Effect of pyridoxine on human hypophyseal trophic hormone release: a possible stimulation of hypothalamic dopaminergic pathway.

A single dose of pyridoxine (300 mg iv) produced significant rises in peak levels of immunoreactive growth hormone GH and significant decrease of plasma prolactin PRL in 8 hospitalized healthy subjects. Serum glucose, luteinizing hormone LH, follicle stimulating hormone FSH and thyrotropin TSH were not altered significantly. In addition, in 5 acromegalic patients who were studied with both L-dopa and pyridoxine, inhibition of GH secretion followed either agent in a similar pattern. These data suggest a hypothalamic dopaminergic effect of pyridoxine.

Enhancement of insulin-induced prolactin secretion by fluoxetine in man.

Fluoxetine hydrochloride, a specific inhibitor of serotonin reuptake, was given orally to five adult males to study its effect on fasting and insulin-stimulated release of PRL. A 3-day course of fluoxetine (30 mg daily) had no demonstrable effect on fasting PRL levels. Fluoxetine significantly enhanced insulin-induced PRL release. These data suggest that serotoninergic pathways have little or no part in the control of spontaneous PRL secretion in man, whereas they may play a role in insulin-stimulated PRL release.

Action of metergoline in suppressing prolactin release induced by mechanical breast emptying.

Ten women were studied during the first post-partum week. Mechanical breast emptying with a breast pump for 30 min induced a marked increase in plasma prolactin (PRL) reaching a maximum 30 min after the beginning of stimulation. In all patients oral administration of the antiserotonin agent metergoline, 8 mg daily for two days, completely blocked any PRL secretion induced by breast stimulation. These results confirm the inhibitory effect of metergoline on PRL release.

Growth hormone and prolactin release in acromegalic patients following metergoline administration.

In six acromegalite patients oral administration of 4 mg of metergoline, an antiserotonin agent, produced a fall in plasma growth hormone (GH) and prolactin (PRL) concentrations. In the same patients this inhibitory effect was observed after administration of dopaminergic drugs, L-Dopa and 2-Br-alpha-ergocryptine. Both GH and PRL levels remained suppressed during a 6 day course of treatmnt with metergoline. These results are consistent with the hypothesis that the inhibitory effect of netergoline on GH and PRL release is determined by inactivation of serotonin receptors in the hypothalamus or at the pituitary.

Dynamic evaluation of prolactin secretion during the early hours of life in human newborns.

PRL secretion was evaluated in 30 human newborns during the early hours of life. Both levodopa and pyridoxine administration failed to suppress PRL release in all subjects. Synthetic TRH elicited a constant, prompt increase in PRL levels. No significant changes were observed after somatostatin injections. These results demonstrate normal pituitary PRL reserve in newborns. The failure to respond to levodopa and pyridoxine administration might reflect partial immaturity of the pituitary dopaminergic receptors.

Effect of LRH on gonadotropin secretion in newborn male infants.

The concentrations of LH and FSH were measured in eight male newborn babies, aged 4-6 h, before and after the administration of 25 micrograms synthetic LHR. A comparison was performed with six control newborns receiving normal saline. Both LH and FSH rose significantly in all subjects after LHR administration. Their values were significantly higher than those observed during the control study. These data demonstrate sensitivity of the pituitary gonadotropes to synthetic LHR and a pubertal-type response to LH in the early hours of human life.

Endocrine functioning in multitransfused prepubertal patients with homozygous beta-thalassemia.

Endocrine function was evaluated in 20 prepubertal patients with homozygous beta-thalassemia treated with frequent transfusions and long term iron chelation therapy. FSH, LH, PRL, and TSH secretion were evaluated by LRH and TRH testing and L-dopa and ACTH were used to assess GH and adrenocortical reserve. No statistically significant differences were found between FSH, LH, PRL, GH, and cortisol secretion in the patients and in normal subjects. There was a relatively high incidence (35%) of primary thyroid impairment since 1 patient had primary hypothyroidism and 6 others had evidence of subclinical hypothyroidism as manifested by increased TSH responses to TRH. However, no statistically significant correlations were found between either serum ferritin levels, total blood transfusions received, and thyroid function.

Experiential sampling in the study of multiple personality disorder.

