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)

The authors report on a female patient with bipolar affective disorder who presented with marked eosinophilia in conjunction with pneumonia five days after a medication change from amitriptyline to desipramine (for intolerable dry mouth). She improved with discontinuance of medications and supportive management, and her eosinophilia normalized. Reinstitution of desipramine was followed by prompt appearance of asymptomatic eosinophilia, which resolved with discontinuation of desipramine. A subsequent depression managed with amitriptyline was followed by no abnormal white blood count findings. Eosinophilia is occasionally encountered in imipramine or desipramine therapy and, although usually asymptomatic, appears to be manageable by switching to amitriptyline or nortriptyline.
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PMID:Massive eosinophilic reaction to desipramine in conjunction with pneumonia. 672 6

The results of double blind trial in which 139 patients with primary depression were randomly assigned to either lofepramine (46), imipramine (48), or placebo (45) are discussed. After treatment with either active drug, lofepramine or imipramine, the clinical outcome was significantly greater than with placebo. No significant differences were found in clinical responses between lofepramine and imipramine. With regard to reported side effects, however, a statistically significant lower number of severe and/or moderate side effects were reported for the lofepramine group than for the imipramine group. In particular, for severe and/or moderate occurrences of dry mouth, the statistically significant lower incidence in favor of lofepramine is by almost a factor of 3 (8 lofepramine vs 21 imipramine patients).
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PMID:A double blind comparison of lofepramine, imipramine and placebo in patients with depression. 675

A double-blind randomized study was performed in 86 depressed out-patients, in order to compare the efficacy and tolerance of mianserin (30 to 60 mg daily) with that of nortriptyline (75 to 150 mg daily). Both drugs were administered for 6 weeks after a wash-out period of 1 week. The Hamilton Rating Scale for Depression was used weekly and the Clinical Global Impression Scale at the end of treatment. Both preparations proved to be effective, with no significant differences in response. However, tolerance in the mianserin group was much better than in the nortriptyline group. Significant differences were found mainly in the incidence and severity of tachycardia, dry mouth, constipation, sweating, insomnia, agitation and oedema.
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PMID:The clinical efficacy and side-effects of mianserin and nortriptyline in depressed out-patients: a double-blind randomized trial. 675 61

The pharmacology, pharmacokinetics, clinical trials, side effects, and dosage of amoxapine are reviewed. Amoxapine is a tricyclic dibenzoxazepine antidepressant that is chemically similar to the antipsychotic agent loxapine. In animal tests, amoxapine and its metabolites block reuptake of the neurotransmitter norepinephrine, with little effect on serotonin. It is rapidly and virtually completely absorbed when administered orally; peak serum concentrations occur one to two hours after ingestion. Amoxapine is widely distributed throughout body tissues and is 90% bound to serum proteins. Aromatic hydroxylation in the liver produces two major metabolites, which are excreted in the urine primarily but also in the feces. Amoxapine's elimination half-life is eight hours; one of the metabolites has a long half-life (30 hours). In clinical trials, amoxapine has been compared with amitriptyline and imipramine in several types of depressed patients. In some studies, amoxapine's therapeutic effects were measurable earlier (at one or two weeks after initiation of therapy) than those of the amitriptyline or imipramine, but generally only a portion of the depression-rating scales yielded statistically significant differences. Side effects noted during amoxapine therapy include hypotension (42%), drowsiness (14%), xerostomia (14%), constipation (12%), blurred vision (7%), fatigue (5%), and vertigo (5%). Amoxapine is approved by FDA for use in patients with neurotic or reactive depressive disorders, endogenous or psychotic depression, and depression accompanied by anxiety or agitation. The usual adult dosage is 200-300 mg daily, either in divided doses or a single bedtime dose. Amoxapine is a safe and effective antidepressant with no striking advantages over other available agents.
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PMID:Evaluation of amoxapine. 676 65

Depression is common in the geriatric population, but recovery rates are gratifying. Safe treatment requires attention to the effects of aging on pharmacokinetics and close monitoring. Antidepressants are the drugs most commonly used; to the standard tricyclic drugs have now been added a tetracyclic and a triazolopyridine. Monoamine oxidase inhibitors and lithium are second-choice options; a benzodiazepine is not generally required. Dosages should be lower than conventionally prescribed. Side effects of antidepressant drugs are common, the most important being slowing of cardiac conduction times and the most common being anticholinergic manifestations, such as dry mouth and tachycardia. Some of the more recently introduced antidepressants may have more advantageous side-effect profiles than the older agents.
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PMID:Drug therapy for depression in the elderly. 684 88

