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)

We review research literature on psychotic (delusional) depression, including demographic, illness pattern, clinical, biological marker and treatment issues. Secondly, we report a study of a consecutive sample of 137 patients meeting criteria for DSM-III melancholia, RDC definite endogenous depression and our "clinical" criteria for endogenous depression, of whom there were 35 "psychotic depressives" (PDs). The PDs were contrasted with the remaining 76 depressives (EDs) and with an age and sex-matched subset (MEDs). The PDs were distinctly older than the EDs at assessment and at initial onset of any affective disorder. Compared to the MEDs, they tended to have longer illnesses, were more likely to be hospitalised (and to have longer stays), to receive (in the past and for the current episode) combination antipsychotic/antidepressant medication and/or ECT, and to have a poorer course over the following year. They were no more likely to have a bipolar pattern, a family history of depressive disorder, schizophrenia or alcoholism, or vegetative depressive features. Developmental psychosocial stressors and antecedent life event stressors were not over-represented. Most of the PDs had delusions, one-fifth reported hallucinations and psychomotor disturbance was marked. Other differential clinical findings were sustained mood disturbance, constipation, and the absence of a diurnal variation in mood and energy.
 ...
PMID:Psychotic depression: a review and clinical experience. 167 37

In four studies, all carried out more than 20 years ago, the combination of tryptophan plus a monoamine oxidase inhibitor was significantly better than tryptophan plus placebo in the treatment of depression. However, there is no evidence that tryptophan has any clinically significant effect on other treatments such as tricyclic antidepressants and ECT. Side effects of the combination of tryptophan and a monoamine oxidase inhibitors have limited the use of this combination. The risk of the serotonin syndrome is small, but it can occur. However, rapid cessation of tryptophan seems to avoid any long lasting adverse effects of the serotonin syndrome. In situations where enhancement of the therapeutic effect of monamine oxidase inhibitors outweighs the risk of adverse effects, the combination of tryptophan and a monoamine oxidase inhibitor is clinically useful. As the studies to date have looked at regular depressed patients, what is needed now is studies of this combination in therapy resistant depression.
 ...
PMID:Use of tryptophan in combination with other antidepressant treatments: a review. 179 98

Depression is highly prevalent in the elderly and there are difficulties with definition and diagnosis. The signs and symptoms of depression may differ from those in younger patients since the elderly are frequently preoccupied with physical ailments and may have more agitation, insomnia and hypochondriasis. The aetiology and cause of depression and its association with psychosocial and other risk factors are discussed, with particular reference to masked depression, depressive delusional illness and 'pseudo dementia'. A range of treatments have been used in depressive patients, including psychotherapy, cognitive therapy, ECT and various drug treatments. In the elderly drugs may cause more problems than in younger patients. These can be divided into those associated with: pharmacokinetics, polypharmacy, side effects, dosage and lethality. Trials of antidepressants in the elderly are discussed and include trials with tricyclic antidepressants, monoamine oxidase inhibitors and SSRIs. Particular reference is made to a trial of fluvoxamine versus mianserin in the elderly, which demonstrated that fluvoxamine is as effective as mianserin in treating depression, and has fewer side effects.
 ...
PMID:The elderly depressed and treatment with fluvoxamine. 180 33

Treatment responses were monitored in 101 depressed patients, ranging in age from 64 to 92 years, hospitalized on a geropsychiatry unit. Forty-six percent of the patients received ECT. Medications were used in the majority of patients. Responses were assessed with both depression inventories (Beck Depression Inventory and Geriatric Depression Scale) and physician-rated global improvement scores. Advanced age was not associated with poor outcome. ECT was the most important variable associated with a good response, regardless of age.
 ...
PMID:Response to treatment of depression in the old and very old. 185 23

Recent reports of reduced seizure duration with ECT under propofol anaesthesia have led to concerns that propofol may diminish the efficacy of this treatment. To investigate the effect of propofol on the response to ECT, we reviewed records of 66 patients with primary depression treated with ECT, 37 of whom had been assessed prospectively with pre- and post-ECT Hamilton and Zung depression severity ratings. Despite demonstrating that the individual seizure duration was significantly reduced with propofol compared to thiopentone we found no evidence of reduced ECT efficacy with propofol. Courses under propofol anaesthesia were on an average two treatments longer than with thiopentone. Although this difference was not statistically significant this may have been due to a type II error. These results suggest that it is premature to abandon the use of this new anaesthetic agent in ECT without controlled prospective outcome studies.
 ...
PMID:Propofol as an anaesthetic agent for ECT: effect on outcome and length of course. 187 62

