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)

1. The authors review the literature describing acute symptomatology produced by the gradual or abrupt withdrawal of heterocyclic antidepressants, monoamine oxidase inhibitors (MAOI) and neuroleptics. 2. Withdrawal of heterocyclic antidepressants and antipsychotic agents causes similar symptomatology. Symptoms produced by the discontinuation of these drugs include nausea, emesis, anorexia, diarrhea, rhinorrhea, diaphoresis, myalgias, paresthesias, anxiety, agitation, restlessness, and insomnia. 3. Psychotic relapse is often presaged by anxiety, agitation, restlessness, and insomnia. Prodromal symptoms are distinguished from the effects of neuroleptic withdrawal by a temporal relationship of the latter to reductions in the dosage or discontinuation of antipsychotic agents. 4. Withdrawal of MAOIs can result in severe anxiety, agitation, pressured speech, sleeplessness or drowsiness, hallucinations, delirium, and paranoid psychosis. 5. MAOI withdrawal phenomena resemble the symptoms produced by the discontinuation of chronically administered psychostimulants. 6. The capacity of MAOIs to exert amphetamine-like effects presynaptically and the propensity of somatic treatments for depression to subsensitize presynaptic receptors regulating the release of catecholamines provide a basis for the development of psychotic symptoms upon the withdrawal of MAOI. Evidence for this hypothesis is reviewed.
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PMID:Heterocyclic antidepressant, monoamine oxidase inhibitor and neuroleptic withdrawal phenomena. 196 71

A herd of 15 mature riding horses with a history of anorexia, weight loss, and lethargy was examined. The animals had been fed a 50/50 mixture of commercial sweet feed and corn screenings contaminated with a heavy growth of Fusarium moniliforme. Thirteen of the horses had one or more neurologic signs. The most characteristic signs were profound depression and mild ataxia. Over the 19-day course of the epizootic, the horses had increasing severe neurologic deficits, including unilateral blindness and delirium. Despite the clinical appearance of dehydration, 12 horses had low PCV (16 to 27%), hematocrit (21.2 to 31.0%; determined by automated cell counter), and RBC counts (3.76 to 5.5 x 10(6) RBC/microliters). White blood cell counts were variable (4,900 to 17,000 WBC/microliters). Necropsy findings included diffuse malacia of the white matter of the frontal cortex and severe multifocal perivascular hemorrhage in the white matter of the temporal cortex, basal ganglia, anterior medulla, and pons. One horse had a hepatic lesion consisting of a mixed inflammatory cell infiltrate and bile duct proliferation. The attack rate of this epizootic was 100%. The course of disease was unusually long in some animals. In an experiment, the fusarium-infected corn screenings were fed to horses and did not cause clinical signs or alterations in blood or serum biochemical values.
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PMID:Clinical and epidemiologic features of an epizootic of equine leukoencephalomalacia. 204 19

Early studies suggested that cerebrovascular change may be an etiological factor in the development of late-life depression. With the advent of magnetic resonance imaging (MRI), it has become possible to examine this hypothesis. MRI studies have demonstrated that patients with late-onset depression have more severe and frequent patchy lesions in the frontal deep white matter and basal ganglia than do controls or patients with early-onset depression. Patients with basal ganglia lesions, primarily caudate, are more likely to develop delirium with antidepressants and electroshock treatment (EST). The prognostic significance and the relationship of these lesions to cognitive impairment is unclear.
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PMID:Organic bases of depression in the elderly. 203 71

The American Psychiatric Association established the Task Force on Quantitative Electrophysiological Assessment in May 1989 to consider several questions of interest to psychiatrists. From the inception of techniques for quantitative electroencephalography (qEEG), the possibility was raised that it would substantially assist in the diagnosis of brain disorders. However, controversy exists over the scientific basis for such approaches and the training necessary for interpretation of computerized records. The task force's charge was to report 1) the present state of scientific knowledge about qEEG, 2) the role of qEEG in clinical psychiatric practice at the present time, 3) the training necessary for the use of qEEG techniques, and 4) the possible future of the technique in the study of mental disorders. The task force concluded that qEEG is particularly useful for the detection of abnormalities in slow waves, which are a feature of delirium, dementia, intoxication, and other syndromes involving gross CNS dysfunction. The ability of qEEG to help in the diagnosis of other disorders, such as schizophrenia or depression, is not yet established. Clinical replications and sharing of normative and patient data bases are necessary for the advancement of this field. Proper use of this technique requires extensive training in a center experienced in its use. Standards for training and for using the technology in psychiatry are urgently needed. This report was approved by the Board of Trustees in December 1990.
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PMID:Quantitative electroencephalography: a report on the present state of computerized EEG techniques. American Psychiatric Association Task Force on Quantitative Electrophysiological Assessment. 205 52

