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)

Body temperature is a balance of the hypothalamic set point, neurotransmitter action, generation of body heat, and dissipation of heat. Drugs affect body temperature by different mechanisms. Antipyretics lower body temperature when the body's thermoregulatory set point has been raised by endogenous or exogenous pyrogens. The use of antipyretics may be unnecessary or may interfere with the body's resistance to infection, mask an important sign of illness, or cause adverse drug effects. Drugs may cause increased body temperature in five ways: altered thermoregulatory mechanisms, drug administration-related fever, fever from the pharmacologic action of the drug, idiosyncratic reactions, and hypersensitivity reactions. Certain drugs cause hypothermia by depression of the thermoregulatory set point or prevention of heat conservation. By affecting the balance of thermoregulatory neurotransmitters, drugs may prevent the signs and symptoms of hot flashes.
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PMID:The effects of drugs on thermoregulation. 1546 Oct 41

The successful use of renal replacement therapy has resulted in longer survival and a population of older patients with chronic kidney disease (CKD) that includes patients with other significant preexisting illnesses. In this review, we analyze the short-term and long-term outcomes associated to persisting hypogonadism in CKD patients. The short-term manifestations, commonly observed in normal postmenopausal women, are either a rare complaint of women with CKD or are frequently attributed to the uremic state. These symptoms include hot flashes, sleep disturbances and depression, sexual dysfunction, vaginal dryness and atrophy, urinary incontinence, and skin aging and wrinkling. The long-term outcomes of hypogonadism have potentially devastating effects on bone, cardiovascular system, and cognitive function, which could significantly alter the quality of life and survival of women with stage 5 CKD (CKD-5). Postmenopausal osteoporosis has been recognized as an important entity associated with renal osteodystrophy, and efforts have begun to tackle the reduced bone-mineral density (BMD) and increased fracture rate seen in this population. Similarly, cardiovascular disease represents the major cause of death in the CKD-5 population, with a 10 to 20 times greater mortality than in the general population. The accumulating evidence for a possible link between osteoporosis and atherosclerosis is discussed, as well as new directions in the understanding of postmenopausal osteoporosis in the context of renal bone disease, under the guidance of the Global Bone and Mineral Initiative endorsed by the Kidney Disease: Improving Global Outcomes initiative. Nephrologists must face gynecological issues with their women patients and design interdisciplinary clinical studies that include strategies that utilize well-tested and newer drug regimens in the management of osteoporosis, cardiovascular disease, and other postmenopausal manifestations in CKD-5 patients.
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PMID:Outcomes associated with hypogonadism in women with chronic kidney disease. 1549 73

Sleep disturbances during menopause are often attributed to nocturnal hot flashes and 'sweats' associated with changing hormone patterns. This paper is a comprehensive critical review of the research on the relationship between sleep disturbance and hot flashes in women. Numerous studies have found a relationship between self-reported hot flashes and sleep complaints. However, hot flash studies using objective sleep assessment techniques such as polysomnography, actigraphy, or quantitative analysis of the sleep EEG are surprisingly scarce and have yielded somewhat mixed results. Much of this limited evidence suggests that hot flashes are associated with objectively identified sleep disruption in at least some women. At least some of the negative data may be due to methodological issues such as reliance upon problematic self-reports of nocturnal hot flashes and a lack of concurrent measures of hot flashes and sleep. The recent development of a reliable and non-intrusive method for objectively identifying hot flashes during the night should help address the need for substantial additional research in this area. Several areas of clinical relevance are described, including the effects of discontinuing combined hormone therapy (estrogen plus progesterone) or estrogen-only therapy, the possibility of hot flashes continuing for many years after menopause, and the link between hot flashes and depression.
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PMID:Hot flashes and sleep in women. 1555 80

Hormonal manipulation in the form of androgen-deprivation therapy for prostate cancer was introduced by Huggins and Hodges in 1941 and resulted in a Nobel Prize in 1966. Hormonal therapy initially had been used in metastatic prostate cancer, but the indications have been expanded including failed local therapy, locally advanced prostate cancer, and neoadjuvant or adjuvant therapy in high-risk localized prostate cancer. In view of the magnitude of the problem of prostate cancer and relatively frequent use of hormonal manipulation, it is important for clinicians to be aware of common side effects, prevention, and treatment to improve quality of life and reduce morbidity and mortality in patients with prostate cancer. This review focuses on the common side effects of hormonal treatment such as osteoporosis, anemia, hot flashes, erectile dysfunction, muscle wasting, gynecomastia, decline in cognitive function, depression, increase in body fat and metabolic changes, and their prevention and treatment.
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PMID:Preventing and treating the complications of hormone therapy. 1586 26

