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)

During the last seven years 65 patients with Gilles de la Tourette's syndrome have been treated. Pimozide was used as the preferred drug because of our experience of treating other hyperkinesias which indicated fewer side-effects than with haloperidol. Of the 65 patients with Gilles de la Tourette's syndrome, 59 were treated with pimozide alone or in combination with tetrabenazine or clonidine. The dose ranges of pimozide were 0.5-9 mg per day. Eighty-one percent experienced a good clinical response without side-effects. The side-effects seen in our patients were sedation, gain in weight, depression, pseudoparkinsonism and akathisia; acute dystonic reactions, blurred vision, slurred speech and xerostomia did not occur. No cases of tardive dyskinesia were seen.
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PMID:Clinical features and long-term treatment with pimozide in 65 patients with Gilles de la Tourette's syndrome. 346 44

Tricyclic antidepressants are among the commonest causes of both non-fatal and fatal drug poisoning in the world. Their toxicity is due to effects on the brain, the heart, the respiratory system and the parasympathetic nervous system. Symptoms usually appear within 4 hours of an overdose and all but the most seriously poisoned patients recover within 24 hours. The most common clinical features are dry mouth, blurred vision, dilated pupils, sinus tachycardia, pyramidal neurological signs, and drowsiness. In severe poisoning, there may be coma, convulsions, respiratory depression, hypotension and a wide range of electrocardiographic (ECG) abnormalities. The most frequent findings on the ECG are prolongation of the PR and QT intervals; the tracing may resemble bundle branch block or supraventricular or ventricular tachycardias. Treatment of poisoning due to the tricyclic antidepressants is essentially supportive, there being insufficient evidence at present to recommend the use of methods to increase elimination of the drug from the body. Gastric aspiration and lavage should be performed if more than 750 mg of drug have been taken. There must be regular monitoring for hypoxia, acidosis and hypokalaemia and these complications should be corrected enthusiastically. Convulsions should be treated with diazepam or chlormethiazole. Muscular paralysis and artificial ventilation should be employed if anticonvulsants are ineffective. Hypotension should be treated firstly by fluid replacement and then with sympathomimetic agents (dopamine or dobutamine). Antiarrhythmic drugs should only be employed if there is evidence of circulatory failure which fails to respond to correction of hypotension. Sodium bicarbonate infusions should be given to cardiotoxic patients who are acidotic and are worth trying even if the patient is not acidotic. Although physostigmine salicylate will reverse most of the features of tricyclic antidepressant poisoning, its effects are short-lived in serious toxicity and it can produce dangerous side effects; physostigmine should therefore be reserved for those patients who have complications of coma or who have resistant cardiotoxicity or convulsions. Drug screening and quantitative determination of tricyclic antidepressant serum concentrations are useful in a minority of patients who have severe, unusual or prolonged symptoms.
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PMID:Poisoning due to tricyclic antidepressant overdosage. Clinical presentation and treatment. 353 21

In this study of ibuprofen overdose, symptoms developed in 19% of patients (24 of 126)--in 7% of children (6 of 88) and in 47% of adults (18 of 38). Central nervous system depression, seizures, gastrointestinal disturbances, bradycardia, hypotension, apnea, abnormal renal functions, hematuria, nystagmus, and blurred vision were observed. No patients became symptomatic more than four hours after ingestion. There was no significant difference (P greater than .05) between symptomatic and asymptomatic adult groups in either total milligrams or milligram-per-kilogram amounts ingested by history. Pediatric patients who became symptomatic had a mean ingestion by history of 440 mg/kg; those who remained asymptomatic had a mean ingestion by history of 114 mg/kg (P less than .001). No patients ingesting less than 99 mg/kg by history developed any symptoms. Two children had seizures or apnea and one died. Ibuprofen occasionally may cause serious toxicity in overdose.
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PMID:Ibuprofen overdose: 126 cases. 377 88

Eight patients representing visual field defects associated with hydrocephalus are reviewed. Seven cases had aqueductal stenosis and one had congenital communicating hydrocephalus. We found five cases of defects in visual field typical of a chiasmal or optic nerve lesion: (1) inferior altitudinal hemianopia with inferior nasal quadrantanopia in the opposite eye; (2) inferior binasal quadrantanopia; (3) unilateral inferior nasal depression; (4) unilateral temporal defect; (5) bilateral central scotoma. In these cases CT demonstrated moderate or marked symmetrical dilatation of the third and lateral ventricles. Four out of five cases showed bulging of the third ventricle anteriorly into the sella turcica on CT or ventriculography. Other three patients had incongruous homonymous hemianopia. Characteristic asymmetrical dilatation of the lateral ventricles was noted in all three cases. The more enlarged lateral ventricles were ipsilateral with the affected visual pathways. The sites of lesion responsible for these field defects seemed to be optic tract in one case and optic radiation in two cases. Ventriculoperitoneal shunt was placed in five out of seven cases. Impaired visual field improved in three patients after shunt insertion. A 28-year-old female who had history of blurred vision fos 14 days showed improvement in visual acuity and field when the enlarged ventricles became slit-like by shunting. In the other two patients defects in visual fields improved in spite of consistent ventriculomegaly. These facts suggested that not only the mechanical forces with distended third ventricle but also increased intracranial pressure played an important role in producing visual field defects in hydrocephalic patients.
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PMID:[Visual field defects in hydrocephalus]. 387 34

