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)

Fifty-two patients with depressive illness characterized by four symptoms (periodical course, psychomotor retardation, diurnal variation, unrealistic self-depreciation) and a score of at least 18 on the Hamilton Depression Scale 1-17 (HDS) were allocated to a double-blind randomized study with femoxetine and imipramine. Patients were diagnosed according to RDC and further classified according to the Newcastle-II index. During the six weeks of treatment, efficacy was evaluated by means of HDS and a global evaluation. Side-effect symptoms were recorded on a check-list by questioning. After six weeks of treatment with femoxetine or imipramine (recommended daily standard dosages are 600 mg femoxetine and 150 mg imipramine (b.i.d.); in the present study, dosages were flexible and could be adjusted according to effect/side-effects) evaluation of efficacy based on HDS, a six-item subscale, groups of HDS items as well as single items showed no statistically significant differences between the treatment groups except with regard to the factor for sleep disturbances in the HDS, where greatest reduction was seen in the femoxetine group. No statistically significant differences regarding side-effect profile were seen. However, in the imipramine group, higher frequencies of such moderate to severe symptoms as dry mouth, constipation and urination difficulties were observed (the greatest difference was seen for dry mouth, p 0.1, while p-values for the remaining two symptoms were greater than 0.1). Moreover, based on the patients' own opinion on side-effects, femoxetine seemed to be better tolerated. One patient took an overdosage of approx. 26 g femoxetine; half of the intake was removed by gastric emptying at the hospital.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Efficacy and tolerance of femoxetine and imipramine in the treatment of depressive states. A randomized, double-blind study. 306 46

Transmission of information in the brain is of a chemical nature. Neurotransmitters are present at very early stages of brain development, having trophic effects on maturation of target neurons as well as mediating the behavioral repertoire of the immature brain. Many centrally acting psychoactive drugs which are commonly used (also during pregnancy) for treatment of depression, asthma, hypertension, epilepsy, parkinsonism, hyperkinetism and other neurological and psychiatric disorders act directly on brain neurotransmitters (in particular monoamines) and behavioral states. Disturbances observed later in life in animals and man, as a result of early interference with brain neurotransmitters, using these drugs, are not gross physical malformations but are in fact subtle behavioral and neurological symptoms such as hyperactivity, emotional lability, attentional distractability and sleep disturbances, similar to symptoms observed in the minimal brain dysfunction syndrome.
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PMID:The role of the central monoaminergic system and rapid eye movement sleep in development. 309 90

The effects of 400-600 mg trazodone on the sleep patterns of ten depressed in-patients treated for 5 weeks were studied during the initial (days 1-3) and terminal (days 26-28) treatment periods. The sleep parameters were compared to those obtained from three sleep recordings performed just prior to the initiation of the treatment and after 2 adaptation nights at the end of a 2-week drug-free period. At the same time, the clinical evolution of patients was evaluated weekly using MADRS and Hamilton-Anxiety scales for anxiety-depression symptomatology and Spiegel and Norris sleep scales. Weekly blood samples were collected to measure plasma levels of trazodone and, at the end of the study, the elimination half-life at steady state was calculated by repeated measurements of plasma levels. Clinical improvement, as assessed by a reduction of more than 60% in MADRS scale scores, was accompanied by evidence of the definitely beneficial effects of trazodone on the disturbed sleep of these depressed patients. From the beginning of treatment, there was a hypnotic-like effect (increase in total duration of sleep and stage II, decrease in sleep latency and intrasleep awakenings). In addition, records at the end of the study showed an increase in delta sleep and an increase in REM latency, an effect classically associated with an antidepressant action. These particularly valuable effects of trazodone on sleep would suggest that this drug should especially be given in cases of depression with major insomnia.
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PMID:Effects of trazodone on the sleep of depressed subjects--a polygraphic study. 313 13

