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)

With careful differential diagnosis and judicious treatment, you may be able to reverse certain aspects of dementia in the elderly. Drug toxicity, depression, metabolic and endocrine disorders, and other systemic problems are all potentially treatable causes of mental deterioration. Even when the cause cannot be identified, you can still treat the patient's symptoms. Antidepressants, antipsychotics, and antianxiety agents, plus supportive measures, often effect marked improvement.
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PMID:Dementia: differential diagnosis and treatment. 3 88

This report concerns the use of d-amphetamine in 88 elderly inpatients who initially failed to respond to rehabilitation procedures. These patients exhibited characteristics of the Poor Motivation Syndrome (PMS), not associated with depression or dementia. The syndrome was seen five times more frequently in women. d-Amphetamine was given for three weeks in increasing dosage (2.5--10.0 mg twice daily). The responses were scored according to mobility, self-care and motivation. Of the 88 patients, 48 improved and another 28 were discharged who would otherwise have remained dependent nursing cases. An unexpected finding was that 17 patients showed an age-related resistance to the effects of the drug (P less than 0.05). The likelihood of a beneficial response also diminished with increasing age (P less than 0.01). Side effects were in the psychiatric sphere; they occurred in 23 patients early in treatment and were not age-related; the drug was withdrawn. Thus treatment with d-amphetamine should be restricted to selected patients who satisfy the diagnostic criteria of PMS, and administration should be carefully supervised. With these safeguards, a substantial proportion of patients previously refractory to rehabilitation will show improvement, become more independent and may be discharged from the hospital in a much more active, less dependent state of mine and body.
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PMID:d-Amphetamine in elderly patients refractory to rehabilitation procedures. 10 13

Reductions in 2 neurotransmitter synthesizing enzymes in brain, glutamic acid decarboxylase (GAD) and choline acetyltransferase (CAT), have been found in dementias of different origins, including senile dementia (Alzheimer type). Significant reductions in cerebral GAD have also been found in depression (unipolar). The GAD reductions did not generally appear to be localised in any specific region of the brain examined. However, the reduction of CAT in the hippocampus, relative to reductions in other areas examined, was substantially greater in the brains with Alzheimer-type changes. GAD and CAT activities in normal brains were examined for the effects of some variable factors inherent in necropsy biochemical measurements. These factors included: (i) age; (ii) agonal status; (iii) time of death, and (iv) delay in tissue sampling; and GAD was found to be significantly influenced by (ii), (iii) and (iv) and CAT by (i), (iii) and (iv). None of these factors accounted for the total alterations in the enzyme activities of the mentally abnormal brains. The results indicate that reductions in cerebral GAD require to be interpreted with caution in view of the sensitivity of this enzyme to premortem status but that reductions in cerebral CAT may be a more reliable index of pathological change in senile (Alzheimer-type) dementia.
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PMID:Neurotransmitter enzyme abnormalities in senile dementia. Choline acetyltransferase and glutamic acid decarboxylase activities in necropsy brain tissue. 14 89

An historical review is presented of the evolution of the clinical apomorphine treatment. Some of the results from the last 10 years of psychopharmacological research have led us to the hypothesis that there exists a close relationship between abstinence and craving symptoms in drug and alcohol addicts, and that anxiety, depression, and tremor symptoms in Parkinsonism (and dementia senilis), are due to disturbances of the same, mainly dopaminergic, pathways in the CNS. In such cases, by means of effective preparations for oral use, we have utilized the synergistic effect of small amounts of apomorphine, L-dopa, and decarboxylase inhibitor with considerable therapeutic effect.
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PMID:Apomorphine revived: fortified, prolonged, and improved therapeutical effect. 35 69

Elderly patients often manifest a variety of symptoms (e.g., depression, memory loss, irritability, hostility), categorized as "senility" or "senile dementia," which are difficult to treat and represent a major therapeutic challenge to the geriatrician. This investigation was designed to assess, under double-blind conditions, a drug often prescribed for these symptoms--cyclandelate. In a 16-week study, 58 elderly patients were randomly assigned to two groups and received either 1600 mg of cyclandelate daily or identical-appearing placebo capsules. Initially, the every four weeks thereafter, the patients were examined for changes in vital signs and for adverse reactions, also, the Sandoz Clinical Assessment-Geriatric (SCAG) Scale and the Nurses Observation Scale Inpatient Evaluation (NOSIE) were completed. At the final evaluation, a physician's global rating was obtained. Our data suggest that cyclandelate is a safe and moderately effective treatment for certain symptoms of senescence in carefully selected patients.
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PMID:Cyclandelate in the treatment of senility: a controlled study. 35 21

