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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There is a suggestive evidence for a relationship between central 5-HT and the occurrence of certain types of depressions. This evidence is derived from three sources: postmortem studies; measurement of CSF 5-HIAA; accumulation of CSF 5-HIAA after transport blockade by probenecid. Disturbances of central 5-HT metabolism are not typical for any depression but for certain types of vital (endogenous) depression. This implies that the group of vital depression, though tending towards homogeneity in terms of symptomatology, is heterogenous in biochemical terms and comprises patients with and without disorders in central 5-HT metabolism. It is plausible that disorders of the 5-HT metabolism play a role in the pathogenesis of depression, instead of resulting from them. This statement is based on the following findings: (i) 5-HTP can abolish or alleviate the depressive syndrome or some of its elements. (ii) This 5-HTP effect can be potentiated by clomipramine (Anafranil), a relative selective inhibitor of 5-HT reuptake. (iii) There exists a negative correlation between 5-HT turnover in the CNS and the therapeutic effect of clomipramine. The alleged distrurbances in central 5-HT are more likely to be predisposing than of direct causative significance. This assumption is based on two observations: (i) In more that 50% of cases, the 5-HT turnover remains low after clinical recovery, the patient being drug-free. (ii) There is suggestive evidence that abolition of the 5-HT deficit (by means of 5-HTP) exerts a prophylactic effect in uni-and bipolar depression.
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PMID:The Harold E. Himwich Memorial Lecture. Significance of biochemical parameters in the diagnosis, treatment, and prevention of depressive disorders. 30 32

On the grounds of different pharmacological properties and possibly different clinical effects, two antidepressants, Anafranil (clomipramine) and Pertofran (desipramine) were compared in the management of depression in general practice. A further comparison was made to ascertain whether a combination of the two antidepressants was more effective than the drugs given alone. One hundred and seventy-three patients were admitted to a double-blind clinical trial, conducted on a multicentre basis in general practice, in which a double-dummy technique was employed. One hundred and forty-one patients completed the study. Of these, 49 received Anafranil, 49 received Pertofran and 43 the combination. Although there were no statistically significant differences between the three treatment regimes, there was a consistent trend in favour of the combination regime. Ninety-one per cent of the patients who completed treatment on the combination showed satisfactory improvement compared with 81% on the Anafranil regime and 78% on Pertofran. An attempt was made to identify three symptom clusters--anxiety, 'anergia' and biological depression. There was no significant difference in the response of these three clusters to the three treatment regimes, nor was there any difference in the incidence and severity of side-effects.
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PMID:A comparative trial of Anafranil, Pertofran and an Anafranil/Pertofran combination. 32 30

The problem of phobic anxiety is viewed in the context of the entire area of mental illness and of its epidemiology in the general population. The importance of the diagnosis of depression in phobic patients and its simultaneous treatment is emphasized. Psychotherapeutic and psychopharmacological methods are discussed and some results of recent trials of clomipramine (Anafranil) are reported. The author concludes that for the successful outcome of treatment an eclectic approach must be considered. The combination of behavioural techniques of desensitization along a hierarchy of anxiety-provoking situations, together with psychotherapeutic support and the simultaneous exhibition of the more specific antidepressant and antiphobic preparation clomipramine would offer the best hope of symptom relief.
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PMID:The management of phobic disorders using clomipramine (Anafranil). 32 31

The subject of dosage of clomipramine (Anafranil) in depression and in obsessional and phobic disorders is discussed. The expectation of success is reported and a recommendation made to adopt flexible dosage. Some side-effects are considered and stress is laid on distinguishing between unwanted pharmacological effects and serious toxic effects. Serious adverse reactions are rare. Contra-indications, both relative and absolute, are discussed. The importance of possible drug interactions is emphasized.
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PMID:Practical considerations on the use of clomipramine (Anafranil) in general practice: an updated review. 32 32

An uncontrolled clinical study was carried out to evaluate the therapeutic efficacy of clomipramine (Anafranil, Geigy Pharmacueticals) in a group of twenty obsessive-compulsive neurotic patients. Clomipramine proved to be extremely useful in alleviating obsessive-compulsive neurosis as well as phobia. This finding was not secondary to the improvement in anxiety or depression which occurred, as the degree of improvement in obsessive symptoms far exceeded the improvement in the other symptoms.
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PMID:Treatment of obsessive-compulsive neurosis with clomipramine (Anafranil). 59 4