Eight patients undergoing antidepressant therapy with nortriptyline for 1--4 years were investigated. The period of the investigation was 7 weeks and included a 2-week placebo period, blind for the patients. Total saliva secretion measurement, the nortriptyline plasma level, and signs and symptoms of depression and side effects were obtained once a week during the study. The results of the investigation were: (1) long-term treatment with nortriptyline is followed by hyposecretion or xerostomia, (2) the reduction of the secretion is reversible, (3) re-establishment of treatment with dosage leading to the same serum level of nortriptyline is immediately followed by a drop in saliva secretion, and (4) the changes in salivary secretion are useful as an indicator of side effects. The practical importance of the investigation is discussed.
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PMID:Saliva secretion following long-term antidepressant treatment with nortriptyline controlled by plasma levels. 693 17

In a small preliminary clinical trial of guanabenz in 16 hypertensives also under treatment with diuretics (hydrochlorothiazide and amiloride), blood pressure was safely and completely controlled in 10 (64%), the criterion for "control" being a reduction to the strict level specified by the Society of Actuaries (130/85 m lambda Hg). The dosage of guanabenz was adjusted upward from 16 mg/day until blood pressure normalized or side effects intervened. The 16 patients accumulated 97 months of guanabenz treatment. The 6 unsuccessful cases included only 2 outright therapeutic failures; the other 4 patients discontinued treatment for various reasons: dry mouth and nausea (with good blood pressure reduction); aggravation of existing depression; or generalized urticaria. The fourth patient discontinued for reasons unknown.
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PMID:Preliminary clinical trial with a new hypotensive, guanabenz, in a group of hypertensive patients. 697 Apr 85

A group of forty patients who presented to their general practitioner with depression or somatic complaints, which were considered to be due to depression, were included in a double-blind trial of dothiepin and amitriptyline. Patient improvement as judged by the Hamilton Rating Scale (HRS) and the Comprehensive Psychopathological Rating Scale (CPRS) indicated that both groups significantly improved over the 6 week period. Only in one comparison, CPRS after 1 week, was there any statistical difference between the groups and in this case dothiepin produced a better response than amitriptyline (p less than 0.05). Statistical analysis of side-effects indicated that the frequency and severity of certain individual side-effects, hypotension, tiredness/sleepiness and dry mouth were significantly less with dothiepin than with amitriptyline at Week 1 (p less than 0.05). The overall incidence and severity of side-effects was also less with dothiepin at all assessments during the trial.
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PMID:A double-blind study of dothiepin hydrochloride (Prothiaden) and amitriptyline in out-patients with masked depression. 701 82

Mianserin (60 mg daily) was compared with chlorimipramine (150 mg daily) in the treatment of 145 depressed in- and outpatients in four centres. The trial was double-blind and fully randomized. Both drugs were effective antidepressants. No significant differences in efficacy could be demonstrated by means of the Hamilton rating scale for depression, the Beck self-rating scale or the clinical global impression, for both in- and outpatients. Hypotension, dry mouth and tremor increased significantly more in inpatients with chlorimipramine than with mianserin. At the end of treatment weight gain was increased significantly more in outpatients after treatment with mianserin. No differences could be demonstrated between the drugs for other side-effects.
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PMID:A double-blind multicentre trial comparing the efficacy and side-effects of mianserin and chlorimipramine in depressed in- and outpatients. 702 47

The analysis of three controlled studies comparing mianserin and clomipramine shows that none of them has elicited statistically significant differences between drugs, although populations were different: primary depression almost equally divided in endogenous and exogenous cases (de Buck), primary depression mostly neurotic (Pinder), involutional melancholia (Blaha). The only difference found as to efficacy was a more precocious onset of action for mianserin in the group of the endogenous depressions (de Buck). Mianserin causes significantly less side effects, above all as to hypotension, dry mouth, tremor and blurred vision.
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PMID:[Analysis of controlled studies comparing mianserin and clomipramine (author's transl)]. 703 87


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