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)

Eighteen patients with Parkinson's disease were treated with placebo for 4 weeks and with the MAO-B inhibitor selegiline for 8 weeks without levodopa in a randomized double-blind clinical study. The maximum dose of selegiline was 30 mg/day and the patients' cognitive functions were evaluated before treatment and at week 12 when they were either on 30 mg selegiline or placebo. A series of neuropsychological tests were used to study general cognitive reasoning, memory, visuospatial abilities, attention, cognitive flexibility, motor functions and depression. Specific cognitive effects were not observed. Slight improvement occurred mainly in learning (easy word associations) which may reflect a limited, nonspecific arousal effect.
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PMID:Selegiline and cognitive function in Parkinson's disease. 177 88

There are a number of ways in which drugs might increase the risk of an elderly person falling. The most important of these are sedation, impaired balance and reaction time, hypotension and drug-induced Parkinson's disease. Demonstrating the association between drugs and falls has been difficult because of certain methodological problems. However, there is now strong evidence that the use of psychotropic drugs, with the possible exception of short-acting benzodiazepines and hypnotics, is associated with a clinically important increase in the risk of falling. This increased risk is present after controlling for confounding factors such as confusion and depression. The evidence linking other drug groups to an increased risk of falls is conflicting. Decreasing the risk of drug-induced falls requires both careful individual adjustment of therapy and also a public health programme to ensure safe drug prescribing for older people.
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PMID:Drug treatment as a cause of falls in old age. A review of the offending agents. 179 21

We studied 15 patients with Parkinson's disease of 40 to 70 years of age; they had more than five years of evolution and of using levodopa. They had "on-off", "wearing-off" phenomena and dyskinesia. The duration of therapy suspension was seven days: they were evaluated daily in the seven days, and every month for six months. The Webster and the Hoehn and Yahr scales were used. Only two patients did not show significant improvement. Thirteen of fifteen patients showed a significant decrease in the Webster scale of up to 8 points. A p value of 0.005 was found at three months which was maintained until the sixth month with a p value of 0.0005; a decrease in this scale was present since the first month. There were no complications following therapy withdrawal. There was a decreased related to depression in most of them and also there was a levodopa dose decrease in seven of them.
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PMID:[Usefulness of drug holiday in patients with Parkinson's disease of more than 5 years of development]. 179 67

The French selegiline multicenter trial was conducted in 1990 to test the possibility to improve disability of de novo parkinsonian patients (P.P.) during the first three months of treatment with selegiline (S) (10 mg/day) monotherapy. 93 P.P. were included in this double-blind, randomized, placebo controlled, clinical trial, in which 13 centers participated. Both parallel groups were followed up from inclusion (D0) to D30, D60 and D90. Drug efficacy was judged with Hoehn and Yahr (HY), Hamilton Depression Rating Scale (HDRS), Unified Parkinson's Disease Rating Scale (UPDRS), Schwab and England scores, decision to introduce levodopa and selfassessment. Biological and clinical parameters (cardio- vascular, weight, side-effects reports) were assessed for tolerability. 84 P.P. (38 P, 46 S) were evaluable for efficacy at D90. When considering the main parameters, S appears superior to placebo: HY scores (p less than 0.001), global UPDRS scores (p less than 0.001) and UPDRS subscores: mental (p less than 0.001), daily living activities (p less than 0.01), motor activities (p less than 0.01). Depressive scores (HDRS) are significantly improved only at D90 (p = 0.005). Levodopa therapy was introduced in 45% of the cases in S groups versus 18.4% in P group. Global impression of efficacy was largely in favor of S; failure was noted in half of the cases in P group and only in 1/5th of the cases in S group. Side-effects were rare and minor. S 10 mg/day monotherapy is statistically superior to placebo in improving de novo P.P. during the first three months treatment. Motor symptoms rapidly improve; mood is only modified after 3 months. S appears to be well tolerated. S may be considered as a good candidate for the initial treatment of P.P.
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PMID:Selegiline in de novo parkinsonian patients: the French selegiline multicenter trial (FSMT). 180 41

Selegiline HCl, 10 mg per day has been reported to improve attention and episodic memory in Parkinson's disease and early Alzheimer's disease. Selegiline also improves motor reaction times in Parkinson's and subjective feelings of increased vitality, euphoria and energy. At doses of between 10 and 40 mg a day it has also been shown to improve depression particularly when psychomotor retardation is prominent and anxiety minimal.
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PMID:Selegiline hydrochloride and cognition. 180 44

