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

The effects of high-dose fluoxetine (median 80 mg/day), standard-dose imipramine (median 200 mg/day), and placebo were studied in 706 outpatients meeting DSM-III criteria for major depressive disorder. Baseline psychomotor activity of each patient was prospectively categorized as agitated, retarded, or neither. Rates of occurrence of total and significant (leading to discontinuation) activating adverse events (insomnia, agitation, anxiety, nervousness) and sedating events (somnolence, asthenia) were compared between treatments on an overall basis and within categories of baseline psychomotor activity. Additionally, these rates were compared across baseline psychomotor activity for each treatment. Efficacy was evaluated on an overall basis and with respect to baseline psychomotor activity. There was more total activation with fluoxetine than placebo (p = 0.008), but total activation with fluoxetine (28%) showed only a trend (p = 0.092) for being greater than with imipramine (21%). Discontinuations for activation with fluoxetine (5%) did not differ from imipramine (5%). Sedation and discontinuations for sedation with both fluoxetine and imipramine significantly exceeded placebo. The only drug-drug difference in discontinuations was for sedation where imipramine (11%) exceeded fluoxetine (5%; p = 0.008). Only for the occurrence of sedation with imipramine (47% among patients retarded at baseline) was there a significant association with baseline psychomotor activity (p = 0.021). Both fluoxetine and imipramine were superior to placebo and equal in efficacy in decreasing total Hamilton Rating Scale for Depression (HAM-D), the sleep disturbance HAM-D factor, and the anxiety/somatization HAM-D factor scores. These improvements were independent of baseline psychomotor activity.
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PMID:High-dose fluoxetine: efficacy and activating-sedating effects in agitated and retarded depression. 162 94

We made a survey among physicians of primary care teams (PCT) from Vizcaya to assess their opinion about the care of the patient with cancer in the terminal period. A total of 85% of the surveyed physicians responded; 70% considered that the care given was inadequate; 90% thought that the patients wishes to die at home. 50% felt that the patient should know the diagnosis, although 85% believed that it was virtually always unknown to him in practice. The most commonly found symptoms were anorexia, asthenia, pain, depression and anxiety, which resulted in serious management difficulties for 25-45% of physicians. 65% were assisted by nurses. The participation of the rest of the team and of specialists was irrelevant. Most felt frustration (59%) and dissatisfaction (78%) with those patients. The physicians find great difficulty to communicate with the patient, and need more information, training and cooperation. Is should be clear that the aim is the well being of the patient, thus diminishing the frustration of the professionals.
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PMID:[The care of the terminal patient as viewed by the family physician]. 1699 Dec 26

The aim of adequate preoperative medication is to minimize the patient's anxiety level. Preoperative anxiety can be consciously and specifically orientated or it can be masked. This double-blind study was performed to evaluate the effects of an anxiolytic drug in comparison with a placebo perioperatively and to assess the post-operative course of the important factors anxiety, depression and asthenia. The Mannheim inventory for subjective state and STAI (State-Trait-Anxiety-Inventory) were offered. The study was undertaken in 60 female patients, who were operated for suspected carcinoma of the breast. We conclude that in such a specific group of patients extensive preoperative psychological preparation must be backed up by the administration of an anxiolytic drug.
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PMID:[Perioperative subjective emotional state]. 228 71

In an open controlled trial of 48 patients with major depression illness (according to DSM-III), the patients were randomly assigned to 2 groups. One group of 25 patients was treated with 200-300 mg/day of trazodone and a second group of 23 patients was treated with 200-300 mg/day trazodone plus 1 ampoule (corresponding to 1000 gamma of lipidic phosphorous) twice daily of hypothalamic phospholipids (HPL). The effectiveness of treatment was evaluated by the Hamilton Rating Scale for Depression (HRSD). Side effects of treatment with trazodone were looked for by measuring systolic and diastolic blood pressure and heart rate and from EEG made before and on the 7th and 30th days of treatment. Combination with HPL shortened the typical latency of action of the antidepressant trazodone, definitely improved the subjective symptoms, especially the psychosomatic symptoms, on the HRDS and decreased the incidence of such side effects of trazodone as hypertension, reflex tachycardia and asthenia.
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PMID:A combination of hypothalamic phospholipid liposomes with trazodone for treatment of depression. An open controlled study. 264 67

In order to compare individual health characteristics of healthy people and patients with borderline arterial hypertension (BAH) and hypertensive disease (HD) 867 TASS employees aged 18-68 (365 men and 502 women) were examined. Abridged variant of a multifactor questionnaire MMPI was used for the determination of the psychologic profile. Those examined were divided into 3 groups, namely, the first group comprised 96 patients with BAH; the second group 41 patients with HD of the 1st stage, and the 3d group consisted of 70 persons with a normal level of arterial pressure (the control group). BAH was detected in 146 persons (17.1%) and HD of the 1st and IInd stages in III persons (13.0%). The analysis of individual characteristics showed that an average profile of the male population with normal blood pressure had no distinct peaks by separate scales, whereas the combination of the characteristics in patients with HD (a rise on the 1st and the 3d scale and a decrease on the 9th one) was regarded as R-factor. The latter revealed a decrease in general activity and the presence of depression and asthenia The above changes were also registered in patients with BAH but they were less distinct and characterized by intermediate indices in patients with HD and the healthy people. No reliable differences were noted among females.
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PMID:[Comparative study of individual characteristics of patients with borderline arterial hypertension and more severe forms of hypertensive disease]. 276 76

