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)

Antipsychotic drugs have an important place in pharmacologic treatment of depression. Major depression with psychotic features responds poorly to treatment if an antipsychotic is not used in addition to an antidepressant; however, an antipsychotic confers no additional benefit in nonpsychotic depression. Antipsychotic drugs do have significant short- and long-term side effects, including pseudoparkinsonism, dystonia, akathisia, and tardive dyskinesia. The possibility of a good therapeutic response with minimal side effects can be increased if psychotic depression is diagnosed accurately and the antipsychotic is prescribed according to established clinical guidelines.
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PMID:Use of antipsychotic drugs in depression. Problems and opportunities. 289 Nov 24

Dopamine receptor blocking drugs, commonly used in the treatment of involuntary movements, may cause potentially serious adverse effects, including tardive dyskinesia. Tardive dyskinesia has not been reported with tetrabenazine, a dopamine-depleting drug. We report a follow-up in 217 patients treated with tetrabenazine for about 18 months (range, 1 to 80). The response was rated on a scale of 0 to 5 (1 = marked improvement, 4 = no response, 5 = worsening). The mean effect from tetrabenazine was rated as follows: 2.3 in 44 patients with tardive dyskinesia, 2.6 in 15 with tardive dystonia, 2.6 in 10 with Huntington's disease, 2.7 in 17 with Gilles de la Tourette's syndrome, 2.8 in 19 with generalized dystonia, 2.8 in 57 with Meige's syndrome, and 3.4 in 25 with other focal dystonias. Twenty-two patients with a variety of unusual movement disorders had a mean effect of 2.9. Parkinsonism occurred as a side effect in 53 patients, sedation in 28, depression in 23, anxiety in 16, insomnia in 11, and akathisia in 10. The choreatic movement disorders are most amenable to tetrabenazine therapy, but tardive and idiopathic dystonia may also be responsive. Tetrabenazine is an effective and relatively safe drug for a variety of hyperkinetic movement disorders.
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PMID:Tetrabenazine therapy of dystonia, chorea, tics, and other dyskinesias. 327 37

Mean-age of onset of Parkinson's disease is 56 years. The older the patient is the more rapid is on average the progression of disability. In the early phase the motor symptoms respond well to therapy. Later, variations of response to therapy and side-effects of therapy occur (wearing-off, end-of-dose akinesia, end-of-dose dystonia, dopaminergic abnormal involuntary movements, pharmacogenic psychoses etc.). Due to the modern pharmacologic treatment of Parkinson's disease with dopaminergic substances disabling stages of the disease occur mean 3 to 5 years later than before levodopa-substitution was initiated. The incidence of depression, distinct cognitive deficits (impairment of memory, visuospatial deficits) and dementia increases in the course of the disease. The tremulous form of Parkinson's disease generally leads to less motor impairment than the rigid-akinetic form. Parkinson's disease of early onset (onset before the age of 40), may be regarded as a subtype of Parkinson's disease. Benign and malignant types of Parkinson's disease may be distinguished, as well as overlaps with multisystem atrophies.
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PMID:Nosography of Parkinson's disease. 346 66

Tardive dystonia is a late onset, persistent dystonia associated with neuroleptic therapy. We report improvement of tardive dystonia in a patient who had received electroconvulsive therapy (ECT) for depression. This improvement may be the result of a direct effect of ECT on the brain or the result of an interaction between the neurochemical processes responsible for both tardive dystonia and depression.
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PMID:Tardive dystonia, catatonia, and electroconvulsive therapy. 614 87

Forty-two patients aged between 19 and 70 years (30 women and 12 men) suffering from primary unipolar depression were randomly selected and treated under double-blind conditions with either mianserin (Lantanon; Organon) or clomipramine (Anafranil; Ciba-Geigy) after an initial wash-out period. Patients on all other medication, including benzodiazepines, were excluded from the study. The severity of depression was assessed on day 0 and after 1, 2, 3, 4 and 5 weeks' treatment. There were no significant pretrial differences between the groups in respect of severity of depression, age, sex or previous psychiatric history. During the 1st week of treatment all subjects received either mianserin 30 mg or clomipramine 75 mg once daily. From the 2nd week onwards the dose was doubled. Thirty patients completed the trial, 16 on mianserin and 14 on clomipramine. The improvement on both treatments was marked, favouring mianserin but only reaching significance in the 5th week. Side-effects, especially tremor, tachycardia, dystonia, dizziness, excitement, nasal congestion and dry mouth, were significantly more common in the group using clomipramine. This study confirms reports that mianserin is an effective antidepressant which is better tolerated and produces fewer side-effects (especially anticholinergic) than comparable tricyclic antidepressants such as clomipramine.
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PMID:Mianserin and clomipramine in the treatment of depression. 704 54

