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)

Prevalence rates of various side effects were studied comparatively among 3 oral contraceptive preparations containing 50 mcg of the estrogen component. Norinyl 1/50, Ovral, and Norlestrin 1 were each randomly assigned to groups of 160 healthy women who had consented to participate in the study designed to quantitate probabilities of experiencing specific side effects and of their continuing into the subsequent cycles. Acne, breast discomfort, nausea, abdominal bloating, headache, fatigue, depression, irritability, vaginal discharge, and breakthrough bleeding were the specific side effects studied; only breakthrough bleedings showed a statistical difference in prevalence. The rate of breakthrough bleeding associated with Ovral use in the 1st 3 cycles (16.6%) was significantly (P .05) lower than that associated with using either Norinyl or Norlestrin (46% and 51.7%, respectively). Norelestrin, aside from breakthrough bleeding, was reported as generally freer of side effects than the other 2 preparations. The probabilities of side effects being experienced in the 2nd or 3rd cycle after the effect(s) was experienced in the 1st cycle showed that overall, for all 3 combination pills, the probabilities significantly decreased from the 2nd to the 3rd cycle (P .05). Also examined was the probability that a side effect would occur in the 2nd or 3rd cycle if the user had not experienced such an effect in the 1st cycle. In each instance, the probabilities are significantly lower (P .05) than the corresponding probabilities where the symptom had been experienced in a previous cycle. These data support the contention that side effects experienced on inititation of oral contraceptives should not prohibit its continuation because the majority of symptoms will disappear as the patient becomes accustomed to the hormonal preparation.
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PMID:The probability of side effects with ovral, norinyl 1/50 and norlestrin. 16 Aug 60

Norplant consists of 6 soft plastic capsules placed in the subcutaneous tissue on the inside of the upper arm which release levonorgestrel continuously over 5 years to prevent pregnancy. Health workers use an aseptic technique to insert the capsules within 0.5 cm of the incision. Scar tissue increases removal time to twice that of insertion time. The 1st year pregnancy rate is 0.2%. Body weight affects the cumulative 5-year pregnancy rate: 0.2% for 50 kg women, 3.4-5% for 50-69 kg women, and 8.5 for 70 kg women. It rises remarkably in the 3rd year. Women find the advantages to be, in order of importance, ease of use, effectiveness, long duration, reversibility, and arm placement. The most common misconception about Norplant is it causes cancer or sterility. Both before insertion and during the early months after insertion, family planning providers must thoroughly explain Norplant and stress how it is different from other contraceptive methods. 1 study reveals that the 1-year continuation rate for women who undergo careful preinsertion counseling is greater than it is for women who do not receive effective counseling (88% vs. 60%). The leading side effect is abnormal bleeding patterns. Even though bleeding patterns change, hemoglobin or ferritin levels do not decrease. In women who experience no bleeding, providers must conduct a urinary human chorionic gonadotropin test at 4-6 weeks. If the test reveal no pregnancy, they need to explain to the women that this is normal. Abnormal bleeding patterns improve with increased duration of Norplant use. Women who need to be carefully monitored or should not use Norplant are those with impaired glucose tolerance, hyperlipidemia, impaired liver function, premenstrual symptoms, and history of depression. The ideal candidate is a woman who has used oral contraceptives (OCs) with no side effects yet forgets to take them daily, has contraindications for estrogen, or has estrogenic side effects from OCs.
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PMID:Who is a candidate for Norplant? 161 60

