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)

Chronic urticaria is a problem for both physician and patient. In an effort to avoid the risks associated with corticosteroid treatment, many first-generation H1-receptor antagonists have been tried and found to induce undesirable levels of sedation when given in amounts sufficient to control urticaria. Cetirizine, a pharmacologically active oxidized metabolite of hydroxyzine, was developed to provide selective H1-receptor inhibition without depression of the central nervous system. In a 4-week, multicenter, double-blind, placebo-controlled safety and efficacy study, cetirizine, in a once-a-day dose (5 to 20 mg), was equivalent in efficacy to hydroxyzine in divided doses (25 to 75 mg/day). The incidence of somnolence in the cetirizine group was not significantly different from that of the placebo group. However, in the hydroxyzine group, the incidence of somnolence was significantly higher than that in the placebo group (p = 0.001). The results of this study demonstrate that cetirizine has a greater safety margin over the older parent drug hydroxyzine.
 ...
PMID:Urticaria: clinical efficacy of cetirizine in comparison with hydroxyzine and placebo. 197 96

Thirty-four dermatology out-patients with chronic idiopathic urticaria and 34 with idiopathic generalized pruritus were investigated using standardized self-assessment psychological questionnaires to determine the incidence of significant symptoms of depression and anxiety. These patients were compared with age- and sex-matched but otherwise unselected general dermatology out-patients. Using the Beck depression inventory, significantly more patients with generalized pruritus (32.4%) had depressive symptomatology (score greater than 14) than controls (13.2%, P less than 0.05). Although more patients with chronic urticaria had depressive symptomatology (14.7%) than controls (4.4%), the difference was not statistically significant. Using the Speilberger state-trait anxiety inventory there were no significant differences between the patients with pruritus or urticaria and their controls with respect to state or trait anxiety scores above the upper 90% probability limit for the general population. Thus, significant depression may be expected in a substantial proportion of patients with idiopathic generalized pruritus but in a relatively small proportion of those with chronic urticaria.
 ...
PMID:Anxiety and depression in patients with chronic urticaria and generalized pruritus. 226 93

The antihistaminic properties of the tricyclic antidepressants have been recognized since these compounds were first developed. Antidepressants, which are equally effective for treating depression or used in the treatment of chronic urticaria, have varying in vitro antihistaminic properties. We compared the duration of H1-receptor blockade by two tricyclic antidepressants, doxepin (the most potent antihistamine) and desipramine (the least potent antihistamine), in a single dose, double-blind, noncrossover study. After baseline prick test with histamine phosphate 1:1000 by Multitest (Lincoln Diagnostics, Decatur, Ill.), the suppression of cutaneous histamine-induced wheal-and-flare responses were measured daily for 7 days in 33 healthy volunteers who were randomly administered a single 25 mg dose of oral desipramine or doxepin. Significant differences in the suppression of the wheal-and-flare responses to histamine between the two drugs were noted (p less than 0.05) during the first 3 days. Desipramine suppressed the wheal for 2 days and flare for 1 day. Doxepin suppressed the wheal for 4 days and flare for 6 days. Our results suggest doxepin should be withheld for at least 7 days before allergy skin testing.
 ...
PMID:Duration of the suppressive effect of tricyclic antidepressants on histamine-induced wheal-and-flare reactions in human skin. 290 76

Astemizole is an H1-histamine receptor antagonist with a long duration of action permitting once daily administration. Its efficacy in seasonal and perennial allergic rhinitis has been convincingly demonstrated, and several comparative studies suggest that astemizole is at least as effective as some other H1-histamine receptor antagonists. A few smaller studies have shown beneficial effects on the symptoms of allergic conjunctivitis and chronic urticaria (but not atopic dermatitis). While astemizole appears to share with other H1-histamine receptor antagonists a tendency to increase appetite and cause weight gain after prolonged use, it offers the important advantage of an absence of significant central nervous system depression or anticholinergic effects with usual doses. Thus, astemizole offers a worthwhile improvement in side effect profile over 'traditional' H1-histamine receptor antagonists, especially in patients bothered by the sedative effects of these drugs.
 ...
PMID:Astemizole. A review of its pharmacodynamic properties and therapeutic efficacy. 620 35