Ancient Greek and Roman physicians recognized the high prevalence of depressive illness in old age and began to differentiate the major mental syndromes of the elderly. Greek humoral theory connected black bile, melancholia and old age, and this formulation dominated medical thinking until the seventeenth century. Beginning with the Enlightenment and continuing throughout most of the nineteenth century, physicians spurned the idea that old age and depression were linked, or tended to view depression as evidence of brain decay. Although twentieth century studies have confirmed that depression in the elderly is a common illness, usually self-limiting and rarely coexisting with dementia, these views have been incompletely incorporated into modern medical practice.
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PMID:Medical views of depression in the elderly: historical notes. 38 91

Catecholamines (CA) are among the most well known neurotransmitters (NT) which act in a wide range of brain structures and are involved in many important functions, such as general arousal, autonomic, neuroendocrine and motor control and possible in emotion and mentation. The neuropharmacology of the brain CA synapses has played a crucial role in understanding the complex phenomena of the central neurotransmission and the feed-back mechanisms by which the central neurones adapt optimally to the functional needs at any time. The model of neurotransmission, as well as the mechanism by which various substances act at the synaptic level are briefly outlined. Due to the fact that the CA are implicated in many important functions of the brain, it has been suggested that certain mental diseases such as depression, as well as mental and behavioral manifestations of the ageing brain might have their origin in an impairment and particularly in a functional deficiency of the CA occurring at various structures. The available evidence in support to this view is outlined and the hypothesis that senile mental deterioration and the mental impairment encountered in various types of dementia (senile, presenile and multi-infarct) may be due to deficiency of the brain CA is discussed. Since the CA and particularly the dopamine deficiency seems to be a common denominator in depression and in senile mental deterioration, it is suggested that the dopaminergic drugs may serve as useful therapeutic means on one hand and important tools for testing the validity of the above hypotheses on the other.
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PMID:[Brain catecholamines, mental diseases, aging and senile dementia: biochemical and pharmacological aspects]. 39 47

In late middle age, many patients consult physicians with nonspecific complaints involving a decline in mental functioning. Distinguishing between psychologic and organic causes of mental impairment, particularly between depression and dementia, is essential.
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PMID:Generalized decline in psychologic functioning. 43 57

The authors describe a series of patients with organic brain syndrome who showed a dramatic clinical response to lithium carbonate therapy. None of the patients had been diagnosed as manic-depressive. Most had extensive psychiatric treatment experiences and had been given both affective and cognitive diagnoses. Six of the eight patients also qualified for the diagnosis of alcoholism. They had been treated with a wide variety of psychotherapeutic medications. Lithium was found to be rapidly and dramatically effective in patients with static lesions of the central nervous system who showed a combination of dementia and agitated depression.
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PMID:Cognitive and affective responses to lithium in patients with organic brain syndrome. 44 63

Averaged cortical evoked responses to auditory and somatosensory stimuli were recorded in elderly depressives, dements, patients with a combination of depression and dementia and normal elderly controls. The subjects were also given a battery of cognitive tests and clinical ratings at stated intervals. The latency of the auditory response was significantly longer in dements than in controls. Depressives had intermediate latencies which did not return to normal after recovery. Although somatosensory stimulu produced the results that pointed in the same direction, the mean response latencies were not statistically significant. Mixed cases were too few for separate statistical analysis but their latencies fell between those of the dements and those of the depressives. Significant correlations emerged between latencies of auditory responses and some cognitive tests, but not with measures of depressive symptomatology. The delay in response to auditory stimuli may be a useful adjunct to diagnosis: in depressives it may reflect organic cerebral change playing a part in the emergence of depressive symptoms in old age.
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PMID:Averaged evoked responses in relation to cognitive and affective state of elderly psychiatric patients. 47 57


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