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John Andrew (Tony) FRCS (b. 1922- d. 30th May 1999) was a neurosurgeon specialising in Parkinson's disease

Professional career

John Andrew qualified at St Bartholomew's Hospital, London, in 1944. After neurosurgical training he spent a year on a Fullbright fellowship in Chicago. He was a consultant at Oldchurch Hospital in Romford and later at the Middlesex Hospital. After he retired he was invited to set up a neurosurgical unit in Abu Dhabi and he remained for several years. With E S Watkins John published a monograph of the detailed anatomy of the nuclei of the human thalamus at a time when surgical treatment of Parkinsonism was developing rapidly. He developed successful stereotaxic techniques for treating other forms of extrapyramidal disease, in particular for treating dystonia musculoram deformans. He also used stereotaxic techniques in treating other forms of tremor including so called “benign essential tremor.” John was a careful surgeon and found it difficult to put up with lower standards in junior colleagues.

Personal life

Outside medicine he enjoyed mountaineering, sailing, and skiing. He was a pianist and a regular visitor to Glyndebourne. Before he retired he built a home in Cyprus and when he became less active he took up painting and exhibited regularly. Some months before he died he suffered a severe stroke, but despite his physical limitations he was never a complainer. He left a wife, Margaret, a singer and music teacher.

Ombre

Ombre is a card game for three players.

NDMA-receptor antagonists

In a double-blind, placebo-controlled, proof-of-concept study, researchers administered an N-methyl-d-aspartate–receptor antagonist (ketamine) to 18 patients already on treatment with lithium (10 patients) or valproate (8 patients) for bipolar depression. From 40 minutes following intravenous injection of ketamine hydrochloride (0.5 mg/kg), the researchers observed significant improvements in depressive symptoms, as measured by standard tools, that were maintained for up to 3 days, an effect not observed in subjects who received the placebo. Five subjects dropped out of the ketamine study; of these, four were taking valproate and one was being treated with lithium. One patient showed signs of hypomania following ketamine administration and two experienced low mood. This study demonstrates a rapid-onset antidepressant effect of ketamine in a small group of patients with bipolar depression. The authors acknowledge the study's limitations, including the dissociative disturbances in patients receiving ketamine that could have compromised the study blinding, and the need for further research.

A more recent double-blind, placebo-controlled study by the same group found that ketamine treatment resulted in a similarly rapid alleviation of suicidal ideation in 15 patients with bipolar depression.

Ketamine is a Class C substance in the United Kingdom and should only be used under the direction of a health professional.