0000000000007256
AUTHOR
F. Holsboer
The dexamethasone suppression test in depressed patients: Clinical and biochemical aspects
Summary Endogenous depression (ED) is regarded as a psychiatric disease with a biological pathogenesis. Consequently patients with ED respond favourably to somatic treatment, whereas for non-endogenously depressed patients drug-treatment would be often inappropriate. Until now, psychopathologists have failed to define precisely the endogenous subtype of depression on clinical features alone. It is well established that a subgroup of depressed patients shows hypersecretion of Cortisol and consequently inadequate suppression of Cortisol after a test dose of dexamethasone. This dexamethasone suppression test (DST) was introduced as a laboratory marker, specifically identifying endogenously dep…
Zotepin versus Perazin bei Patienten mit paranoider Schizophrenie: eine doppelblind-kontrollierte Wirksamkeitsprüfung
The dibenzothiepine zotepine is a new potential "atypical" neuroleptic exhibiting powerful antiserotonergic and antidopaminergic properties. The efficacy of zotepine was evaluated in a double-blind controlled trial versus the tricyclic neuroleptic perazine in 41 patients suffering mainly from the paranoid-hallucinatory type of schizophrenia. The key outcome variable was the extent of mental disturbance as defined by the total score of the BPRS. Additional outcome variables were GAS and CGI. In addition, adverse reactions and extrapyramidal side effects were assessed according to the FSUCL scale and the Gerlach and AIMS rating scale, respectively. Additional variables recorded were blood pre…
Psychotropic Effect of Combined Estrogen-Vit B6 Treatment in Endogenously Depressed Females
Estrogens are among the most commonly prescribed substances in females. Also endogenous estrogen levels change dramatically throughout life and this biological variable has been associated with several psychological signs like premenstrual tension syndrome and depression in older age. Along with clinical practice there is increasing evidence from neuropharmacology suggesting a psychotropic action of estrogens (review: Holsboer, 1982). The most prominent findings are: 1. Reduction of monoamine-oxidase (MAO)-activity by estrogens (McEwen et al., 1978); 2. Competitive inhibition of catechol-o-methyltransferase by 2-hydroxyestrogens, which are major metabolites of estrogens in the CNS (Breuer e…
Role of Testosterone in Male Sexual Impotent Patients
The role of biological factors contributing to development of sexual dysfunction (SD) has given rise to controversy over many years. Whereas a broad consensus is achieved that schizophrenia and affective psychoses have a biological etiology, such mechanisms receive less acceptance for SD. Conversely, the observation that SD is frequently a concomitant factor in affective illness is subject of current interest in research. For both diseases SD and affective disorder impaired gonadal function is documented (Rubin et al., 1981; Benkert and Holsboer, 1984), whereas both disorders may well occur independantly from each other. In the following section we outline briefly some of the presently avai…
Effect of sulpiride in endogenous depression.
Clinical practice and pharmacological data suggest a possible antidepressive action of sulpiride given in low dosages. To further explore the therapeutic efficacy of sulpiride 11 patients with an endogenous type of depression were studied during treatment with an oral daily dose of 150 mg sulpiride. The present data allows the conclusion that (A) low dosed sulpiride seems to act as an antidepressant in severe and milder forms of depression, (B) a clinical progress is seen earlier than is common during treatment with tricyclics and (C) a significant increase of drive is observable. However, sulpiride maintenance therapy did not prevent early relapse into depression. The preliminary nature of…
Antidepressants are functional antagonists at the serotonin type 3 (5-HT3) receptor
Antidepressants are commonly supposed to enhance serotonergic and/or noradrenergic neurotransmission by inhibition of neurotransmitter reuptake through binding to the respective neurotransmitter transporters or through inhibition of the monoamine oxidase. Using the concentration-clamp technique and measurements of intracellular Ca2+, we demonstrate that different classes of antidepressants act as functional antagonists at the human 5-HT3A receptor stably expressed in HEK 293 cells and at endogenous 5-HT3 receptors of rat hippocampal neurons and N1E-115 neuroblastoma cells. The tricyclic antidepressants desipramine, imipramine, and trimipramine, the serotonin reuptake inhibitor fluoxetine, t…