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)

Baclofen, commonly used to reduce severe muscle spasms in patients with spinal cord injuries, is also active in the brain. A patient with pre-existing bipolar affective disorder developed increased depression while on baclofen, which progressed to a delusional depression when baclofen and haloperidol were rapidly decreased. When the dose of haloperidol was increased to a previously well tolerated dose to deal with the depressive delusion, a pseudoparkinson's state developed. This case demonstrates the interactive effects of baclofen and haloperidol on central noradrenergic and dopaminergic systems and suggests a possible neurochemical basis for the difference between delusional and nondelusional depression that is consistent with the different therapeutic response to psychotropic drugs of patients with these illnesses. The paradoxical appearance of the pseudoparkinson state in this patient when much higher doses of haloperidol had been free of such side effects, may reflect baclofen-induced alterations in receptor sensitivity. It appears that baclofen should be used with caution in patients with neuropsychiatric problems and that, when used, the withdrawal of baclofen should be continued over several weeks to allow receptor sensitivity to return to normal levels.
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PMID:A possible neurochemical basis for the neuropsychiatric aspects of baclofen therapy. 632 74

The significant variety of psychopathological presentations of depression causes difficulties in its diagnosis. Depression of middle age is subdivided depending on the predomination of one or another disorder in the clinical picture. There are simple depression and complicated depression with additional psychopathological symptoms. The most difficult is to diagnose depression with onset in early childhood, including infant's age, when the psychopathological presentations depend on the consequences of the perinatal CNS lesion, maternal deprivation and other factors. In children, the clinical picture of depression differs by syndromologic incompleteness, peculiarity of phenomenological presentations and polymorphism of disorders. In adolescence, depression is characterized by the predominance of behavioral disorders, marked psychopathic-like disorders, suicidal attempts, higher frequency of bipolar forms. Depression with late age at onset differs by the abundance of somatic and hypochondriac complaints, anxiety and depressive delusion accompanied by the transitory aggravation of cognitive impairment (depressive pseudodementia).
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PMID:[Age-related aspects of depressive states]. 2442 58

Depressive delusion is the key symptom of psychotic depression also known as major depressive disorder with psychotic features (ICD-10: F 32.3). Delusional topics are limited to guilt, impoverishment and hypochondria. Kurt Schneider described these as being the three primordial fears of human beings. Psychotic depression is distinguished by the particular severity and frequency of the episodes of illness as well as by increased suicidal tendencies. Although one in five patients with a major depression experiences psychotic symptoms, this condition is all too easily overlooked and the appropriate therapy is not initiated. Here we use case histories to illustrate some of the obstacles to diagnosis arising from the difficulty of identifying delusions hidden in a person's experience of depression, life history and personality. A targeted active exploration of these difficulties is significant taking into account the observable symptoms and not only the subjectively experienced symptoms. A phenomenological approach is chosen to explore the matter of depressive delusion and to investigate the interaction of delusion and affect and the special importance of anxiety for the genesis of delusion. In accordance with the current treatment recommendations and against this background, it is proposed that the pharmacological strategy should be supplemented by the use of benzodiazepines more often than has it has been in the past.
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PMID:[Delusional depression : Diagnostics, phenomenology and therapy]. 2735 50