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)

Although therapeutic responsiveness to tricyclic antidepressants has been primarily associated with the affective disorders, clinical investigations in the last decade have suggested that non-affective disorders such as panic disorder, obsessive-compulsive disorder, anxiety disorder, bulimia, enuresis, migraine, and the chronic pain syndrome may also respond to tricyclics and other antidepressants. This therapeutic responsiveness may sometimes be related to improvement in secondary depressive symptoms, but may also clearly occur in the absence of secondary depression; in particular, improvement in the core symptoms of at least some of these disorders may occur without a change in mood. Furthermore, many patients with these disorders display psychobiologic abnormalities that show many similarities, but also some differences, compared to those observed in patients with affective disorders, despite the frequent absence of affective symptoms. While an improvement in subclinical or "masked" depression remains one hypothesis linking tricyclic responsiveness and shared biological abnormalities in this diverse group of diagnostic entities, an alternative hypothesis (the "ven disorder" hypothesis) is presented, suggesting the possibility that tricyclic and other antidepressant-responding patients have a core disorder with common psychobiologic abnormalities but multiple clinical and diagnostic presentations. An alternative hypothesis (the "shotgun" hypothesis) suggests that the multiple actions of tricyclics (e.g. on adrenergic receptors vs. muscarinic receptors vs. serotonin system changes) may each be differentially important in the therapeutic outcome in patients with specific or predominant problems in one or another of these areas. An examination of both the similarities and differences among the non-affective, tricyclic-responsive disorders and the affective disorders may provide clues about the important psychobiologic elements in these disorders, and to the mode of action of tricyclic antidepressants and related drugs across the psychiatric disorder spectrum.
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PMID:Therapeutic responses to tricyclic antidepressants and related drugs in non-affective disorder patient populations. 298 99

In a retrospective cohort study we reviewed our experience using D-penicillamine in children with low-level lead poisoning (whole blood lead levels 25 to 40 micrograms/dL) to determine its efficacy and the incidence of side effects. Two groups were compared: treated subjects (n = 84) were treated with penicillamine at a mean daily dose of 27.5 mg/kg; control subjects (n = 37) received no chelation therapy. Over a prechelation observation period of 60 days, lead levels (PbB) did not change in either group. With a mean period of 76 days of D-penicillamine therapy, PbB fell in treated patients by 33% (P less than 0.001). In 64 patients (76%), PbB was reduced to a currently acceptable range (less than or equal to 25 micrograms/dL). There were eight treatment failures (10%). In control subjects, mean PbB did not change significantly over 119 days of observation. Fourteen control subjects eventually required conventional chelation with calcium disodium ethylene-diaminetetraacetic acid, and 17 were lost to follow-up. Use of D-penicillamine was associated with an adverse reaction in 28 cases (33%); transient leukopenia occurred in eight, rash in seven, transient platelet count depression in seven, enuresis in three, and abdominal pain in two. Treatment was terminated prematurely in eight cases (10%) because of an adverse reaction. We conclude that D-penicillamine is effective therapy for selected children with low-level plumbism, but adverse effects can complicate or prevent its use in some patients.
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PMID:Efficacy and toxicity of D-penicillamine in low-level lead poisoning. 336 95

The present study was conducted to derive pediatric mianserin pharmacokinetic parameters, which were compared to those from healthy young adults, and to obtain preliminary information regarding the utility of mianserin for the management of hyperkinesis in children. The sample consisted of six prepubescent children with hyperkinetic behavior disorders who had not responded, or had developed tolerance to, stimulant medication. Mianserin pharmacokinetics were derived from plasma samples obtained over a 36- to 50-hour period following a single oral dose which ranged from 0.28 to 0.72 mg/kg. Children evidenced a significantly faster elimination half-life and a significantly smaller apparent kinetic volume of distribution than did adults, whereas maximum plasma concentration, time to maximum concentration, and apparent oral plasma clearance were similar. Ratings of behavioral deviance were obtained from teachers and parents during placebo and mianserin titration to a maximum dose of 40 mg/day. Although half the children showed some decrease in hyperactivity ratings, the small sample size and high variability of response preclude conclusions regarding the efficacy of mianserin for childhood hyperkinesis. Possible side effects in our sample included akathisia, excitability, insomnia, and migraine-like headache, as well as cardiovascular effects of tachycardia and two instances of minor electrocardiographic change. Our pharmacokinetic findings will be of import should mianserin prove useful for such childhood disorders as depression and/or enuresis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Mianserin pharmacokinetics and behavior in hyperkinetic children. 359

Thirty-eight children playing or observing a soccer game were the victims of a lightning strike which killed one other child. Interviews with the children and their families documented a number of emotional effects of this disaster, chiefly situational adjustment reactions. The most common reactions involved anxiety, particularly at times of storms. However, the most severely upset children exhibited sleep disturbances, separation anxiety, and nocturnal enuresis. One of two side-flash victims experienced depression for several months; the other experienced no significant emotional upset. Both suffered medical complications and had no memory for the incident. While all children reached at follow-up were doing quite well, those who were most upset by the incident were more likely to refuse to play soccer during the follow-up interval. Stories told to pictures of lightning revealed projections of the children's emotional upset, various defensive reactions to the incident and an increased sense of subjective probability for lightning injuries.
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PMID:Lightning-strike disaster among children. 409 20

