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 past decade, the development of various gonadotrophin-releasing hormone (Gn-RH) agonists, which induce reversible hypo-oestrogenism has opened a new area in the medical management of endometriosis. In an open, multicentre phase III study, the efficacy, tolerance and safety of the Gn-RH agonist leuprorelin acetate were tested. The preliminary results of 104 women treated in seven German centres are presented. Pelvic endometriosis was diagnosed by laparoscopy and classified according to the American Fertility Society scoring system: 33% of patients had minimal, 22% mild, 28% moderate and 8% severe endometriosis and in 9% no pathological results were obtained. The patients' mean age was 30 +/- 6 years and 66 had infertility problems. Treatment was started within the first 3 days of the menstrual cycle and consisted of a subcutaneous injection of leuprorelin acetate 3.75 mg, repeated once monthly over 24 weeks. A follow-up period of 12 months after the last injection has been completed in 70 patients, including a second laparoscopy. At all visits, symptoms were evaluated, physical examinations performed, and blood samples collected for haematological screening, serum chemistry determinations and measurement of the gonadotrophins oestradiol and progesterone and leuprorelin acetate. The median score at laparoscopy fell from 12 before operation to 8 after operation and 2 after treatment with leuprorelin acetate. Of the total number of patients, 89% had improvements in their endometriosis, 8% a deterioration and 3% no change. Patients reported improvement in the following: dysmenorrhoea 93%, dyspareunia 62% and pelvic pain 70%. However, all women complained of at least one of the following symptoms: hot flushes 86%, sleep disturbance 62%, sweating 61%, headache 41%, nausea 32% and depression 20%. Fifty-five percent of patients reported additional side effects such as vaginal dryness, fatigue and lower abdominal pain. After the third injection, amenorrhoea persisted in 94% of the women. Four weeks after the first leuprorelin acetate injection median concentrations of oestradiol fell from 45 pg/ml to 11 pg/ml, follicle-stimulating hormone from 7 U/L to 3 U/L and luteinising hormone from 5 U/L to 1 U/L and remained almost unchanged over the observation period. During the 6 months' treatment, laboratory parameters showed no significant deviations from normal; only total cholesterol, high-density lipoprotein cholesterol and alkaline phosphatase increased. Treatment results were judged as good and satisfactory in 82% and 11% of cases, respectively. On the basis of this study, it can be concluded that leuprorelin acetate treatment is safe, well tolerated and effective in the medical management of endometriosis and endometriosis-related complaints.
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PMID:Treatment of endometriosis with leuprorelin acetate depot: a German multicentre study. 153 21

A double-blind comparison of moclobemide and toloxatone was performed in adult out-patients diagnosed as suffering from a major depressive disorder. Parallel groups of patients received moclobemide, 450 mg/day (n = 135) or toloxatone, 1000 mg/day (n = 133) for 28 days. Both groups showed a significant clinical improvement while on therapy; the response was most marked and rapid in those receiving moclobemide treatment. Improvement was greatest in those patients with the most severe depression at the time of trial onset. A significantly higher number of patients returned to normal sleep patterns following moclobemide treatment than following toloxatone. Overall, tolerance was rated as good or very good in more than 80% of patients. The most frequent complaints in the moclobemide-treated group were hot flushes, dry mouth, constipation and headache, while an increase in anxiety was associated with toloxatone usage. Moclobemide was found to be as effective as toloxatone in the treatment of major depressive episodes, but with the advantages of improved sleep patterns and reduced anxiety.
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PMID:A double-blind comparison of moclobemide and toloxatone in out-patients presenting a major depressive disorder. 154 24

As a continuation of a cross-sectional study in 1981 involving a representative sample of 1886 women between 45 and 55 years of age, 200 pre-menopausal subjects were selected randomly to take part in a follow-up study. Eighty-seven single measures covering 26 areas of health complaints which have been associated with the menopause in medical textbooks were investigated. A tentative method for relating health complaints at several time points to menopausal status is proposed. A significant number of women reported an increase in vasomotor complaints, vaginal dryness, heart palpitations and social dysfunction following the menopause, although many reported no change or even a reduction in these complaints. On the other hand, a decrease in headache and breast tenderness was noted. No significant differences were observed between the numbers of women reporting an increase or a decrease respectively on any of the other 69 measures (20 complaints), which included anxiety, depression and irritability. Further analyses indicated that the increase in social dysfunction was caused by hot flushes and sweating. This paper raises a number of issues regarding the methodology of longitudinal studies.
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PMID:Influences of natural menopause on health complaints: a prospective study of healthy Norwegian women. 156 23

