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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The influence of progesterone on gestagen upon stress reactions and the metabolism of the biogenic amines, noradrenaline (NA) and serotonin (5-HT), were evaluated. For the 1st experiments, the 54 subjects ranged in age from 18 to 30 years. Of these, 19 (35%) had reported premenstrual tension, depression, or somatic complaints. After a preliminary interview the Moss Menstrual Distress Questionnarie and the Eysenck Personality Inventory were completed. Each subject was subsequently seen at Day 8 before predicted menstruation and 1 day before menstruation. At each session, blood samples were taken for progesterone assay. The patients sat in a darkened room and were asked to memorize words heard from a tape recording while being given a mild electric shock. The morning after the session, subjects completed the Scale of Well-Being. Psychic difficulty shortly before menstruation was higher in 49 subjects; in 16.3% of these it was severe. Only 10.2% had a negative effect. There was a correlation between the different tests. Only in the medroxyprogesterone-treated group was there a significantly higher reaction to stress on Day 1 before menstruation than a week earlier. There were large individual variations. For studies of the effects of progesterone on NA metabolism, Sprague-Dawley rats which had been ovariectomized 3 weeks earlier, were given progesterone 20 mg/kg sc on 2 consecutive days. These animals were injected with tritiated NA intracisternally and underwent a stress procedure. 3 hours after the intracisternal injection, rats were killed and tritiated-NA and its metabolites estimated. Progesterone injections did not influence NA turnover or percentage distribution of tritiated-NA and its metabolites in unstressed rats but did increase 5-HT turnover. In stress-altered 5-HT metabolism an effect of progesterone was shown. Footshock also raised endogenous progesterone levels.
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PMID:Influence of progesterone on serotonin metabolism: a possible causal factor for mood changes. 56 84

It is possible to reduce side effects of oral contraceptives by individualizing the dosage and type of pill on the basis of such factors as length and regularity of normal cycle and sensitivity to endogenous progesterone, as demonstrated by premenstrual tension and depression. Tailor-made pills would provide dosages of either estrogen, progesterone, or a combination, calculated on the amount that is necessary to control the ovulatory cycle and subsequently adjusted for any observed side effects. The choice of estrogen or progesterone shoul d be based on a careful medical history that takes all relevant factors into consideration. Most marketed oral contraceptives are combinations designed to contain the minimum effective dosage; however, they must also compensate for such influences as short cycles, malabsorption, and inconsistency in taking the pills. These factors can be dealt with better on an individual basis by the practitioner's prescription of doses based on medical history. This practice may be considered threatening by pharmaceutical companies, but physicians must avoid marketing pressures and concentrate on optimal treatment of individual patients.
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PMID:Letter: Side effects of oral contraceptives. 114 34

Acceptance of an attribution pattern linking negative moods (depression, irritability) to the approach of menstruation and the likelihood of internal and external attributions were examined in a questionnaire study in which cycle phase (pre- versus postmenstrual), mood (positive versus negative), and environment (pleasant versus unpleasant) were varied. Subjects' rating indicated that (a) biology was judged important for explaining negative moods occurring premenstrually: (b) inconsistency between mood and environment produced more internal (personality) attributions, while consistency enhanced external attributions; and (c) emotionally expressive behavior was thought to reflect underlying personality dispositions despite extenuating situational factors (assumed personal causation). The theoretical relevance of the findings to a new conceptualization of premenstrual emotionality and to an attributional chain relating female self-concept and premenstrual tension is discussed.
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PMID:An attributional approach to moods and the menstrual cycle. 117 Nov 72

15 women with premenstrual tension are rated in four symptom groups, anxiety-tension, asthenia-depression, irritability-explosiveness and feelings of swelling. The ratings of anxiety and irritability were also added to a separate group. Ratings were then correlated to plasma oestrogen and progesterone levels and oestrogen/progesterone ratios. There was a significant correlation between oestrogen levels and the anxiety, irritability, anxiety + irritability and depression groups. A correlation was also found between oestrogen/progesterone ratios and anxiety. No significant correlation was found between progesterone levels and symptom ratings.
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PMID:Correlation of symptoms in pre-menstrual tension to oestrogen and progesterone concentrations in blood plasma. A preliminary study. 124 29

