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)

The most prescribed type of psychotropic medication in maghrebian psychiatry is neuroleptics. It is therefore legitimate to study the epidemiology of the most frequent side-effect of long-term treatment with neuroleptics: Tardive Dyskinesia (TD). At the moment, a collaborative study is under way on epidemiology of TD within the framework of the Maghrebian Association of Biological Psychiatry; several studies have also been conducted on this topic in the University Psychiatric Centre Ibn Rochd, Casablanca, Morocco in 1984, 1986 and 1987. For the maghrebian study, only preliminary results from Tunis will be presented. These studies have been interested in two epidemiological aspects: prevalence of TD in hospitalized and out-patients treated with neuroleptics; prevalence of TD-like movements among never treated schizophrenics. The assessment tool used for all the studies was the Abnormal Involuntary Movement Scale (AIMS). Main results of these studies are: 1) General prevalence of TD and risk factors in neuroleptized patients: In Tunis, Douki and Benamor in their on-going study, found a general prevalence of 20.50% (N = 200 in patients). A multi-factor analysis showed that risk factors are (in decreasing order): female gender, age above 60, associated depression, total duration of neuroleptic treatment above 20 years, a frequently discontinued treatment, shock therapies in antecedents or associated, a diagnosis of non schizophrenic psychosis, haloperidol intake below 25 mg and fluphenazine depot above 100 mg daily. In Casablanca, in 1984, Chorfi found a general prevalence of 10% (N = 50 out-patients). In 1986, Bentounsi found a 14.50% prevalence in Casablanca (N = 400 out-patients) and 63.97% in the oldest psychiatric hospital in Morocco in Berreshid (N = 605 in-patients).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Epidemiology of tardive dyskinesias in the Maghreb]. 290 47

The progress of 178 patients with Parkinson's disease who began treatment with levodopa between November 1969 and December 1972 is reviewed after six years. One hundred and twenty-five patients showed an initial improvement of their individual total disability scores exceeding 25 per cent, but after six years of sustained treatment only 37 patients still obtained similar benefit. By 1978 only five patients had maintained their initial improvement compared to 69 patients after two years therapy; however, 47 patients were still better than before treatment. The overall mortality ratio--the ratio of observed to expected death rate--for all the patients was 1.45:1. In those patients who unable to tolerate levodopa for longer than two years the ratio was 2.38:1; in those who were able to tolerate sustained medication, life expectancy was normal (ratio of 0.91:1 for males and 1.14:1 for females). Involuntary movements were the commonest complication of treatment. Three main types were distinguished. Peak dose dyskinesias, beginning 20 to 90 minutes after an oral dose and most severe midway through the inter-dose period, affected 80 per cent of patients. Early morning and end-of-dose dystonia occurred in 20 per cent of patients and biphasic dyskinesia--two distinct episodes of involuntary movements within each inter-dose period--was the least common pattern affecting 3 per cent of patients. Involuntary movements increased in frequency and severity as treatment continued. End-of-dose deterioration ('wearing-off' effect of individual doses) occurred in 65 per cent of patients: unpredictable oscillations in motor performance (the 'on-off' phenomenon) unrelated to the time and dosage of levodopa, occurred in 10 per cent. Psychiatric side effects included toxic confusional states, visual pseudohallucinations and paranoid psychoses and constituted the most frequent reason for stopping medication. Forty (22 per cent) of the patients had suffered severe depression before the onset of disease and levodopa had no sustained antidepressant effect in this group. After six years of treatment with levodopa, 32 per cent of the patients had unequivocal dementia.
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PMID:The impact of treatment with levodopa on Parkinson's disease. 746 63

