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)

Approximately 90% of women experience some symptoms of the premenstrual syndrome (PMS); in up to 40% of cases the symptoms are moderate to severe. The signs and symptoms of PMS usually wax and wane according to a four-phase temporal pattern. Within this overall schema there are a number of PMS subtypes. PMS typically manifests before the age of 30 and rarely resolves spontaneously. While genetic factors may play a role in the development of PMS, other epidemiologic factors do not seem to be involved. Various pathophysiologic mechanisms have been proposed as causing PMS. They are an estrogen/progesterone imbalance, prolactin abnormalities, fluid retention, abnormal production of certain prostaglandins, hypoglycemia, pyridoxine deficiency and shifting levels of endorphins. However, the role of these factors in the etiology of PMS has not been established definitively; thus, treatment remains largely empiric. The author's experience with the use of Danocrine (danazol) on 21 patients with PMS suggests that this synthetic steroid, when used in conjunction with nonpharmacologic treatment options, relieves the symptoms of PMS in up to 85% of patients. Women whose PMS is characterized primarily by mastalgia appear to respond most favorably to treatment; danazol is not recommended for women with primary depression or anxiety symptomatology.
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PMID:Role of danazol in relieving the premenstrual syndrome. 240 19

Medroxyprogesterone acetate injections (Depo-Provera) were given to 625 women at 3 monthly intervals involving 693 episodes. Ages at entry to the study ranged from 15-51 years with the majority in their 20s and a mean age of 30. Length of exposure ranged from 3-168 cycles. 4 women have received more than 160 continuous cycles of DMPA. Of the medication-induced reasons for discontinuing DMPA, bleeding was the most common with an incidence of 10.5% followed by depression (1.4%), weight gain (1.4%), and loss of libido (1.6%). No patient ceased treatment because of headaches, recurrent vaginal infections, mastalgia, nausea, chloasma, hypertension, or other vascular illnesses. The 59 women who move away or were lost to follow-up accounted for 405 cycles of treatment. The solitary unplanned pregnancy occurred in a 28-year-old obese woman who had previously had other method failures, once with an IUD and once with oral contraceptives (OCs). No association was found with carcinoma of the cervix. Of 80 women ceasing treatment to become pregnant, only 1 women has required the assistance of chlomiphene and conceived 2 years after ceasing DMPA. Amenorrhea was the side effect most appreciated by the women using DMPA. Due to the problem of irregular bleeding, it is wise to warn prospective patients about the lack of bleeding control that they have 1 chance in 10 of having relative menorrhagia. Women using OC subject to frequent vaginal moniliasis had a marked reduction in episodes after switching to DMPA. Chloasma, 1 of the minor stigmas of OC, was not induced in any of the patients. DMPA is a safe and efficient reversible method of contraception for women who have various gynecological conditions or problems associated with using OCs.
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PMID:Medroxyprogesterone acetate as an injectable contraceptive. 296 70

A group of 78 women with sudden flushes and associated disorders (pruritus vulvae, headache, anxiety, instability, depression, libido disturbances) related to the menopause were treated with one or two capsules of veralipride daily for 20 days. Excellent or good results were obtained in 54 of the 69 patients (78 p. cent) with sudden flushes, and 29 of the 57 cases (51 p. cent) with associated disorders. The difference in scores before and after treatment is very highly significant (p < 0.001). Clinical tolerance was good as only 2 cases of minimal galactorrhea. 2 cases of mastodynia, 3 cases with mild drowsiness, 2 patients with nervous tension or insomnia, 3 with digestive disorders, 1 with vertigo, and 1 with mild visual disturbances were observed. No modifications in the biological parameters studied were noted. Blood prolactin levels increased during treatment but returned to normal levels 4 days after discontinuation of therapy. No significant modifications in FSH, LH, E2, or E3 plasma levels were noted at the end of the study. Veralipride appears, therefore, to be the prototype for non-hormonal therapy of menopausal disorders.
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PMID:[A new therapeutic approach to menopausal sudden flushes and psychofunctional disorders (author's transl)]. 625 60

This is a survey of 14 placebo-controlled studies regarding the treatment of premenstrual symptoms with bromocriptine. There is no substantial support that bromocriptine is an effective drug in the premenstrual syndrome as an entity. Symptoms such as irritability, depression, and anxiety were not significantly improved during treatment with bromocriptine compared to placebo treatment. Bromocriptine appears to be the treatment of choice in premenstrual mastodynia if the dosage of bromocriptine is at least 5 mg daily. Bromocriptine may therefore have a place in selected cases of the premenstrual syndrome with associated mastodynia.
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PMID:Bromocriptine and premenstrual symptoms: a survey of double blind trials. 635 78

