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)

Four different methods of quantifying the 1-mg Dexamethasone Suppression Test (DST) were contrasted with serial testing in endogenous depressives receiving electroconvulsive therapy (ECT). Of three continuous measures in 38 patients with pretreatment DSTs, only the log-transformed value for plasma cortisol was normally distributed, indicating that it possessed superior psychometric properties. Pretreatment Hamilton Depression Rating Scores (HAM-D) correlated positively with pretreatment DST status, with a similar association noted between posttreatment DST status and HAM-D scores. There was no uniform effect of ECT on the DST. Although pretreatment nonsuppressors showed a trend toward decreased postdexamethasone cortisol values, initial suppressors (cutoff: 5 micrograms/dl) evidenced a significant increase in these values, and 35.3% of initial suppressors were nonsuppressors at final DST assessment. These trends were noted in the DST assessment done following the third ECT treatment, suggesting an effect of regression to the mean. The findings highlight the importance of following initial DST suppressors in studies of this type.
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PMID:Serial dexamethasone suppression tests in initial suppressors and nonsuppressors treated with electroconvulsive therapy. 356 61

Thirty-four newly admitted patients who met the Research Diagnostic Criteria for schizophrenia were assessed on admission and in their 8th week of hospitalization. The data were obtained using the Brief Psychiatric Rating Scale (BPRS), the Hamilton Depression Rating Scale (HAM-D), and the Extrapyramidal Involvement Rating Scale (EPRS). A significant reduction in BPRS scores was observed on Week 8 scores compared with baseline scores (p less than .001); however, no significant difference could be found between baseline and Week 8 HAM-D scores. In addition, no significant correlation between the HAM-D scores and the EPRS scores was seen. Depressive symptoms appear to be present during the acute phase of schizophrenic psychosis and do not remit as rapidly as the psychotic symptoms.
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PMID:Depressive symptoms in acute schizophrenic hospitalized patients. 405 8

Fifty-four patients (34 outpatients, 20 inpatients) fulfilling Research Diagnostic Criteria for Definite Major Depressive Disorder were enrolled in a double-blind study comparing the antidepressant effects of alprazolam versus desipramine. The mean daily dose of alprazolam and desipramine at study termination was 3.78 mg and 208 mg respectively. As there were no significant demographic or clinical differences between outpatients and inpatients, both groups were combined in data analysis. Using the Hamilton Depression Rating Scale (HAM-D) both drug groups showed highly significant improvement beginning with the first week of active drug treatment. HAM-D scores continued to decrease through study termination (six weeks of active drug). There were no significant differences when comparing alprazolam and desipramine (outpatients, inpatients, or both groups combined) on any of the subjective or objective psychometrics used in this study. Clinically, only twelve of thirty-four outpatients (35.3%) were felt to be "markedly or moderately" improved, suggesting that neither the outpatient alprazolam nor desipramine patients did particularly well with drug treatment. In terms of drug safety there was no difference between the alprazolam and desipramine in the number of excessive or serious drug side effects. However, five of twenty-nine alprazolam patients had to discontinue therapy because of excessive drowsiness, and two of the alprazolam outpatients had motor vehicle accidents directly related to this adverse event. Alprazolam appeared as effective as desipramine in the pharmacotherapy of this group of depressed outpatient and inpatients. Alprazolam appeared well-tolerated by most subjects although drowsiness was a common--and at times serious--medication side effect.
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PMID:A comparison of the safety and efficacy of alprazolam and desipramine in moderately severe depression. 408 99

Alprazolam, a triazolobenzodiazepine first developed as an anxiolytic, has been shown to be effective in the treatment of depression in several comparison studies with tricyclic antidepressants. This open label study examined the efficacy and safety of alprazolam in patients aged 56-78. Of 18 patients with evaluable data, 12 were responders (improvement greater than or equal to 50% on the Hamilton Depression Rating Scale); 4 patients were partial responders (HAM-D improvement of 25%-49%); and 2 patients were nonresponders. Initial drowsiness was the only side effect observed.
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PMID:Alprazolam in older depressed inpatients. 613 50

Zimeldine, a new antidepressant with a selective inhibition of 5-HT reuptake, was compared with imipramine in a double-blind comparative study. The trial was conducted on 95 patients with primary major depressive disorder, of endogenous character. During the 4-week study period clinical efficacy was evaluated by using the Hamilton Depression (HAM-D) scale, Beck's Inventory and global ratings. Zimeldine (100 mg b.d.) was shown to have as good an antidepressive effect as imipramine (50 mg t.d.s.) when evaluated on the HAM-D scale. Assessment of the symptom improvement on this rating scale suggested that zimeldine was more effective in improving the patient's insight of the disease. There was no significant difference between zimeldine and imipramine as assessed by a final global improvement rating scale as well as by the patient's own impression. Exploratory data analysis revealed that zimeldine was significantly more effective than imipramine in the following groups; patients over 40 years of age; patients whose initial onset of illness occurred at over 40 years; patients with a history of at least three episodes of depressive illness; patients with mild to moderate depression; and patients who had previously failed to show an appreciable response to other antidepressant treatment. Analysis of global safety ratings revealed that zimeldine is significantly safer than imipramine, with a lower incidence of adverse symptoms involving the autonomic nervous system, especially anticholinergic reactions. No significant difference was observed between the two groups with respect to abnormal laboratory reports. One zimeldine patient developed symptoms suggesting a hypersensitivity reaction (fever, skin eruption and elevation of plasma levels of transaminases), which led to the patient's withdrawal from drug treatment.
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PMID:A multicentre double-blind comparative trial of zimeldine and imipramine in primary major depressive disorders. 623 Aug 95