Depression is not only a common disorder, but also one that is readily treatable. Antidepressant drugs play a major role in treatment, although concurrent use of electroconvulsive therapy or psychotherapy may be indicated for some patients. Antidepressant drugs have been most specifically beneficial for patients with 'endogenous' depressions, but they should be used whenever this type of depression cannot be definitely ruled out. Besides the older tricyclic antidepressants and monoamine oxidase inhibitors, a new 'second generation' group of drugs is now available. Although these drugs offer no great therapeutic advantages over the older ones, they may prove to have a more acceptable profile of side effects, may act more quickly, and may show less cardiotoxicity with overdoses. Whether one can classify depression pathogenetically according to various biological markers, such as urinary excretion of the norepinephrine metabolite, 3-methoxy-4-hydroxy phenylglycol, is still uncertain. At present, the choice of antidepressant drug for an individual patient is largely empirical. Besides being useful for treating depression, antidepressants may be used for treating enuresis, chronically painful states, obsessive-compulsive-phobic states, acute panic attacks and cataplectic attacks in narcoleptics. Many studies have tried to define a therapeutic range of plasma concentrations of these drugs, so as to afford a better basis for dosing, but routine monitoring of drug plasma concentrations is seldom needed; the primary indication for doing so would be in the patient who has received what should be an adequate dose but who is still unresponsive. The value of maintenance treatment with antidepressants has been clearly established; the pattern it takes is best determined by the natural history of the disorder in individual patients. Most drug interactions with antidepressants are pharmacodynamic in nature and can be managed by adjusting doses. Pharmacokinetic interactions with various sympatholytic antihypertensive drugs, such as guanethidine, methyldopa and clonidine, are rare but may be serious. Patients with depression may be spared a considerable amount of discomfort, morbidity, and possibly mortality, by judicious use of antidepressant drugs and the other treatments currently available.
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PMID:Current antidepressant drugs: their clinical use. 611 51

Parasympathetic preganglionic discharges recorded from pelvic nerves in spinal cats were evoked by single-pulse stimulation of sacral afferent fibers of descending excitatory pathways in the thoracic spinal cord. Evoked responses were analyzed on-line by signal averaging. Discharges evoked by either pathway were increased in size by 2-10 times by coadministration of both picrotoxin and strychnine, but not by either drug alone. The combination also markedly enhanced evoked increases in bladder pressure. Strychnine was also effective with bicuculline and in cats depleted of central GABA stores by semicarbazide. The monoamine precursors, 5-HTP and L-dopa, only depressed evoked discharges in both untreated and convulsant-treated animals; this depression was enhanced by tricyclic antidepressants. The results indicate that sacral parasympathetic preganglionic neurons are controlled by an unusual type of strong, local tonic inhibition which is mediated by both GABA and glycine. Both amino acid transmitters must be blocked to unmask this inhibition. Interruption of supraspinal control of this local inhibition may account in part for loss of bladder function following spinal injuries. The 5-HT and NE bulbospinal pathways that terminate near the preganglionic neurons also appear to be inhibitory. Enhancement of this inhibitory monoaminergic transmission by tricyclic antidepressants may contribute to the efficacy of these drugs in treating nocturnal enuresis.
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PMID:Amino acid and monoamine inhibition of sacral parasympathetic preganglionic neurons. 697 82

Similar structured diagnostic interviews about the child were given by different interviewers to a cohort of 307 mother-child pairs. A diagnosis was made by computer on each interview, using specified criteria. Diagnoses on mother-child interviews were compared using the kappa statistic. Kappas of .30 or higher were found for the diagnosis of antisocial personality, conduct disorder, enuresis, mixed behavior-neurotic disorder, and possible depression. Comparisons were made for sex and age. Possible depression and enuresis were diagnosed reliably at all age levels and for both sexes. The limitations of the interview and diagnostic system used are discussed. The findings support the need for further efforts to develop diagnostic research interviews for use with children and adolescents.
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PMID:Development of a structured psychiatric interview for children: agreement on diagnosis comparing child and parent interviews. 717 41

Aspects of mental health were investigated by means of interviews and register data in 34 men operated on for hypospadias in childhood and in 36 matched control subjects. Most hypospadiacs adjust well both in childhood and adult age. However, they reported more neurotic disturbances in their childhood than the controls. Shyness and enuresis were common troubles among the probands, and they had been more timid, isolated and mobbed. Similar although less striking differences in mental health were reported also in adult age. Depression and anxiety were dominating symptoms. The interviewer assessed the hypospadiacs to show more anxiety and to use more immature defence mechanisms and consequently to have less stress tolerance. The probands were further judged to have less capacity for social relations and their overall capacity to utilize existent psychological resources was small as compared to the controls. The findings indicate that hypospadiacs are more prone to neurotic (but not psychotic) disturbances than other young men and have more disturbed social relations. The need for psychological guidance for the boys and their parents is stressed.
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PMID:Penile malformation and mental health. A controlled psychiatric study of men operated for hypospadias in childhood. 718 May 61

With the development and application of specific diagnostic criteria, depression has been clarified as a major cause of behavioral disturbance in children. 62% of a group of 100 prepubertal children with school problems fulfilled the criteria for childhood depression. There was no significant difference in age, sex, grade level, intelligence quotient, or school skills achievement in the depressed versus nondepressed children. The family history was positive for psychiatric illness in 71% and for depression in 42% of the depressed children. In the depressed children, episodic hyperactivity and secondary enuresis were evident during the depressive episode.
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PMID:Relation of intelligence to childhood depression in children referred to an educational diagnostic center. 736 53

This study was conducted to find out the psychiatric symptomatology in the patients and their families attending a primary health care facility. The most frequent symptoms found were of depression (13.2%), followed by hypochondriacal symptoms (8.2%), anxiety symptoms (6.1%) and psychotic symptoms. A large proportion (21.5%) of children had psychiatric symptoms. The common symptoms include enuresis, hostility, tantrums, problems of conduct and destructiveness. Surprisingly, concern for these symptoms was lacking in both the patient and their family members.
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PMID:Psychiatric symptomatology in a primary health setting in Malaysia. 775 63


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