ISSN:0271-0749    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

The disposition of orally administered imipramine (IMI) was studied in 11 depressed alcoholic and 12 depressed nonalcoholic male inpatients. Subjects received 50 mg three times daily for at least 10 days to ensure steady state. Following a temporary discontinuation of therapy, several blood samples were drawn over a 40-hour period. Imipramine, desipramine, and their 2-hydroxylated metabolites were measured in plasma using a high performance liquid chromatography assay. Eight hours following the last dose, alcoholics had significantly lower IMI (50 ± 41 versus 106 ± 46 ng/ml;p<0.005) and 2-hydroxyimipramine (12.8 ± 7.5 versus 22.6 ± 9.8 ng/ml; p< 0.01) levels than controls. The mean terminal half-lives in the two groups were nearly identical (16.3 ± 6.7 hours in alcoholics versus 17.1 ± 5.4 hours in controls). Beck Depression Inventory scores were significantly reduced during IMI therapy (p<0.001) in the nonalcoholic controls, whereas no change was observed in the alcoholic group. These results are consistent with either a decrease in oral bioavailability of IMI in alcoholics or, assuming complete absorption, an increase in intrinsic clearance of 2.5 fold (2444 ± 1151 versus 986 ± 438 ml/min;p<0.005) over the clearance found in control subjects. The latter seems a more likely result of chronic ethanol intake. The fact that lower levels of IMI in the alcoholic group were accompanied by a lack of efficacy in relieving depressive symptomatology suggests that whether through an effect on bioavailability or intrinsic clearance, ethanol consumption is an important consideration when recommending tricyclic therapy.

ISSN:0271-0749    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

An understanding of the effects of antidepressants on sleep can be aided by determinations of tricyclic plasma levels in relationship to sleep. Previous studies have been established that steady state plasma levels of amitriptyline relate to certain aspects of rapid eye movement (REM) sleep. The present investigations attempt to replicate the REM sleep/tricyclic plasma level relationships in a larger group of psychiatric hospitalized patients for depression and to study whether such relationships persist in a group of ambulatory patients studied longitudinally for 1 to 2 years. In an acute treatment study of 38 patients, REM sleep percent and average REM activity demonstrated a significant relationship with plasma levels, even when controlled for age and severity. The sleep-plasma level relationships seem more prominent with amitriptyline levels than with nortriptyline plasma levels. In a long term comparison of plasma levels, tricyclic plasma levels showed a significant correlation with REM latency, REM percent and average REM activity. Thus, it appears that changes in REM sleep such as REM suppression correlate significantly with tricyclic plasma levels both on a short (4 weeks) and long term basis (1 to 2 years). The implications of these findings are discussed.

ISSN:0271-0749    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

The psychiatric side effects of the major antihypertensive drugs other than reserpine are reviewed, including centrally acting drugs such as methyldopa and clonidine, peripheral adrenergic drugs such as guanethidine, β-adrenòceptor blockers such as propranolol, and diuretics. Problems with differential diagnosis and with the interpretation of case reports make assessment of psychiatric side effects difficult. Sedation and sleep disturbances are the most common side effects, occurring with methyldopa, clonidine, and propranolol. Only methyldopa is clearly associated with depression. Other reported effects are toxic confusional states and psychotic reactions. These are rare, however, and no clear patterns of development have been recognized.

ISSN:0271-0749    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

The antimalarial chloroquine is a widely used medication prescribed for a variety of conditions. The authors indicate that its lethality and behavioral side effects are significant and may be underestimated. Moderately low overdosage of chloroquine can result in rapid death. Moreover, therapeutic doses are known to cause psychosis, delirium, personality changes, and depression. It is hypothesized that a drug-induced alteration of mood or a toxic confusional state may result in unintended overdosage and death. Clinicians should consider prodromal signs of toxicity and not classify overdosage prematurely as attempted self-poisoning.

ISSN:0271-0749    

出版商:OVID    

年代:1982

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1982

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1982

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1982

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1982

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1982

数据来源: OVID