摘要:

ABSTRACTThis article reviews progress in research on childhood phobia, generalized anxiety, and separation anxiety disorders from the perspectives of developmental psychopathology and affective neuroscience. These perspectives represent two organizing theoretical schools in the realms of clinical and basic science research. Studies in developmental psychopathology suggest the need to identify specific subgroups of children with one of these anxiety disorders who are particularly at risk for anxiety disorders in adulthood. Studies in affective neuroscience suggest potential neurobiological avenues for identifying such children who face a particularly high risk for chronic anxiety disorders.

ISSN:1044-5463    

DOI:10.1089/cap.1999.9.1

年代:1999

数据来源: MAL

摘要:

ABSTRACTThis experimental animal study was performed in order to assess possible long-term effects of the administration of the selective serotonin reuptake inhibitor fluoxetine (Prozac®) during early periods of juvenile life on the developing central serotonergic and noradrenergic systems. Fluoxetine was administered via the drinking water (5 mg/kg/day) for a period of two weeks to very young (day 25) and somewhat older (day 50) rats. The effect of this treatment on the density of serotonin and noradrenaline transporters was measured by ligand-binding assays in various brain regions. The Bmax-values of [3H]-nisoxetine binding were not affected by either treatment schedule, but a significant increase of the Bmax-values of [3H]-paroxetine binding was found in the brains of early fluoxetine-treated rats. This increase was restricted to the frontal cortex and persisted long after the termination of the treatment into adulthood (day 90). The most likely explanation of this observation is a stimulatory effect of the fluoxetine treatment on the outgrowth of serotonergic projections in the frontal cortex of very young rats. This is the first empirical demonstration of long-lasting effects of the administration of a selective serotonin reuptake inhibitor during juvenile life on the maturation of the central serotonergic system

ISSN:1044-5463    

DOI:10.1089/cap.1999.9.13

年代:1999

数据来源: MAL

ISSN:1044-5463    

DOI:10.1089/cap.1999.9.25

年代:1999

数据来源: MAL

摘要:

ABSTRACTTo further investigate the possible function of the serotonergic system in the pathophysiology of attention deficit hyperactivity disorder (ADHD), platelet serotonin 5-HT2Areceptors were characterized for 19 ADHD children and 17 age-matched control subjects. Subjects were evaluated using the Diagnostic Interview for Children and Adolescents (DICA-R-C)–DSM IV and the Children's Depression Inventory. An aggressive subgroup was also determined by the presence of two or more positive aggressive symptoms on either subjects' or parents' reports. Platelets were isolated from venous blood and 5-HT2Areceptor number, and affinity was determined using125I-LSD binding. There was no difference in platelet 5-HT2Areceptor binding characteristics between the two groups. The results from this pilot study suggest a limited function of 5-HT2Areceptors in the pathophysiology of ADHD and extend the findings of other previous negative studies of the peripheral serotonergic system in ADH

ISSN:1044-5463    

DOI:10.1089/cap.1999.9.27

年代:1999

数据来源: MAL

摘要:

ABSTRACTThis open-label, parallel-group study assessed pharmacokinetics and tolerability of zolmitriptan, a 5-HT1B/1Dagonist for the acute treatment of migraine, and its active metabolite, 183C91, in adolescents compared with adults. Twenty-one healthy adolescent and 18 healthy adult volunteers (with and without history of migraine) received a single 5-mg dose of zolmitriptan. Mean ages were 14.5 years (range 12–17) for adolescents (13 girls, 8 boys) and 39.1 years (range 18–65) for adults (12 women, 6 men). The area under the curve (AUC) and highest observed plasma concentration (Cmax) of zolmitriptan were similar in both age groups; the half-life was 3.01 hours in adolescents versus 3.75 hours in adults. The AUC and Cmaxof 183C91, however, were 36% and 39% higher in adolescents, respectively; the half-life was similar in both age groups. Adverse events were similar in both groups in terms of nature, intensity, and frequency. Exposure to zolmitriptan was not significantly different in adolescents compared with adults, but a shorter half-life in adolescents suggests faster elimination in this age group. Exposure to 183C91 was higher in adolescents, suggesting that formation of the metabolite is at least one of the elimination routes of zolmitriptan that occurs at a faster rate in adolesce

ISSN:1044-5463    

DOI:10.1089/cap.1999.9.35

年代:1999

数据来源: MAL

摘要:

ABSTRACTOpen-label addition of a low-dose typical (pimozide) neuroleptic was shown to be beneficial in some patients with serotonin reuptake inhibitor (SRI)-refractory trichotillomania (TTM). Risperidone's potentially more benign acute and long-term side effect profile makes it a candidate for investigation in the treatment of TTM. We report our experience with the systematic addition of open-label risperidone 0.5 to 3 mg/day in three patients with SRI-refractory TTM. All three patients had a robust decrease in hair pulling as measured by clinician-rated instruments. These results suggest that risperidone addition to ongoing treatment with SRIs may be an effective treatment strategy for patients with SRI-refractory TTM.

ISSN:1044-5463    

DOI:10.1089/cap.1999.9.43

年代:1999

数据来源: MAL

摘要:

ABSTRACTThis is a single case report of an open trial of nimodipine, a dihydropyridine-type calcium antagonist, in the treatment of a 13-year-old boy with refractory, ultradian rapid cycling, bipolar disorder type I. Prior clinical trials with calcium channel blockers in adults with ultrarapid cycling affective disorder supported an empirical trial of nimodipine for treatment of ultradian rapid cycling in this adolescent. Severity of mania and depression were rated before and after nimodipine therapy. A marked decrease in rapid, repeated, and significant mood changes was clinically observed and measured by standardized scales after 9 days of nimodipine 180 mg daily. No adverse effects were noticed. Remission persisted with continued treatment at 36-month follow-up. Medication response was partially attributed to adjunctive therapy with levothyroxine. Implications of treatment benefit are discussed in the context of novel pharmacotherapies for refractory bipolar disorder. These findings are preliminary and do not provide sufficient basis to recommend nimodipine as the treatment of choice in adolescents with ultradian cycling bipolar disorder, but suggest that controlled studies may be indicated.

ISSN:1044-5463    

DOI:10.1089/cap.1999.9.51

年代:1999

数据来源: MAL

摘要:

ABSTRACTThis is the first reported use of electroconvulsive treatment (ECT) in an adolescent with bipolar mania who had been treated with craniectomy for an intracranial neoplasm. The reported case is of a 16-year-old girl with a history of brain stem glioma (pontomesencephalic astrocytoma) diagnosed at 13 years of age. She presented in a psychiatric emergency room with suicidal ideation, depressed mood, irritability, olfactory hallucinations, early insomnia, grandiosity, and guilt. Her symptoms failed to respond to a trial of an antidepressant, mood stabilizer alone, and mood stabilizer in conjunction with a neuroleptic. The decision to use ECT was based on suicidal ideation, extreme disinhibition, and danger to self and others. Significant improvement in mood and remission in psychosis were noted after the eighth treatment. Comparison of 2-week pre-ECT and 3-month post-ECT cognitive testing revealed no change in IQ. This report highlights rapid response and the ability to tolerate ECT in an adolescent diagnosed with bipolar disorder, who had also been treated with radiation and craniotomy.

ISSN:1044-5463    

DOI:10.1089/cap.1999.9.63

年代:1999

数据来源: MAL