As many as 180 children aged 4 to 14 years with depression and pain were examined. According to psychopathology senesthopathic pains, pains with vital depersonalization, hallucinatory pains, and pains marked by elements of delirious perception, and undifferentiated pains were distinguished. The authors review some typological varieties of depression and pain: somatoalgic crises associated with somatized depression and pains associated with depression and depersonalization, somatoalgic crises in depression associated with pseudoneurological disorders, somatoalgic crises in the structure of nocturnal fears in the presence of anxious depression, somatoalgic crises in the presence of short-term well-defined episodes of psychomotor excitation or stupor with fear, distress, dysphoria, hallucinations, senesthohypochondriac conditions in the presence of anxiety, somatoalgia in the structure of the depressive and delirious syndrome. Discuss problems of the disease entities, pathogenesis and therapy.
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PMID:[Pain syndrome in children with depression]. 217 25

Delirium, an acute confusional state, is an organic brain syndrome that manifests deficits in attention, irrelevant or rambling speech, and other cognitive deficits. Its symptoms often fluctuate over the course of the day, and patients may be hyperactive--for example, restless and screaming--or hypoactive--for example, quiet, inactive, and stuporous. Occurring in approximately 20% of hospitalized elderly patients, delirium is the most common psychiatric syndrome in acutely ill general medical and surgical patients. Fifteen to 30% of delirious patients expire, and others are prone to a variety of complications: falls, pressure ulcers, oversedation, dehydration, and others. Almost any acute illness can cause delirium in the elderly, but the most common offenders are acute infections and drugs. Many patients have a pre-existing dementia. The first step in arriving at a correct diagnosis is to distinguish delirium from other psychiatric syndromes that can cause confusion, such as dementia, depression, schizophrenia, and mania. Once delirium is established, a comprehensive general examination and a mental status examination is required. Routine laboratory and radiologic tests are directed at the common metabolic and infectious disorders that precipitate delirium. Treatment is directed at the underlying acute illness. In all patients, it is important (1) to treat the underlying acute illness, (2) to provide appropriate fluid and electrolytes, (3) to discontinue any unnecessary drugs, and (4) to allay the patient's fear and agitation through the use of simple, repetitive instructions, orientation cues, and by limiting the use of physical restraints. If psychotropic medications are needed to treat psychotic symptoms, to prevent patients from harming themselves or others, or to facilitate necessary diagnostic and therapeutic interventions, then haloperidol is the drug of choice in most instances. Drugs with anticholinergic properties should be avoided.
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PMID:Delirium in the elderly. 218 81

This article deals with common issues encountered in elderly persons who are medically ill. Agitation and delirium, including alcohol withdrawal syndrome, are frequently encountered problems, and useful intervention strategies are presented. Depression in this population is discussed, and a brief review of the use of antidepressants is given. Finally, the approach to and management of anxiety, with special focus on the intensive care unit setting, is summarized. Principles of pharmacotherapy in the elderly are reviewed.
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PMID:Perioperative psychiatric considerations in the elderly. 219 18

"Failure to thrive" (FTT) is a term used to describe a gradual decline in physical and/or cognitive function of an elderly patient, usually accompanied by weight loss and social withdrawal, that occurs without immediate explanation. Both age-related and sociodemographic factors predispose the elderly to FTT. The most common etiologies are dementia, depression, delirium, drug reactions, and a few chronic diseases. The diagnostic evaluation of patients with FTT includes a review of the patient's activities of daily living, cognitive function, and mood; a targeted history and physical examination; and selected laboratory studies. Early recognition and management of FTT can reduce the risk of further functional deterioration, hospitalization, or nursing home placement.
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PMID:'Failure to thrive' in the elderly: diagnosis and management. 220 87

Alzheimer's disease is the most common cause of progressive dementia in older adults. Diagnosis is based on a careful history, a thorough physical examination and appropriate laboratory studies. Although the pathology of Alzheimer's disease is well described, the etiology remains unknown. The only well-established risk factors are advanced age and family history. Management problems frequently include depression, delirium, wandering, urinary incontinence and iatrogenic disease.
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PMID:New perspectives in the management of Alzheimer's disease. 223 49

Psychiatric disorders commonly coexist in patients with medical illness. Three disorders encountered frequently are anxiety disorders, depression, and delirium. The authors discuss these psychiatric disorders and their treatment in medically ill patients. Psychiatric consultation may be helpful in such cases.
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PMID:Psychiatric disorders in the medically ill. 224 4


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