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Persona de Mediana Edad , Contracción Miocárdica/efectos de los fármacos , Estimulación QuímicaRESUMEN
As many as 244 patients suffering from endogenous affective psychosis were examined by the clinico-catamnestic method. The clinical and pathogenetic heterogeneity of the given disease has been established. It manifests itself not only in the phenomenologic characteristics of the phasic affective conditions themselves but also in differences of the regularities of the disease course and prediction. Five types of the course of affective psychosis are described. It is discussed whether it is rightful to divide the disease into mono- and bipolar forms as reflecting the disease heterogeneity to the greatest degree.
Asunto(s)
Trastornos Psicóticos Afectivos/diagnóstico , Trastornos Psicóticos Afectivos/clasificación , Trastorno Bipolar/clasificación , Trastorno Bipolar/diagnóstico , Trastorno Depresivo/clasificación , Trastorno Depresivo/diagnóstico , Diagnóstico Diferencial , HumanosRESUMEN
During an experimental psychological examination of 75 patients with endogenous affective psychosis differentiated according to the affect polarity in the disease course, a study was made of the stable personality traits responsible for predisposition to the disease and characterizing the patients' emotional sphere. The comparison of the pathopsychological data to the clinical characteristics supported the rightfulness of differentiating the premanifest condition in accordance with the qualitative traits of the personality structure into pseudopsychopathic, psychopathic and accentuated states as most corresponding to the division of affective psychosis into the mono- and bipolar forms. The implication of the personality factors in the pathogenesis of the distinguished varieties of affective psychosis and the rightfulness of their differentiation by the polarity of the major affect in the disease picture are under discussion.
Asunto(s)
Trastornos Psicóticos Afectivos/psicología , Emociones , Personalidad , Adolescente , Adulto , Trastornos Psicóticos Afectivos/diagnóstico , Anciano , Cuestionario de Factores de Personalidad de Cattell , Humanos , Persona de Mediana EdadRESUMEN
Emotional reactivity of patients with endogenous depression and healthy test subjects towards classic and rock music was compared. According to the questionnaire data and EEG recording, it was established that in depressed patients, analysis and estimation of the emotionally significant information differ from those in healthy persons. In contrast to normals, the classic music exerts an activation effect on the patients whereas rock music evokes negative emotions. Analysis of the time-course of changes in the EEG points to alterations in the system of nonspecific activation in depressions.
Asunto(s)
Trastorno Depresivo/psicología , Emociones/fisiología , Música/psicología , Adulto , Corteza Cerebral/fisiopatología , Trastorno Depresivo/fisiopatología , Electroencefalografía , Femenino , Humanos , Persona de Mediana Edad , Valores de Referencia , Autoevaluación (Psicología) , Encuestas y CuestionariosRESUMEN
In a population of drug-free bipolar and unipolar depressed women, it was found that the concentration of serotonin sufficient to induce half-maximal shape change velocity in platelets is significantly (p less than 0.001) lower (0.13 +/- 0.0.04 microM) than that of closely matched controls (0.532 +/- 0.1 microM). This platelet concentration becomes higher after 1-3 months of antidepressant treatment (0.47 +/- 0.16 microM). Possible mechanisms for this up- or down-regulation of platelet serotonin receptor responsiveness are discussed.
Asunto(s)
Antidepresivos/uso terapéutico , Trastorno Bipolar/tratamiento farmacológico , Plaquetas/efectos de los fármacos , Trastorno Depresivo/tratamiento farmacológico , Receptores de Serotonina/efectos de los fármacos , Serotonina/sangre , Adulto , Trastorno Bipolar/sangre , Carbazoles/uso terapéutico , Trastorno Depresivo/sangre , Femenino , Humanos , Imipramina/uso terapéutico , Masculino , Maprotilina/uso terapéutico , Persona de Mediana Edad , Agregación Plaquetaria/efectos de los fármacosRESUMEN
A comparative clinical analysis was made of the therapeutic efficacy of 13 atypical antidepressants (of the second generation and novel ones) and 5 typical (tricyclic) antidepressants in 1107 patients with depressions of varying nosology, syndromal structure and gravity. The data on psychotropic activity of atypical antidepressants and preferable indications for their administration are provided. The correlations between thymoleptic, anxiolytic and activating influences seen in the spectrum of their psychotropic action are discussed. Recommendations are given for the treatment with these agents of relatively mild depressions of the neurotic and psychopathic types in slow-progressive and border-line mental diseases. It is assumed that the second generation antidepressants occupy an intermediate position between antidepressants, tranquilizers and psychostimulants in the current systematics of psychotropic agents.
