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Clinical Trial 2006; 27(4): 433-437 PubMed PMID: 16892008 Citation  Keywords:  Adult, Anxiety:physiopathology, Depression:physiopathology, Dexamethasone, Feedback, Physiological:drug effects, Follow-Up Studies, Glucocorticoids, Humans, Hydrocortisone:blood, Hypothalamo-Hypophyseal System:physiology, Immunosuppression, Male, Pituitar.   

OBJECTIVES: Higher rates of dexamethasone test (DST) nonsuppression in schizophrenia have been attributed to depressive symptoms, suicidality and negative symptoms. No study concerning first-episode schizophrenia has yet been published.

DESIGN: In patients hospitalised for the first time with first-episode schizophrenia the DST has been performed before, at the end of the acute treatment and after one year. At the same time the clinical evaluation with PANSS was performed. A cortisol value >5 microgram/dl in either of the postdexamethasone samples indicated nonsuppression of cortisol.

RESULTS: A total of 56 males were included. 18% of pts were DST nonsuppressors at medication-free baseline, 5% and 16% after acute treatment and after one year respectively. After 1 year 42/56 of patients fulfilled the criteria of remission. The rate of nonsuppression was 21.4%, 5% and 16.4% in remitters and 7%, 7% and 14.3% in nonremitters. Significant differences in the whole group were found between postdexamethasone cortisolemia at discharge on the one hand and on admission and at the one-year follow-up on the other. Significant correlations were observed between postdexamethasone cortisolemia and negative symptoms at the end of acute treatment.

MAIN FINDINGS: In first-episode schizophrenia the short-term treatment led to a decrease in cortisolemia and rates of nonsuppression and an increase at a one-year follow-up.

CONCLUSIONS: Rates of DST nonsuppression in schizophrenia including first-episode schizophrenia are influenced by the stage of illness and medication status. The impairment of feedback regulation of cortisol secretion may be related to different biopathogenetic mechanisms depending on the phase of the illness....

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Journal Article 2006; 27(4): 415-423 PubMed PMID: 16891999 Citation  Keywords:  Adult, Apolipoprotein E2:genetics, Chronic Disease, Dental Amalgam:adverse effects, Dental Restoration, Permanent, Depression:chemically induced, Fatigue:chemically induced, Female, Genetic Predisposition to Disease, Genotype, Humans, Male, Memory Disorde.   

: In a group of 465 patients diagnosed as having chronic mercury toxicity (CMT), 32.3% had severe fatigue, 88.8% had memory loss, and 27.5% had depression. A significant correlation was found between CMT and the Apo-lipoprotein E4 genotype (p=0.001). An investigation into an additional 864 consecutively seen general practice patients, resulted in 30.3% having evidence consistent with CMT, and once again a significant correlation was found with the APO-E4 genotype (p=0.001). Removal of amalgam mercury fillings when combined with appropriate treatment resulted in a significant symptom reduction (p<0.001) to levels reported by healthy subjects....

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Case Reports 2006; 27(1-2): 260-262 PubMed PMID: 16648780 Citation  Keywords:  Anticonvulsants:therapeutic use, Antidepressive Agents:therapeutic use, Carbamazepine:therapeutic use, Catatonia:classification, Depression:complications, Electroencephalography, Female, Humans, Hypnotics and Sedatives:therapeutic use, Middle Aged, Moclob.   

: We describe a patient who was ill for more than 15 years. She was treated predominantly as a neurological case because of multiple motor signs. The diagnosis of catatonia was considered at the time when she was hospitalized in a psychiatric hospital after a suicidal attempt. The "therapeutic blindness", which was obviously present during 15 years of her illness, is discussed: the ICD--10 is perhaps misleading regarding this diagnosis while it associates it too tightly only to schizophrenia....

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Journal Article 2005; 26(5): 581-592 PubMed PMID: 16264397 Citation  Keywords:  Animals, Arylalkylamine N-Acetyltransferase:antagonists & inhibitors, Data Interpretation, Statistical, Depression, Chemical, Female, In Vitro Techniques, Melatonin:metabolism, Norepinephrine:antagonists & inhibitors, Perfusion, Pineal Gland:cytology, Rad.   

OBJECTIVES: Cell-permeable and specific inhibitors of melatonin secretion are sill lacking among tools of the pineal research. Recently, a large effort has been made in the development of arylalkylamine N-acetyltransferase inhibitors, but in most cases the new drugs were tested exclusively using cell-free assays or non-pineal cells. The aim of the present study was to characterize the effect of N-bromoacetyltryptamine (BAT), the first synthesized cell-permeable inhibitor of arylalkylamine N - acetyltransferase, on melatonin secretion from rat and pig pineal glands.

METHODS: The studies were performed in the superfusion cultures of rat and pig pineal explants. Melatonin secretion was determined by radioimmunoassay (RIA).

RESULTS: BAT strongly inhibited the non-stimulated and norepinephrine - stimulated melatonin secretion from the pig and rat pineal explants, with ED50 0.3 - 0.7 microM. The adrenergic stimulation did not modify significantly the inhibitory potency of BAT on the melatonin release. The decline in melatonin secretion induced by the BAT - treatment was biphasic in both rat and pig pinealocytes, with an initial rapid phase followed by a slow one. The half-time of BAT-induced decline in the non - stimulated and norepinephrine-stimulated melatonin secretion was ca. 25 - 35 minutes. The inhibitory effect of BAT was reversible in pinealocytes of both investigated mammals.

CONCLUSIONS: The results show that BAT is a potent and reversible inhibitor of the melatonin secretion in the mammalian pineal gland and open the way for the use of this inhibitor in investigations on the pinealocyte physiology performed in vitro....