A consecutive unselected series of 60 in-patients suffering from dermatologic disorders (psoriasis, chronic urticaria and fungal infections of the skin) was examined. Twenty patients with each illness were included. Stressful life events immediately before illness onset, levels of psychological distress, and alexithymic traits were investigated. Patients with psoriasis and chronic urticaria were exposed to stressful life situations before disease onset and suffered from psychological distress (anxiety, depression, inadequacy) significantly more than those with fungal infections. Implications for psychosomatic research and treatment are discussed.
 ...
PMID:Life events and psychological distress in dermatologic disorders: psoriasis, chronic urticaria and fungal infections. 741 87

Most reports on the psychological analysis of chronic urticaria have concentrated on psychodynamic theories of causation of the disease. For the present study, we used three kinds of psychological tests as well as electrocardiography to estimate anxiety, depressiveness, psychosomatic symptoms and autonomic nervous functions in 30 outpatients with chronic urticaria and 39 normal controls. For evaluation we used the manifest anxiety scale (MAS), self-rating depression scale (SDS), Cornell medical index (CMI) and convergence of variance of R-R interval (CVR-R). Psychologically positive responses to any one of the tests were seen in 70.0% of the chronic urticaria patients, but in only 25.6% of the controls. These differences all showed statistical significance (P < 0.01). The In(CVR-R) (Y) and age (X) suggested a linear regression, but although the regression slope was steeper for the urticaria group (Y = 2.924-0.027X) than for the controls (Y = 2.702-0.023X), the difference was not statistically significant. These data indicate that patients with chronic urticaria are more anxious, depressive and psychosomatic symptom-prone than normal controls. In conclusion, we suggest that chronic urticaria patients should be diagnosed and treated both dermatologically and psychologically.
 ...
PMID:Anxiety, depression, psychosomatic symptoms and autonomic nervous function in patients with chronic urticaria. 784 Nov 56

The efficacy of psychotropic drugs in combination with antihistaminics or antiallergics in patients with chronic urticaria was investigated. Forty patients, who had had urticaria for at least one month and showed insufficient suppression of symptoms for more than one month while being treated with antihistaminics or antiallergics, were divided into two groups on the basis of their score on three kinds of psychological tests: a manifest anxiety test, a self-rating depression scale and the Cornell medical index. One group had a high score, the other a low score. We investigated both groups with or without psychotropics in combination with antihistaminics or antiallergics. Incidence of urticaria and degree of improvement were examined after 2 and 6 months. There was no statistical difference between the groups after 2 months. After 6 months, the members of the low-score group treated with psychotropics showed a little better prognosis than those not treated. However, the high-score group treated with psychotropics showed a statistically significant decrease of incidence and increase in degree of improvement (P < 0.01). In conclusion, it is suggested that a long-term combination therapy with psychotropics is effective in suppressing urticaria for patients who are anxious, depressive and psychosomatic symptom-prone, and moderately effective for those with a low score in these areas.
 ...
PMID:A combination therapy of psychotropic drugs and antihistaminics or antiallergics in patients with chronic urticaria. 878 72

In a multicenter study, 100 patients with chronic urticaria were examined with a standardized personality test (Giessen test), a standardized symptom questionnaire (Giessener Beschwerdebogen) and a specially developed questionnaire concerning symptoms, history and behaviour during symptomatic periods. Almost one third of the patients showed elevated scores both for depression and for symptoms that are often associated with depression. It therefore seems worth-while examining such persons more specifically and possibly treating them by psychosomatic methods. The present results do not allow the classification of chronic urticaria as a somatization disorder. Since one-third of the patients had symptoms of depression, combined dermatological and psychosomatic approach may make it possible to offer them an appropriately targeted treatment.
 ...
PMID:[Correlation between chronic urticaria and depression/somatization disorder]. 883 99

