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)

Little is known about panic disorder among American Indians. In a pilot project involving two Northwest Coast Indian villages, community health representatives screened the population for panic disorder, substance abuse, and major depression using DSM-III criteria. Accompanying the screening were subsequent patient education and further evaluation by a psychiatrist, a social worker, and primary care physicians. Of fifty community residents who agreed to take the screening examination, seven were found who met diagnostic criteria for panic disorder. Four of the seven had symptoms of alcohol abuse which complicated the course and diagnosis of panic disorder, and individuals with panic disorder reported more than twice the lifetime prevalence of depression in comparison with other community members. Limitations of the study and refinements of study design are needed in future study discussions.
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PMID:Panic disorder among American Indians: a descriptive study. 213 8

The purpose of the present epidemiological study is to investigate and describe panic disorder and sporadic panic attacks among a cohort of young adults, aged 28 years, from the Canton of Zurich in Switzerland. Both DSM-III panic disorder and sporadic panic are characterized by frequent symptoms of somatic anxiety and tension, as well as by frequent symptoms of depressed mood and low vitality. Sporadic panic is more prevalent than panic disorder and shows a greater excess of females over males. The association with depressions (major depression and recurrent brief depression) is similarly high for both types of panic syndromes, while the association with other anxiety disorders is negligible. Several indicators suggest a marked similarity between sporadic panic and DSM-III panic disorder. More impressive differences were observed between subjects with panic disorder alone and subjects with comorbidity of panic and depression. For the latter group, the SCL-90R scores indicated higher severity. Comparison of the scores of life events, conflicts, self-esteem, and the number of chronic problems in childhood suggests a more specific nosological pattern for subjects with panic and depression as compared with those with panic alone.
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PMID:The Zurich Study. IX. Panic disorder and sporadic panic: symptoms, diagnosis, prevalence, and overlap with depression. 213 46

L-5-Hydroxytryptophan (5HTP) was administered to 20 patients suffering from panic disorder and to 20 healthy controls. Subjects received 60 mg 5HTP in 300 ml saline solution. Before, during, and up to 2 hours after 5HTP administration, symptoms of anxiety and depression were assessed. In addition, plasma 5HTP, 3-methoxy-4-hydroxyethylglycol (MHPG), cortisol, beta-endorphin, and melatonin levels were measured at several time points, and the kinetics of 5-hydroxytryptamine (5HT) in blood platelets were measured. During and after the infusion of 5HTP, none of the patients showed an increase in anxiety or depressive symptoms, despite the presence of severe side effects. Some patients even experienced the 5HTP infusion as a relief. In contrast to the patients, nine control subjects reported depressed mood, although no increases in anxiety were noted. In both patients and controls, the 5HTP infusion led to substantial increases in plasma cortisol and beta-endorphin levels, while the plasma MHPG level was unchanged. Plasma melatonin increased significantly after 5HTP administration, suggesting that increasing 5HT availability in man might affect melatonin synthesis. The results of this study are at odds with the hypothesis that there is a supersensitivity of 5HT2 receptors in panic disorder.
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PMID:Behavioral, neuroendocrine, and biochemical effects of 5-hydroxytryptophan administration in panic disorder. 213 31

Preliminary studies have shown that polymorphonuclear neutrophil (PMN) activity is decreased in a state-dependent manner in patients with endogenous depression. The present study investigates this finding in a larger group of psychiatric patients and attempts to determine the identification of the factor responsible for the abnormal neutrophil function. Chemiluminescence responses of PMNs from patients with diagnoses of endogenous depression, panic disorder, anxiety, schizophrenia and alcoholism were assessed concurrently with age- and sex-matched control subjects. The reduction in PMN activity was observed in panic disorder patients as well as during depression but remained normal in schizophrenia, alcoholism and generalised anxiety. The defect in PMN function appears to be related to an abnormal factor in the serum of the patient which is corrected on clinical recovery. Aspirin-inhibited prostaglandin synthesis resulted in an enhancement of PMN activity in healthy subjects, suggesting a possible role for prostaglandins in the abnormal PMN response.
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PMID:Abnormal zymosan-induced neutrophil chemiluminescence as a marker of depression. 214 3

The relationship between anxiety and depressive disorders has been the subject of considerable interest and controversy. In this study, the occurrence and course of affective illness was systematically examined in 63 patients meeting DSM-III-R criteria for panic disorder. Forty (63%) of the patients had experienced at least one major depressive episode. Of these, 13 (32.5%) experienced their first depressive episode prior to the onset of panic disorder, 15 (37.5%) experienced their first depressive episode after the onset of panic disorder, and in 12 (30.0%) the onset of the disorders was concurrent. Patients with agoraphobia had comparable rates of depression (68%) to patients without agoraphobia (53%, P = NS), and they had similar temporal patterns of depressive illness. Comorbidity with social phobia was associated with an increased longitudinal likelihood of major depression compared to patients without this comorbid diagnosis (P less than 0.05). Patients with longer duration of illness, early onset depression, melancholic depression, or family histories of anxiety or depression had an increased likelihood of having experienced recurrent depression. These findings are discussed in the context of current theories regarding the development of affective illness in patients with anxiety disorders.
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PMID:Major depression in patients with panic disorder: factors associated with course and recurrence. 214 6