In Finland, the hormonal diaphragm Levonova was put on the market in the fall of 1990. Since that time, more than 20,000 Finnish women have been using them. The hormonal diaphragm is most suitable for women who want long-term contraception. It has a 5-year duration, and its contraceptive effectiveness equals that of sterilization. Levonova releases levonorgestrel directly into the uterus, thus its effect is local, and therefore, women who cannot take other hormonal preparations can use it. Thus, there is no upper age limit for using Levonova in contrast to oral contraceptive use. Nevertheless, hormonal diaphragms are not recommended for nulliparous women 25 years of age. This preparation is mainly recommended for women who no longer wish to have a child, yet who do not want to undergo sterilization in cases they change their mind. The hormonal diaphragm is fitted during menstruation, or at the latest on the 7th day after the beginning of menstruation. This is a simple procedure, and a follow-up examination 3 months later is recommended. In rare instances, side effects such as headache, lower abdominal tumescence, lack of appetite, and depression can occur, but these are transitory. In general it has been observed that in women who have had heavy bleeding or painful menstruation, these symptoms become ameliorated after the insertion of the hormonal diaphragm. Levonova has been tested during 10,000-use years with the participation of 3500 women using it from 1-5 years. These investigations are currently proceeding, and 50% of women are kept under observation during normal use in order to get Levonova registered in the countries of the European Common Market, the manufacturer, Leiras Pharmaceutical co., has disclosed.
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PMID:[The hormone diaphragm affords safe contraception and relief from menstrual pain]. 161 46

Norplant capsules and Norplant 2 rods contain levonorgestrel (LNG) that is released slowly for up to 2000 days. After removal the progestogen vanished from the blood stream within 96 hours, and fertility is restored in contrast to the pill contraceptives. Norplant provides a cervix barrier against spermatozoa. About 1/2 of women taking it had anovulation or luteinization of unruptured follicles. In ovulating women the midluteal progesterone values were clearly reduced. There have been some reports concerning the increased aggregation of thrombocytes and the decline of high density lipoprotein (HDL) cholesterol levels in Norplant users. Thrombosis, cerebro- and cardiovascular accidents have not been reported. A longterm prospective study of Norplant 2 users showed an unacceptably high rate of pregnancies after the 4th year, thus the rods have to be replaced after 3 years instead of 5 years. 23% of Norplant 2 and 41% of Norplant users had to resort to removal because of side effects. 54% of Norplant and 48% of Norplant 2 users halted use after 3 years because of menstrual disorders, irregular bleeding, depression, and mood changes. LNG has high affinity to sex hormone binding globulin (SHGB), and it is not active in bound form. The free LNG index was lower in women with unwanted pregnancies than in other women. In 1989 the Population Council reported on 7 phase-3 investigations involving 2470 women. Only 398 completed the 5-year observation period: the cumulative pregnancy rate was 3.5, there were 3 pregnancies among those with body weight of 50-60 kg and 8.6 pregnancies among those weighing 70 kg or more. There were 101 unwanted pregnancies, and 1 child was born with intersexual genitals. Endometrium biopsy or curettage is advised in the event of irregular bleeding especially in women over 40, and about 25% of Norplant users have undergone these procedures.
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PMID:[Norplant]. 210 34

As an indicator of analogous brain serotonin metabolism, and by extension of depression tendency, platelet imipramine receptors were measured in women taking the triphasic oral contraceptive Logynon. Logynon (Schering AG Berlin/Bergkamen, Germany) contains levonorgestrel 50 mcg for 6 days, 75 mcg for 5 days and 125 mcg for 10 days, followed by 7 days pill-free; ethinyl estradiol doses are 30, 40 and 30 mcg for the same periods of time. The mean imipramine binding values (Bmax), calculated from Scatchard plots of tritiated uptake by platelets, was 429 in the control cycle, 396 on Day 14 of the 1st treatment cycle, and 582 in the 2nd treatment cycle (p0.02 vs pretreatment). Control means were 412 and 411. No significant differences were seen in affinity (Kd). There were no significant differences in mean Beck Depression Inventory tests, although 1 woman became clinically depressed, with BDI scores of 22 and 33 compared to 2 before taking Logynon. Her Bmax values were 626, 630 and 796 in the pretreatment, 1st and 2nd cycles respectively. Overall, the increase in imipramine binding did not correlate with Beck depression inventory scores.
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PMID:Up-regulatory effect of triphasic oral contraceptive on platelet 3H-imipramine binding sites. 283 63

