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Alternative strategies for quantifying speed of response in major depression
Abstracts
BlOLPSYCHIATRY 1996:39:500-666
649
gonadal steroids or gonadotropins. However, other hormones such as 508. PROLACTIN RESPONSE TO ECT: adrenocorticotropic hormone (ACTH) lind J3·cmlorphin (~·EP) have EFFECTS OF ELECTRODE PLACEMENT been reported to differ in PMS patients and cornrols: ACfH levels were AND DOSAGE found to be signilicantly lower during the luteal phase and j!-EP levels lower during both the tuteal phase and the periovulatory phase in PMS patients compared with controls. We studied the basal hormone levelsof ACfH and J3·EP over one full symptomatic cycle (confirmed by daily ~ S.H. Lisanby, D.P. Devanand, J. Prudic, mood ratings) in women with prospectively diagnosed PMS(n :.: W) and M.S. Nobler, L. Fitzsimons, & H.A. Sackeim heallhy controls(n = 10). Morning blood was drawn three limes/week, from ihe beginning of menses 10 the end of the cycle. ACTH was measured by immunoradlornetrlc assay and ~.EP by radioimmunoassay New York Slate Psychiatric Instltutc, 722 West 168th Street, Unit 72, with afflnity chmmmography, Ovulation was confirmed with Ovuqulek New York. NY 10032 kits. Preliminary results (ANOVA·R) do not show a diagnosis or diagnosis by phase effect for either ACTH or J3-EP. We were able 10 Electroconvulslve therapy (ECT) produces a surge in serum prolactin demonstrate a phase effect for both ACTH (p <0 ,05) ami ~-EP (p <0 (PRL). lt remains unclear whether the magnitude of this surge is a useful .01) reflectlng a decrease in their levels.lrrespccuve of diagnosis. during marker of optimal ECT admlnistraticn, This study investigates the the luteal phase. In conclusion, our preliminary data do not support relations among PRL surge. ECf stimulus parameters, and outcome reported differences in either ACTH or ~·EP levels between women with measures in major depressive disorder (MDD). Patients with MOD PMS and normal controls at any phase of the mensuunl cycle. (0=19. mean age=5S.9 ± 14.2 yrs, S;j% female) were withdrawn from psychotropics for 25 daysandrandomized in a double-blind trial 10 RUL low dose (jUSI above seizure threshold). RUL high dose (2.5 times threshold), BL low dose, or BL high dose ECT. Within-subjecl peak increase in PRL over pretreatment baseline t6.PRL) was assessed S. IS, and 30 min after seizure terminatlon at the 2m.!, 61h• and next to last treatments. ECT increased PRL 5.5 fold (mean .6.PRL=38.8 ± 24.3 nglml). EEG and motorseizureduration werepositivelycorrelated with .6.PRL (p'sRUL. plow dose. p
509. EFFECT OF ECT ON PLASMA HOMOVANILLIC ACID IN ELDERLY MAJOR DEPRESSION: PRELIMINARY FINDINGS H. Lee I & B.A. Lawlor IHilIsidc Hospital. Long Island Jewish Medical Center. 75-59 263rd St, Glen Oaks. NY 11004; 2Menllll Health and Ageing Research Centre. St Patrick's Hospital. Dublin 8, Ireland Although animal studies have demonstrated that electrically induced seizures stimulate dopamine release, little is known about the effects of electroconvulsive therapy (ECT) on plasma hcmovanilllc acid (pHVA), a metabolite of dopamine. in man. Ten patients (9 females, I male.mean age 76.1 + 6.5 years). meeting DSM-lII·R criteria for major depression (n=9) or bipolar disorder-depressed (n= I) and requiring treatment with ECT were entered into the study. Blood was drown for pHVA assay before each Ecr. Brief Psychiatric Rating Scale (BPRS) was udminis· tered at baseline ami weekly thereafter. Factor scores for anxietydepression (ANDP), activation (ACfV) , anergla (ANER), hostilltysuspiciousness (HOST) and thought disorder (THaT) were calculated from the individual DPRS Items. The main finding wasthat correlation of the change in pHVA (delta pHVA) with the change in BPRS (delta BPRS) following ECf showed n trend towards significance (r=O.62.