The study comprised 24 male Lebanese refugees living in Denmark. Twelve of them alleged having been tortured in Lebanon during the period 1981-85. The remaining twelve had neither been imprisoned nor tortured and thus acted as control persons. All the testimonies were found to be valid according to a method previously used by the author. The most common forms of torture were blows against the head, body and foot soles, suspension and asphyxiation. Threats and solitary confinement were frequent, and sexual violations were also reported. At the time of examination (March-November 1986), the main complaints were headaches, various cardiopulmonary symptoms, sleep disturbances with nightmares, impaired concentration and memory, and emotional lability. Suicide attempts were reported. Prior to the torture all the probands had been healthy except for several cases of gunshot wounds. The clinical examination revealed different scars possibly related to torture in nearly all the cases. Missing or fractured teeth, peripheral nerve damage and mental depression were also found. The 12 controls had several mental and physical complaints, but significantly fewer than the probands. Almost all of them had scars from gunshot wounds. The present study clearly indicates that torture plus exilation has a more deteriorating effect on the health status than exilation alone.
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PMID:Physical and psychological sequelae to torture. A controlled clinical study of exiled asylum applicants. 320 47

Identical principal components factor analyses of total Hamilton Rating Scale for Depression scores were conducted for two separate sub-samples (N = 183 and N = 182) drawn from the same clinic population of moderately depressed outpatients. A comparison of the two factor analyses revealed substantial agreement for four factors across the two sub-samples (i.e., four factors from the first sub-sample correlated at least 0.80 with a homologous dimension in the second sub-sample). The four factors were labelled Somatic Complaints, Anorexia, Sleep Disturbance, and Agitation/Retardation. Some additional factors emerged in the analysis of one sub-sample but failed to appear in the other. Overall, these results suggest that the HRS exhibited a relatively stable factorial structure based on a large sample of outpatients with unipolar depressive disorders. Methodological problems with earlier research are discussed in light of the current findings.
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PMID:Factorial structure and factor reliability of the Hamilton Rating Scale for Depression. 322 12

The study describes symptoms and signs of depression in elderly (60 years or over) Finns. Lists of symptoms and signs assessed by the examining physicians in a population study were used in rating, and the symptoms and signs of persons diagnosed as depressed were compared to those of persons who were not depressed. The commonest symptoms both in men and women were sleep disturbances, fatiguability, loss of interest, depressed mood, loss of activity, pains, pessimism and sense of uselessness. In addition, worry was a common symptom in women. Hallucinations and other delusions than those about unforgivable behaviour were very uncommon. Loss of libido did not strongly indicate occurrence of depression, and in persons aged 70 years or over it could not be included in symptoms of depression. Sex differences in the commonest symptoms of depression were evident: worry, crying spells, helplessness, loneliness, suicidal ideas and pains were more common in depressed women than in depressed men. Some age differences in symptoms were also found both in men and in women. Sad expression was a common sign of depression in both sexes. In addition, slow movements, scarcity of gestures and slow speech were quite common signs in depressed men and stooping posture was quite common in depressed women.
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PMID:Clinician-rated symptoms and signs of depression in aged Finns. 323 90

Serotonergic mechanisms have been implicated in levodopa-induced psychiatric toxicity reactions in Parkinson's disease (PD). Although CNS serotonin levels are reduced in Parkinsonian patients, the contribution of this abnormality to the pathophysiology of the motor symptoms of the disease are largely unknown. The following report concerns a 62-year-old female Parkinsonian patient with levodopa-induced "On-Off", depression and sleep disturbances, the severity of which was dramatically reduced by administration of low dosage amitriptyline (a serotonergic agent). The report suggests that impaired central serotonergic functions may be implicated in the pathophysiology of the levodopa-induced "On-Off" and that pharmacologic manipulations of serotonergic functions may be useful in the management of this motor side effect of chronic levodopa therapy.
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PMID:Serotonergic mechanisms in levodopa-induced "on-off" and sleep disorders in Parkinson's disease. 324 78