More than 1.7 million American women are expected to reach menopause each year. Recent Canadian statistics show that a 50-year-old woman can now expect to live until her mid-80s, which implies living at least one-third of her life after menopause. The menopausal transition is typically marked by intense hormonal fluctuations, accompanied by vasomotor symptoms (eg, hot flashes, night sweats), sleeps disturbance, and changes in sexual function, as well as increased risk for osteoporosis, cardiovascular disease, and cognitive decline. More importantly, recent studies have demonstrated a significant association between menopausal transition and a higher risk for developing depression. In the post-Women's Health Initiative Study era, physicians and patients are questioning the safety and efficacy of long-term hormone therapy use. This article reviews the current literature on the benefits and risks of using hormone therapy for the treatment of menopause-related mood disturbances and alternate strategies currently available for the management of menopause-related problems, including antidepressants, complementary and alternative medicine, and selective estrogen receptor modulators.
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PMID:Treatment of menopause-related mood disturbances. 1590 3

In recent studies, patients have reported an increased use of complementary and alternative medicine (CAM). Acupuncture is a popular complementary therapy for patients with cancer. This article will provide current cancer treatment providers with information on acupuncture as well as the research conducted on cancer symptoms and side effects of cancer treatments. Antiemetic studies are the most prevalent and contain the most promising results. Several studies have found that acupuncture significantly reduces the number of emesis (vomiting) episodes for patients receiving chemotherapy. While studies on pain control vary due to the heterogeneity of pain, there are few studies investigating pain caused from cancer and the removal of cancerous tumors. These studies, while promising, provide basic results that need further investigation for more definitive results. Although relatively few studies have been done on anxiety and depression, several researchers have found acupuncture to be just as effective as or more effective than antidepressants for patients without cancer. Studies on breathlessness, while small, have shown acupuncture to have a significant positive effect on chronic obstructive pulmonary disease, breathlessness associated with end-stage cancer, and asthma. Researchers studying xerostomic individuals who have received salivary gland irradiation found significant positive results in salivary flow rates compared to baseline. Patients with hot flashes due to hormonal imbalance may benefit from the use of acupuncture. A recent pilot study showed improvement of chronic postchemotherapy fatigue following acupuncture treatments. Many individuals with cancer have turned to acupuncture because their symptoms persisted with conventional treatments or as an alternative or complement to their ongoing treatments. Despite the immense popularity in the community, few large randomized trials have been conducted to determine the effects acupuncture has on cancer symptoms and side effects of treatments. A majority of the current studies have shown beneficial effects that warrant further investigation with large trial sizes.
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PMID:Acupuncture: role in comprehensive cancer care--a primer for the oncologist and review of the literature. 1591 26

Perimenopause is often marked by vasomotor symptoms and dysphoria. Antidepressant studies have demonstrated decreased frequency and severity of hot flashes in breast cancer survivors and menopausal women. We hypothesized that venlafaxine would relieve both depressive and vasomotor symptoms in depressed perimenopausal women. Sixteen women fulfilling clinical criteria for climacteric phase and Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria for a depressive episode were enrolled in an open-label 8-week trial of extended-release venlafaxine. Depressive and climacteric symptoms were monitored using the Hamilton Rating Scales for Depression (Ham-D) and Anxiety (Ham-A), Clinical Global Impression (CGI) scale, and Greene Climacteric Scale (GCS). Serum follicular stimulating hormone (FSH) and estradiol concentrations were monitored. Significant decreases in Ham-D and Ham-A scores and the GCS psychiatric subscale were seen after 2 weeks of treatment. In an intention-to-treat analysis, 81% of the subjects demonstrated a therapeutic antidepressant response (>50% decline in Ham-D score) and 75% achieved clinical remission (Ham-D score < or =7) after 8 weeks of venlafaxine therapy (75-225 mg/day). Total GCS scores declined 60%, and GCS vasomotor subscores decreased among those with vasomotor symptoms at baseline. These data suggest that venlafaxine treatment improves overall well-being, reduces depressive symptoms, and may diminish baseline vasomotor symptoms in depressed perimenopausal women. Further studies are warranted to investigate the utility of venlafaxine in perimenopausal depression.
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PMID:Venlafaxine in the treatment of depressive and vasomotor symptoms in women with perimenopausal depression. 1609 63

