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 aim of this study was to determine the prevalence, severity and correlates of fatigue in a convenience sample of outpatients with prostate cancer prior to and following 3-months treatment with first-line hormone therapy (cyproterone acetate and goserelin). 'Severe fatigue' in the patients (n=62) was defined as a score on the Fatigue Severity Scale (FSS) greater than the 95th percentile of a group of elderly volunteers without cancer. Subjects also completed other questionnaires about fatigue and about quality of life, anxiety/depression and personality. Subjects underwent a nutritional assessment, tests of voluntary muscle function and attention. The prevalence of 'severe fatigue' at baseline was 8/58 (14%). Median FSS scores increased significantly after 3 months treatment. On multivariate analysis psychological distress explained 28% of the variance in fatigue scores. Treatment was associated with a reduction in voluntary muscle function, loss of muscle bulk, a decline in virility and potency, an improvement in pain and a reduction in nausea/vomiting. Fatigue is an important but under-recognised side-effect of hormone therapy.
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PMID:Fatigue in patients with prostate cancer receiving hormone therapy. 1085 47

Androgen suppressive maneuvers still represent the gold standard for prostate cancer patients. However, they are associated with side effects (fatigue, sexual impotence, hot flushes, anemia, anxiety, depression and osteoporosis) all of which have a negative impact on quality of life. Nonsteroidal antiandrogens compete with dihydrotestosterone for the linkage of its own receptors. These compounds are commonly used in combination with suppressive maneuvers. However, there is a growing experience with them as monotherapy, based on the possibility to spare gonadal function and therefore prevent the effects related to its suppression. Many studies have demonstrated the feasibility and safety of this approach, which can represent a valuable alternative to suppressive maneuvers for patients wishing to retain sexual function, especially for those without distant metastases. Unfortunately, none of the comparative studies performed so far had the power to detect the equivalence between monotherapy and castration.
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PMID:Hormone therapy of prostate cancer: is there a role for antiandrogen monotherapy? 1093 69

PADAM stands for partial androgen deficiency in the aging male, and it is currently diagnosed with a testosterone level below 3 ng/ml (300 ng/dl or 12 nmol/l), and with symptoms varying according to the individual. The symptoms are a reduction or even loss of libido, a decline in muscle mass and strength, enhancement of visceral fatty tissue-padding, dryness of the skin, apathy, tiredness and distortion of mood right up to depression, and ostalgia due to osteoporosis. Before starting any form of hormonal substitution, which is only indicated if clinical symptoms and testosterone deficiency correlate, it is absolutely essential to exclude prostate cancer by using clinical evaluation and PSA values. Close PSA monitoring is necessary during testosterone substitution. In more than 95% of all patients with erectile dysfunction, the cause is not testosterone deficiency. Even a decreased level of dehydroepiandrosterone (DHEA) in an elderly male needs no replacement. There is also no indication for estradiol therapy in men--except in the rare case of aromatase deficiency.
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PMID:[PADAM from the urologic viewpoint]. 1104 38

The aim of this study was to investigate the possibility of predicting anxiety and depression 6 months after the cancer diagnosis on the basis of measures of anxiety, depression (Hospital Anxiety and Depression, HAD scale), subjective distress (Impact of Event, IES scale) and some aspects of social support in connection with the diagnosis. A further purpose was to attempt identification of individual patients at risk of prolonged psychological distress, and to develop an easily applicable clinical tool for such detection. A consecutive population-based series of 522 newly diagnosed patients with breast, colorectal, gastric and prostate cancer were interviewed in connection with the diagnosis and 6 months later. Anxiety and depression close to the diagnosis explained 39% of the variance in anxiety and depression 6 months later. Patients scoring as doubtful cases/cases for HAD anxiety and/or depression were more than 11 times more likely than non-cases to score as doubtful cases/cases at 6 months. Additional risk factors were having an advanced disease and nobody in addition to the family to rely on in case of difficulties. Levels of anxiety and depression at diagnosis predict a similar status 6 months later. The results also indicate that the HAD scale in combination with a single question about social support may be a suitable screening tool for clinical use.
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PMID:Predicting anxiety and depression among cancer patients: a clinical model. 1123 60

