Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002453 (amenorrhea)
 6,245 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Described here is a young woman with intermittent Cushing's disease associated with psychotic disturbance. On five occasions, over a period of four years, she became severely depressed and had acne, amenorrhea, hirsuties and moon facies. On each of the first four occasions the symptoms lasted from two to three months and disappeared spontaneously. Biochemical investigations, including plasma ACTH estimations during the last two episodes, indicated that the adrenocortical overactivity was pituitary-dependent. During the fifth relapse the patient experienced a very severe, depressive psychosis, necessitating bilateral adrenalectomy, which resulted in complete remission.
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PMID:Intermittent Cushing's disease. 47 97

According to several follow-up studies in the literature, anorexia nervosa has to be considered as an affection with a grave prognosis. We have studied the outcome in a group of 32 female patients who could be considered as homogeneous in a number of aspects. The following five criteria, on which the delineation of the syndrome is based, were realized in all the patients: considerable weight loss; limited food intake; amenorrhea; juvenile age of onset; absence of primary organic or specific psychotic disorder. All of them presented a serious symptomatology and had undergone some previous treatment under the form of ambulatory psychotherapy and/or forced feeding. They all received, during their admission in the same hospital, the same form of combined intensive medical and psychotherapeutic treatment. All of them maintained regular psychotherapeutic contacts with the same psychiatrist. According to the outcome, the patients could be categorized into three groups: the cured, the improved, the unimproved. In order to circumscribe some prognostic elements, we have compared a number of clinical, family and personality variables in these groups. As favorable clinical factors can be mentioned: younger age at admission and shorter duration of the illness. Manifestations of impulsive behavior (automutilation, kleptomania, fugues, etc. ...) and sucide attempts are unfavorable. No definite family factors can be defined, although the absence of psychological interaction with the father seems to be unfavorable. A better prognostic outcome is offered by the following personality characteristics, determined by psychological testing: lower neuroticism and higher self-defensiveness on the ABV; a lower general profile and especially a lower score on the schizophrenia scale of the MMPI; less pronounced tendencies to infantile regression, passivity and sexual repression as these are expressed in the TAT.
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PMID:Elements of resistance to a combined medical and psychotherapeutic program in anorexia nervosa. An overview. 81 38

The effects of bromocriptine on neuroleptic-induced endocrinological disturbances (amenorrhea, galactorrhea and impotence) were investigated. Bromocriptine (5.0-7.5 mg/day) was administered to psychiatric patients receiving neuroleptics and developing hyperprolactinemia. The following results were obtained. Menses recurred in 7 of 10 patients with amenorrhea. A decrease in lactation appeared in 5 of 6 patients with galactorrhea. A significant increase in the serum levels of testosterone was observed after 8 weeks of the treatment in male patients. (N = 6). There was no remarkable deterioration in regard to the psychotic symptoms in schizophrenic patients. (N = 7). In non-schizophrenic patients (N = 9), a significant improvement was observed in regard to "somatic concern" (in Brief Psychiatric Rating Scale).
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PMID:Effects of bromocriptine on neuroleptic-induced amenorrhea, galactorrhea and impotence. 288 37

A case is presented of an adolescent girl whose initial psychotic event was the appearance of pseudocyesis, which was terminated by a delusional miscarriage. The delusion was initiated by amenorrhea, which was probably due to a persistent luteal cyst and was perpetuated by the patient's underlying thought disorder. This case supports the somatopsychic hypothesis that pseudocyesis can be initiated by a coincidental physiologic change in a susceptible individual. Physicians must consider a psychotic delusional state in the etiology of pseudocyesis.
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PMID:Pseudocyesis as the presenting symptom in an adolescent patient with an incipient thought disorder. 366 2

Since the basic problem in the use of hypnosis in physiopathological obstetric and gynaecological conditions is the choice of the right method for the right indications, the symptoms and clinical conditions which may benefit from this treatment are discussed. The following gynaecological indications are suggested: dysmenorrhoea and algomenorrhoea; hypogastric plexalgia; frigidity; dyspareunia and vaginismus; psychogenetic amenorrhoea; postoperative psychoses and depressions; gynaecological somatisations of psychotic states. In the obstetric field the main indication are: hiperemesis gravidarum; antenatal training and assistance in labour.
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PMID:[Hypnosis in obstetrics and gynecology]. 719 78

Bromocriptine is an ergot-derived dopamine agonist. Its current uses include the treatment of Parkinson's disease, postpartum ablaction, prolactinomas, acromegaly, and amenorrhea and galactorrhea secondary to neuroleptic use. It is often reported to produce psychiatric side effects such as confusion, hallucinations, and delusions. The literature is reviewed and supports a strong anecdotal relationship between bromocriptine use and psychosis.
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PMID:Bromocriptine and psychosis: a literature review. 770 Oct 22

The treatment for psychiatric disorders in pregnancy remains difficult to implement. We report the case of a 28-year-old woman, 20 weeks pregnant when admitted in our psychiatric department. She presented severe depressive disorder, associated with agitation, and psychotic symptoms as delusion and hallucinations occurred. The patient had a history of recurrent mood disorders dating back to eight years before the current admission, including some atypical episodes (psychotic symptoms only), and alternating with free periods without any trouble. A non-specific personality disorder is also probably present. We first used antidepressant (clomipramine) and sedative phenothiazine drugs. Because of the lack of therapeutic efficacy, three weeks later we tried another pharmacologic prescription, that also failed to improve the patient' status. It was hence decided to proceed with electroconvulsive therapy. We describe here the management of the courses, especially the careful monitoring and the anesthetic features we employed, among which endotracheal intubation, oxygen supply, real-time ultrasonography, and recording uterine contractions and fetal heart rate. All theses measures were applied within a surgical-obstetrical theatre. Nine bifrontal courses were performed in five weeks. They rapidly and completely improved the psychiatric symptoms. No sign of fetal neither maternal bad tolerance occurred. While the patient had been authorized to leave hospital, in 34th weeks amenorrhea a routine ultrasonographic examination discovered worrying fetal ascites signs. After the emergency caesarean delivery, the male newborn child undergone immediately surgical treatment for vascular meconium peritonitis, but died nine days later with metabolic post-surgical troubles. This fatal outcome after electroconvulsive therapy leads us to discuss its possible involvement, and in a more general way the safety and place of this treatment in pregnancy psychiatric disorders. They remain critical situations in which therapeutic methods should be rapidly decided. The authors wish others practitioners to bring new case-reports in order to assess the ECT safety-use during pregnancy.
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PMID:[Case report: electroconvulsive therapy during pregnancy]. 1066 2

