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)

Fluoxetine, a serotonin uptake inhibitor, and amitriptyline, a tricyclic antidepressant, were compared in a 5-week, multicenter, double-blind, randomized trial in 136 out-patient men and women, aged 21-70 years, with major depressive disorder. Overall efficacy was comparable with fluoxetine and amitriptyline [Hamilton 21-Item Rating Scale for Depression (HAM-D21), Raskin, Covi, Clinical Global Impressions-Severity and -Improvement, Patient's Global Impressions]. Mean +/- standard deviation decreases in HAM-D21 total score were 12.9 +/- 9.9 and 11.6 +/- 10.3 (p = 0.423), respectively. Response rates (> or = 50% decrease in HAM-D21 total score) for patients treated > or = 4 weeks were 46.7% and 66.0% (p = 0.039) and remission rates (HAM-D21 total score < or = 7) were 18.3% and 28.3% (p = 0.209), respectively. Response and remission rates for all patients were comparable with fluoxetine and amitriptyline. Study completions were higher with fluoxetine than amitriptyline (87.7% vs 66.2%; p = 0.003). Discontinuations for adverse events were higher with amitriptyline than fluoxetine (22.5% vs 6.2%; p = 0.007). More treatment-emergent nausea and insomnia were reported with fluoxetine (p < or = 0.05); more anticholinergic and orthostatic events and weight gain were reported with amitriptyline (p < or = 0.05). Statistically, but not clinically, significant changes were observed in vital signs. Both fluoxetine and amitriptyline were effective treatments for out-patients with major depressive disorder. Fluoxetine had a more favorable safety profile than amitriptyline.
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PMID:Fluoxetine versus amitriptyline in the treatment of major depression: a multicenter trial. 826 11

A data-analytic strategy is proposed for identifying the symptom-specific effects of each medication in a clinical trial. The within-group effect size is a standardized ratio of the pre-post change relative to the stability of change for each treatment group. Advantages of using this descriptive approach are illustrated by examining antidepressant effects of alprazolam, imipramine, and placebo in a clinical trial for patients meeting criteria for both panic disorder and depression. There was a significant difference between active medication and placebo on the Hamilton Rating Scale for Depression (HAM-D) total, but no difference between the anti-depressant effects of the active medications despite their diverse psychopharmacologic properties. Examination of effect sizes for each HAM-D item revealed distinct symptom-specific effects of each active medication in this study sample. Although these descriptive findings cannot be used for inferential conclusions, they can be used to guide the design of future trials.
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PMID:Effect size as a measure of symptom-specific drug change in clinical trials. 829 Jun 60

We obtained Hamilton Rating Scale for Depression (HAM-D) scores and recorded 5 minutes of rhythm strip both before and after a therapeutic trial of antidepressant medications in 17 patients diagnosed with major depressive disorder (MDD). We calculated the standard deviation (SD) of interbeat intervals and the mean squared successive difference (MSSD) as measures of heart-rate variability (HRV). We then calculated Spearman rank-ordered correlation coefficients between the HRV measures and the HAM-D scores. Changes in SD and MSSD correlated with post-treatment HAM-D scores and with changes in HAM-D scores. These relationships were strongest in patients who responded positively to nontricyclic antidepressant medications. HRV before treatment was not predictive of treatment response, nor did HRV reliably reflect the severity of depressive symptoms. These findings indicate that pharmacologic treatment leading to improvement in MDD is associated with increased HRV. Hence, brief measures of HRV could be developed as a useful adjunctive, physiologic measure of treatment response to pharmacotherapy in clinical trials and other settings. Further, increased HRV associated with successful treatment of MDD may reflect improved autonomic function, decreasing the risk of cardiovascular mortality found in patients with MDD.
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PMID:Increases in heart rate variability with successful treatment in patients with major depressive disorder. 829 Jun 66

