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)

Forty-seven nonmelancholic depressed outpatients were infused with sodium lactate to explore the relationship between history of panic attacks and lactate-induced panic. Lactate panic was rated without knowledge of history of panic. Fifteen of 29 patients (52%) with a history of spontaneous panic experienced panic attacks in response to lactate. Only 1 of 18 patients (6%) without a history of spontaneous panic experienced a lactate-induced panic attack--a highly significant difference. The likelihood of lactate panic was related to frequency of spontaneous panic attacks. The implications of these findings for understanding the relationship of panic attacks and depression are discussed.
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PMID:Lactate provocation of panic attacks in depressed outpatients. 321 65

In response to recent reports relating atypical chest pain to normal coronary arteries and to various types of psychopathology, we developed a pilot study to investigate 1) the prevalence of depression and panic disorder among patients presenting to an emergency room with atypical chest pain, and 2) what the likelihood is of an emergency room physician recognizing the psychosocial factor. Of forty-nine subjects screened, 39 percent scored positively for depressive syndrome on the Center for Epidemiological Studies-Depression rating scale, 43 percent met criteria for panic attack and 16 percent met criteria for panic disorder by DSM-III. Although thirty subjects (61%) screened positively for depression or panic attack, only one received a psychiatric diagnosis of any kind. This pilot study suggests: 1) that the relationship between chest pain and psychopathology in emergency room patients deserves further rigorous study; 2) that depression and panic attacks in association with atypical chest pain may be underdiagnosed by the emergency room physician; and 3) that self-report screening measures as an aid to diagnosis in this population need to be more closely investigated.
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PMID:Screening emergency room patients with atypical chest pain for depression and panic disorder. 323 78

One hundred nineteen patients who met specific criteria for atypical depression completed six weeks of double-blind, randomly assigned treatment with phenelzine sulfate, imipramine hydrochloride, or placebo. The overall response rates were 71% with phenelzine, 50% with imipramine, and 28% with placebo. Phenelzine was widely superior to placebo and also showed superiority to imipramine. Phenelzine superiority appeared even greater after an additional six-week continuation phase. Imipramine was only moderately effective in this atypical depressive sample. Unexpectedly, the superiority of either phenelzine or imipramine to placebo was largely confined to patients in subsets of the study sample who were prospectively judged to also have a history of spontaneous panic attacks and/or show hysteroid dysphoric features. This is consonant with some but not other recent findings and requires replication. Overall, the concept of atypical depression as a subtype that is preferentially responsive to monoamine oxidase inhibitors is supported.
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PMID:Antidepressant specificity in atypical depression. 327 82

Depressive symptomatology in 481 subjects with panic disorder and phobic avoidance was studied as part of an investigation of the efficacy of alprazolam in panic disorder. Subjects who had a major depressive episode (MDE) before the onset of their panic disorder were not included in the trial. With this exclusion criterion, 31% of subjects had a secondary MDE occurring after the onset of the panic disorder. The occurrence of secondary MDE was related to the length of time subjects were ill with panic disorder. Compared with the subjects without depression, those subjects with current MDE had higher scores on measures of anxiety and depression but not on the number of panic attacks per week. The presence of depression and the degree of phobic avoidance contributed independently to measures of the severity of the panic illness. Alprazolam was effective in reducing panic and depressive symptomatology in both depressed and nondepressed subjects with panic disorder. The presence of an MDE was not predictive of the outcome of treatment for the panic and phobic symptoms. Subjects with or without depression responded similarly to alprazolam.
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PMID:Secondary depression in panic disorder and agoraphobia. I. Frequency, severity, and response to treatment. 328 80

Eleven patients with panic disorder or agoraphobia with panic attacks completed an 8-week single-blind trial of trazodone (300 mg/day) without concurrent behavioral instructions. The measures of change included ratings of generalized and panic anxiety, phobias, and depression and a behavioral avoidance test, which were administered during a baseline period of placebo administration and at 4 and 8 weeks of the trial. There was significant improvement on all symptom dimensions, which suggests that trazodone may have specific antipanic and antiphobic actions and underscores the importance of serotonergic mechanisms in these anxiety disorders.
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PMID:Trazodone in the treatment of panic disorder and agoraphobia with panic attacks. 329 92