Sixty-four consecutive patients with advanced breast cancer were included in a study designed to determine the prevalence of asthenia and its association with other clinical features. The Asthenia Score (AS, the average of four tests designed by our group to assess asthenia) was 59 +/- 9 for patients versus 88 +/- 7 for a group of 68 normal controls (p less than 0.001). Twenty-six patients (41%) scored below the tenth percentile of normal controls and were considered asthenics. AS was correlated with depression and the general severity index of the SCL-90 R test. No association was found between AS and nutritional status, lean body mass, tumor mass, anemia, or type of treatment. We conclude that asthenia is a frequent symptom in patients with advanced breast cancer, which, in our series, showed independent correlations only with psychological distress.
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PMID:Association between asthenia and nutritional status, lean body mass, anemia, psychological status, and tumor mass in patients with advanced breast cancer. 278 36

In 60 patients undergoing a curettage in thiopentone induced inhalation anaesthesia with enflurane and N2O/O2 = 2:1, the effects of oral premedication (2 h before anaesthesia) with 30 mg morphine (MST 30) (n = 21), 1 mg lormetazepam (Noctamid) (n = 19) and placebo (n = 21) on psychological (anxiety, depression and asthenia), physiological (blood pressure, heart and respiratory rate) and pain parameters (visual analogue scale, analgesic consumption) were investigated. The study design was single blind, randomized. Before premedication the three groups did not differ in one parameter and so were comparable. MST 30 had a significantly better anxiolytic, Lormetazepam a significantly better antidepressive effect than the compared substance. There were no differences in blood pressure and heart rate. In contrast to lormetazepam and placebo after MST 30 there was no increase in the respiratory rate which can be explained by the anxiolytic stress reducing effect. There was no difference in peri- and intraoperative pain parameters, probably due to the type of surgery. Nausea and vomiting occurred more frequently after MST 30, but there was no significance. A higher rate was probably prevented by the application of transdermal scopolamine the day before surgery. The indication of analgesics (opiates) for premedication is discussed taking the controversy into account. The results of this study show that oral morphine (MST 30) has an anxiolytic effect, one of the most important effects a premedication should have. Further studies should investigate in which types of surgery the analgesic effect of MST 30 is peri- and intraoperatively relevant, so that advantages compared to e.g. Flunitrazepam, Midazolam or Lormetazepam in a higher dosage could be expected.
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PMID:[Effect and side effects of oral morphine, lormetazepam and placebos as premedication]. 288 17

33 depressive patients diagnosed major depressive episode (DSM III) have been assessed by the French translation of the melancholia scale of Bech and Rafaelsen and the following scales: scale of depressive retardation (ERD) (Widlocher), Hamilton depression rating scale with 26 items (HDS 26), Montgomery and Asberg depression rating scale (MADRS). A concurrent validation shows that Bech-Rafaelsen melancholia scale is valid. A principal components analysis with VARIMAX rotation found 4 principal components: retardation and blunted affect, asthenia, anxiety, suicidal impulses.
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PMID:[French adaptation, concurrent validation and factorial analysis of the Bech and Rafaelsen melancholia scale]. 322 85

The case is described of a 43 year old woman with spasmophilic syndrome. For 12 years she had suffered from fainting fits, marked morning asthenia, anxiety, depression, widespread arthromyalgia, blood pressure fluctuations, precordial pains, paresthesia and painful nocturnal cramp. This clinical picture appeared in a subject with a double left kidney and stones in the supernumerary ureter, enlargement of the pancreatic head and tail revealed by a CAT scan and an earlier cholecystectomy. Given the multiplicity of symptoms diagnosis was necessarily by a process of elimination. The data providing grounds for optimism were a positive Chvostek's sign, stable calcium phosphorus profiles, a reduction in ionised calcium and favourable eletromyographic readings.
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PMID:[A case of spasmophilic syndrome]. 360 Nov 38

The main reason for premedication is the reduction of preoperative stress. Despite the proven fact that benzodiazepines best reduce preoperative stress, combinations of opioids and neuroleptic drugs are preferred for premedication by many on reviewing the journal Der Anaesthesist. This double-blind study was performed to investigate midazolam and meperidine/promethazine for intramuscular premedication. Method. 60 patients undergoing minor gynecological surgery were randomly assigned to receive either 5-7.5 mg midazolam or 50-75 mg meperidine and 25-50 mg promethazine intramuscularly 30-90 min before surgery. Anxiety, depression, and asthenia were assessed by the patient before and after premedication but before induction of anesthesia using visual analogue scales and a nominal scale. Sedation was assessed by an observer. Heart rate and blood pressure were the physiological stress parameters. Parameters of acceptance and side effects were registered perioperatively. Results. Midazolam had a significantly better anxiolytic and antidepressive effect. There were no differences in the other parameters except for adverse effects. Meperidine/promethazine produced significantly more side-effects than midazolam. The parameters of acceptance assessed the day after surgery were comparable. Conclusions. We conclude from these results that anesthesiologists still premedicate with meperidine/promethazine because the patients accept this premedication very well when asked the day after surgery. Nevertheless, premedication with midazolam provides significantly better anxiolytic and antidepressive effects with significantly less side-effects. Therefore, midazolam should be preferred to meperidine/promethazine for intramuscular premedication.
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PMID:[Midazolam and pethidine/promethazine for intramuscular premedication]. 363 95


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