Asunto(s)
Antidepresivos/uso terapéutico , Trastorno Depresivo/tratamiento farmacológico , Adolescente , Adulto , Anciano , Ensayos Clínicos como Asunto , Evaluación de Medicamentos , Europa (Continente) , Humanos , India , Persona de Mediana Edad , U.R.S.S.RESUMEN
The processes of lipid peroxidation were studied in healthy subjects and patients with manic-depressive psychosis and schizophrenia using a non-invasive method based on chromatographic determination of endogenic pentane in the expired air. In patients with circular psychosis pentane concentration in the expired air did not differ from the norm, yet with advancing age it decreased (in contrast to an elevation in normal subjects). In schizophrenic patients pentane levels were significantly higher than in age-matched normal subjects. The level of the studied parameter was not correlated with the duration of the disease but showed a definite correlation with the severity of adverse disturbances in schizophrenia.
Asunto(s)
Trastorno Bipolar/metabolismo , Peroxidación de Lípido , Pentanos/análisis , Esquizofrenia/metabolismo , Adolescente , Adulto , Cromatografía de Gases , Femenino , Humanos , Masculino , Persona de Mediana Edad , RespiraciónRESUMEN
Effective 5-HT concentration eliciting the half-maximal rate of platelet deformation (aggregation) in drug-free bipolar or unipolar depressed women was significantly (p less than 0.001) lower as compared with matched controls (0.13 +/- 0.04 microM and 0.532 +/- 0.1 microM, respectively). After 1-3 months of antidepressant treatment this value increased to 0.47 +/- 0.16 microM and was no longer different from control. Possible mechanisms controlling the activity of serotonin2 platelet receptors are discussed.
Asunto(s)
Antidepresivos/uso terapéutico , Plaquetas/análisis , Trastorno Depresivo/tratamiento farmacológico , Receptores de Serotonina/análisis , Serotonina/sangre , Adolescente , Adulto , Antidepresivos/administración & dosificación , Antidepresivos/farmacología , Trastorno Depresivo/sangre , Trastorno Depresivo/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos Biológicos , Agregación Plaquetaria , Receptores de Serotonina/fisiología , Factores de TiempoRESUMEN
The potency of imipramine (IMI) and trazodone (TRA) to inhibit (3H)-serotonin intake in unipolar and bipolar endogenous depressed patients (women aged 17 to 57 years) was evaluated before and during the antidepressant treatment. The potency of IMI was lower and that of TRA higher in patients as compared to controls. The both drugs' potencies became normal in patients treated with antidepressants. The significant decrease of imipramine binding sites density (Bmax) was evident after the treatment as against the normal levels. Significant correlation was observed between a severity of the patient's state evaluated using Hamiltone depression rating scale and the TRA potency but not IMI potency or Bmax. The data suggest different mechanisms regulating the serotonin uptake sensitivity to IMI and TRA. These are apparently involved in the pathogenesis of endogenous depression.
Asunto(s)
Antidepresivos/uso terapéutico , Trastorno Bipolar/sangre , Plaquetas/metabolismo , Trastorno Depresivo/sangre , Imipramina/farmacología , Serotonina/sangre , Trazodona/farmacología , Adolescente , Adulto , Trastorno Bipolar/tratamiento farmacológico , Plaquetas/efectos de los fármacos , Medios de Cultivo , Trastorno Depresivo/tratamiento farmacológico , Interacciones Farmacológicas , Femenino , Humanos , Técnicas In Vitro , Persona de Mediana Edad , Antagonistas de la Serotonina , TritioRESUMEN
In schizophrenic patients, the course of lipid peroxidation (LP) was investigated as indicated by pentane contents in the expired air (gas chromatography) during a course of psychotropic drug therapy. In 80% of the patients LP was activated before the therapy and reduced in its course with the levels in remission comparable to those characteristic of healthy controls. The LP decreased in a "leap-like" manner with episodes far exceeding the control levels. These leaps' rate and the baseline LP increase before therapy positively correlated with severity of the signs of the disease, its duration, and pre-existing level of negative disorders.