The authors describe the application of experiential sampling, a new time-sampling method, to the assessment of rapid state changes in a woman with multiple personality disorder. She was signaled at random intervals during study periods and asked to provide information on alternate personality switches, amnesia, and mood state. The alternates displayed some characteristics that were as different as those occurring between separate individuals studied previously with this method. There were notable discrepancies between the self-report study data and information reported during therapy hours. The authors conclude that the phenomenology of multiple personality disorder is frequently more complex than is suspected early in the course of treatment.

Effect of bromocriptine on affect and libido in hyperprolactinemia.

Six women with primary hyperprolactinemia (mean prolactin level, 50 ng/ml) were matched with six normal women on eight factors influencing life style. Observers blind to endocrine status followed the subjects weekly for 10 weeks. Patients took bromocriptine, 2.5 mg twice daily, or placebo in a randomized double-blind sequence with crossover at 5 weeks. The mean Hamilton score for the patients was compatible with mild depression and higher than that for normal subjects during placebo but not during bromocriptine treatment. Libido was similar in both groups during placebo and bromocriptine. The mean number of orgasms reported per day was lower in patients than in normal subjects during both treatment conditions, although one patient reported orgasms during drug treatment only. Hyperprolactinemia in women may be associated with mild depression and a decrease in orgasmic frequency.

Effect of dopaminergic blockade on the secretion of growth hormone and prolactin in man.

Serum growth hormone (GH) response to insulin and glucagon administration was studied in 12 male and 12 female volunteers under control conditions, and under treatment with pimozide and metoclopramide. In addition, serum prolactin levels were measured during the treatment period. Pimozide and metoclopramide administration had no effect on the GH response to insulin and glucagon. In contrast, serum prolactin levels increased markedly during the treatment period. Dopaminergic blockade is unable to affect GH secretion in response to insulin and glucagon administration in man.

Effect of apomorphine and piribedil on the secretion of thyrotropin and prolactin in patients with primary hypothyroidism.

The administration of apomorphine and piribedil, two dopaminergic agents, significantly reduced thyrotropin (TSH) and prolactin levels in six female patients with primary hypothyroidism. These data provide further evidence for an inhibitory role of dopaminergic stimulation on TSH secretion.

Effect of clomiphene citrate on plasma levels of immunoreactive luteinizing hormone-releasing hormone, gonadotropin, and testosterone in normal subjects and in patients with idiopathic oligospermia.

The effect of clomiphene citrate on plasma immunoreactive luteinizing hormone-releasing hormone (LH-RH), gonadotropin, and testosterone levels was investigated in 10 patients with idiopathic oligospermia and in 10 normal volunteers. A daily 100-mg dose of clomiphene citrate induced a marked, significant increase in plasma immunoreactive LH-RH levels, followed by significant increments in gonadotropin and testosterone values. No significant differences were detected in LH-RH, gonadotropin, and testosterone levels between controls and patients with oligospermia either under basal conditions or during clomiphene treatment.

Dynamic evaluation of prolactin secretion in patients with oligospermia: effects of treatment with metergoline.

Serum prolactin levels were measured in 50 patients with oligospermia and in 20 control subjects under fasting conditions and following the administration of levodopa, pyridoxine, metoclopramide, and synthetic thyrotropin-releasing hormone. Four patients (8%) under fasting conditions had prolactin levels slightly above the normal range. However, no significant differences in prolactin behavior were detected between patients with hyperprolactinemia, patients with normal prolactin levels, and control subjects. The four patients with hyperprolactinemia were treated with metergoline, an ergoline derivative. Metergoline administration promptly reduced the prolactin levels. Spermatogenesis was restored in three patients after 4 to 5 months of treatment.

Predictors of proficient technique and successful lesion detection in breast self-examination.

Seventy-three women attending a health fair completed a questionnaire that measured demographic and health history variables, knowledge, and current practice of breast self-examination (BSE), Multidimensional Health Locus of Control (MHLC; Wallston, Wallston, & DeVellis, 1978), and components of the Health Belief Model (HBM; Rosenstock, 1974) in relation to breast cancer and BSE. These variables formed the basis of a conceptual model of BSE behavior that was examined by having each woman participate in a behavioral trial with a breast model in which her BSE technique and ability to detect simulated tumors was assessed. Regression analyses revealed that self-confidence in the efficacy of BSE was the best single predictor of proficient BSE. Powerful others HLC, knowledge of correct BSE behaviors, and chance HLC, respectively, also contributed significantly to the variance in performance. As anticipated, successful lesion detection was most strongly associated with more proficient BSE technique and higher frequency of BSE practice in the past six months. Internal HLC scores were not predictive of either behavioral measure. Similarly, except for perceived efficacy of BSE, HBM variables showed no strong relationships to observed behavior.