Eltanolone, a new intravenous steroid anaesthetic agent was administered intravenously in a dose of 0.6 mg.kg-1 over 45 s to eight healthy male volunteers to evaluate some of its pharmacokinetic and pharmacodynamic effects. Drug concentration-time data were analysed by PCNONLIN, a non-linear regression programme, showing data consistent with a three-compartment model with initial distribution half-life t1/2 lambda 1 between 0.3 and 2 min, intermediate distribution half-life t1/2 lambda 2 between 12 and 29 min and terminal half-life t1/2 lambda z between 72 and 212 min. The total body clearance of eltanolone was rapid and with individual values in the range 1.6-2.3 l.h-1.kg-1. Eltanolone was initially distributed into a relatively large central compartment V1 between 0.09 and 0.98 l.kg-1 and then extensively further distributed (Vss between 1.80 and 5.44 l.kg-1 and V between 4.87 and 11.87 l.kg-1). The excretion of unchanged of eltanolone in urine was very small, the renal clearance was less than 0.5% of the total clearance. Induction of anaesthesia was trouble free with onset and duration of anaesthesia between 1-2 min and 6-13 min, respectively. There was slight respiratory depression, a small transient increase in heart rate, and a maximum reduction in arterial blood pressure of 23%, as compared with the resting level. Pain on injection and venous sequelae were not seen. Involuntary movements were seen in one subject. We conclude that eltanolone has a favourable pharmacokinetic profile with relatively rapid half-lives, large distribution volumes and rapid total body clearance.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Pharmacokinetics and pharmacodynamics of eltanolone (pregnanolone), a new steroid intravenous anaesthetic, in humans. 783 87

Cocaine use is common among individuals with schizophrenia and schizoaffective illness, with a prevalence ranging from 15-60% of patient samples. It is hypothesized that some schizophrenic cocaine abusers may use cocaine as an attempt to improve anhedonic symptoms or combat neuroleptic side-effects. Flupenthixol (FLX) has the distinct advantage of being both a neuroleptic medication and a potential treatment for cocaine abuse. We evaluated the efficacy of FLX in this dually diagnosed population in an open pilot study consisting of a 4-week inpatient phase and a 6-week outpatient phase. Eight individuals were initially cross-tapered off their neuroleptic medication and were given FLX in a dose of 40 mg of the decanoate every 2 weeks. Psychiatric symptomatology was assessed weekly, using the Positive and Negative Symptom Scale (PANSS) and the Beck Depression Inventory (BDI). Medication side-effects were monitored weekly, using the Simpson Neurological Rating Scale and the Abnormal Involuntary Movement Scale (AIMS). Substantial improvement in psychiatric symptomatology was noted when preadmission scores were compared to scores obtained during the last week of study enrollment. On the PANSS, positive symptom scores and negative symptom scores decreased by 31% and 29%, respectively. Similarly, BDI scores decreased by 57%. Comparing preadmission urine results to those for the last 6 weeks of enrollment in the study showed that cocaine-positive urines decreased by 28%, although most of the patients had a reduction of >75%. Missed clinic visits decreased by 26%. Thus, FLX was well-tolerated by schizophrenic cocaine abusers, suggesting that FLX may be useful for the treatment of this dually diagnosed population.
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PMID:Flupenthixol treatment for cocaine abusers with schizophrenia: a pilot study. 974 39

Previous antiparkinson drug withdrawal studies involving white subjects have yielded inconclusive findings, whereas there is a paucity of data concerning Asian patients. A double-blind, placebo-controlled, randomized trial using gradual withdrawal of antiparkinson medication was conducted to evaluate the need for maintenance antiparkinson therapy for clinically stable Chinese patients with chronic schizophrenia. Seventy-five schizophrenic subjects who had received a diagnosis according to DSM-IV who had been ill for at least 5 years and on antipsychotic and antiparkinson medication for a minimum of 2 years entered the study. After baseline assessment, 58 subjects were matched according to age, sex, age at onset, length of illness, dose and length of antipsychotic and antiparkinson medication, and the presence of various extrapyramidal side effects. Randomly assigned dose-reduction and control groups were formed consisting of 29 subjects each. Trihexyphenidyl (THP), the only oral antiparkinson drug used in the study, was reduced by 1 mg every 2 weeks, whereas other psychotropic medication remained unchanged. Monthly assessment was performed using the Brief Psychiatric Rating Scale, Hamilton Rating Scale for Depression, Abnormal Involuntary Movement Scale, Simpson-Angus Scale, Barnes Akathisia Rating Scale, and the Nursing Observation Scale for Inpatient Evaluation-30. Complete withdrawal of THP was possible in 25 (90%) of the 28 subjects who completed the study, whereas considerable dose reduction was achieved in the remaining 3 subjects. There were no significant differences between dose reduction and control groups on any of the rating scales at the completion of the study. Our results suggest that long-term prophylactic administration of antiparkinson medication is unnecessary in the treatment of the majority of Chinese patients with chronic schizophrenia because withdrawal was accomplished without adverse mental or motor effects.
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PMID:Gradual withdrawal of long-term anticholinergic antiparkinson medication in Chinese patients with chronic schizophrenia. 1021 15