The effect of oral contraceptive use and hospitalization stress on the results of the dexamethasone suppression test (DST) were assessed. This test, in which 1 mg dexamethasone is given at 11:00 p.m., and blood cortisol is analyzed the following day, is used as an indicator or major or endogenous depression, as opposed to situational depression, but specificity of the test remains in dispute. The test subjects were 15 normal volunteers, mostly staff, and 27 surgical patients, who were planning orthopedic surgery the following day. Of the 20 women, 7 took oral contraceptives, (Sequilar, Microgynon 50, Trigynon, Microgynon 30 and Diane). Cortisol was radioimmunoassayed at 4:00 p.m. in volunteers and at 8:00, 4:00 and 11:00 p.m. in hospital patients. Only 1 subject had a positive test (non-suppressor), a non oral contraceptive user, with a cut-off point of 50 mcg/L. The hospital patients' cortisol levels were slightly higher (n.s.). Pill users' cortisol levels were unchanged.
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PMID:Lack of effects of hospitalization and oral contraceptives on DST results in control subjects. 367 80

In the US, the 90% of women, at risk of pregnancy, who use contraceptives account for 47% of all unplanned pregnancies. Thus, if women using no contraceptives or using user-dependent methods were to switch to long-acting hormonal contraceptives like Norplant or injectables, unplanned pregnancy rates would drop. Norplant was approved for use in the US in 1992. The device consists of six rods that release levonorgestrel over a period of five years to suppress the luteinizing hormone surge responsible for ovulation and thicken cervical mucus to prevent sperm penetration. Norplant is highly effective, results in few metabolic changes in users, and can be used by lactating mothers. Side effects (most prevalent in the first six months) include abnormal bleeding, weight gain, depression, and headaches. Adolescents studied reported overall satisfaction with the method. Difficulties with removal can be minimized if the implants are inserted properly. The injectable use of depot medroxyprogesterone acetate (DMPA) was approved in the US in 1992. Contraceptive plasma levels are reached within 24 hours of the injection and are maintained for 14 weeks. DMPA inhibits ovulation and is highly effective when administered once every three months. DMPA is associated with a longer delay in return to fertility than other methods. The side effects of DMPA are similar to those seen in Norplant users. Concern about changes in bone density are currently being investigated. DMPA users have increased low-density lipoprotein cholesterol levels and decreased high-density lipoprotein cholesterol levels as compared to IUD users. DMPA (unlike Norplant) can be used effectively in women using anticonvulsant medications or antibiotics. It is also safe during lactation. Research into hormonal methods is being concentrated on the development of a two-rod and one-rod Norplant delivery system, on biodegradable delivery systems, and on various injectable formulations, including once-a-month estrogen/progesterone combination methods.
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PMID:New contraceptives in the 1990s. 758 38

To learn more about the side effects associated with Norplant use in adolescence, the charts of 110 women 13-21 years of age (average, 17.2 years) who received the implants through hospital-based adolescent gynecology clinics in Arkansas were reviewed. The implants were inserted between March 1991 and February 1993; the mean length of time since insertion was 12.7 months (range, 8-19 months). 64% of Norplant acceptors were African-American. Weight and blood pressure measurements were obtained at baseline and at three follow-up periods: 1-4 months, 5-7 months, and 8 or more months. Overall, the average weight gain was 3.3 kg, but there were significant racial differences. At follow-up one, African-American females showed an average weight gain of 1.4 kg compared to no gain among White females. At follow-up three, the mean weight gain was 5.4 kg for African Americans and 2.6 kg for White youth. 37% of all participants reported no change in menstrual patterns, 28% experienced irregular (mainly light) bleeding, and 13% were amenorrheic; no data were available for the remaining 22%. There were no significant changes over time in blood pressure, and acne and depression were each recorded in only one chart. Three women requested Norplant removal during the study period. Overall, the findings of this study suggest that Norplant-related side effects may be less severe among adolescents than adult women, most notably the incidence of bleeding irregularities (82% in adult Norplant acceptors). To ensure Norplant continuation, however, adolescents should be counseled about the possibility of slight weight gain and light bleeding.
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PMID:Adolescents and Norplant: preliminary findings of side effects. 766 87