The premenstrual symptom complex many women experience in a moderate to severe form can be divided into four subgroups. Because there is more than one syndrome and nervous tension is one of the most common symptoms, the term premenstrual tension syndromes (PMTS) is used. The most common subgroup, PMT-A, consists of premenstrual anxiety, irritability and nervous tension, sometimes expressed in behavior patterns detrimental to self, family and society. Elevated blood estrogen and low progesterone have been observed in this subgroup. Administration of vitamin B6 at doses of 200-800 mg/day reduces blood estrogen, increases progesterone and results in improved symptoms under double-blind conditions. Women in this subgroup consume an excessive amount of dairy products and refined sugar, and progesterone may be of value in them. The second-most-common subgroup, PMT-H, is associated with symptoms of water and salt retention, abdominal bloating, mastalgia and weight gain. The severe form of PMT-H is associated with elevated serum aldosterone. Vitamin B6 at high dosage suppresses aldosterone and results in diuresis and clinical improvement. Vitamin E helps the breast symptoms. Methylxanthines and nicotine should be curtailed and sodium limited to 3 gm/day. PMT-C is characterized by premenstrual craving for sweets, increased appetite and indulgence in eating refined sugar followed by palpitation, fatigue, fainting spells, headache and sometimes the shakes. PMT-C patients have increased carbohydrate tolerance and low red-cell magnesium. Adequate magnesium replacement results in improved glucose tolerance tests and decreased PMT-C symptoms. Deficiency of the prostaglandin PGE1 may also be involved in PMT-C. PMT-D is the least common but most dangerous because suicide is most frequent in this subgroup. The symptoms are depression, withdrawal, insomnia, forgetfulness and confusion. In ten PMT-D patients the mean blood estrogen was lower and the mean blood progesterone higher than normal during the midluteal phase. Elevated adrenal androgens are observed in some hirsute PMT-D patients. Two PMT-D patients with normal blood progesterone and estrogens had high lead levels in hair tissue and chronic lead intoxication. This subgroups needs careful medical attention when the symptoms are severe. Therapy should be individualized according to the results of the evaluation.
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PMID:Nutritional factors in the etiology of the premenstrual tension syndromes. 668 67

The symptomatology of the premenstrual syndrome is frequently seen in general and gynecological practice. The aim of this study was to examine the therapeutical effect of dydrogesterone (Duphaston) on the typical premenstrual complaints as depression, headache, edema, mastodynia, dysmenorrhea and bleeding irregularities. Oral administration of 20 mg dydrogesterone b.i.d. during the second half of the menstrual cycle could well relieve the complaints mentioned above. Best results of treatment were obtained in cases of dysmenorrhea, bleeding irregularities, depression and edema. In our patients mastodynia was not influenced by dydrogesterone-therapy. As shown by basal body temperature and progesterone in plasma the menstrual cycles remained ovulatory under therapy. The treatment with dydrogesterone was tolerated well in general, blood pressure and body weight were not altered significantly. The majority of patients wished to continue the treatment beyond the period of this study.
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PMID:[Treatment of the premenstrual syndrome with a retroprogesterone (Duphaston)]. 718 74

The objective of the study was to assess the clinical effectiveness of the monophasic oral contraceptive Marvelon by examining its safety and its effectiveness in controlling the menstrual cycle as well as the frequency and types of side effects. 24 healthy women with an average age of 24.5 years (range of 18-33 years) were the subjects. 23 had previous reproductive events: 18 births, 5 spontaneous abortions, and 16 induced abortions. 17 women had used contraceptives sporadically: 3 postcoital pills, 8 triphasic pills, and 6 monophasic pills. During the year prior to initiating Marvelon use 2 women had experienced oligomenorrhea, 5 had had hypermenorrhea, 6 had had dysmenorrhea, and 3 had had irregular uterine bleeding. The observation period of contraceptive use lasted 4-6 months, during which a total of 121 cycles were evaluated without one single case of pregnancy. This meant a 100% contraceptive safety or a Pearl index of 0. 20 of the patients had stable cycles. 4 women with 13 of the 121 cycles (10.5%) had menstrual disorders. There were 5 cases of breakthrough bleeding and 8 cases of spotting. Weak dysmenorrhea occurred only in 2 patients. Other side effects included: nausea (2), headache (2), nervousness (2), mastodynia (3), vertigo (1), depression (1), and increase of body weight (2). As the duration of taking Marvelon increased the frequency of menstrual disorders declined. Not a single case of post-pill amenorrhea occurred. At the present time over 5 million women use Marvelon in the world. Epidemiological studies involving 14,903 women with a total of 98,225 menstrual cycles have revealed only 4 pregnancies or a Pearl index of 0.06. In the present study regular pseudomenstrual bleeding was confirmed in 89.5% of investigated cycles, which compares to 96.1% indicated in the literature. Marvelon proved to be a modern, safe contraceptive with stable control of the menstrual cycle, and which exhibited only minor side effects.
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PMID:[A clinical trial with the monophasic contraceptive Marvelon]. 779 30