The potential antidepressant effects of estrogen replacement therapy were examined cross-sectionally in a population of 1190 women 50 years and older living in Rancho Bernardo, California. Of the total, 294 (24.7%) were currently using estrogen. Among women aged 50-59 years, those currently using noncontraceptive estrogen had a significantly higher rate of Beck Depression Inventory scores of 13 or higher than all untreated women of the same age and higher mean depressive symptom scores than women who had never used estrogen. However, after age 60, mean depressive symptom scores and rates of categorical depression increased significantly in the untreated women but not in the treated women. A similar pattern was found when depressive symptom measures of treated and untreated women were stratified by the number of years since last menstrual period. Greater depressive symptoms in currently treated versus untreated women aged 50-59 years may reflect treatment selection bias, as a higher proportion of symptomatic depressed climacteric women seek treatment. The decreased risk of depressive symptoms after age 60 may reflect a long-term benefit of estrogen replacement or the selective discontinuation of estrogen by depressed women. In this cohort, reports of hot flushes, moods, and insomnia as the reason for estrogen use fell in parallel with a decline in depressive symptoms with increasing age, suggesting that hormone replacement therapy provided relief of physical symptoms, ie, possible causes of psychological distress. Clinical trials are needed to confirm these observations and postulated explanations.
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PMID:Estrogen use and depressive symptoms in postmenopausal women. 160 93

In an open, multicentre study, transdermal administration of oestradiol (E2) by means of skin patches was investigated in a Finnish patient population suffering from typical post-menopausal symptoms. A total of 249 women applied a patch twice weekly for 6 months. Whereas 85% of the subjects were experiencing hot flushes and 83.5% sweating before therapy, only 5.7% and 11.8%, respectively, reported these symptoms at the end of the trial. Furthermore, 97.6%, 95.7% and 94.8% of the subjects reported that depression, headache and sleep disturbances, respectively, had disappeared during therapy. Skin irritation occurred in 18.2% of these predominantly fair-skinned women. Frequent sauna bathing did not interfere with the patch therapy. General acceptance of the treatment was excellent, 84.8% of the patients completing the treatment, of whom 78% were willing to continue the treatment after the trial. These results show that transdermal administration of E2 is effective in relieving post-menopausal symptoms. Local tolerability was good and the majority of the patients considered the transdermal treatment to be superior to their previous oral replacement therapy.
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PMID:Transdermal oestrogen replacement therapy in a Finnish population. 177 81

Nine postmenopausal women with symptoms and signs of androgen excess due to long-term use of an injectable androgen-estrogen combination were studied retrospectively. Cosmetically disturbing hirsutism was the major complaint in eight subjects. Other symptoms included hot flushes, decreased libido, mood changes, depression, and postmenopausal bleeding in the one patient with an intact uterus. Seven women had clitorimegaly; the clitoral index ranged from 45-120 mm2 (normal up to 35). Serum total testosterone levels were elevated in eight women, ranging from 5.7-14.9 nmol/L (normal up to 2.43). The androgen-estrogen combination was discontinued and oral or transdermal estrogen replacement was instituted. In five women followed serially for 16-24 months, elevated testosterone levels required 12-20 months to return to the normal premenopausal range.
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PMID:Elevated serum testosterone, hirsutism, and virilism associated with combined androgen-estrogen hormone replacement therapy. 187 87

Twelve patients with symptomatic uterine fibroid were treated with Goserelin acetate, a depot Gn-RH analogue administered s.c. in a dosage of 3.6 mg every 28 days for a 6 month period. Mean age of the patients was 39 (26-47). A menopausal-like state, evidenced by hot flushes, depression, vaginal dryness, hysteroscopic endometrial atrophy, and hormonal values (FSH, LH, E2), was seen in all patients. After only two months of treatment, a significant reduction was noted in the size of the fibroid, being even greater than that in the following four months. Only one patient in the series underwent surgery. General tolerability of the drug was optimal. These data suggest the efficiency of this type of treatment in obtaining a significant reduction of fibroid volume as well as subjective symptomatology. The cost-benefit ratio is optimal, allowing postponement of surgery and the possibility of vaginal, as opposed to abdominal, hysterectomy and affronting problems of anaesthesiology and post-operative recovery for patients "at risk".
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PMID:Use of GnRH depot analogue in the treatment of uterine fibroids. 215 Jul 37