A self-administered symptom questionnaire was completed by 477 patients in a hypertension clinic. The complaints of the patients were analysed according to the type of therapy being given and the dose of drug taken. Methyldopa therapy was associated with sleepiness, weakness of the limbs, sleeping longer at night, and rising more frequently at night to pass urine. Diarrhoea, impotence, failure of ejaculation, blurred vision, depression, and the symptoms of postural hypotension were not related to methyldopa therapy. Bethanidine administration was related to postural hypotension, impotence, and failure of ejaculation but not to weakness of the limbs, blurred vision, depression, or diarrhoea. Patients receiving guanethidine complained of postural hypotension, failure of ejaculation, and had their bowels open more frequently. Similarly, patients receiving propranolol had an increased frequency of defaecation but also tended to complain of weakness of the limbs.Considering each drug individually, 5% of patients failed to take the prescribed dose of diuretic whereas
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PMID:Side effects of hypotensive agents evaluated by a self-administered questionnaire. 472 58

Tricyclic antidepressants (for example, amitriptyline) and other types of antidepressants (for example, amoxapine and maprotiline) are competitive antagonists of muscarinic acetylcholine receptors, the predominant class of acetylcholine receptors in the brain. Some evidence suggests that this muscarinic receptor blockade in brain alleviates depression. However, all tricyclic antidepressants appear to be equally effective in treating depression despite having differences in their antimuscarinic potencies while having similar ranges of therapeutic blood levels. It is more likely that the antimuscarinic potency of antidepressants is related mainly to the frequency with which they cause such symptoms as blurred vision, dry mouth, and urinary retention. Information on the antimuscarinic potency and other receptor-blocking potencies of antidepressant agents can be helpful in minimizing or avoiding certain side effects when these drugs are given to patients.
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PMID:Antimuscarinic and other receptor-blocking properties of antidepressants. 613 Jan 92

1 Preliminary results of a double-blind placebo-controlled trial of mianserin and maprotiline carried out in 58 outpatients with primary depressive illness are reported. 2 Patients received six weeks' treatment with 30 to 90 mg mianserin, 75 to 225 mg maprotiline or one to three capsules of placebo, all medication being taken at night. 3 There were statistically significant improvements in each treatment group and a better response to mianserin than to placebo or maprotiline on the Hamilton Rating Scale for Depression, after one week's treatment. 4 Neither mianserin nor maprotiline was superior to placebo after two or four weeks' treatment and relatively few patients completed six weeks' treatment because of a generally unsatisfactory response. 5 Unwanted effects were not particularly troublesome, though mianserin and maprotiline caused more drowsiness and blurred vision than did placebo, while maptrotiline produced more constipation than either of the other two treatments. 6 The importance of placebo-controlled trials of antidepressants is emphasized and the precautions that should be taken when they are carried out in outpatients are described.
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PMID:Placebo-controlled trial of mianserin and maprotiline in primary depressive illness: a preliminary report. 633 11

The pharmacology, pharmacokinetics, clinical trials, side effects, and dosage of amoxapine are reviewed. Amoxapine is a tricyclic dibenzoxazepine antidepressant that is chemically similar to the antipsychotic agent loxapine. In animal tests, amoxapine and its metabolites block reuptake of the neurotransmitter norepinephrine, with little effect on serotonin. It is rapidly and virtually completely absorbed when administered orally; peak serum concentrations occur one to two hours after ingestion. Amoxapine is widely distributed throughout body tissues and is 90% bound to serum proteins. Aromatic hydroxylation in the liver produces two major metabolites, which are excreted in the urine primarily but also in the feces. Amoxapine's elimination half-life is eight hours; one of the metabolites has a long half-life (30 hours). In clinical trials, amoxapine has been compared with amitriptyline and imipramine in several types of depressed patients. In some studies, amoxapine's therapeutic effects were measurable earlier (at one or two weeks after initiation of therapy) than those of the amitriptyline or imipramine, but generally only a portion of the depression-rating scales yielded statistically significant differences. Side effects noted during amoxapine therapy include hypotension (42%), drowsiness (14%), xerostomia (14%), constipation (12%), blurred vision (7%), fatigue (5%), and vertigo (5%). Amoxapine is approved by FDA for use in patients with neurotic or reactive depressive disorders, endogenous or psychotic depression, and depression accompanied by anxiety or agitation. The usual adult dosage is 200-300 mg daily, either in divided doses or a single bedtime dose. Amoxapine is a safe and effective antidepressant with no striking advantages over other available agents.
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PMID:Evaluation of amoxapine. 676 65

The analysis of three controlled studies comparing mianserin and clomipramine shows that none of them has elicited statistically significant differences between drugs, although populations were different: primary depression almost equally divided in endogenous and exogenous cases (de Buck), primary depression mostly neurotic (Pinder), involutional melancholia (Blaha). The only difference found as to efficacy was a more precocious onset of action for mianserin in the group of the endogenous depressions (de Buck). Mianserin causes significantly less side effects, above all as to hypotension, dry mouth, tremor and blurred vision.
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PMID:[Analysis of controlled studies comparing mianserin and clomipramine (author's transl)]. 703 87

Daytime drowsiness and other sleep related symptoms such as attention and concentration difficulties, blurred vision and slurred speech were evaluated using seven point rating scales in 51 drug free depressed patients and an age and sex matched control group. Degrees of depression and anxiety were quantified using the Beck Depression Inventory and State Trait Anxiety Inventory respectively. Daytime drowsiness and sleep related symptoms were seen to be significantly higher in the index group. Both depression and anxiety scores significantly correlated with daytime drowsiness.
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PMID:Daytime sleepiness in depression. 719 12


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