A multicentric noninterventional trial (open study without control) to investigate the efficacy and tolerance of a drug in a large number of patients under routine medical conditions was performed for a new solid preparation from an extract of the fruit of Vitex agnus castus (VAC, Vitex, chaste tree, Chasteberry) in 1634 patients suffering from premenstrual syndrome (PMS). A specific questionnaire was developed for determining the effect of Vitex on psychic and somatic complaints, on the four characteristic PMS symptom complexes depression, anxiety, craving, and hyperhydration (DACH), and on single groups of symptoms. After a treatment period of three menstrual cycles 93% of patients reported a decrease in the number of symptoms or even cessation of PMS complaints. To a certain extent, this effect was observed within all symptom complexes and correlated with the global assessment of therapeutic efficacy. Whereas 85% of physicians rated it as good or very good, 81% of patients assessed their status after treatment as very much or much better. Analysis of frequency and severity of mastodynia as the predominant symptom revealed that complaints still present after 3 months of therapy were mostly less severe. Ninety-four percent of patients assessed the tolerance of Vitex treatment as good or very good. Adverse drug reactions were suspected by physicians in 1.2% of patients, but there were no serious adverse drug reactions. Hence, the risk/benefit ratio of the new Vitex preparation can be rated as very good, with significant efficacy for all aspects of the multifaceted and inhomogeneous clinical picture of PMS, with a safety profile comparable to other Vitex preparations.
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PMID:Treatment of premenstrual syndrome with a phytopharmaceutical formulation containing Vitex agnus castus. 1078 28

3 groups of women aged 19-25 with normal weight and in good physical health were studied. In the first group, 40 subjects received a monophasic oral contraceptive (OC) containing .15 mg of levonorgestrel (LNG) and .03 mg of ethinyl estradiol (EE). In the second group, 32 women received a triphasic OC containing LNG and EE (.05 mg of LNG + .03 mg of EE; .075 mg of LNG + .04 mg of EE; .125 mg of LNG + .03 mg of EE). In the third group, 34 women received a monophasic OC containing .15 mg of desogestrel (DSG) and .03 mg of ethinyl estradiol (EE). The observation lasted 6 month, involving 646 menstrual cycles. 3 months and 6 months later, checkups were conducted to find out about characteristics of the cycles, spotting or BTB (hemorrhagic rupture), weight change, and other minor disorders. After 3 months, spotting occurred in 4.1% of the monophasic LNG group, in 5.8% of the monophasic DSG group, and in 1% of the triphasic group (significantly higher in the DSG group). Heavy bleeding decreased from 25% in the LNG group, 25% in the triphasic group, and 17.6% in the DSG group to 0 after 6 months. Likewise, dysmenorrhea disappeared in all 3 groups. Weight change occurred in 50% of the LNG group, in 57% of the triphasic group, and in 76% of the DSG group. Premenstrual disorders, such as mastodynia, dropped from 40 to 25% in the LNG group, from 75 to 50% in the triphasic group, and from 54.5 to 36.3% in the DSG group after 6 months. Depression decreased from 20 to 8.3% in the LNG group and from 18.1 to 4.5% in the DSG group. Acne fell from 25% to 0 in the triphasic group and from 31.8 to 9 in the DSG group. These OCs were well tolerated without major differences between their minor side effects.
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PMID:[Oral contraceptives and their minor side effects: comparison of three low-dose estroprogestinic combinations]. 1228 7

35 predominantly multiparous, sexually active women aged 25-44 years were fitted with levonorgestrel 20 T (Schering) IUDS in the post- menstrual phase, or in rare instances, right after abortion. the devices contained 60 mg of levonorgestrel releasing 20 mcg/day with the life span of 5 years. The patients were followed up every 3-6 months to detect side effects and complications. The first year contained a total of 339 months of observation, while the figure rose to 461 months in the second year. Spotting lasting 15-20 days followed insertion, but in later months only 7% of patients complained of bleeding or menstrual spotting. 7-8% of cases tended to have oligomenorrhea in the first year; 1/3 to 1/2 of them had hypomenorrhea during the first and second year. True amenorrhea started in 20-30% of women, persisting through both years. Longer duration of flow occurred in 32.4-4.57.1% of cases during these 2 years. Hormonal effects (headache, acne, hirsutism, depression, mastalgia, and inflamed varicose veins) ranged from 18.2- 33.3%. Levonorgestrel 20 T demonstrated more superior contraceptive efficacy than Progestasert; however, serious menstrual cycle disorders associated with it also increased. All progestin-releasing devices (the minipill, Norplant, Progestasert) induced menstrual changes, thus their use is preferable for therapeutic indications such as hypermenorrhea and uterine fibroid.
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PMID:[Two-year clinical performance of the Levonorgestrel 20 T IUD]. 1231 72


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