Risperidone is a potent antagonist of both dopamine (D2) and serotonin (5-HT2) receptors, demonstrating improvement of both positive and negative symptoms and a lower propensity for inducing extrapyramidal symptoms (EPS) than typical neuroleptics. Its most common side-effects, found in the Canadian multi-centre trial (Chouinard et al., 1993), were agitation, anxiety, insomnia, EPS, headache and nausea, in order of frequency. With regard to endocrine effects, risperidone causes an increase in prolactin levels similar to that of other neuroleptics (Claus et al., 1992). In open clinical trials (De Cuyper, 1991), the overall incidence of risperidone-induced endocrine side-effects was quite low: 2.9 % for amenorrhoea and 1-2% for galactorrhoea. However, it is assumed that the incidence can vary depending upon the characteristics of patients and the drug regimen, i.e. dosage and titration schedule. In our experience, hyperolactinaemia is likely to occur when prescribing risperidone to female or first-onset psychotic patients: we are reporting 5 cases of risperidone-induced hyperprolactinaemia with these characteristics.
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PMID:Hyperprolactinaemia induced by risperidone. 1128 51

Prolactin is a polypeptide hormone that is synthesized and secreted from specialised cells of the anterior pituitary gland, known as lactotrophs. The hormone was given it's name because extracts from the bovine pituitary gland caused growth of the crop sac and stimulated the elaboration of crop milk in pigeons, and promoted lactation in rabbits. Although prolactin is best known for the multiple effects it exerts on the mammary gland, it has over 300 separate biological activities not represented by its name. It sub serves multiple roles in reproduction other than lactation and is an important modulator of homeostasis in the mammalian organism. Hence Bern and Nicoll suggested renaming it "omnipotin or versatilin". Schizophrenia is a severe psychiatric disorder that affects approximately one percent of the population worldwide. It is well established that traditional typical anti-psychotics elevate prolactin levels. It is also agreed that the serum prolactin concentration is not elevated in patients with schizophrenia who are not receiving anti-psychotic medication. Hyperprolactinaemia has direct effects on the brain and on other organs. Direct consequences include galactorrhoea. Indirect consequences of hyperprolactinaemia include oligomenorrhoea and amenorrhoea, erratic or absent ovulation, sexual dysfunction, reduced bone mineral density and cardiovascular disease. With the advent of prolactin sparing anti-psychotics, ample consideration needs to be given to the physiological consequences of hyperprolactinaemia in schizophrenic patients. In this paper we will examine molecular biology, secretion and physiology of prolactin. The consequences of hyperprolactinaemia in humans including effects on fertility, sexual dysfunction, bone mineral density, cardiovascular disease, changes in psychopathology and movement disorders will be reviewed. The literature on the association between schizophrenia, anti-psychotic medication and hyperprolactinaemia and more specifically on the consequences of this hyperprolactinaemia in schizophrenic patients will also be reviewed.
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PMID:Prolactin and schizophrenia: clinical consequences of hyperprolactinaemia. 1208 58

Hyperprolactinaemia has been associated with a variety of side effects including amenorrhoea, galactorrhoea, sexual dysfunction, breast engorgement and osteoporosis. Since the mid-1970s, the impact of antipsychotics on human prolactin (hPrl) levels has been investigated. Baseline levels of hPrl were found to be similar in healthy controls and patients who were diagnosed as having schizophrenia. Short-term acute studies done after single parenteral or oral doses of phenothiazines found rapid two- to tenfold increases in hPrl. Similar increases were found in longer term studies that reported increases of three times in both men and women after 3 days that doubled again after several weeks of treatment. A study of longer term injectable fluphenazine enanthate found that elevation induced by a single injection lasted up to 28 days. The same results with significant increases have been reported with the butyrophenone, haloperidol. Substantial increases are found after single injections (up to nine times) and after weeks of treatment (up to three times sustained). Thus, early literature believed that there might be an association between these induced changes and response to therapy. However, prolactin is secreted by the anterior pituitary and is under inhibitory control of dopamine released from the tuberoinfundibular neurones. Thus, increases in prolactin are due to antipsychotic impact on tuberoinfundibular tract, one of four dopamine-related tracts. With the application of clozapine and other atypical antipsychotics, it was found that medications can successfully treat psychosis without increasing hPrl. In fact, early single-dose trails found clozapine to reduce hPrl by 16%. Later studies replicated this result and also found that up to 6 weeks of administration led to reductions in hPrl of up to 80%. Risperidone, however, has been found to persistently elevate hPrl in studies, despite its impact on other receptor sites. Olanzapine, quetiapine and ziprasidone have all been found to have little effect or produce decreases in hPrl. Most recently, aripiprazole, in early studies, appears to produce significant reductions in hPrl while maintaining therapeutic efficacy for psychosis.
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PMID:Antipsychotics: impact on prolactin levels. 1238 84


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