Sleep patterns of two consecutive nights were analyzed in 26 drug-free patients with Parkinson's disease (PD), who were clinically divided into depressed (n = 8) and nondepressed (n = 18) groups. Sleep electroencephalographic (EEG) recording showed significantly shorter rapid eye movement (REM) latency in depressed PD patients (41.1 +/- 21.7 min) compared to nondepressed PD patients (129.0 +/- 84.9 min, p less than 0.002). Furthermore, shortened REM latency (less than or equal to 65.0 min) was observed with significantly more frequency in depressed PD patients (6 out of 8) compared to nondepressed PD patients (4 out of 18, p less than 0.02). The other sleep parameters studied did not differ significantly between the two groups of patients. Because shortened REM latency is one of the most reliably documented biological features of major depression, these findings may be of some importance for understanding the nature of depression in the course of PD.
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PMID:Sleep EEG in depressed and nondepressed patients with Parkinson's disease. 182 Dec 32

Approximately 50% of patients with Parkinson's disease experience clinical depression. Neurotransmitter deficits in depression and Parkinson's disease suggest a common lesion may be responsible for this high incidence. In addition to similar psychological profiles, the clinical features of Parkinson's disease and depression likewise overlap making the distinction difficult. Differentiating these two diseases is very important, as each is treatable. The neuroscience nurse is in a unique position to evaluate the patient with Parkinson's disease for signs and symptoms of depression.
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PMID:Depression in Parkinson's disease. 183 80

Depression in patients with Parkinson's disease (PD) is a significant clinical problem for which the etiological basis remains unclear. Several authors have asserted it to be a reactive state to progressive, disabling symptoms, whereas others have suggested a neurochemical basis. Recent evidence suggests serotonin deficiencies as a plausible explanation.
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PMID:An analysis of the prevalence and etiology of depression in Parkinson's disease. 183 81

A total of 240 patients of Parkinson's disease (PD) were studied (125 male, 115 female). The age of onset was 60.0 +/- 9.9 years(Y) (mean +/- S.D.) (range 30-87). A 0-4 rating score was applied on each of 6 major symptoms: i.e. tremor, rigidity, bradykinesia, gait, activities of daily living and fluctuation with maximum score of 24. According to the Hoehn and Yahr's stages, there were 44 cases in stage I, 141 in stage II, 31 in stage III, 19 in stage IV and 5 in stage V. Fluctuation in symptoms occurred in 42.9%, dyskinesia in 7.1%, psychosis in 9.6%, depression in 4.6%, and dementia in 2.9%. The mean duration of PD was 4.9 +/- 4.5 Y with 40% 5 years or longer. Significantly longer duration of PD was seen in the patients suffering from fluctuation (6.7 +/- 4.7 Y), dyskinesia (10.7 +/- 6.7 Y) and psychosis (9.4 +/- 6.5 Y). The mean duration of L-dopa treatment was 4.1 +/- 3.4 Y. The patients showing fluctuation (6.2 +/- 4.0 Y) or dyskinesia (7.6 +/- 4.7 Y) had significantly longer duration of L-dopa treatment. The mean daily dose of L-dopa was 370 +/- 203 mg. The patients with fluctuation (430 +/- 187 mg) or dyskinesia (545 +/- 265 mg) received significantly higher dose of L-dopa. Dementia tended to occur in the patients having later age of onset of PD (71.2 +/- 11.2 Y). The symptom score was significantly worse in those with fluctuation, dyskinesia, psychosis and dementia. It was well correlated with the Hoehn and Yahr's staging system.
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PMID:Abbreviated rating score for Parkinson's disease. 184 38

The central functions of norepinephrine (NE) are a recent discovery: regulation of alertness and of the wakefulness-sleep cycle, maintenance of attention, memory and learning, cerebral plasticity and neuro-protection. The anatomical, histological, biochemical and physiological properties of the central noradrenergic system: extreme capacity for ramification and arborization; slow conduction, non-myelinized axons with extrasynaptic varicosities producing and releasing NE; frequency of co-transmission phenomena, and; neuromodulation with fiber effect responsible for improvement in the signal over background noise ratio and selection of significant stimuli form a true interface between the outside world and the central nervous system, notably for the neocortex in the context of the cognitive treatment of information. This central noradrenergic system is involved in the neurophysiology and the clinical features of cerebral aging (ideation-motor and cognitive function slowing down, loss of behavioral adjustment), neuro-degenerative disorders (SDAT, Parkinson's disease), certain aspects of depression and less obvious conditions (head injuries, sequelae of cerebrovascular accidents, sub-cortical dementia). The recent development of medications improving alertness (adrafinil, modafinil) with a pure central action and specifically noradrenergic, may contribute to an improvement in these multifactorial disorders.
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PMID:[Noradrenaline and cerebral aging]. 186 52


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