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)

Immunological, neuroendocrine and psychological parameters were examined in 14 psychophysically healthy subjects and in 17 panic disorder patients before and after a 30-day course of alprazolam therapy. T lymphocyte proliferation in response to the mitogen phytohemagglutinin, lymphocyte beta-endorphin (beta-EP) concentrations, plasma ACTH, cortisol and beta-EP levels were examined in basal conditions and after corticotropin-releasing hormone (CRH) stimulation. Cortisol inhibition by dexamethasone (DST) and basal growth hormone (GH) and prolactin levels were also examined. Depression, state or trait anxiety, anticipatory anxiety, agoraphobia, simple and social phobias, severity and frequency of panic attacks were monitored by rating scales. The immune study did not reveal any significant difference between patients and controls, or any effect of alprazolam therapy. The hormonal data for the two groups were similar, except for higher than normal basal ACTH and GH plasma levels, lower than normal ratios between the ACTH and cortisol responses to CRH, and blunted DST in some patients. All the impairments improved after alprazolam therapy, in parallel with decreases in anxiety and in severity and frequency of panic attacks.
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PMID:Psychoimmunoendocrine aspects of panic disorder. 133 59

Graded doses arginine-vasopressin (AVP) were administered to depressed patients and control subjects to compare the sensitivity of the pituitary-adrenal system of these subjects for this compound. The plasma levels of cortisol, adrenocorticotropic hormone (ACTH) and beta-endorphin were measured before and after intravenous AVP injection. The hormonal output was taken as a measure of pituitary-adrenal function. In control subjects 3 doses AVP and placebo were used, whereas in patients two doses AVP, a low and a high dose, and placebo were tested. All tests were carried out in the afternoon when the pituitary-adrenal system is stable and more susceptible for stimulation. Patients were subdivided into dexamethasone suppressors and nonsuppressors based on their DST status before testing to look for differences among these groups. Control subjects showed no response of the hormones to the lowest dose AVP and a moderate response to the higher doses. Interestingly, depressed patients as compared to controls responded more to the lowest dose AVP in particular with respect to ACTH. DST status did not influence the results. These findings suggest an enhanced sensitivity of the pituitary to low doses AVP in depressed patients. Thus, AVP might play a role in HPA dysfunction in depression.
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PMID:Stimulation of the pituitary-adrenal axis with a low dose [Arg8]-vasopressin in depressed patients and healthy subjects. 133 98

Recurrent brief depression (RBD) has recently been proposed as a new subtype of affective disorder characterized by episodes of major depression which last less than two weeks. The aim of this study was to further evaluate the validity of this putative subtype by means of clinical and biological data. DST, TSH response to TRH and sleep EEG variables were compared in 25 RBD patients sex- and age-matched to 25 major depressed (MD) and 25 healthy subjects. Family history, age at onset, and psychiatric comorbidity did not discriminate RBD from MD. Recurrent unipolar depression was found to be more prevalent in MD. Although less severely depressed during the biological tests, patients with RBD did not significantly differ from those with MDD on basis of DST non-suppression, blunted TSH response and shortening of REM latency. Compared to controls, a greater sleep onset latency was observed both in RBD and MD and a lower total sleep time in MD patients only. These results suggest that RBD could be viewed as a subtype of affective disorder sharing many characteristics with MDD.
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PMID:Biological and clinical features of recurrent brief depression: a comparison with major depressed and healthy subjects. 147 36

A young female anorexia nervosa patient reported who was undigested with food, weight dropped to half of the normal standard. She manifested not only episodic bulimia, impulsive self-injury, suicidal attempt, and obvious depressive emotion; but also self-provoked-vomiting, wandering, stealing and lying. The course of disease lasted already three years, she got 37 points on Hamilton Depressive Scale. Positive DST and normal EEG were exhibited in lab tests. The patient was improved after comprehensive therapy for about 5 months and then discharged. The recent literatures were reviewed on epidemiology, etiology, clinic features, therapy, prognosis and its relationship with depression.
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PMID:[Anorexia nervosa with bulimia and self-provoked-vomiting (a case report)]. 159 55

We studied 26 inpatients (17 females; mean age +/- SD: 41.2 +/- 14.3 years) who met the DSM III criteria for a major depressive episode and had a mean (+/- SD) Hamilton Depression Score of 19.3 +/- 8.0. All patients were drug free and medically healthy at the time of experimentation. We found a significant correlation between the CD4/CD8 ratio and the Hamilton Anxiety Score (r = 0.57, p less than 0.005). When splitting our sample in dexamethasone suppression test suppressors (DST-S) and nonsuppressors (DST-NS), this relationship appeared only in DST-NS (DST-NS: r = 0.81, p less than 0.005; DST-S: r = 0.20, p = NS). These results are discussed in terms of heterogeneity among major depressive disorders and possible relationships between catecholaminergic activity and the immune system.
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PMID:Lymphocyte subsets in major depressive patients. Influence of anxiety and corticoadrenal overdrive. 162 82

