摘要:

AbstractAntidepressant medications have been in general use since the late 1950s. Many patients are treated as outpatients and often continue with their normal routines during treatment. Individuals may undertake activities where any change in memory functioning, negative or positive, might have important consequences. Furthermore, many antidepressants have similar efficacy. Information about differential effects upon memory would seem valuable information for the clinician to have at his or her disposal. This paper reviews available evidence on the effects of antidepressants on human memory. Many studies have involved the single or short‐term administration of antidepressants to healthy volunteers, thereby not acknowledging that depressionper sehas a negative impact on memory processes. Even in the studies on patient samples, groups very with regard to type and severity of depression, dosage and duration of treatment. Limited evidence, however, does suggest that antidepressants may exert differential effects upon memory functioning which could be predicted from their action on specific neurotransmitter syste

ISSN:0885-6222    

DOI:10.1002/hup.470060202

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractThe four traditional aspects of validity comprise: criterion, content, face and construct. Criterion validity is assessed by calculating the degree of correlation between test score and external criterion (e.g. driving ability of flying skill). While this form of evidence is rare, it has been demonstrated in a few psychopharmacology studies, especially with psychomotor tasks (e.g. target tracking). Content validity is an index of the appropriateness of test selection. Many test batteries cover a wide range of psychological functions, and thus display a degree of content validity. However, the functions being assessed often differ, reflecting the absence of agreement over what ‘human performance’ should comprise. Most test batteries also contain a preponderance of simple tasks, and content validity could be improved through the inclusion of ‘higher cognitive’ tasks. The difficulties of assessing performance using a single test are also critically examined. Face validity is not a true index of validity, but a reflection of whether the test looks right. It can often be misleading, although it does have positive functions (e.g. for subject motivation). Sensitivity to psychoactive drug effect is also a prerequisite for tests in this area, although it is not in itself an index of validity. The construct validity of human performance tests, together with an overview of test meaning and interpretation, are examined in the final paper of this

ISSN:0885-6222    

DOI:10.1002/hup.470060203

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractForty‐eight healthy volunteers with a normal sleep/wake history participated in a two‐centre, double‐blind, parallel group study comparing the effects of estazolam 2.0 mg, triazolam 0.25 mg, and placebo on sleep, performance and alertness following 180 degree reversal in sleep/wake schedule. Sleep‐phase reversal produced decreased sleep time, primarily during the last 2 hours of the sleep period. Estazolam prevented this transient insomnia by maintaining sleep in the latter part of the sleep period. Triazolam did not significantly change total sleep time, which was intermediate between that of the estazolam and placebo groups. Neither active compound produced significant effects on subsequent performance or al

ISSN:0885-6222    

DOI:10.1002/hup.470060204

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractThe cognitive decline in Alzheimer's disease has been shown to correlate with deficits in central cholinergic neurotransmission. Among various treatment attempts using cholinergic drugs a trial of the cholinesterase inhibitor tetrahydroaminoacridine (THA) (Summerset al., 1986) attracted considerable interest due to the positive effects reported on dementia symptoms. We have studied the effects of THA and placebo in a double‐blind crossover trial over 9 weeks in 15 patients with dementia of Alzheimer type. Doses of the drug (75–150mg/day) were titrated for each patient before entering the study. Clinical and biochemical effects were monitored using a battery of psychological tests, clinical rating scales and laboratory tests, including measurements of monoamine metabolites in the cerebrospinal fluid (CSF). The clinical results were mostly negative. Almost half of the patients had elevated liver enzymes (ALT and AST) in the THA period and these subjects showed more improvements of clinical ratings and psychological tests than did the patients without elevated liver enzymes. Levels of acetylcholine and the monoamine metabolites HVA and 5‐HIAA in CSF were elevated on THA. The results indicate that THA has a therapeutic potential, although its pharmacokinetic profile and its liability to induce liver damage may limit the clinical use of the drug in the f

ISSN:0885-6222    

DOI:10.1002/hup.470060205

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractSingle doses of caffeine (250 mg, 500 mg) or placebo were administered double‐blind to healthy volunteer subjects (n= 12), using a fully balanced crossover design (Williams square) with 1‐week washout. Assessments were made predrug, and at 45 min and 165 min post‐drug administration. The test battery comprised physiological measures (blood pressure, heart rate and urinary volume), subjective measures of alertness, a letter cancellation task (one‐target, two‐target and four‐target versions), and two computerized measures of attention and vigilance: a rapid information processing task and a continuous attention task. Physiological variables did not alter following caffeine administration, but subjective and cognitive variables showed significant changes in the predicted direction. Thus, doserelated changes in subjective calmness and interest were observed, together with changes in performance for the letter cancellation task at low and intermediate difficulty levels. A dose‐related performance improvement was observed for the rapid information processing task. The continuous attention task was also sensitive to the effects observed for the rapid information processing task. The continuous attention task was also sensitive to the effects of caffeine. The 250 mg dose offset the decline in attention observed under placebo, and indeed facilitated performance at both post‐drug administration times. The 500 mg dose impaired performance at 45 min and improved it at the 165 min post‐administration time. Sensitivity to vigilance change was also observed within test sessions for this test, indicating that the continuous attention task was more sensitive to caffeine‐induced changes in attention than the rapid informat