Major depression and clinically significant depressive symptoms occur commonly in the community-dwelling, medically ill, and institutionalized elderly. Both major depression and depressive symptoms need thorough evaluation and treatment because of the significant morbidity and mortality associated with these syndromes. Depression may be difficult to diagnose, especially in the medically ill elderly, because of the masking of depressive symptoms by somatic complaints or the presumption that symptoms are attributable to concurrent medical illness. Therefore, the clinician must be alert to the possibility of depression in the elderly patient. Although no specific diagnostic test is available, rating scales can be useful in screening for depression in the elderly patient. It is necessary to rule out medical illness or medications as contributing factors to depression. Psychotherapy and psychopharmacology, alone or in combination, are effective treatments for most elderly patients with depression. ECT is a safe and effective treatment for major depression in this population. Depression in the elderly is potentially a chronic and relapsing illness with significant associated medical and social morbidity. Because of their frequent contact with the elderly, nurses play a particularly important role in the diagnosis and treatment of depression. They need to recognize typical and atypical symptoms of depression and must be familiar with the potential side effects of antidepressant treatment. Close monitoring for these potential side effects can minimize disability. By working as a team with physicians, psychologists, and others, nurses have a necessary role in the care of the elderly depressed patient.
 ...
PMID:Depression in the elderly. Characteristics and clinical management. 189 94

The findings are reported of a retrospective study of 25 patients with a refractory depression in the restricted sense, admitted for ECT to a psychiatric department of a general hospital (Rijnstate, Arnhem). The results after ECT and the course during 2 years after the treatment were inventoried and compared with data in the literature. At discharge, 12 patients were classified as 'recovered', 9 were improved and four showed little or no change. After two years, 4 patients had died, one of them having committed suicide. Of the 22 follow-up patients 19 patients were at home: 15 could be classified as cured, 3 considered their condition improved and 4 were unchanged. Twelve were found to have had a recurrence of depression which in ten of them could be controlled with antidepressive drugs or ECT. ECT as a part of treatment of depressions may be regarded as useful and may safely be administered in a psychiatric department of a general hospital.
 ...
PMID:[Electroconvulsive therapy in a peripheral hospital]. 192 14

Few studies report the use of ECT in adolescents. Within a period of 3 years, 9 patients aged 15 to 19 were treated by ECT in our department. Indications were acute schizophrenia, delusional depression and delusional mania, resistant to usual medication. ECT proved to be a safe treatment with good short-term outcome. Long-term outcome did not seem to be modified by treatment. These results are discussed in relation to the use of ECT in adults and adolescents reported in the literature.
 ...
PMID:[Use of electroconvulsive therapy in adolescence]. 197 44

Verbal and visuospatial memory and dichotic listening performance were examined in 15 acutely depressed patients with no history of ECT, 17 depressed patients currently in remission, 15 remitted depressed patients who had received ECT six months or more in the past, and 20 normal controls. The neuropsychological functioning of an additional group of 10 acutely depressed patients was also studied before and two weeks after ECT. The results revealed some evidence of logical and autobiographical memory impairment two weeks following ECT, but no evidence that ECT impaired dichotic listening ability. Rather, a normalisation of hemispheric laterality was apparent on the dichotic listening task following ECT and the concomitant relief from depression. There was also no evidence of cognitive dysfunction on any task in individuals who were tested six months or more following their last ECT treatment.
 ...
PMID:Dichotic perception and memory following electroconvulsive treatment for depression. 224 66

Among 48 patients with diagnoses of depression according to DSM-III, there was a significant relation between therapeutic failure of unilateral ECT, as measured by scores on the Hamilton Rating Scale for Depression, and the concomitant use of a benzodiazepine. Of the 34 patients who showed a good therapeutic response to unilateral ECT, those taking benzodiazepines had smaller changes in their Hamilton depression ratings from before treatment to after treatment and were more symptomatic at the end of the course of ECT. Thus, when patients take benzodiazepines during a course of unilateral ECT, the maximum therapeutic response may be compromised.
 ...
PMID:Evidence for less improvement in depression in patients taking benzodiazepines during unilateral ECT. 237 37


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>