Lithium augmentation of antidepressant drugs was studied in 51 patients with endogenous refractory depression. The remission after 28 days of lithium was obtained in 28 patients (55%). Better effect of lithium was shown in bipolar than unipolar patients, with subjects with lower pre-lithium severity of depression and in those with rapid improvement (within 7 days) on lithium addition. Factors such as age, gender, number of prior antidepressant (or ECT) treatments, type of preceding antidepressant, mean plasma lithium concentration and the results of DST did not show any association with the outcome of lithium augmentation. The 'priming' effect of lithium may contribute to the mechanism of lithium potentiation in a proportion of depressed patients.
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PMID:Adding lithium to antidepressant therapy: factors related to therapeutic potentiation. 163 34

In order to assess the predictive value of somatic and biological factors in antidepressant trials, non specific parameters, i.e. natural course of illness, life events, placebo effect ... have to be controlled by means of studies vs placebo. Among somatic factors, retardation seems to predict a positive response to antidepressants. The predictive value of other endogenous signs--like insomnia or weight loss--is still questioned. Few biochemical parameters appear relevant when metabolites of central monoamines, their precursors and the enzymatic processes involved are considered. The serotoninergic system is the focus of many studies. Among the neuroendocrine indices, the DST proved too poorly specific of depression. Among the physiological parameters, some characteristics of sleep EEG, like a shortening of REM latency, seem promising. Pharmacological challenges, for instance response to stimulant drugs, gave inconsistent results and should be discussed on ethical grounds. Many studies have been undertaken but presently no routine reliable biological index is available to predict a response to antidepressants.
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PMID:[Somatic and biological factors predicting a response to antidepressive agents]. 180 63

Even though the DST has not proved successful as a marker for depression, it has stimulated a considerable amount of research into the interaction between neuroendocrine function and mood states. With the objective of perfecting the DST methodology, investigators have explored the interaction between dexamethasone plasma concentrations and cortisol response, and have found that there is a significant inverse correlation between dexamethasone concentrations and cortisol concentrations. Although this relationship is one of the factors that affects cortisol response in depressed patients, it usually explains less than 20 percent of the variance of cortisol response. One can only conclude that the affective state explains a certain amount of the remaining variance. Dexamethasone plasma concentrations may be altered by a variety of drug and disease interactions. Many enzyme inducers, including phenytoin, carbamazepine, and phenobarbital, increase dexamethasone CL, but some drugs that might be expected to alter dexamethasone CL, such as cimetidine and tobacco smoke, do not affect it. Any disease that causes hepatic dysfunction could be expected to decrease dexamethasone CL, whereas renal failure may increase dexamethasone CL. Neither Cushing's syndrome nor congenital adrenal hyperplasia appear to alter dexamethasone CL. Alcoholism has a dual effect on the DST. Chronic alcohol abuse may cause a cushingoid state, which could interfere with the DST interpretation. Also, chronic alcohol use may result in hepatic dysfunction, or an induction of P-450 enzymes. As a result of these different actions, alcohol could result in either an increase or decrease in dexamethasone CL. Studies of dexamethasone pharmacokinetics conducted in depressed patients are few, but they generally agree that DST nonsuppressors exhibit an increased dexamethasone CL when compared with suppressors. The only two studies to investigate this population longitudinally report somewhat contradictory results; one study reports an increase in dexamethasone CL following recovery from depression, and the other a decrease. Since only one of the studies was conducted using intravenous dexamethasone, differences in bioavailability might explain some of the differences in results between the two studies. In spite of the unresolved questions, these studies have stimulated research into an entirely new area: the possibility that affective diseases may alter the pharmacokinetics of some drugs.
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PMID:The impact of dexamethasone pharmacokinetics on the DST: a review. 181 2

The nosological status of major depression with mood-congruent psychotic features was explored by a cross-sectional demographic, clinical and biological assessment and a 7-year prospective follow-up of 2 samples of patients fulfilling, respectively, DSM-III criteria for this condition and for major depression without psychotic features. The 2 patient groups did not differ with respect to demographic and historical features, response to DST and outcome. The global severity of the index episode was greater in psychotics. All nonpsychotics and 69% of psychotics were treated with antidepressants alone or in combination with benzodiazepines, whereas the addition of neuroleptics was required only in 31% of psychotics. A tendency towards an interepisodic diagnostic stability was verified in nonpsychotics more than in psychotics, but was less pronounced than that reported by the authors advocating the nosological autonomy of delusional depression. These data support the view that major depression with mood-congruent psychotic features is not a distinct diagnostic entity, but rather a more severe depressive subtype.
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PMID:Major depression with mood-congruent psychotic features: a distinct diagnostic entity or a more severe subtype of depression? 229 12

Hypothesizing that a positive DST result could reflect an aberrant stress reaction in subjects with alexithymic features, the authors investigated the relationship between alexithymic features and DST results in 266 subjects from a Finnish adult population sample. Alexithymic features were assessed with the Beth Israel Questionnaire. The authors found a statistically significant association between observed alexithymic features and a positive DST result. This association could be seen after adjustment separately for age, social rank, marital status, and the occurrence of depression.
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PMID:Alexithymic features in relation to the dexamethasone suppression test in a Finnish population sample. 238 54


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