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)

Most of the drugs commonly used in the treatment and prophylaxis of depression, mania, and psychotic illness have, as one of their prominent side effects, the ability to increase appetite, stimulate carbohydrate craving, and promote weight gain. These side effects are troublesome to patients, and frequently constitute a major reason for premature discontinuation of therapy. This review examines the relative likelihood of the occurrence of appetite stimulation and weight gain with various psychotropic medications. Potential mechanisms of these effects and strategies to minimize or avoid weight gain during pharmacotherapy of psychiatric illness are examined. Evidence suggests that those compounds, which either antagonize or downregulate serotonin receptors, are more likely to stimulate carbohydrate hunger and weight gain. Amitriptyline, chlorpromazine, mesoridazine, thioridazine, and lithium are most likely to produce weight gain. Compounds that have more pronounced serotonergic action, such as fluoxetine and fenfluramine, are more likely to decrease carbohydrate craving and promote weight loss.
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PMID:Psychotropic drug induced weight gain: mechanisms and management. 305 18

Twenty-one smokers underwent 24-h abstinence from cigarettes. Both prior to, and after, the abstinence period cardiovascular and subjective effects of smoking a cigarette were measured. Withdrawal symptoms found during abstinence were: irritability, depression, hunger, difficulty concentrating, restlessness and urges to smoke. In addition, the subjects reported feeling physically less well. Withdrawal discomfort was positively correlated with the strength of the subjective effects (e.g. dizziness, nausea) of smoking the post-abstinence cigarette after taking account of estimated nicotine boost from that cigarette. A similar, though only marginally significant association was found between withdrawal severity and heart rate boost from the post-abstinence cigarette. Our results suggest that the severity of withdrawal may be related to loss of acute tolerance to nicotine. It is not clear whether this is due to more rapid nicotine clearance, constitutional differences in sensitivity to nicotine in the absence of acute tolerance, or other factors. There was no evidence to support the view that higher chronic tolerance to nicotine's heart-rate effects was associated with more severe withdrawal. If anything, the reverse appeared to be the case.
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PMID:Loss of acute nicotine tolerance and severity of cigarette withdrawal. 313 4

The alpha 2-adrenergic agonist clonidine has been reported to increase feeding in several species. This study evaluated the effects of clonidine (500-700 micrograms/day), administered per os, to four treatment-resistant anorexia nervosa patients in a long-term placebo-controlled crossover trial. All patients increased their body weight significantly. Clonidine administration, however, did not influence the rate of weight gain, nor did clonidine affect hunger or satiety sensations. Similarly, 24-hour urinary 3-methoxy-4-hydroxyphenylglycol levels and levels of anxiety and depression were unchanged by clonidine. By contrast, clonidine showed significant hemodynamic effects; clonidine lowered systolic and diastolic blood pressure, reduced pulse rate, and produced sedation. Discontinuation of clonidine was associated with a small but significant weight loss compared to a small weight increase during the initiation of clonidine treatment. The results suggest that clonidine may not be indicated in the treatment of anorexia nervosa.
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PMID:A placebo-controlled crossover study of oral clonidine in acute anorexia nervosa. 329 35

The hunger perceptions and satiety responses to a high-calorie, carbohydrate-rich food among 10 normal-weight females who met the DSM-III criteria for bulimia were compared with 10 normal-weight females who denied a current or past history of eating or weight disorders. As indicated by self-report responses on the Hunger-Satiety Questionnaire, bulimics did not differ from the normals in their perceptions of hunger sensations. Differences, however, were detected in the responses following eating. Most notably, the bulimics reported feelings of irritability, nervousness, tenseness and depression which persisted 30 minutes later. These findings and directions for future research are discussed.
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PMID:Hunger perceptions and satiety responses among normal-weight bulimics and normals to a high-calorie, carbohydrate-rich food. 346 Jan 5

Methylamphetamine given intravenously as a single 15 mg dose led to a pronounced elevation of mood in 7 out of 21 depressed patients compared to a control injection of sterile water administered on another occasion in random order under double-blind conditions. All 7 responders experienced an increase of VAS self-ratings of hunger in contrast to what has been observed in normal subjects who show a decrease in hunger after amphetamine. The implications of these findings are discussed in the light of monoamine theories of depression and appetite control.
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PMID:The effects of methylamphetamine on mood and appetite in depressed patients: a placebo-controlled study. 357 40

Ratings of withdrawal symptoms were obtained from 52 Smokers Clinic clients who abstained throughout a four week group treatment programme involving use of nicotine chewing gum. Mean ratings of irritability, depression, hunger, restlessness, and inability to concentrate were significantly higher in the first week of abstinence than at baseline, although only a minority of smokers experienced severe withdrawal symptoms. Disturbance of mood and concentration returned to baseline within four weeks while increases in hunger persisted. The average amount of time spent with the urge to smoke started to decline early in treatment, but the average strength of urges and overall difficulty not smoking did not decline until the fourth week. At the end of treatment 35% were still experiencing strong urges to smoke and 23% reported finding it difficult keeping themselves from smoking. The findings have practical implications for preparing smokers for cessation with the aid of nicotine gum.
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PMID:Time course of cigarette withdrawal symptoms during four weeks of treatment with nicotine chewing gum. 363 Aug 7