We evaluated psychiatric symptoms and neurocognitive functioning among 25 institutionalized and 25 outpatient DSM-IV-diagnosed schizophrenia patients, as well as 25 middle-aged and elderly normal comparison subjects. All subjects were assessed with the Positive and Negative Syndrome Scale, Hamilton Rating Scale for Depression, modified Simpson-Angus Extrapyramidal Symptom Scale, the Abnormal Involuntary Movement Scale, and the Mattis Dementia Rating Scale (DRS). The two patient groups had similar levels of depressive symptoms, but the institutionalized patients had more severe positive and negative symptoms and were on higher doses of neuroleptic medication. The institutionalized patients had significantly more cognitive impairment on the DRS than outpatients and normal comparison subjects, particularly on the subscales of initiation/perseveration, conceptualization, and memory. Results are discussed in terms of the possible neuropathology associated with cognitive impairment in chronic schizophrenia.
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PMID:Cognitive deficits and psychopathology in institutionalized versus community-dwelling elderly schizophrenia patients. 1044 49

The objective of this study was to obtain information from providers of a behavioral health service and from decision makers for organizations interacting with that service (external contacts) on their attitudes regarding outcomes assessment in their clinical practice. The goal of obtaining the information was to use it in development of a formal Outcomes Assessment Program for the service. The design was a semi-structured interview format, with entry into a computer database and qualitative analysis of responses obtained. Participants included all providers (n = 26) and a purposive sample of external contacts (n = 10) of an academic Department of Psychiatry. Results indicated differences among categories of external contacts regarding priorities of types of outcomes (general health, general mental health, disorder specific, or patient satisfaction) to be shared and absence of concordance within the service about these priorities. No guidelines were available about preferred instruments, though the Global Assessment of Functioning, the Beck Depression Inventory, and the Abnormal Involuntary Movements Scale emerged as instruments to be prioritized in the service's program. Physicians and nonphysicians differed in their perceptions as to important barriers and advantages of a clinical outcomes assessment program. In conclusion, the survey raised providers' awareness of outcomes assessment and provided information that was used in developing the service's Outcomes Assessment Program. Components of the Program that were influenced by survey input were priorities of outcomes instruments to be included and their potential audiences, time sequence of Program development, time to be allotted to outcomes assessment in clinical encounters, and content of educational experiences for providers.
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PMID:Incorporating results of a provider attitudes survey in development of an outcomes assessment program. 1045 35

The aim of this study was to evaluate the reliability and validity, as well as the specificity, of the Greek version of the Calgary Depression Scale for Schizophrenia (CDSS). Schizophrenic inpatients consecutively admitted at the Eginition Hospital, University of Athens, were included in the study. Patients were assessed on admission using the CDSS, the Hamilton Depression Rating Scale (HDRS), the Positive and Negative Syndrome Scale (PANSS), the Rating Scale for Extrapyramidal Side Effects (RSESE), the Rating Scale for Drug-Induced Akathisia (RSDIA) and the Abnormal Involuntary Movement Scale (AIMS). The CDSS was found to have a high inter-rater reliability, as well as test-retest reliability or split-half reliability. The internal consistency of the CDSS was good (a=0.87). There were positive correlations between the CDSS and the HDRS, or the depression cluster of the PANSS. The mean score on the CDSS showed no significant correlations with that of the PANSS negative subscale (r=0.123); a negative but not significant correlation with that of the PANSS positive subscale (r=-0.036); a weak correlation with that of the PANSS general psychopathology subscale (r=0.218); and no significant correlations with that of the RSESE (r=0.197), the RSDIA (r=0.160) or the AIMS (r=0.031). Our results give further support to the reliability, the validity, and the specificity of the CDSS.
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PMID:The Greek version of the calgary depression scale for schizophrenia. 1080 41

