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)

Two hundred forty-one elderly depressed patients entered the 8-week, double-blind phase of this parallel-group, multicenter study; 161 patients were randomized to receive sertraline (50-200 mg/day) and 80 were randomized to receive amitriptyline (50-150 mg/day). Among evaluable patients, there were no statistically significant differences between treatments in any of the primary efficacy variables: change in total Hamilton Rating Scale for Depression (HAM-D) score (17 items), percentage change in HAM-D score, change in HAM-D Item 1, change in Clinical Global Impressions (CGI) Severity score, change in the Depression Factor of the 56-item Hopkins Symptom Checklist, and the CGI Improvement score at the last visit. Similar results were obtained using data from all patients (intention-to-treat analysis), except that amitriptyline was superior in HAM-D Total score (p = .044). The two drugs produced a similar degree of response: on the basis of the HAM-D criterion, 69.4% of sertraline patients and 62.5% of amitriptyline patients responded, and, on the basis of CGI criterion, 79.5% of sertraline and 73.4% of amitriptyline patients responded. Twenty-eight percent of the sertraline patients withdrew from the study because of a treatment-related side effect and 2.5% (4) because of a laboratory abnormality. In comparison, 35% of the amitriptyline patients withdrew because of treatment-related side effects. Sertraline was associated with a statistically lower frequency of somnolence, dry mouth, constipation, ataxia, and pain and a higher frequency of nausea, anorexia, diarrhea/loose stools, and insomnia; thus, anticholinergic effects were less common and gastrointestinal effects were more common with sertraline than with amitriptyline.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Double-blind, multicenter comparison of sertraline and amitriptyline in elderly depressed patients. 225 79

We investigated the efficacy of interferon-alpha (IFN-alpha) treatment in 5 patients with human T-lymphotropic virus type I (HTLV-I)-associated myelopathy (HAM). Treatment with IFN-alpha yielded clinical improvement of gait, and sensory and/or sphincter disturbance in 4 out of the 5 HAM patients. IFN-alpha treatment did not bring about uniform changes in lymphocyte subsets or anti-HTLV-I antibody titer of peripheral blood. Although the stimulation indexes to phytohemagglutinin, concanavalin A, and pokeweed mitogen were decreased in the culture of the peripheral blood lymphocytes (PBL) in the 5 HAM patients before the treatment, the stimulation indexes to these mitogens were significantly increased except in 1 case after the IFN-alpha treatment. These changes were based primarily on the depression of the spontaneous proliferation of PBL without mitogen. These results appear to point out a very important phenomenon for the investigation of the pathogenesis of HAM.
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PMID:The efficacy of interferon-alpha treatment in human T-lymphotropic virus type-I-associated myelopathy. 227 19

In order to test the hypothesis that weight changes on fluoxetine are a function of baseline weight, we divided a group of 39 depressed outpatients into 3 groups based on the Fogarty table: ideal, underweight, and overweight. Subjects were participants in an open label depression trial that was carried out over 3 years. Doses ranged from 20 mg to 80 mg depending on the patients' response and side effect profile. Demographic data, weights and Hamilton Rating Scale for Depression (HAM-D) scores were collected at baseline. Subsequent Hamilton scores and weights were obtained at monthly intervals until the subjects were terminated from the study. Only those subjects who remained in the study for at least 6 months were included in this analysis. Overweight subjects showed a significant weight loss of 3.3 lbs (p less than .001) in the first 2 months whereas ideal weight subjects gained 4.4 lbs (p = .02) over a 4-month period. All of these changes were maintained throughout the study. The underweight patients showed no consistent trends. All patients examined (those who completed 6 months or more in the trial) had significant decreases in their HAM-D scores (p less than .001).
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PMID:Weight changes on fluoxetine as a function of baseline weight in depressed outpatients. 227 32

We describe the construction and validation of the TRIM, an empirically derived scale designed to rate tricyclic antidepressant response in major depression. Symptoms selected were those that improved in direct association with therapeutic desipramine plasma levels, were frequently present, were substantially correlated with the scale total, could be reliably rated, and for which interview ratings were concordant with observed behavior. Eight symptoms met these criteria and were included. The sensitivity of the TRIM was tested and compared with the Hamilton Rating Scale for Depression (HAM-D) and the Montgomery Asberg Depression Scale (MADS) in a new 4-week prospective desipramine study of nonpsychotic unipolar inpatients with major depression. TRIM 4-week totals were significantly associated with total desipramine plus hydroxydesipramine plasma concentrations, r = -0.32, p less than 0.05, but HAM-D and MADS scores were not. Using multiple regression to control for pretreatment severity, TRIM scores were significantly associated with desipramine plus hydroxydesipramine levels, while HAM-D and MADS scores were not. The data appear to validate the sensitivity of the TRIM and illustrate that scales designed for drug response may detect drug effects that global scales do not.
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PMID:A scale for rating tricyclic response in major depression: the TRIM. 228 98