An open study of four dosage regimes of clomipramine (Anafranil)--10 mg t.d.s., 30 mg o.n., 25 mg t.d.s. and 75 mg o.n.--was performed in patients seen in general practice suffering from depression. The primary purpose of the study was to gather information on steady-state blood levels of unchanged drug and major metabolite. However, clinical assessments were also made on a seventeen symptom depression rating scale initially and after 1,2 and 4 weeks treatment and side-effects were assessed. Seventy patients were admitted to the study; forty-nine completed it. All four treatment groups showed significant improvement. The groups were small and no significant differences emerged between them. The best response of 77% improvement on total score after 4 weeks was obtained in the group of patients receiving 25 mg t.d.s. The patients on 30 mg daily showed a 67% response when this was divided and 65% when given singly. The worst response was obtained in the patients receiving 75 mg single dose (50%). Thirteen of the twenty drop-outs did so because of side-effects. Ten of these were in high dose groups. However, amongst patients who completed the study there was no difference in the side-effects observed in the four groups.
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PMID:Comparisons of various clomipramine (Anafranil) dosage regimes. 86 80

An attempt was made to measure the effects of depressive illness and of clomipramine (Anafranil) therapy in doses of 30 mg and 75 mg daily on sexual appetite and performance. A special questionnaire was devised to gather information on sexual habits before illness, during illness and following treatment. It proved difficult to differentiate between the beneficial effects of recovery from depression and the possible adverse drug effects on sexual activity. Two patients dropped out of the study because of supposed sexual side-effects--a male with ejaculatory difficulties and a female with orgasmic impotence. Fifty-four patients completed the sexual questionnaire and a four-week course of clomipramine. There were nineteen males and thirty-five females. Sixty-eight per cent of males and 57% of females had their 'sex life' impaired by depressive illness. Coital rate was decreased and depression interfered with performance and satisfaction. Clomipramine therapy seemed to have advantageous and disadvantageous effects. The advantageous effects were probably associated with improvement in depressive illness. There was evidence that clomipramine had an adverse effect sexually in 26% of males and 14% of females. The effect was dose-related in females.
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PMID:Sexual side-effects of clomipramine (Anafranil). 86 89

In a multicentre general practitioner trial, in which patients were treated with various dose regimes of clomipramine (Anafranil, Geigy Pharmaceuticals), patients and doctors completed independently of each other a series of visual analogue scales on admission and after one, two and four weeks of treatment. A regression technique is described to deal with the comparison between patient and doctor completed scales. It is suggested that this method is more informative than just giving correlations between ratings. The study shows that for the two target symptoms, depression and anxiety, the agreement between patient and doctor ratings is poor, particularly at the beginning of the study. The 'best' results are obtained for initial sleep, appetite and libido. Some explanations for these findings are offered, and further researches of the visual analogue scale are suggested.
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PMID:Comparison between physician and patient completed visual analogue scales. 86 90

The proper assessment of depression in general practice requires the use of adequate and sensitive measurement of target symptoms. In a pilot trial of a new 50 mg formulation of clomipramine (Anafranil) various new techniques of measurement were explored, namely, the General Health Questionnaire, a series of visual analogue scales with a centre reference point and a new physician rating scale for depression.
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PMID:Experiences with some new scales for use in general practice trials. 86 91

In 30 patients suffering from vital depression (the syndrome of endogenous depression) a negative correlation was found between the pre-therapeutic post-probenecid CSF 5-HIAA response and the therapeutic response to clomipramine (Anafranil). Clomipramine is a tricyclic antidepressant with a strong potentiating effect on central 5-HT. The following conclusion was drawn: if the cenral 5-HT turnover is diminished in depressions, then correction of this biochemical disturbance leads to alleviation of depressive symptoms. This finding is considered to support the concept of '5-HT-deficient depression'. Five of the 8 clomipramine-resistant patients showed a favourable response to nortriptyline, a NA-potentiating anti-depressant. The pre-therapeutic CSF MHPG concentration in these patients was not related to the therapeutic efficacy of nortriptyline. So, the assumption that these patients have been NA-deficient was not confirmed. However, renal MHPG excretion was not measured and possibly this variable correlates better with cerebral NA metabilism than MHPG in lumbar CSF which is of mainly spinal origin.
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PMID:New evidence of serotonin-deficient depressions. 89 99


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