Twenty-four women with large, myomatous uteri, measuring between 218.7 and 2,920 cm3 were treated with gestrinone, a tri-enic steroid with antiestrogen and antiprogesterone properties. In order to saturate the receptors of the large myomata, the doses used to treat these women were twice the recommended dosage of 2.5 mg, 3 times weekly, used to treat smaller tumors. The treatment lasted 6 months to 1 year. In all cases there was a reduction in uterine volume. In the 24 patients, the mean uterine volume of 724.9 cm3 on admission decreased to 450.73 cm3 at 6 months. For 14 patients treated for a full year, the mean uterine volume of 689.73 cm3 decreased to 329.22 cm3. Menstruation was suppressed in all patients by the end of the 2nd month of treatment. Episodic bleeding occurred in 6 patients but in only 1 did this last longer than 1 week. Other symptoms such as pelvic discomfort and dysuria disappeared or were significantly alleviated by the 2nd month of treatment. Side effects included seborrhea, acne, nervousness, myalgia and arthraglia, hoarseness and mild hirsutism but all these symptoms were promptly reversed following discontinuation. The mean increase in weight was 3.4 kg in 6 months. No menopausal symptoms such as hot flushes and depression developed during this trial. Six patients complained of excessive sweating. Blood glucose creatinine, blood urea nitrogen, alkaline phosphatase, pyruvic and glutamic transaminases remained within the normal range.
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PMID:Treatment of large fibroids with high doses of gestrinone. 222 12

In a double blind study of the effects of hormone replacement therapy in climacteric women, two different dosages of estradiol--17 beta valerate and levonorgestrel, with the same ratio between the amounts of the two steroids (Cyclabil and the trial preparation having the code number SH D 386 F respectively), were compared. The differences in effects on symptoms, certain humoral parameters including serum lipids, and endometrial histology before and after 12 months of therapy were evaluated. The study population consisted of 120 healthy women in the age range 41-63 years, many of whom had undergone previous estrogen treatment. All had typical climacteric symptoms and were peri- or postmenopausal. There were no significant differences between the two preparations as regards the effects on symptoms--except for episodes of hot flushes and depression (loss of confidence), which were more frequent during treatment with the higher dosage. One of the main objects of the study was to determine whether the lower dosage would be sufficient to prevent the development of endometrial hyperplasia. To this end, endometrial samples were collected before and after 12 months of treatment, using "Mi-markTM" disposable equipment for endometrial cytology/histology. No significant endometrial hyperplasia was found in either of the groups during the period of investigation. The serum lipid pattern was evidently more influenced in the group treated with Cyclabil. The drop-out rate was 20%, most of them being due to side effects of mild to moderate severity such as undesirable withdrawal bleedings or unsatisfactory relief of symptoms, which sometimes resulted in a wish to return to earlier treatment regimens.
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PMID:Clinical experience with a low-dose combination of estradiol valerate and levonorgestrel. Double-blind comparative study between SH D 386 F and Cyclabil. Effects on symptoms, lipids and endometrial condition. 310 96

Women between the ages of 40 and 59 years were classified as pre-, peri-, and postmenopausal, with and without hot flash symptoms, for comparison of somnographic sleep variables. Few differences in sleep variables were noted between the groups. However, peri- and postmenopausal women experiencing hot flashes (symptomatic) tended to have lower sleep efficiencies than those not experiencing hot flashes. As well, rapid-eye-movement (REM) latency was longer (p less than 0.05) in the symptomatic women (means = 94.2 min) than in the nonsymptomatic women (means = 71.4 min). Although an age difference existed between the menopausal status groups, it was less than a decade and a main group effect for sleep efficiency and REM latency was seen while controlling for age and/or depression.
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PMID:Sleep patterns and stability in perimenopausal women. 314 91


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