Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have reviewed the therapeutic effects of benzodiazepines employed as adjuncts to cancer treatment. These agents have been used primarily for alleviating or attenuating situational anxiety, insomnia, chemotherapy-induced nausea and vomiting, and anticipatory nausea and vomiting. Situational anxiety not corrected by psychosocial support, symptom control, or time may be successfully treated with benzodiazepines. Procedure-related anxiety, for example, that related to bone marrow biopsy, venipuncture, intrathecal therapy, and the insertion of subclavian and femoral catheters, is a serious problem that may be alleviated by the use of benzodiazepines. Insomnia not caused by a depression serious enough to warrant treatment with a tricyclic antidepressant also may be successfully treated with benzodiazepines. Many clinicians have found benzodiazepines to be useful adjuncts to a cancer chemotherapy regimen because of their anxiolytic, sedative, and amnesic properties and also because of their suspected antiemetic properties when these drugs are used in conjunction with known antiemetic agents. The ability of lorazepam to induce antegrade amnesia has proved particularly useful in alleviating anticipatory nausea and vomiting connected with repeated courses of cytotoxic chemotherapy. Furthermore, since benzodiazepines are relatively safe drugs, their continued and probably expanded uses as cancer therapy adjuncts can be anticipated.
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PMID:Contributions of benzodiazepines to cancer therapy. 289 34

In his classic case, Alzheimer described cognitive symptoms such as amnesia, aphasia, and apraxia and noncognitive symptoms such as delusions and agitation. Recent studies have suggested that depression also occurs in Alzheimer's disease. In this study, 144 patients who met criteria for Alzheimer's disease were examined for depression on a modified version of the Present State Examination. The prevalence rate of major depression was 17%. The depressed Alzheimer's disease patients were more cognitively impaired and more disabled than the nondepressed patients. Studies are needed to clarify the etiology and treatment of depression in Alzheimer's disease.
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PMID:Depression and Alzheimer's disease. 276 95

The clinical effects and pharmacokinetics of 24 h infusion of midazolam (MDZ) during major maxillofacial surgery and postoperative observation in an Intensive Care Unit (ICU) were studied in 20 patients. During anaesthesia, infusion of MDZ at 5 mg/h combined with 67% nitrous oxide, 1.8 (s.d. = 0.8) mg of fentanyl, and 26.5 (s.d. = 11.4) mg of vecuronium, adequately suppressed clinical responses to surgical nociceptive stimuli. Postoperatively, infusion of MDZ was continued in the ICU at 5 mg/h until 9 a.m. of the first postoperative day for sedation of the intubated but spontaneously breathing patients. The depth of sedation in the ICU was scored from 1-5 (1 = "awake and tense", 5 = "unable to communicate"). During infusion the sedation score decreased from 3.8 after ICU arrival to 2.2 at 8 a.m. of the first postoperative day. Neither ventilatory nor circulatory depression were observed. After cessation of MDZ, recovery from sedation was fast. The degree of amnesia was low. During constant rate infusion no increase in plasma concentration of either MDZ or metabolites occurred. T1/2 beta of MDZ after cessation was 125 min (range 90-320) and its total body clearance was 10.5 ml/kg/min (s.d. = 3.1). The volume of distribution, clearance and T1/2 beta were significantly longer in women than in men. It was concluded that 24 h of MDZ infusion at 5 mg/h caused satisfactory ICU sedation with fast recovery, but that individual tailoring of the infusion rate may still improve the quality of sedation.
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PMID:Continuous infusion of midazolam during anaesthesia and postoperative sedation after maxillofacial surgery. 292 80

The typical patient with post-traumatic hypopituitarism is a young adult male presenting months to years after an automobile accident, following which he was unconscious for several days. He will probably have sustained a fracture of the base of the skull and on recovery is likely to have permanent visual or other neurological sequelae. Temporary or permanent diabetes insipidus may have occurred. The features of panhypopituitarism such as weight loss, fatigue, faintness, loss of libido, and impotence may have been ascribed to depression or the "postconcussion syndrome" and often inappropriate treatment and rehabilitation advised. The striking feature on review of the literature is that the pathological consequences of head injury to the pituitary and hypothalamus have been well described, while only 47 cases of traumatic hypopituitarism have been reported. The most likely reason for this disparity is that head injury of sufficient severity to cause hypothalamic and pituitary damage commonly led to death. More patients now survive, owing to the availability of intensive care; accordingly, most cases have been reported in the last 15 years. However, several patients are described in whom the initiating head injury was not associated with a skull fracture or followed by coma. We recommend that patients with major head injury (defined by post-traumatic amnesia greater than 24 hours), and in particular those with fractures of the base of the skull or diabetes insipidus should be closely monitored for symptoms and signs of endocrine dysfunction and appropriate dynamic pituitary-function tests performed.
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PMID:Post-traumatic hypopituitarism. Six cases and a review of the literature. 301 25