In the three years since its launch, sildenafil citrate (Viagra), an oral agent for the treatment of erectile dysfunction (ED), has been prescribed to more than 10 million patients worldwide and has been further evaluated in clinical studies in diverse patient populations. Significant improvements in erectile function have been demonstrated in double-blind, placebo-controlled trials in patients with ED and underlying diabetes, cardiovascular disease, minor depression, spinal cord injury and multiple sclerosis. Promising results have also been reported for patients with treated prostate cancer, end-stage renal failure, Parkinson's disease, and spina bifida and in multiple organ transplant recipients. Accounts of sildenafil use in clinical practice and postmarketing data reflect clinical trial findings of effectiveness in a broad spectrum of ED aetiologies and overall good tolerability. As in the clinical trials, most adverse events associated with sildenafil use have been transient, mild or moderate effects that rarely lead to treatment discontinuation.
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PMID:Three-year update of sildenafil citrate (Viagra) efficacy and safety. 1132 62

This study investigated the association between prostate cancer risk and energy restriction during childhood. The authors examined the hypothesis among 58,279 men aged 55-69 years enrolled in the Netherlands Cohort Study on Diet and Cancer. Information on diet and risk factors was collected by questionnaire in 1986. Additional information was collected on residence during the Dutch Hunger Winter (1944-1945) and the World War II years (1940-1944) and father's employment status during the economic depression of 1932-1940, used as indicators of exposure. A case-cohort approach was used. After 7.3 years of follow-up (through December 1993), 903 prostate cancer cases were available for analysis. Analyses were carried out for all prostate cancer cases. The prostate cancer rate ratio for men who had lived in a western Netherlands city in 1944-1945 was 1.15 (95% confidence interval (CI): 0.80, 1.31), and the rate ratio for men who had lived in a western rural area in 1944-1945 was 1.30 (95% CI: 0.97, 1.73). Residence during the war years (1940-1944) and father's employment in 1932-1940 showed no relation to prostate cancer risk. In subgroup analyses in which exposure before, during, and after the adolescent growth spurt was evaluated, the same pattern as that of the overall data was shown. The authors found no evidence for the hypothesis that energy restriction early in life decreases prostate cancer risk later in life.
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PMID:Energy restriction in childhood and adolescence and risk of prostate cancer: results from the Netherlands Cohort Study. 1154 58

The exact physiological role of DHEA remains unknown but DHEA supplementation has recently been proven beneficial in typical deficient states like adrenal insufficiency or major depressive illlnesses. The putative favorable effects of DHEA in other conditions remain controversial. However, recent studies confirmed positive effects of DHEA administration in healthy elderly people, mostly more than 70 years old women, on skin, bone density, muscle strength and several neuropsychological symptoms. Positive effects on sexual interest and satisfaction and sense of well-being are more consistent in elderly women than in men. The recommended administered dose is 25 mg to 50 mg once a day in women and 100 mg in men. Androgenic side effects (greasy skin, acne, increased growth of body hair) are frequent but reversible side effects. Dose adaptation is recommended in these conditions. It is justifiable to prescribe DHEA in patients with adrenal insufficiency. Other possible indications are depression and prolonged glucocorticoid therapy. In elderly people, DHEA administration might be considered in DHEA depleted-patients with skin dryness or atrophy, muscle weakness, low bone density or neuropsychological symptoms. The treatment should be taken under close medical supervision in order to detect a possible hormone-dependent cancer such as breast cancer in women and prostatic cancer in men. The patients should be informed on the potential risks of DHEA administration and on the lack of definitive proven beneficial effects of DHEA, waiting the results of well-conducted controlled double blind prospective studies.
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PMID:[DHEA: orthodox or alternative medicine?]. 1168 Feb 5

