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)

This article discusses drug-induced psychosis and depression in the elderly population. Selected reports with particular emphasis on the geriatric population are evaluated with histamine blockers, antiparkinson, anti-inflammatory, antituberculosis, antineoplastic, antidepressant, anticonvulsant, cardiac, antihypertensive, and steroid drugs. Particular emphasis is placed on possible mechanisms of these side effects and factors contributing to increased incidence in the elderly population. In review, the clinician is advised to use special caution when prescribing these agents in the elderly considering increasing patterns of drug-induced psychosis and depression.
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PMID:Drug-induced psychosis and depression in the elderly. 289 32

1. It is a clinical impression that some patients given oral corticosteroids develop a sense of wellbeing that is 'inappropriate' to improvements in physical health. This has been termed steroid 'euphoria', but unlike steroid-induced psychosis it has not been documented. 2. To test for the size and frequency of this phenomenon, 20 patients with severe chronic obstructive airways disease (mean FEV1 0.86 l) were given 30 mg of prednisolone for 14 days, after a period of placebo administration in a single-blind study. 3. Lung spirometry and arterial saturation during exercise were measured serially, together with established measures of mood state. 4. No changes in spirometry or arterial saturation during exercise were detected until 7 days of active therapy. 5. Mood state did not change during the placebo period, but small significant reductions in anxiety and depression were measured after 3 days of prednisolone and before any measurable improvement in lung function. Mood state did not then further improve, despite measurable improvements in lung spirometry. 6. This is evidence that prednisolone may produce a mild 'inappropriate' sense of wellbeing within a population receiving the drug, rather than as an occasional idiosyncratic response.
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PMID:Evidence of prednisolone induced mood change ('steroid euphoria') in patients with chronic obstructive airways disease. 324 75

Presented here is a model for the diagnosis and treatment of cocaine dependence. Intrinsic in the understanding of this model is the use of the disease concept of chemical dependence. Within the construct of this model we regard cocaine dependence or "cocainism" as a disease process and part of the spectrum of the disease of chemical dependence. We note that "pure" cocainism is rare and cocaine is usually just another chemical used in the polyaddicted patient. We call cocaine the "Great Precipitator" as it often brings the polyaddicted chemically-dependent person into a crisis that requires a treatment intervention. Cocainism, with its overwhelming compulsion and destruction, often precipitates a crisis in a matter of months from first use. As psychiatrists practicing addictionology, we understand the need to deal with cocainism as a primary disease process rather than a symptom of an underlying psychiatric illness. We deal with cocainism as we deal with alcoholism. While the DSM-III requires withdrawal and tolerance changes to be an essential feature for dependence, we more easily identify the disease of cocainism by its production of intense psychological addiction. Thereby the diagnosis of the disease of cocainism, as with other drugs (including alcohol) in the spectrum of chemical dependence, is characterized by the persistent, uncontrolled, compulsive use of cocaine. This illogical, irrational compulsion with continued, repeated use of cocaine as it destroys the individual's life, is the primary symptom of this disease. In regards to specific considerations, the psychiatric complications of cocainism, which can include cocaine induced psychosis, can persist beyond the intoxication period. We also note the depression that can accompany abstinence from cocaine and often has a protracted course following initial abstinence as well. We advocate the very cautious use of any psychotropic medications after an alloted period of time since we find that many of these additional symptoms seem to dissipate during the treatment process when involved in our suggested setting. In the cases of where it is determined that additional psychiatric illness co-exist with cocaine and chemical dependence such as in "dual diagnosis" patients, we have had that success by treating both illnesses concomitantly and aggressively. The "contract" with the dual diagnosis patient has afforded excellent results in this instance. The treatment modalities most effective in this model include a treatment team with its multidisciplinary and recovering and non-recovering characteristics, and the use of the group process and peer group therapy.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Cocainism--a workable model for recovery. 387 Jul 54

Psychotic states are mimicked by the use of many drugs including amphetamines, cannabis, lysergic acid diethylamide, psilocybin, mescaline, isoniazid, and L-dopa. A paranoid psychotic picture in a clear sensorium is characteristic of amphetamine psychosis. In developing countries, malaria among other diseases is a frequent indicator of chloroquine administration. The present communication reports a series of chloroquine-induced psychosis in a clear sensorium simulating affective illness, such as mania, mixed affective states, or depression. The psychosis disappeared after cessation of the drug, combined with or without the use of low dosage phenothiazines in excited patients. From our cases, two types of presentation of chloroquine psychosis could be seen: (1) psychic with clear sensorium, mood changes, alteration in motor activity, delusions, and hallucinations; and (2) psycho-organic with clouded sensorium, disorientation, and fleeting hallucinations. The precise nature of the mechanism of the psychosis is not clear because of the limited number of reported cases.
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PMID:Chloroquine psychosis: a chemical psychosis? 731 Sep 24