Psychopharmacology. An historical perspective.

This article explores the field of psychopharmacology from an historical perspective. Part 1 traces the uses throughout history of psychoactive substances that are widely abused by modern society. Part 2 examines the development in the 1950s and 1960s of drugs and other physical methods that have revolutionized the treatment of the mentally ill.

The acute psychiatric diagnostic interview.

The general outline of a psychiatric diagnostic interview given in Table 1 includes some broad suggestions for the amount of time to spend on each section. As a structured interview based on a symptom checklist questionnaire yields higher frequency of reports of symptoms, it is advisable to follow this type of format rather than a totally unstructured interview technique. Sim recommends a structured format that lends itself to computerization. Griest and colleagues suggest a computer interview, and there are data supporting the diagnostic accuracy of such a system. Within the framework of any diagnostic interview, a thorough exploration of the 10 critical elements listed in Table 5 is essential for accurate diagnosis. This information, which is usually obtainable in about 30 minutes, will enable the clinician to make a preliminary diagnosis, decide upon pharmacotherapy, and determine if hospitalization is warranted. A more intensive but lengthy and time-consuming structured diagnostic interview is the Schedule for Affective Disorders (SADS), which is more appropriate for inpatients or patients being considered for a research protocol.

Gender differences in antidepressant and activating drug effects on self-perceptions.

Gender difference in neuropharmacologic responsivity have received surprisingly little attention in clinical research. In view of well-known gender differences in the prevalence of depression, we wondered whether men and women would respond differently to antidepressants or to an activational drug known to predict antidepressant response. Using clorgyline and D-amphetamine in 2 small samples, we illustrated several methodological approaches for examining possible gender-linked differences in the effects of these drugs on self-perceptions. Gender-linked differences in cognitive-perceptual processes may, in turn, be linked to differences in encoding or consolidating information about our experiences into our self-image for later recall.

Circulating prorenin and renin in response to intravenous adrenocorticotrophic hormone in essential hypertension.

Plasma prorenin and renin changes after a bolus injection of 25 U intravenous adrenocorticotrophic hormone (ACTH, synacthen) were studied in seven untreated uncomplicated essential hypertensives over a period of 24 h. Plasma prorenin did not change significantly during the study, whereas renin after 24 h was higher than at baseline (4.3 +/- 0.6 versus 2.3 +/- 0.9 ng angiotensin I (Ang I)/ml per h, P less than 0.01). We conclude that endogenous glucocorticoid stimulation induced by exogenous ACTH and ACTH itself seem to induce a secondary or tertiary rather than a primary effect on the human renin gene.

Blunted adrenocorticotrophic hormone release during captopril treatment.

High tissue levels of angiotensin II have been reported in the median eminence suggesting a possible role in the regulation of adrenocorticotrophic hormone (ACTH) secretion. To verify this hypothesis in man, the pituitary-adrenal axis response to hypoglycaemia was studied before and during captopril treatment in eight male essential hypertensive patients (stage I WHO; aged 35-52 years). Plasma levels of ACTH, cortisol and glucose were measured before and 60, 90 and 120 min after an intravenous bolus of normal saline as placebo an, 3 days later, after an intravenous bolus of rapidly acting insulin (0.1 IU/kg body weight). Captopril treatment was then started and both placebo and hypoglycaemic tests were repeated 15 days thereafter. No changes in ACTH, cortisol or glucose plasma levels were observed after acute normal saline, either before or during captopril administration. On the contrary, hypoglycaemia induced a sharp increase of ACTH plasma before captopril (from 27.7 +/- 11 to 131.30 +/- 26 pg/ml, P less than 0.01, 60 min after insulin) but not during angiotensin converting enzyme (ACE) inhibition (from 28.9 +/- 9 to 42.9 +/- 11 pg/ml, NS, at min 60 of the study). Our present data, showing a blunted ACTH response to hypoglycaemia during ACE inhibition, suggest that circulating angiotensin II may participate in the regulation of the release of the ACTH, possibly by a stimulation of angiotensin II receptors localized in the brain but outside the blood-brain barrier.