The efficacy of bromocriptine (Bromergon, Lek) was studied in a group of 21 women with premenstrual syndrome (PMS). To qualify for inclusion, the patients had to have a score of 20 or more on Casper's Analog Self-Rating Scale for Premenstrual Tension Syndrome completed during the last premenstrual week. The study was designed as a double-blind, randomized, cross-over trial introduced by a wash-out cycle. Patients received Bromergon in a daily dose of 5 mg from cycle day 10 to the onset of menstruation for two consecutive menstrual cycles, followed by two placebo cycles or vice versa. The subjects were instructed to complete the scale every three days from cycle day 3 to the onset of menstruation. A statistically significant improvement due to the administration of Bromergon was observed in symptoms associated with overreactiveness to normal prolactin levels, i.e. abdominal tension, edema, weight gain and breast tenderness. Scores on the linear analog scale and physician's assessments differed regarding psychological symptoms. The investigators observed no difference in the presence of psychic symptoms in the treatment-free period, on Bromergon therapy and during the administration of placebo. On the other hand, self-rating scores reflected an improvement in the presence of depression and irritability during Bromergon treatment. The results obtained suggest that Bromergon may be a useful agent for the treatment of somatic symptoms associated with PMS, while it seems somewhat less effective in PMS cases where psychic symptoms are the major complaint.
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PMID:Bromocriptine (Bromergon, Lek) in the management of premenstrual syndrome. 129 45

The selective serotonin reuptake inhibitors (SSRIs) include fluoxetine, fluvoxamine, citalopram, paroxetine and sertraline. These medications may be effective for a variety of indications. The literature clearly supports their efficacy in some of these conditions in major depression. Data concerning their use in other areas is clearly preliminary but promising. These include reports of treatment of obsessive-compulsive disorder, atypical depression, panic disorder, premenstrual tension, eating disorders, substance use disorders, chronic pain, dementia, and personality disorders with aggressive or impulsive features. The variety of clinical uses for the SSRIs may compel re-examination of traditional diagnostic categories and theories of how antidepressants work.
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PMID:Potential indications for the selective serotonin reuptake inhibitors. 143 Oct 22

Cyclic progestin therapy has been widely advocated as an adjunct to postmenopausal estrogen replacement therapy to reduce the risk of endometrial carcinoma. Acceptance of this approach, however, appears to have preceded detailed evaluation of possible adverse side effects of progestins that could result in patient noncompliance. We evaluated the nonmenstrual physical and psychological side effects of oral medroxyprogesterone acetate given in conjunction with transdermal estrogen in two groups of women with previous hysterectomy and oophorectomy. Twenty-four women with prospectively documented severe premenstrual syndrome (PMS) before surgery and 24 women with no such history of adverse premenstrual changes received transdermal estrogen 100 micrograms on days 1-25 and either oral medroxyprogesterone acetate 10 mg daily or an identical placebo (days 12-25) in a randomized, double-blind, cross-over design. Mood and physical symptoms were monitored prospectively, using daily self-ratings on the Daily Symptoms Checklist. The Beck Depression Inventory and Premenstrual Tension Self-Rating Scale were completed on day 24. At the study's completion, the patients were asked which treatment period they preferred. Paired comparisons did not reveal any significant differences, and preference for treatment was equally divided between medroxyprogesterone acetate and placebo. We conclude that addition of medroxyprogesterone acetate 10 mg/day for 14 days to cyclic transdermal estrogen therapy (days 1-25) produces no consistent adverse physical or psychological effects on women for one cycle of treatment, regardless of their PMS history.
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PMID:A randomized, double-blind, placebo-controlled, cross-over trial to assess the side effects of medroxyprogesterone acetate in hormone replacement therapy. 182 50