During the 20 years that have elapsed since clomipramine (chlorimipramine) was first marketed, it has become well established in the treatment of depressive illness, particularly treatment-resistant depression. However, in addition to its role as an antidepressant, attention is being focused on the use of clomipramine in 2 other areas of psychiatry: obsessive compulsive disorder and panic disorder. Short term clinical trials have shown that clomipramine is generally more effective than amitriptyline, imipramine, desipramine, nortriptyline or clorgiline in reducing obsessive compulsive symptoms. Clomipramine appears to produce some short term benefit with exposure therapy in patients with obsessive compulsive disorder. However, the efficacy of the drug after long term follow-up has not been fully investigated. The antiobsessional efficacy of clomipramine appears to be independent of its antidepressant activity. In patients with panic disorder with or without agoraphobia (DSM-IIIR), clomipramine reduces the frequency and severity of panic attacks within 7 to 21 days of beginning treatment and efficacy is maintained for at least 12 months. Clomipramine is more effective than imipramine, the generally accepted standard treatment for patients with panic disorder after 2 weeks' treatment, but after 6 or 10 weeks both drugs are similarly effective. Other double-blind studies have shown that clomipramine is more effective than placebo and at least as effective as fluvoxamine and oxitriptan (5-hydroxytryptophan) in reducing panic attacks and associated anxiety. Adverse effects associated with clomipramine treatment are mild to moderate in nature and are predominantly a result of the drug's anticholinergic activity. The incidence of seizures is dose related, occurring in 0.48% of all patients receiving clomipramine less than or equal to 250 mg/day and 2.1% of patients receiving greater than or equal to 300 mg/day. In conclusion, the available data indicate that clomipramine is a worthwhile addition to the limited treatments available for obsessive compulsive disorder and panic disorder, two psychiatric disorders which have previously been difficult to manage pharmacologically.
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PMID:Clomipramine. An overview of its pharmacological properties and a review of its therapeutic use in obsessive compulsive disorder and panic disorder. 217 9

Seventy-nine patients with panic disorder were randomized to an 8-week double-blind treatment with alprazolam, imipramine, or placebo. Patients kept daily records of panic attacks, activity, anxiety, sleep, and medication use. Weekly measures of anxiety, depression, somatic symptoms, fears, avoidance, disability, and improvement were obtained. All patients underwent a symptom-limited exercise treadmill and other cardiovascular measures. By physician and patient global assessment, patients receiving alprazolam or imipramine were significantly better than patients on placebo. The alprazolam effects were apparent by week 1; the imipramine effects by week 4. All groups showed significant reductions in anxiety, depression, somatic measures, and panic attack frequency. At 8 weeks, patients in the alprazolam group reported significantly less fear than patients in the other two groups. Subjects in the imipramine group showed a significant increase in heart rate and blood pressure.
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PMID:Cardiovascular and symptomatic reduction effects of alprazolam and imipramine in patients with panic disorder: results of a double-blind, placebo-controlled trial. 218 12

Some forms of anxiety and affective disorder, such as panic disorder and major depression, appear distinct, while other forms, such as generalized anxiety disorder and chronic depression or dysthymia, may lie on a continuum and blend with each other. However, even panic disorder and major depression have many common features. Moreover, for reasons not yet clear, they occur together frequently, and their combined occurrence in the same patient has been associated with greater severity and chronicity, decreased treatment responsiveness, and, possibly, increased familial prevalence of anxiety and/or depression. Finally, studies of primary care patients suggest the frequent occurrence of a mixed anxiety-depressive disorder that may often be subsyndromal by DSM-III-R criteria but is nevertheless associated with prominent distress and/or impairment.
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PMID:Anxiety and depression: discrete diagnostic entities? 219 2

Clomipramine, a preferential inhibitor of 5-hydroxytryptamine uptake, has proven effective in the management of depression, resistant depression, and obsessive compulsive disorder. Investigators have also reported benefits of this medication in patients with phobia, panic disorder, chronic pain, Gilles de la Tourette's syndrome, premature ejaculation, anorexia nervosa, cataplexy, and enuresis. In double-blind studies of patients with depression, clomipramine has been significantly more effective than placebo and equivalent to standard tricyclics. Clomipramine is particularly well suited for the treatment of resistant depression, for which its efficacy may be enhanced by combination therapy with tryptophan and/or lithium. In at least 12 double-blind comparative trials, clomipramine has exhibited significant benefit in patients with obsessive compulsive disorder, this efficacy not being limited to patients with an associated depressive illness. In the United States, clomipramine is approved only for the treatment of obsessive compulsive disorder.
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PMID:Worldwide use of clomipramine. 219 35

Buspirone, an azapirone derivative and a 5-HT1A partial agonist, is the first nonbenzodiazepine anxiolytic introduced into medicine for the treatment of generalized anxiety disorder. A series of well-controlled clinical trials demonstrated that its anxiolytic properties were similar to those of various benzodiazepines and significantly better than placebo. More recently, antidepressant effects were also observed. Patients with clinical indications for which buspirone seems to be particularly appropriate are those with generalized anxiety disorder, those with chronic anxiety, the anxious elderly, and, perhaps, many patients of all ages who suffer from mixed symptoms of anxiety and depression. Studies conducted with patients suffering from panic disorder have so far been inconclusive, and thus buspirone is, for the present at least, not recommended for routine treatment of panic disorder. Buspirone seems to be most helpful in anxious patients who do not demand immediate gratification or the immediate relief they associate with the benzodiazepine response. Slower and more gradual onset of anxiety relief is balanced by the increased safety and lack of dependency-producing aspects of buspirone. Finally, whether or not buspirone may possess "curative" properties, in addition to "anxiety-suppressant" properties, that allow the patient to improve coping skills with time requires further exploration.
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PMID:Buspirone in clinical practice. 221 69


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