ISSN:0271-0749    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;This symposium offers the practicing clinician a general overview of ongoing research strategies exploring possible functional alterations in neurotransmitters, neuroreceptors, and regulatory neuropeptides in subjects with major affective disorders. Such alterations, if demonstrable, might provide new mechanistic insights into the pathophysiology of these illnesses and suggest novel therapeutic approaches to their pharmacological management. Rather than attempting to describe all neurobiological research strategies, we have selectively focused on strategies using specific pharmacological challenges attempting to perturb discrete central nervous system neurotransmitter pathways while recording the behavioral and neuroendocrine correlates of such manipulations. This introductory manuscript will describe the advantages as well as the limitations of such strategies and, in addition, will attempt to provide a general overview of neuroanatomical, neurochemical, and neuroendocrine mechanisms relevant to a conceptual understanding of the putative psychiatric relevance of such strategies.

ISSN:0271-0749    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;The cholinergic‐adrenergic balance hypothesis of affective disorders suggests that, in the areas of the brain that regulate mood, depression may represent a relative predominance of central cholinergic tone over adrenergic tone and that mania may represent the converse. Currently, converging lines of investigation from a number of independent groups suggest that affective disorder patients may have a central cholinergic receptor hypersensitivity that induces a vulnerability to affective and neuroendocrine disturbances. This article reviews the evidence for cholinergic mechanisms in the regulation of affective state and describes current research strategies using centrally active cholinomimetic agents to explore disturbances in affective disorder subjects.

ISSN:0271-0749    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;The authors review studies of dopaminergic agents in affective disorder patients. Although evidence from cerebrospinal fluid studies, from the pharmacology of the antidepressants, and from several clinical trials implicates the dopamine system in the regulation of mood or activity level, as yet, no replicated study shows that affective disorder patients are different from normals in their neuroendocrine response to the dopaminergic agents L‐dopa and apomorphine. Some possible reasons for this apparent normality of neuroendocrine response are discussed.

ISSN:0271-0749    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Peptides regulate neuroendocrine and limbic system functioning in animals. Both systems show major disturbances in the affective disorders. Only thyrotropin releasing hormone (TRH), luteinizing hormone releasing hormone (LHRH), melanocyte stimulating hormone inhibiting factor (MIF‐I), and 1‐desamino‐8‐D‐arginine vasopressin (DDAVP) have been administered to affectively ill patients. The thyroid stimulating hormone (TSH) response to TRH is blunted (≤5 μU/ml) in some patients during depression and mania and in alcoholics. The blunted response may be an important tool in the diagnosis of depression and mania. Together with other demonstrated endocrine abnormalities, the blunted TSH response suggests a profound alteration in the physiological relationship between the central nervous system and the anterior pituitary in affective illness. Behaviorally, TRH, LHRH, DDAVP, and MIF‐I have general activating effects in humans that have not yet been demonstrated to be restricted to or specific to affective illness. The interpretation of peptide challenges, however, in the study of affective illness is obfuscated by the small number of patients used and the multiple sites that peptides at pharmacological doses may affect.

ISSN:0271-0749    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;The discovery of an endogenous opioid system has been rapidly followed by animal studies suggesting its importance in neuroendocrine regulation and behavior. Abnormalities of these functions in affective illness suggest that evaluation of behavioral and hormonal responses following the clinical administration of opiate agonists or antagonists might yield information pertinent to the pathogenesis, diagnosis, and treatment of depression. However, initial double‐blind controlled clinical studies have yielded little evidence to support this suggested involvement of the opioid system in affective illness. Acute administration of opiate agonists has sometimes yielded a mild antidepressant response in depression, and naloxone has occasionally been reported beneficial in mania. There is, however, little to suggest that these responses are specific to affective illness. A decreased prolactin response to morphine administration has been reported in depression, but is not direct evidence of opioid system dysfunction in depression since abnormal prolactin responses to other challenges in depression have previously been reported. The endogenous opioid system is actually multiple systems marked by distinct distributions of multiple endogenous opioid peptides and opiate receptor subtypes, as well as varying accessibility to drug administration. Future challenges in depression may rely upon the development of opiate agonists and antagonists with preferential binding to opiate receptor subtypes and preferential distributions to stress particular endogenous opioid systems. Opiate peptide challenges may well be administered intrathecally to overcome the blood‐brain barrier. Opiate antagonist challenges will rely upon increasing doses of naloxone, up to 10 mg/kg, in order to increase the range of blocked endogenous opiate systems. Chronic administration of challenges has been a seldom used strategy but may be important in evaluation of the physiology of sensitization and tolerance to pleasure in affective illness.

ISSN:0271-0749    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;This paper reviews the neuroanatomy and neuropharmacology of the central serotonergic system. Clinical evidence implicating altered serotonergic function in patients with affective disorders is summarized, as are the attempts to uncover central serotonergic dysfunction in these patients using pharmacological challenges. The authors conclude that the function of the brain serotonergic system in patients with affective disorders is relatively unexplored and would be a fruitful area of study for both the clinician and researcher.

ISSN:0271-0749    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1981

数据来源: OVID