Brofaromine is a new, reversible, and selective type-A monoamine oxidase inhibitor (MAOI) that also has serotonin reuptake inhibitory properties. Its dual pharmacologic effects offer promise in the treatment of a wide spectrum of depressed patients while producing less severe anticholinergic side effects in comparison with standard drugs. A multicenter, double-blind, placebo-controlled study including 220 patients was undertaken to evaluate the efficacy and safety of brofaromine in major depression. This study of a fixed-dose design and 6 weeks' duration found that brofaromine was significantly better than placebo on the Overall Evaluation of Efficacy, Beck self-rating scale, HAM-D Bech subscale, HAM-D total 14 items (minus the three sleep items), HAM-D depressed mood item and retardation factor, and worse than placebo on the insomnia items of HAM-D. Significantly more patients on placebo than on brofaromine did not complete the trial due to lack of efficacy. In comparative controlled studies (n = 899), brofaromine was found to be at least as efficacious as tricyclic antidepressants (imipramine) and standard MAOIs (tranylcypromine and phenelzine). Reductions of at least 50% in the HAM-D total score were seen in 58-66% of patients treated with either brofaromine or imipramine (n = 609). Brofaromine also was found to be of comparable efficacy to tranylcypromine in two clinical trials (n = 132), one of which included patients considered to have a treatment-resistant depression (n = 39). In another double-blind study that compared brofaromine (150 mg/day) to phenelzine (45 mg/day) (n = 158), there was no difference between brofaromine and phenelzine.
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PMID:Brofaromine in depression: a Canadian multicenter placebo trial and a review of standard drug comparative studies. 831 97

Data from 38 double-blind and two single-blind studies with moclobemide vs. placebo and/or standard antidepressants (10 drugs) were available for an intent-to-treat meta-analysis (n = 2,371). In all, 236 subjects received placebo and 1,107 moclobemide. As a measure of efficacy, a > or = 50% decrease from the baseline on the Hamilton Rating Scale for Depression (HAM-D) and its new subscales was taken. Furthermore, the Global Assessment of Efficacy (GAE) was analyzed. New subscales of the HAM-D consist of a retarded depression and an agitation/anxiety scale. The two factors were obtained from factor analyses of 12 x 8 random subsamples resulting in a stable solution. The subjects were subclassified by severity (low, medium, high) prior to treatment. The response to placebo was consistently lower in high scorers. In contrast to that, high scorers on active drugs (moclobemide, imipramine, and clomipramine) showed a tendency to higher response rates. Response rates were, in general, higher on the subscale retarded depression than on agitation/anxiety for both placebo and active drugs. Response rates to moclobemide were highest in unipolar endogenous depressives (66%) followed by bipolars (57%), neurotic depressives (52%), and reactive depressives (43%).
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PMID:Efficacy of moclobemide in different patient groups. Results of new subscales of the Hamilton Depression Rating Scale. 831 98

The Hamilton Rating Scale for Depression (HAM-D) and DSM-III-R criteria were simultaneously employed to assess the prevalence of depression in 26 outpatients with dementia of the Alzheimer type and 26 age-matched normal control subjects. Both assessment methods evidenced a higher frequency of depression during the severe stages of Alzheimer's disease. Among the Alzheimer patients, the prevalence rate of depression produced by the HAM-D (38%) was higher than the rate produced by DSM-III-R criteria (23%). Such a difference was due to the weight given by the HAM-D to the vegetative symptoms reported by the Alzheimer patients with more severe dementia. In a subgroup of 14 Alzheimer patients who underwent computed tomography, the volumetric measurement of CSF spaces did not reveal any difference between the depressed and nondepressed patients. On the basis of these results, the clinical problems related to the assessment of depression in Alzheimer's disease are discussed.
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PMID:Assessment of depression in Alzheimer's disease: symptoms, syndrome, and computed tomography findings. 835 17