The efficacy of desipramine for mild depression was tested in a double-blind, placebo-controlled study of outpatients with scores below 19 on the Hamilton Rating Scale for Depression (HAM-D). Of 103 such patients, 23 dropped out and 16 improved during a ten-day placebo period. Among 64 patients completing the randomized portion of the study, significantly more improved with desipramine that with placebo. The Research Diagnostic Criteria (RDC) category of major depressive disorder largely accounted for the drug-placebo response difference found for the entire sample. Patients with intermittent depressive disorder improved significantly less frequently with desipramine than patients with major depressive disorder. Independent of RDC diagnosis, severity of illness correlated with outcome. Thus, patients with pretreatment HAM-D scores at or above the median demonstrated significant drug effect, while patients with lower pretreatment HAM-D scores did not.
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PMID:Efficacy of desipramine in depressed outpatients. Response according to research diagnosis criteria diagnoses and severity of illness. 633 80

The dexamethasone suppression test (DST) was performed as part of the preliminary workup in 85 previously untreated outpatients with major affective disorder, unipolar depressive type, who were over age 60. All patients were given a systematic structured interview (NIMH-DIS), and all had scores over 20 on the 21-item Hamilton Depression Rating Scale (HAM-D). Only 12 patients (14%) had positive DSTs; more of the non-melancholic (6 of 25; 24%) than melancholic (6 of 60; 10%) patients failed to suppress serum cortisol following standard dexamethasone challenge (p less than .10). DST results did not correlate with patients' HAM-D or Zung depression scores, gender, response to treatment, or any other variable studied. These findings suggest that, in comparison to previous reports, a positive DST may be 1) less common in major depressive disorders, 2) no more common in more severely depressed patients, and 3) less relevant to indications for specific treatment.
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PMID:Dexamethasone suppression in depressed elderly outpatients. 646 26

Using a pluridiagnostic approach, the dexamethasone suppression test (DST) was studied in 67 depressed inpatients in its relationship to diverse clinical variables. The International Classification of Diseases (ICD), the Research Diagnostic Criteria (RDC), the Newcastle Index, the Hamilton Depression Rating scale (HAM-D), and the Bf-s self rating questionnaire were applied. Fifty-two per cent of endogenous depressed (ICD), 51% of major depressive (RDC) and 53% of endogenous depressed (Newcastle) patients demonstrated dexamethasone nonsuppression (DSTN) with a value above 110 nm/l. Six per cent of neurotic depressed (ICD), 9% of minor depressive (RDC) and 23% of neurotic depressed (Newcastle) patients were dexamethasone nonsuppressors. Significantly higher values (after P-correction) for DSTN could be detected in severity ratings as measured with Newcastle (P less than 0.001) and HAM-D global score (P less than 0.001) and also for HAM-D factor 4 (somatic complaints, P = 0.001). All the other evaluated variables did not discriminate between patients with dexamethasone suppression and with nonsuppression.
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PMID:Dexamethasone suppression test in a pluridiagnostic approach: its relationship to psychopathological and clinical variables. 661 17

Trazodone (TZ), a 'new generation' antidepressant and amitriptyline (AMT) were administered in a double-blind controlled study to 43 depressed inpatients. The Hamilton Depression Rating Scale (HAM-D), the AMDP-system and the Bf-s self-rating questionnaire were used for documentation of psychopathological changes and autonomic side effects. The Newcastle-Scale for definition of a neurotic and an endogenous subgroup of depression was retrospectively applied. No significant improvement was noticed on the Bf-s self-rating questionnaire in the TZ group as compared to the AMT group (p less than 0.001). The global HAM-D score decreased significantly in the TZ group (p less than 0.05) as well as in the AMT group difference (p less than 0.01) emerged during the trial in favour of AMT. Core symptoms of depression were significantly improved in the AMT group but not in the TZ group: depressed mood (p less than 0.001), psychic anxiety (p less than 0.001) and retardation (p less than 0.05). TZ was faster actin than AMT in controlling agitation. Results of this clinical study demonstrate TZ to have sedative and some anxiolytic properties but only negligible antidepressant efficacy.
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PMID:Trazodone and amitriptyline in treatment of depressed inpatients. A double-blind study. 702 79

Clinical and experimental work indicates that cholinergic functions might play a role in modulating affectivity in man. In this acute double-blind study either the cholinolytic agent biperiden or placebo infusions were administered to six depressed females. The Janke and Debus self-rating questionnaire (EWL-K), the modified Hamilton depression scale (HAM-D), and the Montgomery and Asberg depression scale (MADRS) were used for documentation of psychopathological change. There was an acute antidepressant effect during infusion of the active drug in comparison to placebo as measured on the global MADRS and EWL-K, but not on the modified HAM-D. Single items such as depressed mood, work and interests (HAM-D), sadness, concentration difficulties, inability to feel (MADR-S), and depressiveness (EWL-K) responded selectively and significantly to the biperiden infusion. It is concluded that cholinergic activity might be involved in the regulation of affectivity in man.
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PMID:The cholinolytic biperiden in depression. An acute placebo controlled study. 704 40


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