Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One of the most frequent indications of psychosurgical treatment is incurable obsessions. Up to now, capsulotomy or cingulotomy has been preferred. In our opinion, the variety of obsessive conditions require a more thorough approach to the selection of interbrain targets. Forty-seven patients with pure obsessive-compulsive disorders as well as disorders connected with depressions, epileptic syndrome, schizophreniform state and Gilles de la Tourette's syndrome with extremely severe resistance to medical therapy were examined. Eighteen patients were operated on. Surgical treatment is permissible only in cases fulfilling the three following criteria: (1) clinicopsychopathological permissibility (duration of disease, resistance to medication, psychopathological status); (2) physiological permissibility (the presence of a brain target, defining the psychopathological status), and (3) technical permissibility (the availability of proper stereotactic, imaging, electrophysiological and other apparatus necessary to carry out the surgical treatment). One supposes that the outcome of surgical treatment is determined by all three criteria. For the purpose of improving the efficiency of stereotactic treatment, a number of methods of surgical treatment depending on the psychopathological status are suggested. For example, in case of comorbidity of obsession with the epileptiform syndrome, we suggest cingulotomy (capsulotomy) and amygdalotomy; in case of comorbidity with depression we suggest cingulotomy and innominatotomy. The long-term observation of the outcome of stereotactic treatment covers a period from 2 up to 9 years.
 ...
PMID:Differential approach to psychosurgery of obsessive disorders. 971 21

Alcoholism, especially the urge to drink and relapse from abstinence, is deeply associated with obsession. And also alcoholics on abstinent 10 years or more are still higher on the obsessive-compulsive symptom dimension more than the depression and interpersonal sensitivity. Obsession was introduced by Kraepelin in 1915 and has been studied extensively since. When a person with obsession becomes exhausted with chronic rumination accompanied suspicion, he or she is driven to impulsive acts like alcoholics, and develops a personality disorder that displays persistent abnormal activities. Impulsive-compulsive spectrum characterizes by dimensions of risk-aversive/risk-seeking and harm-avoidant/harm- minimizing behaviors. Disorders on the compulsive end of the spectrum include obsessive-compulsive disorder, hypochondriasis, body dysmorphic disorder, anorexia nervosa an depersonalization. Mixed compulsive and impulsive disorders include Tourette's disorder, trichotillomania, pathologic gambling, sexual compulsions and alcoholism. Disorders on the impulsive end of the spectrum include borderline personality disorder and antisocial personality disorder. Using 123I-IMP SPECT, regional cerebral blood flow significantly decreased in alcoholics without Korsakoff sign (WAIS FIQ 90 or over) than alcoholics with Korsakoff signs (WAIS FIQ 89 or under) and control on the frontal lobe and thalamus. Recent model of obsessive-compulsive pathophysiology demonstrating that cortical regions have different effects on the direct and indirect pathways, indicates that the the different effects of serotonergic agents in the cortex alone could result in a change in balance between the direct versus indirect basal ganglia pathway. This article reviews alcoholism and obsession, ego dystonic and ego syntonic, approach-avoidance conflict, a recent biological approach to alcoholics and a spectrum for obsession.
 ...
PMID:[Dependence and obsession]. 1020 21

Researchers interested in investigating the possible therapeutic effects and the mechanisms of action of nicotine in neuropsychiatric disorders face a social-scientific-ethical dilemma. This dilemma comprises three components: (1) the known addictive potential of nicotine makes careful evaluation of the therapeutic potential of this compound socially unattractive; (2) the potential misuse of scientifically determined data by the tobacco 'lobby' creates ethical concerns; and (3) the possible confusion between the differential effects of nicotine in human smokers versus non-smokers creates difficulties in study designs in voluntary human subjects. Therefore, it is imperative that, at the onset of this review, the authors stress that they do not advocate cigarette-smoking as a route of nicotine intake under any circumstances on the basis that controlled dosing of nicotine may be of potential benefit in some neuropsychiatric disorders. In this article, we review the psychopharmacology of nicotine and its effects in a variety of neuropsychiatric disorders including schizophrenia, depression, anxiety and Tourette's syndrome. Possible mechanisms of action of nicotine directly or indirectly via its interaction with other neurotransmitter systems (i.e. serotonin, dopamine and noradrenaline) in relation to its potential role in these disorders are discussed. It is postulated that new drugs may need to be developed that selectively interact with nicotinic receptors without addiction potential.
 ...
PMID:Smoking, nicotine and psychiatric disorders: evidence for therapeutic role, controversies and implications for future research. 1034 Feb 89