Fifteen examples of red cells are described which showed discrepant reactivity on routine grouping with two monoclonal anti-D typing reagents, HAM-A being negative and MAD-2 strongly positive. The reaction profile of these cells with a number of monoclonal anti-D characterised the samples into two new variant groups, DHMi and DHMii. DHMi was characterised by a negative reaction with BRAD-8 and DHMii by a negative reaction with BRAD-5. DHMi cells were found to have a papain-sensitive site, identified by Mab 21 G6, which was not detectable in DHMii. The presence of allo-anti-D in one case of DHMi suggests a partial D in these individuals. The positive reaction of HAM-A with sialidase- and endo-F-treated DHMii cells suggests that sialic acid and/or N-glycans could possibly be involved in blocking the reaction with untreated cells. All samples typed as C-E+. One was e negative while the rest had variable depression of the e and f antigens. Marginal depression of E was seen with those DHMi cells tested, but not with DHMii cells. Data from family studies suggest that the variant D in both DHMi and DHMii is inherited as a cDE gene complex and is controlled by the RH locus.
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PMID:Identification of two new D variants, DHMi and DHMii using monoclonal anti-D. 857 37

Most previous phototherapy research has been conducted on trials of 1 week duration. This study compares response to phototherapy at weeks 1 and 2. All subjects (n = 26) were between 18 and 65 years and met Diagnostic and Statistical Manual of Mental Disorders, 3rd ed, revised, (DSM III-R) criteria for major depression, recurrent, seasonal pattern and had a Hamilton Depression Rating Scale score (HAM-D) > or = 20. A rater blinded to treatment schedule and study hypothesis repeated the HAM-D-31 1 and 2 weeks after baseline to assess treatment response to bright light. Response rates at week 1 defined by 50% reduction in HAM-D-31 and HAM-D-31 score < 8 were 62% and 27%, respectively. At week 2, however, 65% had a 50% reduction in HAM-D-31 and 62% had a HAM-D-31 < score 8 (chi-square = 6, p = 0.01). Four patients (15%) who were nonresponders at week 1 responded after 2 weeks. The results show a statistically different outcome after 2 weeks of treatment and suggest the necessity of longer trials of phototherapy.
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PMID:Influence of phototherapy treatment duration for seasonal affective disorder: outcome at one vs. two weeks. 858 Feb 28

1. The presence of mood disturbances and platelet 3H-imipramine binding, a putative peripheral serotonergic marker, were evaluated in a group of 27 cocaine users three days after drug withdrawal. 2. Parameters of cocaine use and the linkage between cocaine withdrawal and "post-cocaine depression" were also investigated. In a subgroup of 10 patients, both psychopathological and biological measurements were repeated after 5 or 6 weeks. 3. Interpretation of the data by Pearson's analysis showed a statistically significant and positive correlation between Hamilton Rating Scale for Depression (HAM-D) scores and period of use. A trend towards a negative correlation, which however did not reach the statistical significance, was found between 3H-Imipramine binding and period of cocaine use, number of days of abstinence and HAM-D scores 4. When compared with normal volunteers at baseline, patients had significantly lower Bmax and Kd values which returned towards normal values after 5 or 6 weeks of cocaine withdrawal. 5. These results indicate the presence of a decreased platelet imipramine binding during cocaine withdrawal which may be due to the effect of the drug or alternatively, a result of concomitant depression which may be primary or secondary in origin. The decreased imipramine binding is a reversible phenomenon, since it increases with the time, in parallel with the improvement of depressive symptoms.
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PMID:Phenomenology and neurobiology of cocaine withdrawal: are they related? 858 80

31 aged inpatients (60-88 years) with major depressive episode (DSM-III-R) have been investigated in order to study the dynamics and reversion of cognitive disorders in late depression and their relation to the course and outcome of depressive phases. The dynamic evaluation was achieved by 4-times testing with HAM-D and MMSE within the phase. All patients had some cognitive disfunction at the crucial of the phase, which in most cases (90.3%) was completely reversible during the therapy. It was found that cognitive disorders were partly associated with depression and where party related to the aging processes. The degree of cognitive impairments at the crucial stage of the phase depended upon the severity (t = 0.73; p < 0.001) and complexity (t = 0.71; p < 0.001) of the depressive syndrome. It also correlated with the duration of active therapy (t = 0.53; p < 0.005) and quality of the following remission (t = 0.48; p < 0.01). The dynamic assessment of the cognitive disorders may be used for the differentiation of pure depression from the states with the beginning degenerative disease, for the prediction of the course and outcome of depression and response to the therapy.
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PMID:[Cognitive disorders in the structure of endogenous depression in old age]. 858 80


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