Psychogenic excoriation (PE), characterized by excessive scratching or picking of the skin, is not yet recognized as a symptom of a distinct DSM-IV disorder. It is a chronic disorder with a high rate of psychiatric comorbidity. The purpose of this study was to compare patients diagnosed with PE and patients with another dermatological disease in terms of comorbid psychiatric disorders. Thirty-one consecutive subjects were recruited from an outpatient dermatology clinic. The control group was composed of 31 patients with chronic urticaria. All subjects were interviewed using the Structured Clinical Interview for DSM-III-R (SCID-I), Beck Depression Inventory (BDI), Hamilton Anxiety Rating Scale (HARS), and Yale-Brown Obsession and Compulsion Scale (Y-BOCS) and also completed a semistructured questionnaire. Current major depressive syndrome was the most common psychiatric disorder in the PE group. There was a statistically significant difference between the two groups in terms of current major depressive syndrome (PE group 58.1%, control group 6.5%, P<.01). In the PE group, 45.2% of subjects were diagnosed with obsessive compulsive disorder (OCD), while the rate of OCD was only 3.7% in the control group (P <.01). The PE group scored significantly higher on the BDI, HARS, and Y-BOCS. The results of this study point to the close relationship of PE to depression and OCD.
 ...
PMID:The relation of psychogenic excoriation with psychiatric disorders: a comparative study. 1276 14

Chronic urticaria is a common condition that can be very disabling when severe. A cause for chronic idiopathic urticaria (CIU) is only infrequently identified. Potential causes include reactions to food and drugs, infections (rarely) and, apart from an increased incidence of thyroid disease, uncomplicated urticaria is not usually associated with underlying systemic disease or malignancy. About one-third of patients with CIU have circulating functional autoantibodies against the high affinity IgE receptor or against IgE, although it is not known why such antibodies are produced, or how the presence of such antibodies alters the course of the disease or response to treatment. There are only a few publications relating to childhood urticaria, but it is probably similar to the adult form, except that adult urticaria is more common. The diagnosis is based on patient history and it is vital to spend time documenting this in detail. Extensive laboratory tests are not required in the vast majority of patients. Chronic urticaria resolves spontaneously in 30-55% of patients within 5 years, but it can persist for many years. Treatment is aimed firstly at avoiding underlying causative or exacerbating factors. Histamine H1 receptor antagonists remain the mainstay of oral treatment for all forms of urticaria. The newer low-sedating antihistamines desloratadine, fexofenadine, levocetirizine and mizolastine should be tried first. Sedating antihistamines have more adverse effects but are useful if symptoms are causing sleep disturbance. Low-dose dopexin is effective and especially suitable for patients with associated depression. There is controversy as to whether the addition of an histamine H2 receptor antagonist or a leukotriene antagonist is helpful. For CIU, second-line agents include ciclosporin (cyclosporine) [which is effective in approximately 75% of patients], short courses of oral corticosteroids, intravenous immunoglobulins and plasmapheresis, although the last two were found to be beneficial in small trials only. Treatments for CIU with only limited or anecdotal supportive evidence include sulphasalazine, methotrexate, stanazol, rofecoxib and cyclophosphamide. The efficacy of photo(chemo)therapy is controversial. Physical urticarias may respond to H1 receptor antagonists, although in delayed pressure urticaria, and cold, solar and aquagenic urticaria, the response may be disappointing. Second-line agents for physical urticarias vary depending on the urticaria and most have limited supportive evidence. The potential for spontaneous resolution, the variation in the disease activity and the unpredictable nature of the disease makes the efficacy of treatments difficult to assess.
 ...
PMID:Chronic urticaria: aetiology, management and current and future treatment options. 1551 52


1 2 Next >>