RESUMO
Sleep onset growth hormone secretion is a reliable and reproducible finding in young adults and children. Secretion typically occurs during the first non-REM period of sleep and, despite some evidence to the contrary, growth hormone secretion has frequently been associated with the first period of slow wave sleep. By measuring delta wave activity (0.5-2 Hz) instead of slow wave sleep and, accounting for the within subject variability, it has not been possible to demonstrate a consistent or statistically significant linear relationship between delta wave activity and sleep-related growth hormone secretion. This suggests the presence of more complex mediating factors and the possibility that sleep onset and growth hormone secretion are two separate processes which are independently stimulated by events associated with sleep onset.
Assuntos
Ritmo Delta , Eletroencefalografia , Hormônio do Crescimento/sangue , Fases do Sono/fisiologia , Adolescente , Adulto , Eletroencefalografia/instrumentação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Processamento de Sinais Assistido por ComputadorRESUMO
Prior studies suggest that the addition of lithium salts may enhance treatment responses in depressions that have not responded to tricyclic antidepressants. The authors report on the efficacy of lithium augmentation in an open-label study of 20 outpatients with recurrent major depression who had not responded to greater than or equal to 12 weeks of treatment with imipramine (mean dosage = 256 mg/day) and psychotherapy. Only 1 patient (5%) responded during the first week of treatment, but the cumulative response rate increased to 65% during the 6-week clinical trial. Improvement in patients receiving lithium augmentation was significantly greater than the improvement observed in a historical control group of imipramine-resistant patients who received continued treatment with the imipramine-psychotherapy combination. The results support the usefulness of a 6-week trial of lithium augmentation in outpatients with resistant depression. It remains unclear whether the effectiveness of lithium augmentation is due to a true potentiation effect, a primary antidepressant effect by lithium, or a combination of both those factors.
Assuntos
Transtorno Depressivo/tratamento farmacológico , Imipramina/uso terapêutico , Adulto , Ensaios Clínicos como Assunto , Terapia Combinada , Transtorno Depressivo/terapia , Quimioterapia Combinada , Feminino , Humanos , Lítio , Carbonato de Lítio , Masculino , Pessoa de Meia-Idade , PsicoterapiaRESUMO
The discovery of clinical and biological variables which correlate with the rate of treatment response is an important aim of outcome research. In this report, such items were assessed in a large group of patients with recurrent depression to determine what variables contribute to stabilization during treatment. Relatively few items were strongly related to time to stabilization aside from age, clinical severity of illness, and number of previous episodes. One biological variable, cortisol nadir, was positively related to the time of stabilization. Similar assessments of non-responders did not yield any specific predictors.