Adrenocorticotropin, calcitonin, and antidiuretic hormone as tumor markers in patients with bronchogenic carcinoma of various histological types.

We measured basal and dexamethasone-suppressed plasma ACTH in 246 patients with bronchogenic carcinoma (105 with small-cell carcinoma); in 138 of these patients (67 with small-cell carcinoma) basal and pentagastrin-stimulated serum calcitonin was also determined. In addition, in a subgroup of 120 patients (58 with small-cell carcinoma) plasma ADH with reference to plasma osmolality was also assayed. Non-suppressible plasma ACTH was found in 45% of patients with small-cell carcinoma but only in isolated cases of large-cell carcinoma, adenocarcinoma, and squamous-cell carcinoma. Serum calcitonin was increased in 28% of patients with small-cell carcinoma but only in few patients with other tumor types. Stimulation of calcitonin by pentagastrin was ineffective. Plasma ADH was inappropriately high in 47% of patients with small-cell carcinoma. Strikingly high also was the incidence of increased ADH concentrations in patients with large-cell (40%), adenocarcinoma (46%), and squamous-cell carcinoma (29%). By measuring plasma ACTH after dexamethasone suppression and ADH with reference to osmolality, the sensitivity of these tumor markers in detecting pathological hormone secretion is markedly increased. In small-cell carcinoma the simultaneous measurement of ACTH, ADH, and calcitonin gives a high yield of positive results (74%), indicating that this set of tumor markers is a promising aid in diagnosis and therapy control.

A comparative, multicenter trial between bromocriptine and amitriptyline in the treatment of endogenous depression.

A double-blind, multicenter trial compared bromocriptine (Parlodel) with amitriptyline in 83 endogenously depressed patients. The patient sample consisted mainly of agitated endogenous depression, and most of the patients were treated within a daily dose range of 30--50 mg bromocriptine or 120--200 mg amitriptyline. In both the global assessment and the Hamilton Depression Rating Scale, amitriptyline scored higher than bromocriptine, but the differences were not statistically significant. There was little difference between the drugs with respect to tolerability. Bromocriptine's potential role in psychiatry will probably be in those patients in whom an alternative treatment to standard antidepressant therapy is required and a less sedative effect with minimal anticholinergic response is indicated. Bromocriptine's use in Parkinson's disease, where the incidence of depression has been reported to be as high as 37%, has been well documented. Bromocriptine's antidepressant properties add to its therapeutic value in this disease.