[Dexamethasone suppression test in endogenous depression and schizophrenia in male and female patients]. / Test hamowania deksametazonem w depresji endogennej i schizofrenii u mezczyzn i kobiet.

Dexamethasone Suppression Test was performed during an acute phase in 81 patients with endogenous depression and 105 schizophrenic patients. The lack of suppression of cortisol was found in 1/3 if those ill with depression and 1/3 of those ill with schizophrenia. A relationship between those results and age was shown in female schizophrenic patients. In both groups a yearly rhythm was observed, however female patients differed from male patients.

Adding lithium to antidepressant therapy: factors related to therapeutic potentiation.

Lithium augmentation of antidepressant drugs was studied in 51 patients with endogenous refractory depression. The remission after 28 days of lithium was obtained in 28 patients (55%). Better effect of lithium was shown in bipolar than unipolar patients, with subjects with lower pre-lithium severity of depression and in those with rapid improvement (within 7 days) on lithium addition. Factors such as age, gender, number of prior antidepressant (or ECT) treatments, type of preceding antidepressant, mean plasma lithium concentration and the results of DST did not show any association with the outcome of lithium augmentation. The 'priming' effect of lithium may contribute to the mechanism of lithium potentiation in a proportion of depressed patients.

[Carbamazepine in the treatment of depressive syndromes]. / Karbamazepina w leczeniu chorób depresyjnych.

Carbamazepine treatment was used with 54 patients suffering from endogenous depression and organic depression. The anti-depressive effect was found to be the best in those patients with organic depression, while in endogenous depression it was better with bipolar affective disorder and with irregular EEG recordings.

Changes in carbamazepine plasma concentrations in psychiatric patients during treatment.

Plasma concentrations of carbamazepine (CBZ) were studied in 24 psychiatric patients who were given 400 mg of CBZ every 12 h. The assays were performed on the 1st, 3rd, 8th, 15th, 22th and 29th day of the therapy. The highest minimum 12h plasma CBZ concentrations occurred on the 3rd day of therapy, then decreased up to the 15th day and remained stable thereafter. The CBZ half-time values also diminished up to the 15th day of therapy and then stabilized. This may suggest that the enzymatic autoinduction of CBZ is completed within the first 1-2 weeks of therapy. CBZ plasma levels were slightly but insignificantly higher in patients taking CBZ alone than in patients in which CBZ was added to other psychotropic drugs. A significant correlation was found between the minimum CBZ plasma concentration after the first dose and that at steady state. A dosing schedule for CBZ administration has been proposed with administration of 75% of the maintenance dose during the first week and the full CBZ maintenance dose from the beginning of the second week of CBZ therapy.

[Dexamethasone suppression test and the positive and negative symptoms of schizophrenia]. / Test hamowania deksametazonem, a objawy pozytywne i negatywne schizofrenii.

40 patients (26 males, 14 females), aged 18-50 years, with diagnosis of schizophrenia were studied before the treatment for recurrence of acute schizophrenic symptom was started. All patients had dexamethasone suppression test (DST) and BPRS and Hamilton Depression Scale tests. Initial cortisol plasma concentration correlated positively with the intensity of productive symptoms measured by BPRS. The cortisol plasma level measured 17 hour after dexamethasone administration correlated negatively with the global symptom intensity in the BPRS. Pathological DST results were observed in 14 patients (35%). These patients presented lower intensity of psychopathological symptoms in the BPRS as compared to the remaining patients. The intensity of depression measured by Hamilton Scale did not show correlation with DST results. We conclude that in the schizophrenic patients during acute phase of the disease, the intensity of psychopathologic symptoms (mainly productive symptoms) is related to increased activity of the hypothalamo-hypophyseal-suprarenal axis which manifests itself with increased basal levels of plasma cortisol. Reactivity of this axis, with good suppression in the DST results seems to be normal. The intensity of depressive symptoms did not show significant relation to activity of the axis judging from DST results.

[Monitoring of the treatment of endogenous depression with imipramine and amitriptyline (preliminary report)]. / Monitorowane leczenie depresji endogennej imipramina i amitryptylina (doniesienie wstepne).

Monitored treatment of a depressed phase of unipolar affective disorder was conducted in 11 female patients receiving imipramine and in 12 females taking amitriptyline. Patients were randomly assigned to one of the drug and in 6 patients the drugs were switched because of the lack of response to the first used compound. In the imipramine treated group a satisfactory response after 4 weeks of management (less than 6 points on Hamilton's depression scale) was observed in 6 patients and in amitriptyline treated group in 5 patients. Patients displaying a satisfactory response to amitryptyline had significantly higher--as compared to remaining patients in the group--plasma levels of the drug after two and four weeks of treatment. Such an association was not observed in patients treated wtih imipramine. Severity of depression and motor retardation before the treatment was similar both in patients with satisfactory and with poor response to imipramine as well as to amitriptyline. However the intensity of anxiety symptoms was higher in patients exhibiting poor response to treatment with amitriptyline and imipramine as well.

Dissimilar effects of lithium and carbamazepine on erythrocyte lithium transport in vivo: clinical implications.

The effect of lithium (Li) and carbamazepine (CBZ) on erythrocyte lithium transport in vivo was investigated in 28 patients with affective or schizoaffective illness (14 given Li and 14 given CBZ). In 12 of them, Li or CBZ were added to current psychotropic treatment. The activities of erythrocyte lithium-sodium countertransport (LSC), lithium-potassium cotransport (LPC) and passive lithium diffusion (PLD) were assayed before and after 28 days of treatment. The administration of Li caused a significant decrease of LPC as well as PLD activity. The administration of CBZ resulted in a significant increase of the activity of LPC system. No systematic relationship was observed between Li or CBZ-induced alterations in erythrocyte transport and changes in clinical state of patients. The possible clinical implications of the dissimilar effect of Li and CBZ on erythrocyte lithium transport are discussed.

Studies of lithium pharmacokinetics in patients with affective illness.

Lithium pharmacokinetics after a single dose and pharmacokinetic prediction of optimal lithium carbonate dose in steady-state, were investigated in 15 patients with affective illness. In nine patients the course of plasma concentration after a single dose was characteristic for two-compartment and in six patients for one-compartment model. Patients fitting the two-compartment model required higher daily lithium dose to achieve steady-state therapeutic lithium level than patients fitting the one-compartment model. A significant correlation was found between plasma lithium level 12 and 24 h after a single dose and the daily dose required for achieving optimal lithium level in the course of subsequent lithium administration.

[Epidemiology and psychopathology of epileptics in Bydgoszca Province registered between 1976 and 1980]. / Untersuchungen zur Epidemiologie und Psychopathologie der zwischen 1976 und 1980 in der Woiwodschaft Bydgoszcz registrierten Epileptiker.

In the years 1976-1980, the province of Bydgoszcz had a total of 2635 registered epileptics, or 0.37% of the entire population, over the age of 16. From these, 200 patients were randomly selected, and between 1983 and 1985 a complats clinical follow-up investigation was carried out. Among the most frequent mental disorders found were postparoxysmal twilight state (19.5%) and affective psychoses (11%), among the chronic disorders, dementia of varying intensity (26.5%). In contrast with previous investigations the present investigation made it possible to determine with precision the cause of epileptic attacks. The ratio was 61% to 31%.