There are two families of dopamine (DA) receptors, called D1 and D2, respectively. The D1 family consists of D1- and D5-receptor subtypes and the D2 family consists of D2-, D3-, and D4-receptor subtypes. The amino acid sequences of these receptors show that they all belong to a large superfamily of receptors with seven transmembrane domains, which are coupled to their intracellular signal transduction systems by G-proteins. The implications of DA receptors in neuropsychiatry and cardiovascular and renal diseases are discussed. Neuropsychiatry indications include Parkinson's disease, schizophrenia, migraine, drug dependence, mania and depression, and Gilles de la Tourette syndrome. The underlying dysfunction of dopaminergic systems and the potential benefits of dopaminergic therapy in these different indications are critically examined. With respect to the pharmacological treatment of Parkinson's disease, a range of DA agonists are in various stages of preclinical and clinical development. D2-receptor agonist activity is predominant in most effective antiparkinsonian DA agonists. However, in practice, it is difficult to treat patients for several years with DA agonists alone; therapeutic benefit is not sustained. Rather, the use of a combination of DA agonists and levodopa is considered preferable. Reports of the efficacy of DA partial agonists await confirmation, and recent clinical investigations also suggest the potential of D1 receptor agonists as antiparkinson drugs. Regarding migraine pathogenesis, clinical and pharmacological evidence suggests that DA is involved in this disorder. Most prodromal and accompanying symptoms may be related to dopaminergic activation. Several drugs acting on DA receptors are effective in migraine treatment. Furthermore, migraine patients show a higher incidence of dopaminergic symptoms following acute DA agonist administration, when compared with normal controls. In cardiology, the therapeutic benefits of DA agonists are noted in the treatment of heart failure. Low doses of DA are widely used for its specific dopaminergic effects on renal function, which are suggested to be beneficial, and for its alpha- and beta-adrenergic-mediated responses that occur with higher doses. However, studies have been unable to demonstrate that DA can prevent acute renal failure or reduce mortality. It appears that the significant progress that is being made in the molecular understanding of DA receptors will continue to have a tremendous impact in the pharmacological treatment of neuropsychiatric, cardiovascular, and renal diseases.
 ...
PMID:Dopamine receptors--physiological understanding to therapeutic intervention potential. 1059 3

The frontostriatal system (dorsolateral prefrontal cortex, lateral orbitofrontal cortex, anterior cingulate, supplementary motor area, and associated basal-ganglia structures) is subject to a range of neurodevelopmental disorders: Tourette's syndrome (TS), obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), schizophrenia (SCZ), autism, and probably depression. The system is responsible for our adaptive responses (initiation, execution, or withholding) to environmental situations, and the above disorders, involving effectively excessive release or withholding of various types of response, are all a consequence of changes in specific frontostriatal regions. The disorders all have a genetic component, and their persistence in the genome indicates that their clinical manifestations may also be associated, perhaps in low levels in close relatives, with certain adaptive advantages in given situations. Thus autism is associated with computational careers, depression with literary creativity, SCZ with lateral thinking and the Odyssean personality, ADHD with an Ice-Age readiness to respond, OCD with a focused range of interests, and TS with competitive sports and jazz improvisation. The disorders are all highly comorbid, and which one predominantly manifests may depend on how the frontostriatal system happens to be compromised as a result of inherited genetic predispositions and environmental contingency. We review the adaptive nature of the various subclinical manifestations and the evidence for concomitant phenomena (possibly epiphenomena): alterations in structural, functional, and behavioral lateralization in each syndrome. Indeed it is not clear that altered lateralization in frontostriatal disorders of a neurodevelopmental origin generally has any adaptive significance; it may often simply serve as a marker for altered regulatory function of the frontostriatal system, alterations which in low genetic dosage or penetrance continue to play an adaptive role in clinically unaffected close relatives of probands, but which, in high dosage or penetrance in the probands themselves, are generally deleterious.
 ...
PMID:The neurodevelopmental frontostriatal disorders: evolutionary adaptiveness and anomalous lateralization. 1085 79

Neuronal nicotinic acetylcholine receptors (nAChRs) represent a large family of ligand-gated cation channels with diverse structures and properties. In contrast to the muscular nAChRs, the physiological functions of neuronal nAChRs are not well defined to date. Behavioral studies indicate that brain nAChRs participate in complex functions such as attention, memory, and cognition, whereas clinical data suggest their involvement in the pathogenesis of certain neuropsychiatric disorders (Alzheimer's and Parkinson's diseases, Tourette's syndrome, schizophrenia, depression, etc.). For the majority of these disorders, the use of nAChRs' agonists may represent either a prophylactic (especially for Alzheimer's and Parkinson's diseases) or a symptomatic treatment. The possible mechanisms underlying these beneficial effects as well as the characteristics and potential therapeutic use of new, subtype-selective nAChRs agonists are presented.
 ...
PMID:Nicotine, brain nicotinic receptors, and neuropsychiatric disorders. 1088 Jul 17