Clinicians examined the family planning decisions of 3938 women who underwent prenatal diagnosis (ultrasonography, amniocentesis, or chorionic villus sampling) at the Division of Reproductive Genetics at the University of Tennessee in Memphis between January 1988 and May 1993. 104 women were carrying fetuses with chromosome abnormalities, of whom 92 opted to terminate their pregnancies. 57 women were carrying fetuses with neural tube defects, of whom 49 chose to end their pregnancies. Among the 91 fetal chromosome abnormality cases with complete information on family planning decisions, 84 had autosomal abnormalities and 7 had sex chromosome abnormalities. Among the 41 fetal neural tube defect cases with complete information on family planning decisions, 22 had spina bifida and 19 had anencephaly. The mean age of women with a chromosome abnormality fetus was higher than that of those with a neural tube defect fetus (36.8 vs. 27.3 years; p 0.03). Just 20 women (15.2%) chose permanent sterilization after continuing or terminating the affected pregnancy. Women carrying fetuses with chromosome abnormalities were more likely to choose permanent sterilization than those carrying fetuses with neural tube defects (18.7% vs. 7.3%; p 0.03). Advanced maternal age was associated with the decision to undergo permanent sterilization (p 0.04). Physicians should counsel women who have opted to terminate a pregnancy of an abnormal fetus to delay any decision to undergo permanent sterilization to allow for resolution of grief and depression. They should advise the women to use safe, reliable, and long term reversible contraceptive agents (e.g., Norplant subdermal implant system, the injectable Depo-Provera, IUDs, and oral contraceptives).
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PMID:Family planning decisions after prenatal detection of fetal abnormalities. 797 49

Between October 1986 and November 1988, physicians enrolled 267 20-41 year old women in a clinical trial of Norplant-2 (2 Silastic rods with 70 mg levonorgestrel each) at the National Taiwan University Hospital to evaluate the advantages and side effects of Norplant-2. 36 women were lost to follow up. 63% suffered from menstrual problems during the first 3 months. 73.6% of these women still had menstrual problems at 6 months. 6 women then chose to discontinue using Norplant-2. 51.8% of the remaining women had persistent menstrual problems at 1 year. 62% of women who discontinued Norplant-2 before the end of 3 years discontinued it due to menstrual problems. The continuation rate was 84.5% at 1 year, 61.3% at 2 years, and 52% at 3 years. 78.6% of women who discontinued Norplant-2 to become pregnant conceived within 1 year after its removal. Just 1 woman (.04%) became pregnant while using Norplant-2. She was thin and smoked heavily. Her aborted fetus had an abnormal fetus had an abnormal karyotype (47,XY,+22). The mean serum total cholesterol and triglyceride levels dropped considerably after Norplant-2 implantation from 164 to 147 mg/dl and from 81 to 63 mg/dl at 12 months, respectively; p .05). Mean hemoglobin levels increased from 12.6 g/dl to 13 g/dl at 12 months (p .05). Levonorgestrel did not affect liver or renal functions. Mean body weight and blood pressure remained the same. Observed psychophysiologic symptoms included depression, acne, headaches, nervousness, and insomnia. These findings indicated Norplant-2 to be safe, reversible, long-acting, and very effective, therefore the family planning program in Taiwan should add it to its contraceptive menu.
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PMID:Norplant-2 subdermal contraceptive system: experience in Taiwan. 810 98


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