The authors examined 29 patients with ischemic heart disease and 3 patients with neurocirculatory dystonia. According to the results of echocardiography it was found that dilatation of the left ventricle and decrease in its contractility were more pronounced when the anginous attack was attended by a rise of the ST segment on the ECG than when it was attended by depression of the ST segment. During an ergometry-induced anginose attack with no changes on the ECG the diastolic filling of the left ventricle was disturbed but its contractility did not change, which evidently points to early manifestations of ischemic changes in the myocardium.
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PMID:[Electro- and echocardiographic changes during an angina attack in an ergometrine pharmacological test]. 726 35

The results of the bicycle ergometry test in 274 patients with angina pectoris and 228 patients with cardiac-type neurocirculatory dystonia are analysed. Tolerance to physical exercise was much lower in individuals with angina pectoris than in patients with neurocirculatory dystonia. Changes in the repolarization phase on the ECG were encountered more frequently in patients with angina pectoris (82.7%) than in those with neurocirculatory dystonia (30.7%). Changes in the ST segment prevailed in the former (77.2%) and changes in T wave in the latter (20.3%). Depression of the ST segment by 1 mm and more was recorded in 10.4% of patients with neurocirculatory dystonia. Analysis of additional diagnostic criteria, however, suggested that these individuals had a false-positive test.
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PMID:[Comparison of bicycle ergometry test data in patients with stenocardia and cardiac-type neurocirculatory dystonia]. 744 74

The progress of 178 patients with Parkinson's disease who began treatment with levodopa between November 1969 and December 1972 is reviewed after six years. One hundred and twenty-five patients showed an initial improvement of their individual total disability scores exceeding 25 per cent, but after six years of sustained treatment only 37 patients still obtained similar benefit. By 1978 only five patients had maintained their initial improvement compared to 69 patients after two years therapy; however, 47 patients were still better than before treatment. The overall mortality ratio--the ratio of observed to expected death rate--for all the patients was 1.45:1. In those patients who unable to tolerate levodopa for longer than two years the ratio was 2.38:1; in those who were able to tolerate sustained medication, life expectancy was normal (ratio of 0.91:1 for males and 1.14:1 for females). Involuntary movements were the commonest complication of treatment. Three main types were distinguished. Peak dose dyskinesias, beginning 20 to 90 minutes after an oral dose and most severe midway through the inter-dose period, affected 80 per cent of patients. Early morning and end-of-dose dystonia occurred in 20 per cent of patients and biphasic dyskinesia--two distinct episodes of involuntary movements within each inter-dose period--was the least common pattern affecting 3 per cent of patients. Involuntary movements increased in frequency and severity as treatment continued. End-of-dose deterioration ('wearing-off' effect of individual doses) occurred in 65 per cent of patients: unpredictable oscillations in motor performance (the 'on-off' phenomenon) unrelated to the time and dosage of levodopa, occurred in 10 per cent. Psychiatric side effects included toxic confusional states, visual pseudohallucinations and paranoid psychoses and constituted the most frequent reason for stopping medication. Forty (22 per cent) of the patients had suffered severe depression before the onset of disease and levodopa had no sustained antidepressant effect in this group. After six years of treatment with levodopa, 32 per cent of the patients had unequivocal dementia.
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PMID:The impact of treatment with levodopa on Parkinson's disease. 746 63

Seventeen patients with prominent orofacial dystonia of unknown cause (idiopathic orofacial dystonia: Meige's disease) were examined and several clinical features seen that, to my knowledge, had previously not been recognized. These include a family history of dystonia or other extrapyramidal disorders, a high incidence of depression, and frequent extension of spasms beyond the orofacial muscles. The course of the muscle spasms varies: rapid progression (eg, two months) to maximal disability occurred in some patients, and clear improvement after years of severe disability was observed in others. In addition to the muscle spasms, neurological abnormalities that suggest dysfunction of the basal ganglia were frequently present. The "spasm facial median" of Meige may be a distinct dystonic disorder, unrelated to idiopathic torsion dystonia.
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PMID:Clinical features of Meige's disease (idiopathic orofacial dystonia): a report of 17 cases. 746 47

Of 842 consecutive patients with movement disorders seen over a 71 month period, 28 (3.3%) were diagnosed as having a documented or clinically established psychogenic movement disorder. Tremor was most common (50%) followed by dystonia, myoclonus, and parkinsonism. Clinical descriptions of various types are reviewed. Clinical characteristics common in these patients included distractability (86%), abrupt onset (54%), and selective disabilities (39%). Distractability seems to be most important in tremor and least important in dystonia. Other diagnostic clues included entrainment of tremor to the frequency of repetitive movements of another limb, fatigue of tremor, stimulus sensitivity, and previous history of psychogenic illness. On examination, 71% had other psychogenic features. Over 60% had a clear history of a precipitating event and secondary gain and 50% had a psychiatric diagnosis (usually depression). Twenty five per cent of patients presented with combined psychogenic movement disorder and organic movement disorder; 35% resolved and this subgroup had a shorter duration of disease than those who are unresolved. Psychogenic movement disorder represents an uncommon diagnosis among patients with movement disorders. The ability to make a diagnosis rests on the presence of a multitude of clinical clues and therapeutic action should be taken as early as possible.
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PMID:Psychogenic movement disorders: frequency, clinical profile, and characteristics. 756 21


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