Stanley R. Platman

Potentiation of a monoamine oxidase inhibitor by tryptophan.

Abstract This double blind study investigated the reported potentiation of an MAO inhibitor by tryptophan. Twenty seriously depressed patients were placed on phenelzine sulfate. Half of these patients received supplements of tryptophan while the remainder received a placebo. Those receiving the tryptophan supplements showed significantly more improvement as measured by a modified version of the Hamilton scale. The possible pathways for the mediation of this tryptophan effect are discussed.

Mechanisms of renal lithium handling and their relationship to mineralocoticoids: A dissociation between sodium and lithium ions

Abstract Lithium-induced alterations in electrolyte excretion were studied in 16 patients with manic-depressive disease and in one normal subject under conditions of controlled sodium, potassium and fluid intake. An increase in urinary sodium and potassium excretion and in urine volume were noted on the first day of lithium administration. By lithium day 3, transient sodium retention occured. These changes in electrolyte excretion were not correlated with measurable changes in endogenous creatinine clearance. Sodium loading diminished and sodium depletion increased lithium retention. While sodium depletion always raised serum lithium levels, in one patient signs of lithium toxicity appeared despite relatively low serum lithium concentrations. These observations suggest that serum lithium may not be an accurate indicator of lithium overdose, especially during states of acute sodium depletion. Chlorothiazide and the aldosterone antagonist spironolactone produced a striking sodium diuresis, but lithium excretion did not increase consistently and at times decreased. Differences in renal sodium and lithium handling were also observed in response to desoxycorticosterone acetate (DOCA) administration. In rats, DOCA failed to cause lithium retention despite prompt retention of sodium. During the DOCA ‘escape’ period, lithium excretion increased and serum lithium concentration fell. Thus, renal lithium handling, unlike sodium handling, appears independent of mineralocorticoids. These characteristics of lithium excretion during DOCA administration in rats and aldosterone blockade in man suggest that the proximal tubule is the major site of lithium reabsorption in these species. These in vivo studies in man and animals indicate a decreased capacity of active transport systems in the kidney to handle the lithium ion as effectively as the sodium ion. These differences in sodium and lithium handling by the kidney may be related, in part, to lithiums mechanism of action, particularly if active transport systems in the central nervous system are qualitatively similar to those of the kidney with respect to lithium handling.

A clinical trial of methysergide and lithium in mania

SummarySix manic patients were studied in an open sequential drug trial of placebo and the serotonin antagonist methysergide; lithium was then substituted double-blind. No dramatic change occurred in individual manic item scores or in mean daily mania ratings after 48 hours or seven days of methysergide, although several of the patients showed slight trends toward improvement. However, after a mean duration of 10.3 days of lithium treatment, all manic item scores improved dramatically and significantly, so that complete clinical remission was evident in all patients. In view of the discrepancy between these essentially negative findings and several recent positive reports on the efficacy of methysergide in the treatment of mania, the authors feel that the indolealkylamine hypothesis of affective disorders should be further investigated.

Eysenck Personality Inventory as a Mood Test with Manic-Depressive Patients

The Eysenck Personality Inventory was used as a mood indicator instead of as a trait test with a group of manic-depressive patients associated with a research ward. Some patients completed the EPI while in a normal state, some while in a depressed or manic state, and some in two or more clinically defined states. Results showed that depression was associated with a significant decrease in extraversion and a significant increase in neuroticism. The manic state however, was not clearly differentiated from the normal one. It appears that the inventory may be a useful indicator of depressive mood.

Self-Concepts Associated with Mania and Depression

14 manic-depressive patients, 16 staff and 52 college students described their normal self, their ideal self, and their least-liked self in terms of certain personality traits. The emotion profile for the depressed state correlated highly with the least-liked self, but the manic profile did not correlate with any other description. Data suggest that ideal-self studies are basically concerned with social stereotypes.

An Investigation of Electrolyte and Fluid Distribution in the Affective Disorders.

Excerpt Evidence has accumulated for 70 years suggesting the relationship between electrolyte and fluid balance and the cyclic effective disorders. Recent studies in humans with affective disorders...

The Role of Cations in Psychiatry.

Excerpt Lithium has now become an accepted therapy in the treatment and prevention of manic episodes. The empirical basis for its mechanism of action is considered to be related to alterations in t...