Because the clinical actions of psychotherapeutic agents can be influenced by their pharmacokinetics, we investigated plasma tranylcypromine in relation to treatment outcome in 26 patients with bipolar depression. After oral administration of a tranylcypromine dose, plasma drug levels were measured hourly from 5-8 hours (N = 16) or 0-8 hours (N = 10) postdose, and pharmacokinetic parameters were calculated. Depressive symptoms were rated using the Hamilton Rating Scale for Depression (HAM-D), and subjects were categorized as responders, partial responders, or nonresponders, based on end-pair ratings. Twelve subjects were responders, seven were partial responders, and seven were nonresponders (mean scores = 3.2, 13.1, and 24.9, respectively); pretreatment HAM-D scores did not differ among the three groups. Tranylcypromine elimination (t1/2) was unrelated to clinical outcome. However, plasma tranylcypromine measured 5 hours postdose (5hTCP) was correlated with the end-pair HAM-D scores (r = 0.48, p less than 0.015) and was significantly higher in nonresponders than in responders (ANOVA, F = 4.7, p less than 0.02; Newman-Keuls test, p less than 0.05). For subjects who were studied from 0-8 hours postdose, the time to peak absorption (Tpeak), the area under the plasma tranylcypromine-versus-time curve, and the volume of distribution (Vd) were determined. Two subjects having delayed (3-4 hours) Tpeak also manifested elevated mean 5hTCP (63.9 vs. 34.1 ng/ml).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Plasma tranylcypromine: relationship to pharmacokinetic variables and clinical antidepressant actions. 237 18

Secondary depressive symptomatology in 435 subjects with panic disorder and phobic avoidance was studied before and after alprazolam treatment. No subject who had a primary affective disorder was included. Calculation of Hamilton Depression Rating Scale factor scores revealed that the agitation/anxiety, sleep disturbance, and somatization factors accounted for approximately 75% of the HAM-D total score; these all showed significant improvement with alprazolam treatment. There were few differences in dimensions of depressive symptomatology between those subjects with and those without major depression; the main difference was in the overall intensity of the depression.
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PMID:Secondary depression in panic disorder and agoraphobia. II. Dimensions of depressive symptomatology and their response to treatment. 252 51

Elderly hypertensive patients with psycho-organic syndrome were treated with nicardipine (40-60 mg daily) alone or combined with hydrochlorothiazide (30 mg). This treatment led not only to a significant reduction in blood pressure but also to improvement in the score of the scales used for psychogeriatric evaluation (SCAG = Sandoz Geriatric Assessment Scale and HAM-D = Hamilton Rating Scale for Depression). These findings appear to confirm the possibility to consider nicardipine a drug of first choice for the treatment of arterial hypertension in the elderly with psycho-organic syndrome.
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PMID:[Nicardipine in the therapy of arterial hypertension in elderly patients with the psycho-organic syndrome. Report on the results of the clinical study]. 252 91

