Organic brain disease

Greendyke RM, Kanter DR, Schuster DB, et ai. Propranoioi treatment of assauitive patients with organic brain disease. J Nerv Merit Dis 1986 174 290-294. 

A 75-year-old white man, without a history of psychiatric disorders, took cortisone 50 mg/day for 6 weeks for pulmonary fibrosis and developed severe obsessive-compulsive behavior without affective or psychotic symptoms. He was given risperidone without any beneficial effect. The dose of cortisone was tapered over 18 days. An MRI scan showed no signs of organic brain disease and an electroencephalogram was normal. His symptoms improved 16 days after withdrawal and resolved completely after 24 days. Risperidone was withdrawn without recurrence. 

For methodology, the clinical assessment of mental state has always been achieved by an examination known as the mental status exam. Uniting neurology and psychiatry, the mental status exam is a comprehensive checklist of mind functions that are known to be disrupted by organic brain disease, i.e. brain disease caused by a physical rather than a mental condition. 

Most conventional antidepressants lower sexual desire and performance. However, the reversible type A selective MAO inhibitor moclobemide produced intense pathological sexual desire in three men with organic brain disease (two with strokes and one with idiopathic Parkinson s disease) (14). In one man, the hypersexuality was associated with features of pathological jealousy in a paranoid state, but in the other two increased sexuality was an isolated symptom. One of these patients, who had been impotent after the stroke, resorted to telephone sex services, a most uncharacteristic behavior for him. In all cases, the hypersexuality remitted when moclobemide was withdrawn. There have been two previous case reports of moclobemide-induced hypersexuality in women without organic brain disease. This must be a rare adverse effect, but it is possible that in the cases reported here the organic brain disease may have contributed. 

The syndrome may develop in up to 1% of patients using antipsychotics and is more prevalent at high doses. The elderly, and those with organic brain disease, hjqserthyroidism or dehydration are thought to be most susceptible. Clinical features include ... 

Hepatic disease hypersensitivity to valproate pregnancy (FDA category D) children < 2 years (especially those on multiple antiwnvulsant therapy, those with congenital metabolic disorders, those with severe seizure disorders, and those with organic brain disease) pancreatitis. 

Desipramine is a tricyclic antidepressant, inhibits reuptake of norepinephrine and serotonin in CNS, and is indicated in relief of symptoms of depression. Desipramine (75 to 150 mg p.o./day in divided doses) is indicated in endogenous depression major depression with melancholia or psychotic symptoms depression associated with organic brain disease, alcoholism, schizophrenia, or mental retardation and the depressive phase of manic-depressive disorder. Desipramine is absorbed rapidly from the GI tract, distributed widely in the body, and appears also in breast miUc. It is bound to plasma proteins to the extent of 90%, undergoes extensive first-pass metabolism, and its metabolites are excreted in urine. Desipramine strongly blocks the norepinephrine uptake mechanism and has no effect on the uptake of serotonin. Desipramine has weak alpha -adrenergic and... 

Proton NMR spectroscopy ( H MRS) has shown to offer excellent possibilities for evaluation of biochemistry in vivo. Due to its non-invasive character it is of increasing interest not only for the study of human brain diseases, which describe the majority of clinical applications, but also for metabolic characterization of organs outside the brain, as prostate, liver, heart or skeletal muscle. Studies on skeletal muscle have been of increasing interest during the last years, since it was shown that MRS enables the differentiation between two muscular lipid compartments the bulk fat components along the fasciae and muscular boundaries, which are called extramyocellular lipids (EMCL), and the metabolically highly active intramyocellular lipids (IMCL). The latter are stored in spherical droplets in the cytoplasm of muscle... 

Unlabeled Uses Prevention of migraine treatment of behavior disorders in Alzheimer s disease bipolar disorder chorea, myoclonic, simple partial, and tonic-clonic seizures organic brain syndrome schizophrenia status epilepticus tardive dyskinesia... 

Atherosclerosis, cancer and degenerative brain diseases may result from specific processes in an organ or a cell system and at the same time may be the result of the universal aging process. Damage to DNA by radicals may be a significant contributor to the age-dependent development of cancer (Halliwell, 1994). Diseases associated with oxidative stress, free radicals and metabolites generating free radicals in the body are listed in Table 3.7 (Stahelin, 1999). It is not yet clear, however, whether the oxidative stress is the primary cause of the diseases or whether formation of radicals is a secondary effect of tissue damage caused by the disease. 

The view that so-called mental problems stand in the same relation to brain diseases as, say, urinary problems stand in relation to diseases of the kidney is superficially attractive, even plausible. The argument goes like this. The human body is a biological machine, composed of parts, called organs, such as the heart, the lung, and the liver. Each organ has a natural function and when this fails, we have a disease, such as coronary atherosclerosis, emphysema, hepatitis. If we define human problems as the symptoms of brain diseases, then they are brain diseases, even in the absence of any medically ascertainable evidence of brain disease. We can then treat mental diseases as if they were brain diseases. 

It is useful in tbe treatment of anxiety, tension, moderate to severe agitation, hostility, and hyperactivity. It also finds its usefulness in schizophrenia, psychotic reactions related to organic brain syndromes and in Gilles de la Tourette s disease (unusual barking). 

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