The extent to which the high discontinuation rate for oral contraceptives is due to adverse effects of mood, well-being and sexuality is explored, taking into account early studies on high dose combined and sequential pills, recent studies on low-dose combined and triphasics, experimental design factors, effects of OCs on free androgen levels, psychosocial factors and reasons for choosing or stopping pills, effects on depressive illness, premenstrual syndrome, sexuality, and possible mechanisms for direct effects of steroids on mood and sexuality. Study design is complicated by selection of early or late oral contraceptive users, types of controls, and unknown confounding factors such as reason for choice of pills, effect of a reliable contraceptive on the sexual relationship, prior history of depression and premenstrual tension. Furthermore virtually all topics reviewed here resulted in inconsistent or contradictory findings, making a case for individual variation and subgroups of women with different responses regarding the end point being examined. Examples include whether progestogen alter female sexual desire or male attraction; and whether rising or falling free testosterone levels affect sexual response. Factors affecting experimental design include culture, language, life-cycle, type of relationship, personal qualities affecting contraceptive choice, manner of eliciting reports of side effects, steroid dose, whether ovulation was blocked, initial or established pill-use, possibility of missed pills, and type of controls. Current pill users seem to discontinue for depression and low libido less frequently than did users of higher dose pills, and severity scores of adverse effects are lower. Premenstrual and other cyclic events may be altered in timing, and premenstrual symptoms are relieved in most women, but worsened in some who take pills. It is likely that women with depressive and premenstrual complaints tend to discontinue pills, leaving the remaining users with greater reported well-being. There are conflicting reports on improved and adverse effects of pills on sexuality and libido, implying that pill choice confounds the results, that libido cycles are altered, or that subtle effects of steroids on sexual response are overwhelmed by psychosocial factors in some women. Studies on the effects of steroids on biological sexual responses, and metabolism of serotonin and other neurotransmitter related to depression have not yielded definite conclusions.
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PMID:The effects of oral contraceptives on well-being and sexuality. 207 4

Current theories of affective disorders do not account for many of the biological markers replicated in patient studies. We link many biological findings in a reasonable physiological relationship, compatible with mechanisms of action of pharmacological and electroshock therapies for depression. We propose that excessive phospholipase-A2 (PLA2) activity disrupts membrane fluidity, composition, and therefore, the activity, of membrane-dependent proteins. Similar disruptions in these proteins are documented in depressed patients and can be accounted for by excessive PLA2 activity. This paradigm accounts for disturbances in the activity of Na-K-ATPase, beta2- and alpha2-adrenergic receptors, MAO, norepinephrine and serotonin uptake, and imipramine binding. Disturbances in other membrane-dependent proteins, tyrosine and tryptophan hydroxylase, can explain the biogenic amine hypothesis. Inhibition of glucocorticoid receptor and TRH receptor binding to their respective ligands by PLA2 may explain patient nonsuppression in the Dexamethasone Suppression Test and poor response in the TRH stimulation test. Physiological regulators of PLA2 activity; calcium, cortisol, estrogen, progesterone, and PGE2 are documented abnormalities in some patients with affective disorders and consistent with excessive PLA2 activity. Thus, postpartum depression and premenstrual tension syndrome may be described in the paradigm. The mechanisms of action of tricyclic antidepressants, lithium, electroconvulsive shock, and some novel antimanic agents can be described in terms of alterations of PLA2 activity. Interestingly, ethanol perturbs membrane fluidity and membrane-bound enzymes in a manner similar to excessive PLA2 activity. A hereditary factor predisposing patients to affective disorders may be a gene defect at either PLA2 or in its regulation.
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PMID:Are disturbances in lipid-protein interactions by phospholipase-A2 a predisposing factor in affective illness? 256 35

Pooled data were analyzed for 367 female patients enrolled in a double-blind, placebo-controlled, multi-centre trial comparing buspirone, a non-benzodiazepine anxiolytic, and diazepam in the treatment of generalized anxiety disorder. After a 4 to 7-day wash-out period, patients were allocated at random to receive one or other of the trial medications or placebo over a 4-week period. Mean daily dosages were 24.5 mg for buspirone and 20.8 mg for diazepam (range 10 mg to 60 mg for both drugs). Patients were assessed on entry and at weekly intervals using the Hamilton Anxiety Rating Scale, and at the end of treatment both patients and physicians gave an overall opinion of response to treatment. Details of adverse events were also recorded. The results showed that both buspirone and diazepam were approximately equal in efficacy and superior to placebo. Menstruation and the occurrence of premenstrual tension did not alter the anxiolytic activity of either drug. Patients taking diazepam had significantly more adverse effects, i.e. drowsiness, weakness, fatigue, inco-ordination and depression, than did those in the buspirone group. In a separate commentary, the anxiety disorder and the data from the study are reviewed to place them in the overall perspective of gynaecological care.
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PMID:A pooled, double-blind comparison of the effects of buspirone, diazepam and placebo in women with chronic anxiety. 264 17


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