This study assessed the efficacy of ziprasidone for the treatment of schizoaffective disorder. Data were taken from subsets of patients with schizoaffective disorder, derived from two separate double-blind, placebo-controlled, parallel-group, multicenter studies. A total of 115 hospitalized patients with an acute episode of schizoaffective disorder were randomly assigned to receive either fixed oral doses of ziprasidone 40 mg/day (N = 16), 80 mg/day (N = 18), 120 mg/day (N = 22), 160 mg/day (N = 25), or placebo (N = 34) for 4 to 6 weeks. Mean baseline-to-endpoint changes in Brief Psychiatric Rating Scale (BPRS) total, BPRS Core, Clinical Global Impressions Severity scale (CGI-S), BPRS Depressive, BPRS Manic, and Montgomery-Asberg Depression Rating Scale total scores were compared between the placebo and ziprasidone groups. Neurological (Simpson-Angus, Barnes Akathisia, Abnormal Involuntary Movement Scale [AIMS]) and other side effects were also assessed. Significant dose-related improvements on all primary efficacy variables (BPRS total, BPRS Core, CGI-S) and for BPRS Manic items were observed with ziprasidone treatment in a combined analysis of data from both studies (p < or = 0.01). Ziprasidone 160 mg/day was significantly more effective than placebo in improving mean BPRS total, BPRS Core, BPRS Manic, and CGI-S scores (p < 0.05). At 120 mg/day, ziprasidone was significantly more effective than placebo in improving mean CGI-S scores (p < 0.05). The incidence of individual adverse events was generally low in all treatment groups and was not dose-related. In addition, no significant differences were observed between baseline-to-endpoint mean changes in Simpson-Angus and AIMS scores with placebo or ziprasidone 40 to 160 mg/day. These results suggest that ziprasidone may have efficacy in the treatment of affective as well as psychotic symptoms of schizoaffective disorder, with a low side-effect burden.
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PMID:Ziprasidone in the short-term treatment of patients with schizoaffective disorder: results from two double- blind, placebo-controlled, multicenter studies. 1119 44

We examined the impact of the subthalamic nuclei (STN) deep brain stimulation (DBS) on the health-related quality of life (QoL) of patients with advanced Parkinson's disease (PD). Seventeen consecutive patients with refractory motor fluctuations and dyskinesia were included in the study (mean age, 60.9 +/- 7.7 years [range, 43-74 years]; disease duration, 16.4 +/- 8.5 years [range, 7-38 years]; mean off-medication Hoehn and Yahr stage, 4.23 +/- 0.66 [range, 2.5-5]). Each patient's assessment was carried out using common rating scales, following the Core Assessment Program for Intracerebral Transplantation (CAPIT) protocol. Dyskinesia and emotional state were evaluated through the Abnormal Involuntary Movement Scale (AIMS) and the Hospital Anxiety and Depression Scale (HAD). QoL was assessed by means of the Parkinson's Disease Questionnaire Spanish version (PDQ-39). Significant benefit was obtained in the motor manifestations and complications of disease, as well as in the functional state and mood (P < 0.001). Some QoL dimensions (mobility and activities of daily living) and the PDQ-39 Summary Index (PDQ-39SI) showed a significant improvement (P < 0.001). Benefit was modest (P < 0.05) for three other domains (emotional well-being, stigma, bodily discomfort) and nil for the rest. There was no correlation between the change obtained in the QoL (PDQ-39SI) and in the other variables. As measured by the PDQ-39, STN-DBS significantly improves important aspects of QoL in patients with advanced PD.
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PMID:Bilateral subthalamic nucleus stimulation and quality of life in advanced Parkinson's disease. 1192 Nov 26


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