This naturalistic study examined the treatment response to imipramine of 60 patients who had panic disorder or agoraphobia with panic attacks. Only half of the patients could tolerate the drug, but of those who did, 88% obtained a markedly beneficial clinical effect. An amphetamine-like side effect accounted for most of the dropouts. More than one-half of the responders achieved clinical remission at doses (less than or equal to 100 mg/day) and plasma levels (less than or equal to 150 ng/ml) considered to be subtherapeutic for depression. There appears to be neither a clear threshold for response nor a therapeutic dose range for imipramine in the treatment of panic. Doses should be adjusted individually and increased conservatively.
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PMID:A naturalistic study of imipramine in panic disorder and agoraphobia. 330 Mar 74

A preliminary controlled investigation of the effectiveness of Anxiety Management as a treatment for generalised anxiety disorder (GAD) is described. Patients with a primary diagnosis of GAD, in which the current episode had lasted for at least 6 months but not more than 2 years, were included. Anxiety Management, a self-help treatment including procedures for managing somatic and cognitive symptoms, and for dealing with avoidance and low self-confidence, was given either immediately or after a 12-week waiting period. The average length of treatment was 8.7 sessions. Highly significant changes in anxiety, depression, and problem ratings were shown after treatment. These changes were replicated when the waiting list group had also received treatment, and gains were maintained by both groups for 6 months. Similar degrees of improvement and maintenance of change were shown in subgroups with and without minor depressive disorder or recurrent panic attacks.
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PMID:Anxiety management for persistent generalised anxiety. 332 92

Sixteen patients with panic attacks were treated with alprazolam at an anxiety clinic between March 1982 and April 1983. For all patients charts were reviewed for baseline data and treatment results at 1 and 6 months. Quantitated self-rating scales and the Clinical Global Impressions scale were used to assess progress. Alprazolam appeared effective for panic, agoraphobia, and depressive symptoms in 7 of 11 patients with either panic disorder or agoraphobia with panic attacks (DSM-III-defined diagnoses); side effects occurred in 4 of the 11 patients, were limited to oversedation, and resulted in no discontinuations of drug. However, alprazolam was ineffective in controlling panic, agoraphobia, and depression in 5 patients with panic attacks and secondary major depressive episode; for this group of patients, side effects were apparently paradoxical and required drug discontinuation in 3 of these 5 patients.
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PMID:Alprazolam in the treatment of panic attack patients with and without major depression. 333 78

Ninety-one patients with panic attacks limited historically to depressive episodes had more severe depressive symptoms and were less likely to recover during a 2-year follow-up than 417 depressed patients who did not have panic attacks. Family study data clearly distinguished another 15 patients with panic disorder and secondary depression; interviewed relatives of panic disorder patients were significantly less likely to have primary depression and significantly more likely to have various anxiety disorders. These data support the hierarchical system by which many of the contemporary diagnostic systems separate panic disorder and major depression.
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PMID:Depression and panic attacks: the significance of overlap as reflected in follow-up and family study data. 334 44

In a multicenter placebo-controlled study, the safety, side effects, and patient acceptance of alprazolam for the treatment of panic disorder and agoraphobia were examined. A total of 525 patients meeting DSM-III criteria for agoraphobia with panic attacks or panic disorder were randomly assigned to receive alprazolam or placebo, which they took for eight weeks. The mean daily dose at the end of the study was 5.7 mg of alprazolam or 7.5 capsules of placebo daily. Potentially serious reactions to alprazolam occurred in ten of 263 subjects who received the drug. These included acute intoxication (three), hepatitis (two), mania (two), amnesia (one), aggressive behavior (one), and depression (one). Treatment-related side effects that were worse in patients taking alprazolam than in those taking placebo included sedation, fatigue, ataxia, slurred speech, and amnesia. Sedation was the most frequent but tended to subside with dose reduction or continued administration of the drug. Patient acceptance of alprazolam, as measured by the rate of completion for study participants, was high. Eighty-four percent of patients receiving active drug completed the study compared with 50% receiving placebo.
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PMID:Alprazolam in panic disorder and agoraphobia: results from a multicenter trial. II. Patient acceptance, side effects, and safety. 335 44


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