A variety of symptoms are reported frequently as being part of a menopausal syndrome. These include hot flashes, night sweats, menstrual irregularities, vaginal dryness, depression, nervous tension, palpitations, headaches, insomnia, lack of energy, difficulty concentrating, and dizzy spells. The question of whether and how symptoms occur together is important for women who want to know which symptoms can be attributed to menopause and which to aging generally or to other physical or psychosocial factors. To address this question, the present article examines the following avenues of research: (1) the clustering or grouping of symptoms; (2) the temporal association of different symptoms with stages of the menopausal transition; (3) the consistency of symptom reporting across cultures, race, and ethnicity; and (4) the consistency of risk factors for symptoms. Results of the factor analysis studies do not support a single syndrome consisting of menopausal and psychological or somatic symptoms. The prevalence of symptom reporting across the transition also argues against a menopausal syndrome because vasomotor symptoms follow a unique pattern that differs from that of other symptoms. Cross-cultural differences suggest that symptom reporting is not universal. Finally, although there is some overlap in risk factors for symptoms, menopausal status is more consistently related to vasomotor symptoms than to psychological or physical ones. Results of these investigations all argue against a universal menopausal syndrome. Future research should focus on how symptoms are interrelated, what factors are uniquely related to vasomotor symptoms, and identifying whether there is a subgroup of women who are more likely to report symptoms.
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PMID:A universal menopausal syndrome? 1641 25

Two case reports of women treated with an individual cognitive behavioral treatment (CBT) for menopausal hot flashes are presented. Both women reported substantial improvements in the number of hot flashes experienced as well as in their quality of life as measured by the Menopause Quality of Life Scale (MENQOL), the Hamilton Rating Scale for Depression (HAM-D), and the Hamilton Rating Scale for Anxiety (HAM-A). Improvements in hot flashes and quality of life were maintained 6 months after treatment ended. It is hypothesized that CBT reduces hot flashes by reducing central sympathetic activation, perceptions of stress, and self-critical thoughts. The long-term efficacy of CBT for hot flashes should be examined in large controlled clinical trials.
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PMID:Cognitive behavior therapy for menopausal hot flashes: two case reports. 1643 70

We observed the relief of hot flashes in breast cancer survivors taking tamoxifen and treated with sertraline for depression. Our objective was to assess the effect of sertraline on the frequency and severity of hot flashes, mood status, and health-related quality of life. We used a randomized, double-blind, placebo-controlled, crossover study using 6 weeks of sertraline (50 mg each morning) versus placebo. Study participants were 62 breast cancer survivors from an oncology clinic in a tertiary care center on adjuvant tamoxifen reporting bothersome hot flashes. Patients were asked to keep a daily hot flash diary to record hot flash frequency and severity, from which hot flash scores (frequency x severity) were calculated. The Center for Epidemiologic Studies depression scale and Functional Assessment of Cancer Therapy--Breast (FACT-B) (at baseline, 6 weeks, and 12 weeks) were used to assess mood and quality of life. Sixty-two women were accrued. Forty-seven women (median age 53.9 years, range 36.6-77.1 years; 89% postmenopausal; 85.5% Caucasian) completed the first 6 weeks and 39 completed 12 weeks. The baseline daily hot flash frequency and score were 5.8 (standard deviation 4.1) and 11.5 (14.0), respectively. At the end of the first 6 weeks, hot flash frequency decreased by 50% in 36% of those taking sertraline compared to 27% taking placebo. In the crossover analysis, sertraline was significantly more effective than placebo: women crossing from placebo to sertraline had a decrease (-0.9 and -1.7) in hot flash frequency and score, whereas those crossing from sertraline to placebo had an increase (1.5 and 3.4) in hot flash frequency and score (p = 0.03 and 0.03). Forty-eight percent preferred the sertraline period, 11% preferred the placebo period, and 41% had no preference (p = 0.006). Measures of depression and quality of life were within normal range and did not change significantly within treatment groups. Sertraline decreases hot flashes in breast cancer survivors taking tamoxifen and women prefer sertraline to placebo. Further study of sertraline for the management of hot flashes is warranted.
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PMID:Randomized, double-blind, placebo-controlled, crossover study of sertraline (Zoloft) for the treatment of hot flashes in women with early stage breast cancer taking tamoxifen. 1650 35


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