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Journal Article 2005; 26(3): 261-263 PubMed PMID: 15990733 Citation  Keywords:  Aged, Alzheimer Disease:blood, Cognition Disorders:blood, Depression:blood, Female, Folic Acid:blood, Humans, Lipoproteins:blood, Male, Risk Factors, Severity of Illness Index, Smoking:blood,.   

: The risk for Alzheimer's disease (AD) is associated with lifestyle factors, especially cigarette smoking. In this study we investigated the influence of smoking on the serum levels of folic acid, LDL and HDL in AD patients, patients with minimal cognitive impairment (MCI) and patients with major depression. We investigated a total of n = 374 patients in the diagnostic categories:, AD: n = 272, MCI: n = 60, Major depression: n = 42. We found significantly lower HDL levels in smokers and previous smokers in comparison to non-smokers, p<0,05. The LDL: HDL ratio in smokers was significant higher (+20%) compared to previous smokers and non-smokers, p < 0.05. The mean levels of folic acid were statistically significant (p<0.05) lower (-24%) in smokers compared to non-smokers. Patients with MCI and Alzheimer;s disease (and also major depression) who are "smokers" show serum levels of HDL and folic acid that are known to be strong risk factors for vascular damage and increased risk for vascular brain damage and impaired cognitive function. Therefore cessation of smoking, substitution with folate or statin therapy of smoking patients with MCI or AD might be beneficial to slow down further cognitive decline....

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Journal Article 2004; 25(6): 435-437 PubMed PMID: 15665806 Citation  Keywords:  Aged, Alzheimer Disease:cerebrospinal fluid, Cognition Disorders:cerebrospinal fluid, Depression:cerebrospinal fluid, Dopamine:metabolism, Female, Homovanillic Acid:cerebrospinal fluid, Humans, Hydroxyindoleacetic Acid:cerebrospinal fluid, Male, Middle Ag.   

: In this study we investigated the cerebrospinal fluid (CSF) concentrations of 5-hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA) in Alzheimer (AD) patients (n=75), patients with mild cognitive impairment (MCI, n=9) and patients with depression (n=7). CSF HVA was significantly elevated in AD with depression (Geriatric Depression Scale, 15 point version GDS>5) in comparison to AD without depression (p<0.05, ANOVA) and CSF HVA showed a significant positive correlation with the GDS score of AD-patients (p=0.03, Spearman Rho: 0.38, Spearman Rank Correlation). In the group of AD patients CSF 5-HIAA was positively correlated with cerebrospinal fluid beta-amyloid 1-42 (Abeta42), p<0.05, Spearman Rho: 0.3, Spearman Rank Correlation, but not with CSF tau. Additionally, there was a significant positive correlation between cerebrospinal fluid 5-HIAA and HVA in the group of AD patients (p<0.0001, Rho: 0.47, Spearman Rank correlation). Neither 5-HIAA nor HVA in CSF could differentiate between mild cognitive impairment, depression and AD. The results of this study support the hypothesis that the serotonergic system plays a role in the course of AD. They further suggest an important role of dopamine metabolism in depression within AD patients....

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Clinical Trial 2004; 25(6): 419-422 PubMed PMID: 15665803 Citation  Keywords:  Adult, Anti-Anxiety Agents:administration & dosage, Antidepressive Agents:administration & dosage, Antipsychotic Agents:administration & dosage, Depression:drug therapy, Drug Therapy, Combination, Female, Humans, Hyperprolactinemia:blood, Male, Middle Age.   

OBJECTIVES: Amisulpride in antipsychotic doses can induce hyperprolactinemia. The aim of this study was to prove whether the same is true for low doses of amisulpride.

METHODOLOGY: Plasma prolactin levels were measured in 5 males and 5 females with depressive symptoms who were treated with 50 mg of amisulpride per day as an augmentation to antidepressants (n=5), benzodiazepine anxiolytics (n=8) or in monotherapy (n=1). Six of these patients were assessed prior to onset of amisulpride treatment and after 10 days of amisulpride use. Four patients had been using amisulpride for more than a month.

RESULTS: There was a significant increase of prolactin levels from mean 16+/-6 ng/ml to 113+/-65 ng/ml (median 14.5 ng/ml to median 92 ng/ml; Wilcoxon matched pair test, p=0.027). All patients had hyperprolactinemia (30-200 ng/ml). The prolactinemia was significantly higher in females (mean 160+/-50 ng/ml; median 198 ng/ml) than in males (mean 48+/-12 ng/ml; median 48 ng/ml; Mann-Whitney U test, p=0.041).

CONCLUSION: Even low doses of amisulpride used as an augmentation to antidepressant treatment, benzodiazepines or in monotherapy seem to be associated with hyperprolactinemia. The co-medication of antidepressants and benzodiazepines can potentially increase intensity of prolactinemia....

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Journal Article 2004; 25(3): 207-210 PubMed PMID: 15349087 Citation  Keywords:  Adult, Concanavalin A:pharmacology, Depression:immunology, Depressive Disorder:immunology, Female, Humans, Lymphocyte Activation:drug effects, Male, Middle Aged, Mitogens:pharmacology, Phytohemagglutinins:pharmacology, Reference Values, T-Lymphocytes:drug.   

BACKGROUND: The biological basis of treatment resistance in depression still remains unclear. Some studies suggest that there exists a relationship between a disturbance in the immune system and depression.

AIMS: To investigate the immune status of patients with treatment resistant depression, we compared the in-vitro lymphocytic responses to three different mitogens in 10 drug-free patients with treatment resistant depression and 10 normal controls matched for age and sex.

RESULTS: We observed a marked increase in the lymphocyte mitogenic activity to mitogens of T lymphocytes.

DISCUSSION: This activation of lymphocyte function may be indicative of a pathological stimulation in cell-mediated immunity in patients with treatment resistant depression....

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