Two anaesthetic techniques were compared in a randomized trial of 60 ASA I and II women admitted for diagnostic dilatation and curettage of the uterus. Group I had fentanyl 2.5 micrograms/kg and thiopentone 2 mg/kg i.v. Supplementary thiopentone 50 mg was given every 15 s until loss of the eyelid reflex. Anaesthesia was maintained with nitrous oxide in oxygen 2/1 together with supplementary thiopentone 50 mg as required. Group II had midazolam 0.1 mg/kg i.v. and a supplementary 0.025 mg/kg every second min until sleep or dysarthria, followed by paracervical blockade with 1% mepivacaine 10 ml on each side of the portio. There was no significant depression of the cardiovascular system. The working conditions for the gynaecologist were good in both groups. The midazolam technique gave just as good amnesia as did general anaesthesia, and there was a high degree of patient satisfaction in both groups. In the thiopentone group there was a significant depression of the respiratory rate and a significantly higher frequency of adverse effects (nausea and vomiting) as compared to the midazolam group. It is concluded that paracervical blockade combined with midazolam, titrated i.v., until sleep or dysarthria, is a recommendable anaesthetic technique for diagnostic dilatation and curettage.
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PMID:Midazolam combined with paracervical blockade compared to general anaesthesia for curettage of the uterus. 306 45

An 18-item self-rating test of memory functions was administered to two patient groups: seven patients with amnesia resulting from Korsakoff's syndrome and six other amnesic patients. These results were compared to results obtained previously for depressed psychiatric inpatients (n = 19) and depressed inpatients prescribed electroconvulsive therapy (ECT) (n = 35). The latter group was tested both before and 1 week after completion of the course of ECT. One pattern of memory self-ratings was reported by the two groups of depressed patients. These two groups reported an approximately equivalent level of impairment across all test items. A different pattern of memory self-ratings was reported by the two groups of amnesic patients and by the group tested after ECT. These patients reported considerably more impairment on some items than others, such that performance was not equivalent across test items. Finally, the patients with Korsakoff's syndrome underestimated their memory problems, reporting a less severe impairment than the other amnesic patients. The results show that the memory problems experienced in depression and in amnesia are distinguishable with self-assessment techniques. In addition, the similarity between memory self-ratings reported by patients after ECT and by amnesic patients supports the idea that memory complaints after ECT reflect primarily the experience of amnesia. Self-rating forms like the one described here may have useful application to many diagnostic groups where questions arise about the nature of reported memory problems.
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PMID:Self-ratings of memory dysfunction: different findings in depression and amnesia. 323 47

In a multicenter placebo-controlled study, the safety, side effects, and patient acceptance of alprazolam for the treatment of panic disorder and agoraphobia were examined. A total of 525 patients meeting DSM-III criteria for agoraphobia with panic attacks or panic disorder were randomly assigned to receive alprazolam or placebo, which they took for eight weeks. The mean daily dose at the end of the study was 5.7 mg of alprazolam or 7.5 capsules of placebo daily. Potentially serious reactions to alprazolam occurred in ten of 263 subjects who received the drug. These included acute intoxication (three), hepatitis (two), mania (two), amnesia (one), aggressive behavior (one), and depression (one). Treatment-related side effects that were worse in patients taking alprazolam than in those taking placebo included sedation, fatigue, ataxia, slurred speech, and amnesia. Sedation was the most frequent but tended to subside with dose reduction or continued administration of the drug. Patient acceptance of alprazolam, as measured by the rate of completion for study participants, was high. Eighty-four percent of patients receiving active drug completed the study compared with 50% receiving placebo.
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PMID:Alprazolam in panic disorder and agoraphobia: results from a multicenter trial. II. Patient acceptance, side effects, and safety. 335 44

Neuropsychological impairment and pathologically delayed Acoustic Brain stem Responses (ABR) have been found in patients examined after minor head injury. The relation of these alterations with the emergence of post-concussional symptoms is unknown. In this study 27 patients were examined with ABR within 48 hours of a clearly defined head injury and with a complete neuropsychological test battery one month after the trauma. They were checked for postconcussional symptoms such as headache, depression or dizziness one year later. ABR recordings were pathological in four patients. Neuropsychological testing showed no difference between patients and age-matched controls. No correlation was found between postconcussional symptoms and ABR and neuropsychological examination results, posttraumatic amnesia, and neurotic symptoms present before the trauma. Subclinical brain stem involvement as shown by ABR does not seem to correlate with symptoms of the postconcussional syndrome. This greatly limits the use of ABR in forensic medicine.
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PMID:[Value of neuropsychologic tests and acoustic evoked brain stem potentials in the prognosis of subjective complaints in patients with brain concussion]. 361 86

Six male patients were studied on the morning following upper abdominal surgery for highly selective vagotomy. Nalbuphine hydrochloride was infused i.v. at different rates that increased progressively in each hour over a 4-h period. In the last 15 min of each hour, the plasma nalbuphine concentrations were almost steady (73-68, 71-82, 116-113 and 201-208 ng ml-1). Patients and an observer made hourly assessments of pain and sedation. Although the changes in the pain and sedation scores were not significant, the patients' mean pain scores increased when the mean plasma nalbuphine concentrations were greater (greater than 82 ng ml-1), which suggested that nalbuphine analgesia had been reversed. Nalbuphine caused sedation and possibly induced amnesia which could invalidate retrospective assessment, since the patients' assessment of analgesic efficacy at the end of the study was good. No cardiovascular depression or significant decrease in the ventilatory rate was recorded.
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PMID:A dose-response study with nalbuphine hydrochloride for pain in patients after upper abdominal surgery. 368 10

This study compared the performance of groups Alzheimer, Korsakoff, and depressed patients and a group of healthy controls at various clinical tests of memory, and wide differences were found in the discriminatory power of the different tests. In addition, the patterns of performance of the Alzheimer and Korsakoff groups differed, and to some extent this was understandable in terms of what is known about the nature of organic amnesia. Depressed patients showed relatively mild impairments, which were not correlated with the severity of their depression.
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PMID:Clinical tests of memory. 377 22


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