In the development of the majority of children, ritualistic behaviour may be seen as a normal phenomenon. In some children and adolescents, however, these rituals become time-consuming, interfering, irritating and annoying. The most common obsessions in both children and adults with obsessive-compulsive disorder (OCD) are related to a fear of dirt and contamination, fear of some terrible happening, and the fear of harming a loved one. The most common compulsions are washing fixations, checking behaviour and rituals (including mental rituals). Prevalence studies show that OCD in children and adolescents is far more common than previously thought. It is estimated that up to 2% of this population have symptoms fulfilling OCD criteria. The impact of early OCD onset can be profound, with long-term studies indicating that approximately 50% of these patients will also suffer from OCD in early adulthood. These patients tend to remain socially isolated, to have fewer relationships than their non-OCD peers, and have a tendency to remain within the family home during early adulthood. In addition, childhood OCD is associated with comorbid psychiatric disorders, in particular depression, anxiety and panic disorders, Tourette's syndrome and eating disorders. Treatment strategies for childhood OCD reflect those used in adult psychiatry. The most effective psychotherapeutic approach is based on cognitive-behavioural therapy with exposure and prevention. In contrast to pharmacotherapeutic agents without serotonin activity, the serotonin-specific antidepressants appear to be effective and well-tolerated in the treatment of OCD in children.
 ...
PMID:Obsessions: the impact and treatment of obsessive-compulsive disorder in children and adolescents. 1088 29

Pharmacotherapy which, together with behavior therapy, is a major pillar in the treatment of obsessive-compulsive disorder (OCD), can bring about a distinct symptomatic improvement in 50-70% of the patients. In addition to the classical tricyclic antidepressant, clomipramine, a number of new selective serotonin reuptake inhibitors have now been approved for the treatment of OCD. In comparison with depression, pharmacotherapy of OCD is characterized by a long latency of effect of eight to twelve weeks, and by the high doses required by some patients. A combination of pharmacotherapy and behavior therapy is superior to behavior therapy alone, in particular in the case of patients with predominantly obsessive thoughts and additional symptoms of depression. In the case of aggregation with the Tourette syndrome or schizotypal personality disorders, the additional administration of a neuroleptic is recommended. Open studies and case histories have reported good results with pimozide, haloperidol, clozapine and risperidone.
 ...
PMID:[Drug treatment of obsessive-compulsive disorder. With proper drugs and some patience many patients can be helped]. 1089 82

Over the past 10 years, innovations in physics and computer science have promoted magnetic resonance imaging (MRI) as an essential tool for investigating the biological substrates of psychiatric disorders. Requiring no radiation exposure, MRI is now the preferred imaging technique for pediatric populations. However, the rapid technical advances in MRI pulse sequences, data processing, and analysis have made it increasingly complex for clinicians to compare and critically evaluate MRI research studies. This paper selectively reviews MRI research on five psychiatric conditions occurring in childhood or adolescence: ADHD, autism, childhood-onset schizophrenia, Tourette syndrome, and early-onset depression. The selection of papers reviewed was based on four criteria: the originality of the idea underlying the paper, the quality of the sample and methodologies used, the presence of controversial findings in the paper, and whether the paper was a clear illustration of specific methodological strengths or weaknesses. The two goals of this review paper are to update clinicians on morphometric brain imaging in child psychiatry and the methodological issues pertaining to image acquisition and analysis, and to promote critical reading of future MRI studies.
 ...
PMID:MRI neuroimaging of childhood psychiatric disorders: a selective review. 1103 81

The treatment of the Gilles de la Tourette syndrome has evolved from case reports, clinical experience and more recently blinded trials usually in small numbers of patients. We have reviewed the evidence available to clinicians. The oldest and still most widely prescribed drug, haloperidol, should now not be considered the first-line agent in children as other agents have superior adverse effects profiles. Symptomatic treatment should be targeted to the specific additional psychopathologies seen in the syndrome. For the treatment of tics, sulpiride, tiapride, possibly pimozide and in some cases clonidine may be considered first-line agents. Although a body of data supports pimozide, caution has to be exercised in relation to possible cardiac effects. Antidepressants and stimulants have an important place in the management of depression, obsessionality and attention deficit hyperactivity disorder. The latter also responds to clonidine making it a rational first choice where ADHD coexists with GTS. There are a multitude of other drugs advocated in the literature in addition to reports of neurosurgery and the novel use of immune modulation. Therapeutic trials for GTS are challenging. However, further data from blinded trials are required before many of these treatments can be considered to be mainstream treatment options.
 ...
PMID:Gilles de la Tourette syndrome: symptomatic treatment based on evidence. 1114 Jul 81


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>