Asunto(s)
Peroxidación de Lípido , Esquizofrenia/metabolismo , Adulto , Pruebas Respiratorias , Cromatografía de Gases , Humanos , Peroxidación de Lípido/efectos de los fármacos , Pentanos/análisis , Pentanos/metabolismo , Esquizofrenia/tratamiento farmacológicoRESUMEN
Using gas chromatography the authors have studied the time course of lipid peroxidation (LPO) in patients with manic depressive psychosis (a depressive phase) during a course of antidepressive therapy. The results indicate that the levels of LPO in young patients (up to 30 years) with a disease standing of up to 5 years are significantly higher than in age-matched controls whereas with increasing duration of the disease the levels of this parameter decrease and in elderly patients (over 50 years) with a longer duration of the disease (over 15 years) this parameter is significantly lower than in age-matched controls. A decrease of LPO is particularly pronounced in a bipolar course of manic depressive psychosis.
Asunto(s)
Trastorno Bipolar/metabolismo , Peróxidos Lipídicos/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Trastorno Bipolar/terapia , Pruebas Respiratorias , Cromatografía de Gases , Enfermedad Crónica , Femenino , Humanos , Persona de Mediana Edad , Oxidación-Reducción , Pentanos/análisisRESUMEN
The inhibitory effect of imipramine (IC50) on [3H]serotonin uptake and its kinetic parameter (V400) were measured in platelets of 9 patients with unipolar and 6 with bipolar affective disorder. The IC50 and V400 values in depressed patients were significantly higher (p less than 0.002) than these found in the control group. Treatment with antidepressants significantly decreased the IC50 values. The results support the hypothesis postulating that depression is related to a decreased modulatory capacity of imipramine binding sites and that the clinical effectiveness of these drugs is associated with the said modulatory capacity.
Asunto(s)
Trastorno Bipolar/tratamiento farmacológico , Plaquetas/metabolismo , Trastorno Depresivo/tratamiento farmacológico , Imipramina/uso terapéutico , Serotonina/sangre , Adolescente , Adulto , Trastorno Bipolar/sangre , Plaquetas/efectos de los fármacos , Medios de Cultivo , Trastorno Depresivo/sangre , Resistencia a Medicamentos , Femenino , Humanos , Imipramina/farmacología , Técnicas In Vitro , Persona de Mediana Edad , Antagonistas de la SerotoninaRESUMEN
Radioimmunological procedure enabled to estimate alpha- and gamma-endorphins in human blood plasma without pre-extraction. Basal level of these neuropeptides in peripheric blood plasma of 18 healthy donors constituted: C alpha = 392 +/- 244 pg/ml and C gamma = 20.6 +/- 9.1 pg/ml. Content of these endorphins in blood plasma did not depend on age and sex. Concentration of alpha- and gamma-endorphins were shown to correlate in peripheric blood (r = 0.88); this suggests the overall mechanisms for regulation of their synthesis, secretion and degradation. At the same time, distinct differences in concentrations of alpha- and gamma-endorphins in blood plasma were not found in groups of healthy donors and of patients with endogenous psychoses and pronounced depressive symptoms.
Asunto(s)
Trastorno Depresivo/sangre , Endorfinas/sangre , Adolescente , Adulto , Donantes de Sangre , Femenino , Humanos , Masculino , Persona de Mediana Edad , Radioinmunoensayo , alfa-Endorfina , gamma-EndorfinaRESUMEN
The intensity of lipid peroxidation was studied in schizophrenic and manic-depressive patients. Peroxidation was found to be activated in these diseases as assessed by the content of peroxidation products in the lipid fraction of blood plasma. Manic-depressive patients showed a significant decrease in the intensity of peroxidation processes with improvement in the clinical symptoms of the disease.
Asunto(s)
Trastorno Bipolar/sangre , Peróxidos Lipídicos/sangre , Bases de Schiff/sangre , Esquizofrenia/sangre , Adolescente , Adulto , Femenino , Fluorometría , Humanos , Masculino , Persona de Mediana Edad , PolarografíaRESUMEN
On the basis of the clinical examination of 141 patients of both sexes with delirious schizophrenia, the authors present clinical descriptions of different varieties of the premorbid personality make-up and of the types of adverse personality changes in patients with varying course and degree of the disease progression. These parameters are correlated with the dynamic characteristics of the personality at the initial stage of delirious schizophrenia as well as with a number of other clinical-pathogenetic parameters (sex, age at the moment of the disease manifestation). The suggestion is discussed that premorbid personality characteristics and sex have not only pathogenic but also pathoplastic effect on the formation of the clinical picture of the subsequent disturbances. The question is raised whether the clinical parameters characterizing the manifestations and time-course of personality alterations associated with delirious schizophrenia can be used as early prognostic signs.