In the 3 y since its initial approval, sildenafil has become the most widely used treatment for erectile dysfunction (ED) and has been prescribed to more than 13 million patients worldwide. Significant improvements in erectile function have been demonstrated in double-blind, placebo-controlled studies in diverse patient populations. A significant treatment effect has been shown with sildenafil in men with ED and a history of diabetes, cardiovascular disease, minor depression, spinal cord injury and multiple sclerosis. In addition, promising results have been shown in patients with treated prostate cancer, end-stage renal disease, Parkinson's disease and spina bifida and in multiple-organ transplant recipients. Postmarketing data of the use of sildenafil in clinical practice confirm the efficacy and safety found in clinical trials and high satisfaction with treatment. Public awareness of the common occurrence of ED and the high likelihood of a potentially favorable response to an oral treatment increased dramatically with the introduction of sildenafil. Physicians, however, are still not comfortable with ED management, which negatively affects pharmacotherapy response rates and patients' compliance to treatment. Continuing medical education seems mandatory to overcome existing problems in ED management.
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PMID:Sildenafil citrate: lessons learned from 3 years of clinical experience. 1185 Jul 35

The pineal hormone melatonin is the mediator of external light to physiologic adaptation to day and night rhythms, it regulates reproduction in animals but attempts to utilize melatonin in women for contraception have failed. Melatonin seems to be the natural hormone to facilitate sleep in insomniac patients and causes no hang over. When applied together with benzodiazepine it allows reduction of benzodiazepine without withdrawal effects. It should be applied 2 h before sleeping time in doses between 3 and 5 mg. Melatonin acts via the gamma-aminobutyric acid- and benzodiazepine receptor explaining its success in treatment of seizures in children and in adults. Constant application of benzodiazepine reduced the production of natural melatonin in rats, supporting the evidence that long-term application of benzodiazepine in humans does not restore sleeping habits but reduces natural sleeping habits even more. Low melatonin levels were seen in bulimia or neuralgia and in women with fibromyalgia; replacement reduced pain, sleeping disorders, and depression in fibromyalgia and bulimia. Melatonin profiles are a diagnostic tool to distinguish between several forms of depression, like major depression, winter depression (SAD), unipolar depression, delayed sleep phase syndrome (DSPS). In patients with a major depression success with antidepressants correlated with an increase in their melatonin profiles but only patients suffering from DSPS can be successfully treated with melatonin. In perimenopausal women melatonin administration did produce a change in LH, FSH and thyroid hormones. Some oncostatic properties are supported by cell culture work and studies in animals. In Nordic countries indigenous people suffer less from breast and prostate cancer, winter darkness seems to protect. The supposedly increased melatonin levels created the 'melatonin hypothesis'. Epidemiological studies did show that blind people indeed have half the rate of breast cancers, supporting the hypothesis. Controversial results concerning melatonin and insulin resistance and glucose tolerance have been published. In postmenopausal women application of melatonin reduced glucose tolerance and insulin sensitivity. Pregnant women should avoid melatonin, since its teratogenic effect is not known. Patients suffering from non-hormone dependent tumors, like leukemia, should avoid melanin, since tumor growth was promoted in animal experiments. It can be expected that melatonin will receive wide consideration for treatment of sleeping disturbances, jet lag, and fibromyalgia once an oral formulation becomes available in Europe.
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PMID:Melatonin deficiencies in women. 1195 97

Erectile dysfunction is a condition affecting 1 in every 10 men. Although its occurrence is related to ageing, illness and its necessary therapy can play a major role. Prostate cancer can lead to erectile dysfunction both psychologically through depression and emotional distress, and physically through therapy for the disease. An international quality of life survey involving 401 patients with prostate cancer was conducted. The objectives of the study were to investigate the patients' understanding of the treatment options they received, to explore the importance of the patient-doctor communication in the treatment of prostate cancer and to see what effect treatment had on patient's sexual function. One of the main findings of the survey was that too little counselling or information on treatment options and their effects on sexual function was provided to patients. Patients themselves felt that psychosexual counselling, in particular, would be helpful. In addition, therapy for prostate cancer appears to have a significant impact on patients' lifestyle and also on their libido, sexual function and activity.
Prostate Cancer Prostatic Dis 1998 Jun
PMID:Prostate cancer and sexual function. 1249 92


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