This study compares patients with acute methamphetamine psychosis to those with chronic methamphetamine psychosis and it investigates how the two groups differ in terms of psychosomatic findings, social background, and so on. The subjects consisted of 100 outpatients diagnosed at our clinic as having methamphetamine-induced psychosis over a period of sixteen years (1979 to 1995). Of these patients, 73 were of the acute type (currently using the drug or totally abstinent for less than 3 months), and 27 were of the chronic type (totally abstinent from the drug from 2 to 38 years). Psychosomatic Findings Ninety five patients (68 acute-type and 27 chronic-type) were classified into six clinical clusters, depending on which of the following states was dominant: paranoid-hallucinatory state, schizophrenia-like state, short-tempered and impulsive state, manic-depression-like state, neurosis-like state, and permanent-encephalopathic state. In the clinical cluster of paranoid-hallucinatory state, all 32 patients were of the acute-type. On the other hand, of those patients in the clinical cluster of neurosis-like state, the majority (N = 25) were of the chronic-type. Social Background The social background of 99 patients (72 acute-type and 27 chronic-type) was investigated under the three headings of: gangsters, criminal records and broken families. Of 19 patients who are gangsters, 18 cases were acute and the remaining case was chronic. Of 64 patients with criminal records, 51 were acute and 13 were chronic. Of 24 patients who come from broken families, 20 were acute and 4 were chronic. In all of these three items, the rate of acute-type patients was significantly higher than that of chronic-type patients. Based on the results obtained, the medical treatment and the prognosis of the patients, the author refers to preventive measures for stimulant-drug abuse.
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PMID:[A study on methamphetamine psychosis in a psychiatric clinic--comparison of acute and chronic-type cases]. 977 96

A survey of the prescribing of psychotropic drugs was carried out at the Psychiatric Hospital of Bahrain. This retrospective study on 60 inpatients of the Long Stay Ward revealed a man:woman ratio of 2.7. 91% of the men and 88% of the women were over 40 years old. 44 of the 60 patients had a diagnosis of schizophrenia, the rest had dementia, depression, schizoaffective disorders, drug-induced psychosis, general paralysis or Huntington's chorea. 95% of patients received antipsychotic drugs. Thioridazine was the most common drug followed by chlorpromazine. The mean number of drugs/patient was 1.7, with 41.7% of patients receiving only 1 drug. Tardive dyskinesia was observed in 11 patients and 9 experienced varying degrees of tremor. The findings confirm that psychiatric illness treated by psychiatrists need not lead to polypharmacy. As a consequence, its treatment may be less likely to result in adverse reactions than when patients are treated by general practitioners.
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PMID:Utilisation of psychotropic drugs in patients of the long stay ward. 1014 30

Neuropsychiatric symptoms are a frequent feature of advancing Parkinson's disease (PD). The reported prevalence of depression varies greatly between different studies but there is general consensus that between 40 and 50% of patients will be affected. Depression may antedate motor manifestations of Parkinson's disease and is usually of moderate or mild intensity. However, depression is of major impact on the quality of life in PD patients according to a recent survey. Drug-induced psychosis is one of the major therapeutic challenges in Parkinson's disease and may occur in up to 6% in otherwise uncomplicated de novo patients when first receiving dopaminergic therapy. It increases in frequency, in advanced disease and particularly in patients with dementia where up to 22% may be affected. There is an amazing lack of controlled clinical trials assessing the effects of antidepressants in clinical trials including more than 20 patients and assessing efficacy of antidepressants specifically in the context of mood changes in Parkinson's disease. A comprehensive literature search yielded only a total of 17 articles of which a majority included less than 20 patients and/or did not use valid depression ratings. The only randomized controlled trial was conducted more than 20 years ago using nortryptiline while no controlled trials were available on the use of serotonin reuptake inhibitors. Studies assessing the antidepressant action of dopaminergic therapies are few and inconclusive. Thus, while tricyclic antidepressants or SSRIs are widely used in clinical practice, there is still a need for controlled clinical trials proving their efficacy specifically in parkinsonian depression. Three randomized controlled trials are now available assessing the efficacy of the atypical neuroleptics clozapine and olanzapine in the treatment of drug-induced psychosis. While clozapine is of proven efficacy at least in the short-term management of this complication without negative impact on the motor symptoms, olanzapine in currently used doses of 2.5 to 15 mg/d seems to aggravate motor symptoms with lesser effect on psychosis compared to clozapine. Currently, clozapine is the atypical neuroleptic of choice for the treatment of drug-induced psychosis in Parkinson's disease.
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PMID:Treatment options for depression and psychosis in Parkinson's disease. 1169 83