Asunto(s)
Personalidad , Esquizofrenia/diagnóstico , Adulto , Automatismo/diagnóstico , Deluciones/diagnóstico , Empleo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Esquizofrenia Paranoide/diagnóstico , Psicología del Esquizofrénico , Ajuste Social , SíndromeRESUMEN
The preventive lithium therapy of paroxysm-like endogenic psychoses is associated with a change in the personality responses, in particular to the patient's own mental disease which makes it possible to speak about certain personality changes that manifest themselves phenomenologically by the formation of the adequate criticism of the disease, the psychological dependence on the lithium therapy and by peculiar reduction of emotional responses. The pathogenetic treatment of the described phenomena is sophisticated and calls for the consideration of both therapy and features of the endogenous process.
Asunto(s)
Trastorno Bipolar/prevención & control , Trastorno Depresivo/prevención & control , Litio/uso terapéutico , Personalidad , Esquizofrenia/tratamiento farmacológico , Adolescente , Adulto , Factores de Edad , Anciano , Actitud Frente a la Salud , Trastorno Bipolar/psicología , Trastorno Depresivo/psicología , Emociones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicología del EsquizofrénicoRESUMEN
Multicentre international studies make it possible to amass rapidly and reliably the necessary amount of representative data allowing for the verification of the results obtained by different scientific schools. They also represent the most effective approach to the search for attaining the mutual understanding among specialists of different scientific schools and for the elaboration of uniform clinical outlooks . Guidelines were developed to be adhered to while organizing and conducting multicentre psychopharmacological studies. The authors describe the general scheme and the basic stages of a multicentre psychopharmacological study of leponex which involved specialists from ten centres from six countries (CSSR, GDR, HPR, PRB , PPR, USSR).
Asunto(s)
Clozapina/uso terapéutico , Dibenzazepinas/uso terapéutico , Esquizofrenia/tratamiento farmacológico , Evaluación de Medicamentos/métodos , Europa Oriental , Humanos , Cooperación Internacional , Cinética , PronósticoRESUMEN
To help individual prediction of the therapy efficacy, the authors elaborated a new method for analyzing the response of the clinical and pharmacokinetic parameters to the pre-treatment administration of the test dose of a psychotropic drug. The above approach was employed in a multicentre clinical-pharmacokinetic study of leponex ( clozapin ) which involved ten research centers from six countries and a total of 136 patients. On the basis of the clinical and pharmacokinetic parameters, a cumulative index was obtained and its prediction potentialities were established. The prognostic assessment of the affectiveness obtained on the basis of this approach was in agreement with the real efficacy of the course therapy in 84% of all cases.
Asunto(s)
Clozapina/administración & dosificación , Dibenzazepinas/administración & dosificación , Evaluación de Medicamentos/métodos , Esquizofrenia/tratamiento farmacológico , Clozapina/sangre , Predicción , Humanos , Cinética , Pronóstico , Esquizofrenia/sangreRESUMEN
Leponex was used to treat 120 schizophrenic patients with doses varying from 50 to 550 mg and the course of therapy lasting for two months. Considerable specificities were revealed in the spectrum of the drug psychotropic activity and the nature of its side effects. Leponex was especially effective in cases of delirious, hallucinational and catatonic symptomatology. This drug was proved to be a method of choice in progressive protracted schizophrenic psychoses accompanied by the above disorders. The regimen of gradual and slow accretion of daily doses throughout the treatment with leponex utilized in this study is assessed as optimal for preventing the development of toxic side effects associated with the use of this drug.
Asunto(s)
Clozapina/administración & dosificación , Dibenzazepinas/administración & dosificación , Esquizofrenia/tratamiento farmacológico , Adolescente , Adulto , Antipsicóticos/uso terapéutico , Escalas de Valoración Psiquiátrica Breve , Clozapina/efectos adversos , Deluciones/tratamiento farmacológico , Femenino , Alucinaciones/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Esquizofrenia/diagnóstico , Esquizofrenia Catatónica/tratamiento farmacológicoRESUMEN
The use of prolonged-action lithium carbonate preparations (quilonormretard and micalite) in 53 patients with manic-depressive psychosis and schizophrenia has shown that those drugs possess pronounced prophylactic properties. An open, two-stage control examination of 35 patients has demonstrated an advantage of the prolonged-action lithium carbonate preparations over instant-action ones in preventing relapses of affective and schizoaffective psychoses. Peculiarities of the prolonged-action lithium carbonate preparations on the quantitative and qualitative characteristics of the disease course are discussed.