In order to investigate the role of serotonergic mechanisms in depressive disorders, the fenfluramine challenge test was performed in 31 patients suffering from different types of depression. The strategy was to select a simple method (i.e., easier to perform than CSF studies for instance) to be applied to a wide range of patients, as close as possible to everyday cases in a clinical setting (i.e., not only to such severe or highly selected groups as is normally the case in biological research in psychiatry). The neuroendocrine test (which consisted of the measurement of variations in the secretion of prolactin, growth hormone and Cortisol after the administration of 60 mg dl-fenfluramine p. o.) did not correlate with symptoms of behavior patterns previously identified with a "serotonin deficit" (i. e., suicidal behavior or attempts, lowering of the control of impulses, sleep disturbances) but only with the severity of the diagnosis (in the DSM-III hierarchical scale) or with indexes of endogeneity (Newcastle scale). This fact could be explained by methodological artifacts (i. e., dlfenfluramine is not a clean probe, showing influence in the dopamine and noradrenaline metabolism; the absorption of fenfluramine was not controlled) or by the fact that the involvement of serotonin in affective disorders is not a selective, isolated dysfunction, but is integrated in more complex interrelationships. Nevertheless, our preliminary findings (even without the results of the comparison with a control group and the evaluation of a few more data and cases) do coincide with the absence of predictors or the lack of specific patterns of response of symptoms with new selective re-uptake blockers of serotonin antidepressants.
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PMID:The fenfluramine challenge test in the affective spectrum: a possible marker of endogeneity and severity. 328 85

In the United States, depression is the most common psychiatric disorder and is the psychiatric problem most often seen by the generalist. Thus, it is essential for the primary-care physician to have a thorough understanding of the diagnosis and management of depression. Patients often present with complaints such as weight loss, appetite changes, sleep disturbances, pain, psychomotor agitation or retardation, decreased sexual drive, loss of energy, and somatic complaints. When depression is suspected, the clinician should first rule out secondary depression attributable to other psychiatric or medical illnesses, or medications. In addition, certain age categories--children, adolescents, and elderly individuals--have characteristic symptoms and behavior patterns suggestive of depression. Identifying the suicidal patient is another important aspect in the treatment of depressed individuals. In addressing this issue, questions have been formulated to help identify patients who may be potentially suicidal. Treatment modalities for depression include exercise regimens, psychotherapy, and pharmacotherapy. The standard pharmacotherapy has been the administration of tricyclic antidepressant agents; newer drugs are currently available that have comparable efficacy, and perhaps better safety profiles than the tricyclic agents.
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PMID:Diagnosis and treatment of depression. 332 Nov 26

The history of psychosomatic medicine in the 20th century is predominantly marked by a concern with studies of major diseases (e.g., angina pectoris, bronchial asthma, diabetes mellitus, essential hypertension, neurodermatitis, rheumatoid arthritis, etc.). Traditional physicians also narrowly focus on disease--a trend that began with Morgagni in the 18th century. But disease (defined by structural alterations) is not the only cause of illness and disability. In fact, most persons seeking health care are ill without having a disease. It is only recently that this distinction has been fully made. The various manifestations of ill-health go by a variety of descriptive names--the functional or irritable bowel and hyperventilation syndromes, fibromyositis, psychophysiological, functional and somatoform or somatization disorders. They lead to loss of productivity, cost the health care system excessively, produce negative reactions in physicians, and are fertile ground for iatrogenic disease. They do not constitute discrete syndromes but overlap, each also being closely associated with anxiety and depression, sleep disturbances or marital disruption. They are the manifestations of sick persons not only of disturbances of bodily systems. They may be precipitated by unemployment, marital discord, bereavement, and job dissatisfaction. Curiously, ill-health has not been the major area of investigative interest of psychosomatic medicine. This presentation will emphasize why it should be, and why proper interventions may radically reduce the cost of medical care, prevent iatrogenic disease, and reduce the use of ill-advised procedures.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Some unexplored regions of psychosomatic medicine. 333 83


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