Psychosis is a disabling nonmotor complication of Parkinson's disease (PD). Visual hallucinations are the most common clinical manifestation and have been observed in up to 40% of patients with advanced disease in hospital-based series. Age, cognitive dysfunction, depression, as well as severity and duration of disease have all been identified as risk factors in multiple studies. All major antiparkinsonian drugs can induce psychosis in at-risk patients. Early drug-induced psychosis has been observed in up to 16% of patients treated with dopamine agonists and has been associated with increased risk for the development of dementia later on. Management of psychosis in PD is complex and includes control of potential triggers and reductions of polypharmacy as well as the addition of atypical antipsychotics. Cholinesterase inhibitors may prove an additional option in psychotic PD patients with dementia.
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PMID:Psychosis in Parkinson's disease. 1450 60

The present study was aimed at exploring the prevalence and factor structure of methamphetamine (MA) psychotic symptoms. The data were obtained from a cross-country evaluation of substance use, health, and treatment in MA psychotic in-patients. The prevalence rates of lifetime and current psychotic symptoms were determined by using Mini-International Neurospychiatric Interview-Plus, Module M. The Manchester scale was used to assess the severity of psychotic symptoms during the week prior to assessment. All eight items of the Manchester scale were subjected to principal-component analysis, eigenvalue one test, and varimax rotation. The data of 168 patients (127 male and 41 female) included in the analyses were obtained from Australia, Japan, the Philippines and Thailand. Persecutory delusion was the most common lifetime psychotic symptom found in 130 participants (77.4%), followed by auditory hallucinations, strange or unusual beliefs, and thought reading. Auditory hallucinations were the most common current symptom found in 75 participants (44.6%), followed by strange or unusual beliefs and visual hallucinations. Current negative symptoms were also found in 36 patients (21.4%). Apart from a factor of anxiety and depression, the results yielded a two-factor model of MA psychotic symptoms, which were negative and positive/disorganized syndromes. The negative syndrome comprised poverty of speech, psychomotor retardation, and flattened/incongruous affects. The positive syndrome consisted of delusions, hallucinations, and incoherent speech. Both positive/disorganized and negative syndromes should be taken into account in assessing MA psychotic symptoms. The clinical findings do not support the shortcomings of amphetamine-induced psychosis in modelling the negative symptoms of schizophrenia.
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PMID:Psychotic symptoms in methamphetamine psychotic in-patients. 1460 49

The frequency, phenomenology, and risk factors of hallucinations and delusions were investigated in 64 consecutive inpatients with Parkinson's disease. Fifty patients were admitted to our hospital with symptoms related to Parkinson's disease: psychiatric problems 27 (psychosis 22; anxiety 2; depression 2; mania 1): motor symptoms, 20 (wearing-off 5; akinesia 4; freezing 4; postural instability 4; dyskinesia 2; tremor 2; dystonia 1), and sensory symptoms, 3. Fourteen patients were admitted with other medical problems (pneumonia 4; cerebral infarction 3; bone fracture 3; lumbago 2; seizure 1; cat bite 1). Totally 49 patients had psychiatric problems. Psychosis was present in 43 patients, dementia in 10, depression in 8, mania in 1, anxiety in 10, agitation in 6, stereotypy in 2, and hypersexuality in 2. Of the 43 patients with psychoses, 40 presented with visual hallucinations, 18 with auditory hallucinations, and 23 with delusions. To determine what the clinical correlates with the severity of psychosis were, we divided the patients into 3 groups: the severe group, 22 patients admitted because of psychotic symptoms; the mild group, 21 patients admitted because of problems other than psychosis but presenting psychotic symptoms; and the control group, 21 patients who had no psychotic symptoms. Incidences of auditory hallucinations and delusions were higher in the severe group as compared to the mild group. Patients in the severe group had higher Hoehn-Yahr stages, lower Mini-Mental State Examination scores, decreased H/M ratios of cardiac 123I-MIBG uptake, and lower frequencies of background activity on electroencephalograms. There were no differences in age at admission, age at onset of Parkinson's disease, duration of illness, amounts of levodopa and dopamine agonists received, Hamilton's depression rating scores, and brain MR findings, including atrophy and ischemic changes. Emergence of psychotic symptoms in parkinsonian patients appears to be clearly associated with impaired cognitive function. Therefore, it may be associated with the disease process itself. Terms such as dopaminomimetic or levodopa-induced psychosis may not be appropriate when describing psychosis in Parkinson's disease.
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PMID:[Psychoses in patients with Parkinson's disease; their frequency, phenomenology, and clinical correlates]. 1571 92


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