The general public feels that cocaine is not particularly dangerous because it does not produce a well defined physical dependency and abstinence syndrome. However, when addiction is defined as compulsion, loss of control and continued use in spite of adverse consequences, cocaine drug hunger can be seen as an agent of addictive disease. Withdrawal from cocaine dependence usually involves depression, anxiety and lethargy. These usually clear within a week, leaving only the "drug hunger" to contend with. Medication is rarely needed. When cocaine is the primary addiction, after withdrawal the most effective treatment is group therapy with other recovering cocaine abusers. We incorporate the principles of recovery and define positive and constructive alternatives in dealing with cocaine hunger. Recovery programs should be flexible and involve individual and family education on recovery and the nature of addictive disease. Exercise that produces cardiopulmonary stimulation is a helpful means of reducing drug hunger and anxiety during recovery therapy.
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PMID:Diagnostic, treatment and aftercare approaches to cocaine abuse. 610 Jan 90

Many smokers would like to give up cigarettes and reduce their risk of ill health or premature death. One reason why they so often fail is the rapid onset of withdrawal symptoms such as irritability, hunger, depression and acute craving for cigarettes. This paper looks at what underlies the cigarette withdrawal syndrome, and in particular the role of nicotine. The evidence reviewed indicates that partial nicotine replacement helps to alleviate withdrawal symptoms following cigarette abstinence, and switching to a low nicotine cigarette can lead to effects normally associated with cigarette withdrawal. Much of the discomfort associated with cigarette abstinence appears to be a direct result of nicotine deprivation. Relief of withdrawal symptoms by means of a temporary substitute source of nicotine can assist smokers who are highly motivated to give up.
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PMID:Psychology and pharmacology in cigarette withdrawal. 639 35

Twenty-six smokers took part in a study which examined subjective and physiological effects of switching to an ultra-low yielding cigarette (0.1 mg nicotine) for 10 days. Subjects were randomly assigned to one of two groups. One group continued smoking their usual brand while the other group switched to the low yielding cigarette. Subjective ratings and physiological measures were taken at baseline, then after 1, 3 and 10 days in the respective conditions. Plasma nicotine concentrations dropped by some 60% after switching. Although substantial, this drop was considerably less than the drop in nominal yield of the cigarettes (around 90%), indicating marked compensation on the part of these smokers. Switching to the low yielding cigarette was accompanied by a significant increase in hunger and a drop in heart rate. These effects typically occur following cigarette withdrawal. However, other common cigarette withdrawal symptoms, such as irritability, depression, and inability to concentrate, were not detected.
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PMID:Does switching to an ultra-low nicotine cigarette induce nicotine withdrawal effects? 643 79

Increasing numbers of individuals with a diagnosis of cocaine abuse (DSM-III, 305.6) are seeking medical and psychiatric care. The majority of users inhale the drug in powdered form, as cocaine is rapidly absorbed by mucous membranes. The patterns of use resemble those for the use of alcohol and marijuana: recreational, intensified, circumstantial, and compulsive. When cocaine is taken intravenously or by freebasing, individuals are much more vulnerable to developing a compulsive pattern of use that could lead to an organic delusional syndrome. Cocaine causes systemic effects that are similar to those of amphetamine, but they have a much shorter duration of action. Blood pressure, heart rate, feelings of "pleasantness" and "stimulation" are increased, and hunger is decreased. Acute tolerance may develop over hours of continuous use, but it disappears after a short period of abstinence (overnight). In psychomotor testing, performance that is impaired by fatigue is restored to baseline levels. Users like cocaine because they feel more alert, energetic, sociable, and sensual. However, these positive feelings are commonly followed by anxiety, depression, irritability, fatigue, and craving more cocaine. Chronic intoxication is always associated with adverse psychosocial sequelae. Treatment initially must be directed toward the patient's stopping all use of cocaine, employing strategies such as contingency contracts, urinalysis, family intervention, the assignment of financial control to others, or hospitalization. Several psychopharmacologic agents are helpful as an adjunct to a comprehensive treatment plan. Overdoses of cocaine are treated by diazepam and propranolol. Antidepressant medications, both TCAs and MAOIs, often help relieve the symptoms of depression that emerge when chronic use of cocaine is discontinued. Classical and operant conditioning contribute to craving for the drug and opportunities to extinguish these factors are valuable in preventing relapse. Compulsive users often have an Axis II diagnosis of borderline or narcissistic personality disorder, which require long-term psychodynamic psychotherapy.
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PMID:Cocaine abuse and its treatment. 652 10


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