Buspirone is a unique anxiolytic drug with established efficacy in the treatment of anxiety. In animals, buspirone has been shown to alter drinking preference from alcohol to water. The following study was conducted to evaluate the behavioral effects of buspirone in patients meeting the Diagnostic and Statistical Manual of Mental Disorders (3rd ed.; DSM-III) criteria of alcohol abuse. These patients were motivated to reduce or stop drinking, though none were abstinent at baseline. Buspirone was compared with placebo in a double-blind, 8-week trial in 50 outpatients with mild to moderate alcohol abuse. Patients were assessed at baseline and at end point using the following psychometric and alcohol behavior measures: Drinking Behavior Interview (DBI), Alcohol Craving Scale, the Hamilton Anxiety (HAM-A) Rating Scale, the Hamilton Depression (HAM-D) Rating Scale, and the Physician Questionnaire. Dosage was initiated at 5 mg buspirone 3 times a day (15 mg/day), with a flexible regimen to a maximum of 30 mg/day. The mean daily dose was 20.5 mg buspirone, which is comparable to the anxiolytic dose. Efficacy measures were available for 45 patients (24 buspirone, 21 placebo). The treatment discontinuation rate was markedly lower (p = 0.002) on buspirone; 12 placebo patients and 2 buspirone patients discontinued due to lack of effect (p = 0.001). No patients discontinued due to adverse effect. Buspirone reduced alcohol craving by 40% (p = 0.001), in association with reduced HAM-A and HAM-D scores (p = 0.006) and improved the physician's assessment of global psychopathology. Buspirone treatment was also associated with a 57% decrease in DBI scores; statistical comparison of the DBI data with placebo was precluded by the high discontinuation rate in the placebo group. While these results should be interpreted with caution due to the limited sample size and high placebo discontinuation rate, the findings suggest that further evaluation of buspirone in the management of alcoholism, especially abstinent alcoholics, is warranted.
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PMID:Buspirone in the treatment of alcoholic patients. 265 38

Fengabine is a new GABAmimetic compound active in animal models predictive of antidepressant activity. The present overview reports the results of 6 double-blind trials versus tricyclics (TCAs) (3 in outpatients and 3 in inpatients). Overall, 398 adult patients (149 males and 249 females) were treated; 194 with fengabine and 204 with TCAs (98 clomipramine, 63 amitriptyline and 43 imipramine). 284 suffered from major depression (MD) (including major depressive disorder and bipolar disorder, depressed; DSM III) and 114 from minor depression (MiD) including dysthymic disorder, atypical depression and adjustment disorder with depressive mood (DSM III). Dosage ranged from 600 to 2,400 mg/day for fengabine and 50 to 200 mg/day for TCAs. Efficacy was evaluated with the HAM-D scale. 311 subjects (154 fengabine and 157 TCAs) ended the 4-week treatment period. Considering the whole sample and mean IAM-D scores, no significant differences emerged between the 2 treatment groups at any of the assessment periods. Because of a significant treatment x type of depression interaction, MD and MiD were analysed separately, and a different trend appeared in the 2 subgroups with TCAs behaving slightly better than fengabine in MD and fengabine performing slightly better than TCAs in MiD. Using the physician's clinical improvement, 74% of patients under fengabine and 72% of those under TCAs were rated as improved or much improved. Side effects, particularly of the anticholinergic type were significantly more frequent in the TCAs group. Gamma-GT were more frequently altered in the fengabine group (30.4 vs. 10.5%); this increase was interpreted as a consequence of enzymatic induction. Lastly, more patients taking fengabine exhibited an increase in cholesterol values.
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PMID:Fengabine, a new GABAmimetic agent in the treatment of depressive disorders: an overview of six double-blind studies versus tricyclics. 266 80

Eighteen patients with seasonal affective disorder (SAD) participated in a double-blind, placebo-controlled crossover study in 1986-1987. Each received, in random order, d-fenfluramine (15 mg p.o. twice daily)-a serotonin-releasing drug previously shown to suppress carbohydrate craving-or a placebo; these were given for 4 weeks separated by a 2-week washout period. Symptoms were assessed by means of clinical interviews and the Hamilton Rating Scale for Depression (HAM-D) with a special SAD addendum (AAD). Patients were also weighed. Depression scores (mean +/- SE) were identical before treatment with drug (20.9 +/- 1.3, HAM-D; 13.3 +/- 0.8, AAD) or placebo (21.4 +/- 1.2, HAM-D: 13.2 +/- 0.6, AAD). During placebo treatment, mean HAM-D scores declined by 22% (p less than .02) and AAD scores by 9% (p greater than .2). During d-fenfluramine treatment, HAM-D scores fell by 71% (p less than .001) and AAD scores by 73% (p less than .001). Thirteen (72%) of the patients demonstrated complete reversal of their abnormal test scores while taking d-fenfluramine. The group as a whole lost weight (mean = 1.2 kg) while receiving d-fenfluramine (p less than .033) but not when taking placebo. A second study, conducted in 1987-1988 with nine subjects who had previously responded to d-fenfluramine, showed that the drug remains effective for the full 3-month annual period of symptoms. These results indicate that d-fenfluramine may be useful in treating SAD and suggest that serotonin is involved in both SAD's affective and appetitive symptoms.
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PMID:Treatment of seasonal depression with d-fenfluramine. 267 Sep 15


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