ISSN:0885-6222    

DOI:10.1002/hup.470060206

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractThe effects of clobazam on critical flicker fusion threshold (CFFT) and menstrual cycle‐related symptomatology were examined in a double‐blind placebo‐controlled study of 11 normally cycling women. Clobazam 10 mg or placebo was administered in two doses, the evening before and the morning of testing at four points in the menstrual cycle (days 7, 14, 21 and 26). Subjects were tested on CFFT and completed the Menstrual Distress Questionnaire (MDQ) and the Premenstrual Mood Index (PMI). Results showed that clobazam did not disrupt the menstrual cycle rhythm in CFFT, which accords with the non‐sedative nature of this drug. The lack of effect of clobazam on subjective indices, Impaired Concentration and Behaviour Change of the MDQ confirms the lack of sedative effects. A general tendency, however, was observed for clobazam to reduce symptom reports on some other MDQ PMI scales in the first half of the cycle and to produce a subsequent exacerbation of symptoms in the second half of th

ISSN:0885-6222    

DOI:10.1002/hup.470060207

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractThe influence of ageing on serum levels of tertiary tricyclic antidepressants (TCAs) was studied in 385 psychiatric inpatients treated daily with one of three TCAs: 157 patients with amitriptyline (154 ± 47 mg, mean dose ± SD), 183 with doxepin (177 ± 59 mg) and 45 with clomipramine (153 ± 51 mg). The patients were divided into three age groups: 125 of them were aged65 years. The numbers of blood samples for gas‐chromatographic monitoring of steady‐state concentrations of serum tertiary and secondary TCAs were 192 for amitriptyline, 240 for doxepin and 138 for clomipramine. The concentrations of serum amitriptyline and nortriptyline rose in an age‐related manner. The serum clomipramine and norclomipramine concentrations were higher in the middle‐aged than in the young patient groups, whereas serum doxepin and nordoxepin concentrations changed less markedly with advancing age. The variations of serum amitriptyline and nortriptyline concentrations were not greater in old patients than in middle‐aged ones. Neither were the variations in doxepin and nordoxepin concentrations enlarged with advancing age (but those in clomipramine and norclomipramine concentrations were wider in middle‐aged than in young patients). The number of too high (‘toxic’) TCA concentrations was inconsistently greater in the elderly than in the two younger age groups. The results suggest that the liability of old patients to the adverse effects of TCAs is not—at least with all TCA treatments—due to the enlarged variation in serum drug levels or to the increased frequency of ‘toxi

ISSN:0885-6222    

DOI:10.1002/hup.470060208

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractA double‐blind controlled trial of Fengabine, a GABA agonist, against placebo was carried out in outpatient major depressives. Subjects were treated for up to 6 weeks with Fengabine three times daily using 900 mg daily in the first week and 1800 mg daily thereafter. A total of 49 subjects were included, of whom 32 completed 6 weeks. Efficacy analyses showed no evidence of superiority of active drug over placebo, and the two groups were closely comparable throughout the study. Fengabine was free of subjective side‐effects other than a small number of complaints of nausea and diarrhoea, and some ocurrence of bright yellow urine. There was a substantial incidence of raised liver enzymes: 44 per cent of patients on Fengabine developed somede novoelevation, necessitating early termination of the study. The findings did not support any therapeutic value for this group of GABA agonists in depress

ISSN:0885-6222    

DOI:10.1002/hup.470060209

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractWe and others have previously reported that the non‐specific serotonin receptor antagonist methysergide inhibits the PRL response to ECT wheras the 5HT‐2 antagonists ketanserin and ritanserin have no effect. In the present study the effect of serotonin uptake inhibition on this neuroendocrine response was examined in two separate placebo‐controlled experiments. According to our results neither clomipramine (25 mg orally) nor fluoxetine (20 mg orally) affected the PRL response to ECT. An analysis of the placebo day data from 32 subjects indicates that a high PRL response to ECT is associated with female sex and bilateral electrode plac

ISSN:0885-6222    

DOI:10.1002/hup.470060210

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractBlood concentrations of oxytocin (OT), vasopressin (VP) and their associated neurophysins were measured before and after the first electroconvulsive therapy (ECT) given to 12 depressed patients. The maximum concentrations of all four peptides coincided at +2 min, but the increases in OT and VP were about four‐fold greater than their associated neurophysins. None of the peptide increases correlated with spike‐wave or total cerebral seizure activity as measured by electroencephalog

ISSN:0885-6222    

DOI:10.1002/hup.470060211

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY