Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Trigeminal (V) tractotomy and cold block of synaptic transmission in V nucleus caudalis were used to show that caudalis modulates the responses to innocuous and noxious stimuli of single V main sensory-oralis neurones recorded in anaesthetized or decerebrate cats. Cold block caused a reversible depression of mechanosensitivity of 91 of 105 V-thalamic relay and non-relay cells tested; V tractotomy also decreased sensitivity. The possibliity that the effects observed with cold block of caudalis were caused by direct spread of cooling to the main sensory-oralis region, and not by depression of a tonic, net facilitatory influence of caudalis on main sensory-oralis cells, was ruled out by several controls. With cold block of caudalis there also occurred a reversible shrinkage in mechanoreceptive field size and reversible reduction in sensitivity of rapidly adapting and slowly adapting mechanoreceptive neurones. Occasionally no change or an increase in sensitivity occurred, the latter suggesting the liklihood of an inhibitory influence from caudalis as well as the facilitatory influence. The effects of interactions of innocuous and noxious V stimuli were likewise subject to ascending influences from caudalis. Cold block also reversibly depressed responses to tooth pulp and V cutaneous noxious stimuli, although pulp-evoked responses were depressed less than mechanical or infraorbital nerve-elicited responses. Our results indicate that caudalis, as well as acting as a relay site to thalamus, also exerts a predominantly facilitatory influence on the relay to the thalamus and local reflex centres of mechanoreceptive and nociceptive information through the V main sensory-oralis region. The findings also might in part explain the analgesia, partial loss of tactile sensibility, and relief from V neuralgia reported after V tractotomy.
 ...
PMID:Inputs to trigeminal brain stem neurones from facial, oral, tooth pulp and pharyngolaryngeal tissues: II. Role of trigeminal nucleus caudalis in modulating responses to innocuous and noxious stimuli. 18 52

Clomipramine is the most potent 5-HT reuptake blockade agent among the antidepressants. A comparison between the effect of clomipramine and a less powerful 5-HT reuptake blockade agent (amitriptyline) could test the hypothesis that brain 5-HT is a mediator of pain sensation. Groups of patients of either sex, with pain indication of trigeminal neuralgia, tension headache or postherpatic neuralgia, received doses of clomipramine or amitriptyline in a single blind clinical experiment. The results after three months of treatment showed that clomipramine: (1) was better than amitriptyline in treating trigeminal neuralgia; (2) tended to be better in the treatment of tension headache; and (3) amitriptyline is better in treating postherpatic neuralgia. Clomipramine was better tolerated. The results support the hypothesis that in certain pain situations, clomipramine exerts a beneficial effect, not only because of its effect on the depression and anxiety level of the patient, but also via its effects on the 5-HT brain system.
 ...
PMID:Clomipramine and amitriptyline in the treatment of severe pain. 48 62

Common cervicobrachial neuralgia is less frequent than sciatica and its aetiological profile is more varied: men and women are equally affected, triggering factors or previous history are less often found and patients with anxiety or depression are relatively numerous. Clinically, signs of C7 lesion are present in half the patients. Acroparesthesias are frequent and may be the initial signs. Nocturnal pain is present in 50% of the cases. Signs of neurological deficit are rare, except for abolition of a reflex. The association of cervicobrachial neuralgia with tendinitis of the upper limb or algodystrophy of the shoulder is too frequent to be fortuitous. Left to itself, the syndrome usually lasts several months and sometimes one year. Recurrences are rare. The most frequent sequela is a painful neck.
 ...
PMID:Clinical semiology of common cervicobrachial neuralgia. Data from 50 hospital cases. 143 11

The antidepressants have been reported to be effective in the treatment of many pain syndromes, for example headache and neuralgia. The pain of the study was to evaluate the effectiveness on small (75 mg per die) dose of imipramine administered additionally to the routine. Conservative treatment of patients with acute low back pain. The analysis of six different indices of improvement revealed, that the outcome of therapy in the group of 50 patients treated with imipramine was significantly better, than in comparable group treated routinely. The effect of imipramine have not been related to the occurrence of depression or to the other factors from anamnesis and physical examination influencing pain.
 ...
PMID:[Value of adjuvant treatment with imipramine for lumbosacral pain syndrome]. 166 4

Carbamazepine, a first-line drug for the treatment of epilepsy and neuralgia, may exert hazardous effects on the cardiac conduction system. Standard ECG and long-term ECG monitoring and invasive electrophysiologic testing were carried out in 10 patients who required this drug for neurologic disorders, but in whom its safe use had been questioned because of symptoms of ECG abnormalities. We observed depression of sinus node function and an atrioventricular conduction delay with a significant prolongation of the PQ interval of 16 msec (9%; 95% confidence interval: 1.9% to 16.5%; p less than 0.05), of which the HV interval was significantly prolonged but not the PA and AH intervals. These effects are in accordance with previously shown class 1A properties. However, the lack of effects on QRS, JT, and QT intervals at normal heart rates is a class 1B characteristic. Thus carbamazepine seems to have composite electropharmacologic actions. A cause effect relationship between carbamazepine treatment and significant arrhythmias was established in five patients. Thus the negative chronotropic and dromotropic effects of carbamazepine may, at least in predisposed patients, induce symptoms confusingly similar to the epileptic seizures it is used to prevent.
 ...
PMID:Electrophysiologic effects and clinical hazards of carbamazepine treatment for neurologic disorders in patients with abnormalities of the cardiac conduction system. 201 74

The mechanism of action of aspirin as an analgesic is an inhibition of biosynthesis of prostaglandins. Thus the site of action has been believed to be peripheral. However, when aspirin is injected intra- thecally, it produces an analgesic effect. Aspirin has a membrane-stabilizing effect and it is used locally for the treatment of post- herpetic neuralgia. Epidural opioids are frequently used for the management of post-operative pain or cancer pain. Pharmacokinetic studies have shown that delayed respiratory depression results from migration of morphine in the cerebrospinal fluid to the brain. Peak concentrations of morphine near the brain stem occur about 3 hours after lumbar epidural injection, whereas lipophilic opioids such as meperidine, peak concentration occur within 30 to 60 minutes. The clearance from cerebrospinal fluid of lipophilic opioids is more rapid than that of morphine. Besides opioids, alpha 2 receptor agonists such as clonidine also have analgesic action when administered into the epidural space. Somatostatin is one of many neuropeptides found in the spinal cord. It has dual action: a mediation of thermal nociception and a general antinociceptive action. When somatostatin is administered intrathecally or epidurally, it produces analgesic effect and its efficacy appears to be equal to that of morphine.
 ...
PMID:[Remarks on some analgesics used in the pain clinic]. 256 60

Controlled release morphine sulfate (MS Contin) is a relatively new oral preparation for the relief of chronic severe (cancer) pain. We describe a patient with severe neuralgia who experienced respiratory depression after ingestion of one single dose of morphine sulfate (20 mg). Administration of nalorphine chloride resulted in instant normalisation of respiratory function. This case illustrates respiratory depression as an adverse effect of MS Contin.
 ...
PMID:[Respiratory depression following controlled-release morphine sulfate tablets]. 271 Feb 34

ADs have achieved popularity in the treatment of chronic pain syndromes associated with organic and psychogenic illness. This is surprising as there is little evidence from controlled studies that they are of value other than in the treatment of depression. There is good evidence for an intimate relationship between the neurotransmitters involved in the regulation of pain and mood and the mode of action of both opiates and antidepressants. There are also similarities in the clinical pharmacology of both groups of drugs, including evidence of a co-analgesic action when ADs are used in conjunction with opiates. Uncontrolled studies suggest that, when ADs have been reported to relieve pain when used alone, this is consequent on relief of depression. Their reported effectiveness in neuralgic pain appears to be dependent on being used in conjunction with a phenothiazine. Controlled studies do not support their use in chronic pain other than for relief of depression. Overall, it may be said that they have a useful opiate-potentiating role in pain due to cancer, are valuable in treatments of neuralgia when given with a phenothiazine, and, in other conditions, may relieve depression-associated pain by their AD action. New AD drugs with specific effects on MA metabolism may reveal if ADs have an analgesic action independent of their AD effect and suggest its biochemical basis. This would have important implications for improving knowledge of pain biochemistry and physiology. Few areas of modern therapeutic endeavour allow prescription of drugs in the absence of objective evidence of benefit. Current practice in chronic pain reflects the problems associated with psychological assessment in chronic physical illness, the complexity of chronic pain syndromes, and the natural desire to explore every avenue to relieve patients' symptoms.
 ...
PMID:Antidepressants in chronic pain. 614 Oct 5

This presentation will briefly describe the operation of this Pain Center and discuss the two chronic pain problems most commonly seen in our geriatric population: osteoarthritis of the spine and herpetic neuralgia. Osteoarthritis of the spine is the most common radiologic finding in middle-aged and older people with low back pain. 32% of our patients have this diagnosis as the basis of their chronic pain. The typical patient is 72 years old and has a past pain history which includes several years of back pain treated by various physicians with anti-inflammatory agents and analgesics to no avail. Past history of surgery and drug abuse is rare; however, depression is common. Therapy at the Pain Center is primarily the use of an exercise program and epidural and/or subarachnoid steroids. At the last visit, approximately 70% of the patients have had significant improvement. Herpetic neuralgia is found in 13% of all patients seen at the Mount Sinai Medical Center Pain Center. Our typical patient is 73 years old and has had PHN for 10 months unrelieved by various topical and oral medications. Although rarely is there a history of drug abuse or surgery, extreme depression is common. If the duration of the neuralgia is less than one year, 85% of patients get significant or complete relief from the use of sympathetic nerve blocks and/or the subcutaneous infiltration of steroids and local anesthetic. Once the PHN has been present for more than one year, only 55% of the patients are improved.
 ...
PMID:Treatment of osteoarthritis of the spine and herpetic neuralgia at the Pain Center, Mount Sinai Medical Center. 626 70

13, mostly male, cases of cluster headache and 15, mostly female, cases of atypical facial neuralgia were submitted to the psychosomatic anamnestic interview of Seguin. A very high proportion of patients in both groups had suffered from early deprivation of physical gratification. Pain itself started initially after a sequence of masked depression followed by dental or facial intervention in most atypical facial neuralgias, and by emotional stress in half of the patients with cluster headaches. Pain afterwards still hid and expressed a current underlying depression in both groups.
 ...
PMID:The onset of facial pain. A psychological study. 744 41


1 2 3 4 Next >>