BlOLPSYCHIATRY 1996:39:500-666
649
gonadal steroids or gonadotropins. However, other hormones such as 508. PROLACTIN RESPONSE TO ECT: adrenocorticotropic hormone (ACTH) lind J3·cmlorphin (~·EP) have EFFECTS OF ELECTRODE PLACEMENT been reported to differ in PMS patients and cornrols: ACfH levels were AND DOSAGE found to be signilicantly lower during the luteal phase and j!-EP levels lower during both the tuteal phase and the periovulatory phase in PMS patients compared with controls. We studied the basal hormone levelsof ACfH and J3·EP over one full symptomatic cycle (confirmed by daily ~ S.H. Lisanby, D.P. Devanand, J. Prudic, mood ratings) in women with prospectively diagnosed PMS(n :.: W) and M.S. Nobler, L. Fitzsimons, & H.A. Sackeim heallhy controls(n = 10). Morning blood was drawn three limes/week, from ihe beginning of menses 10 the end of the cycle. ACTH was measured by immunoradlornetrlc assay and ~.EP by radioimmunoassay New York Slate Psychiatric Instltutc, 722 West 168th Street, Unit 72, with afflnity chmmmography, Ovulation was confirmed with Ovuqulek New York. NY 10032 kits. Preliminary results (ANOVA·R) do not show a diagnosis or diagnosis by phase effect for either ACTH or J3-EP. We were able 10 Electroconvulslve therapy (ECT) produces a surge in serum prolactin demonstrate a phase effect for both ACTH (p <0 ,05) ami ~-EP (p <0 (PRL). lt remains unclear whether the magnitude of this surge is a useful .01) reflectlng a decrease in their levels.lrrespccuve of diagnosis. during marker of optimal ECT admlnistraticn, This study investigates the the luteal phase. In conclusion, our preliminary data do not support relations among PRL surge. ECf stimulus parameters, and outcome reported differences in either ACTH or ~·EP levels between women with measures in major depressive disorder (MDD). Patients with MOD PMS and normal controls at any phase of the mensuunl cycle. (0=19. mean age=5S.9 ± 14.2 yrs, S;j% female) were withdrawn from psychotropics for 25 daysandrandomized in a double-blind trial 10 RUL low dose (jUSI above seizure threshold). RUL high dose (2.5 times threshold), BL low dose, or BL high dose ECT. Within-subjecl peak increase in PRL over pretreatment baseline t6.PRL) was assessed S. IS, and 30 min after seizure terminatlon at the 2m.!, 61h• and next to last treatments. ECT increased PRL 5.5 fold (mean .6.PRL=38.8 ± 24.3 nglml). EEG and motorseizureduration werepositivelycorrelated with .6.PRL (p's
509. EFFECT OF ECT ON PLASMA HOMOVANILLIC ACID IN ELDERLY MAJOR DEPRESSION: PRELIMINARY FINDINGS H. Lee I & B.A. Lawlor IHilIsidc Hospital. Long Island Jewish Medical Center. 75-59 263rd St, Glen Oaks. NY 11004; 2Menllll Health and Ageing Research Centre. St Patrick's Hospital. Dublin 8, Ireland Although animal studies have demonstrated that electrically induced seizures stimulate dopamine release, little is known about the effects of electroconvulsive therapy (ECT) on plasma hcmovanilllc acid (pHVA), a metabolite of dopamine. in man. Ten patients (9 females, I male.mean age 76.1 + 6.5 years). meeting DSM-lII·R criteria for major depression (n=9) or bipolar disorder-depressed (n= I) and requiring treatment with ECT were entered into the study. Blood was drown for pHVA assay before each Ecr. Brief Psychiatric Rating Scale (BPRS) was udminis· tered at baseline ami weekly thereafter. Factor scores for anxietydepression (ANDP), activation (ACfV) , anergla (ANER), hostilltysuspiciousness (HOST) and thought disorder (THaT) were calculated from the individual DPRS Items. The main finding wasthat correlation of the change in pHVA (delta pHVA) with the change in BPRS (delta BPRS) following ECf showed n trend towards significance (r=O.62.