Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Five healthy female subjects participated in a starvation experiment. After an initial baseline phase (A) they lost about 8 kg in a 3-week phase of complete food abstinence (B); thereafter they recovered to their original body weight (C) and kept this weight stable over more than 4 weeks (D). While all dexamethasone suppression tests (DST's) during the initial baseline were normal, half of the DST's (7/14) in the fasting phase showed insufficient suppression. In the following weight gain phase, all DST's were sufficiently suppressed. Twenty-four hour plasma cortisol patterns during fasting (B) showed a significant increase, as well as increased cortisol half-life, increased time in secretory activity, and increased number of secretory episodes. Administration of the alpha 2-adrenergic receptor agonist clonidine during fasting did not induce a further decrease in plasma cortisol level, whereas it did during baseline. The results demonstrate that weight loss, reduced caloric intake, and catabolic state have a very powerful influence on the hypothalamo-pituitary-adrenal (HPA) axis and other endocrine systems. The results shed new light on endocrine dysfunctions in mental disorders associated with reduced caloric intake, such as anorexia nervosa and depression, and question the specificity of certain endocrine dysfunctions for depression.
 ...
PMID:Effect of experimental and pathological weight loss upon the hypothalamo-pituitary-adrenal axis. 378 35

The few studies reported to date suggest that CSF cortisol is increased in depression and mania compared to normal subjects but that this increase is not specific to these disorders, since increased levels occur in other psychiatric and neurologic disorders. The CSF elevation is probably secondary to cortisol changes in the blood, but CSF levels appear to be more stable. The diurnal change in CSF may also be greater than that in blood. The significant correlation between CSF and blood levels observed in monkeys has not been found in humans. Future studies must control for time of day, as well as diagnostic factors, and ideally should include other measures of cortisol function, such as urinary excretion or the DST. Regulation of CSF cortisol is not well understood, and its relationship to other brain chemistries is unclear.
 ...
PMID:CSF cortisol in affective illness. 384 51

Plasma cortisol levels of 41 patients suffering from major depressive episodes were measured at 4 p.m. and 10 p.m. one day after administration of 1 mg dexamethasone at 10 p.m. Comparison of cortisol results to clinical improvement measured by the Beck Depression Inventory before and after 5 weeks of treatment with either ECT, chlorimipramine, amitriptyline, or phenelzine showed no difference between nonsuppressors and suppressors in relation to clinical improvement. Clinical prediction of the outcome of acute response to these treatments using an initial DST does not seem feasible.
 ...
PMID:The DST as a predictor of acute response to treatment with ECT, chlorimipramine, amitriptyline, and phenelzine. 394 22

DST responses of 67 Israeli inpatients, a group heterogeneous in ethnic background, were examined. Overall, 56% of depressed patients and 34% of patients with diagnoses other than depression were DST nonsuppressors. Ethnic background did not significantly influence the DST response. Scores on the Carroll Rating Scale for Depression (CRS) and the Physical Complaints List (PCL) did not correlate significantly with DST response. PCL scores correlated significantly with the diagnosis of depression. The data support the view that the DST has limited utility as a biologic marker of depression, but that an analysis of physical complaints using the PCL may be useful in the differential diagnosis of depression in some cultures.
 ...
PMID:Physical complaints correlate better with depression than do dexamethasone suppression test results. 395 76

Two patients with major affective disorder--one unipolar and one bipolar--exhibited normal DSTs while psychotically depressed (mood congruent delusions), yet exhibited nonsuppression on the DST in the course of subsequent separate nonpsychotic depressive episodes. If valid, these results may provide further evidence for considering psychotic and nonpsychotic depression as clinically distinct entities.
 ...
PMID:Dexamethasone suppression test results in delusional versus nondelusional depression: preliminary evidence of distinct clinical entities. 398 19

The use of the dexamethasone suppression test in a general hospital setting is discussed with a review of some of the literature pertaining to the test. The test was performed on a series of 47 patients where there was a high index of suspicion that depression was present. Of the patients with a final diagnosis of depression, 77% had a nonsuppressive DST. There were no false positives. Bipolar depressed patients were more likely to be nonsuppressors than unipolar patients.
 ...
PMID:The dexamethasone suppression test in a general hospital psychiatric setting. 408 3

Alprazolam, a triazolobenzodiazepine, was successfully used to treat a patient with recent cardiac disease who presented with DST-positive endogenous depression. The relative absence of cardiotoxic effects warrants the consideration of this medication in cardiac patients with concurrent anxiety and/or depression.
 ...
PMID:Successful treatment of endogenous depression with alprazolam in a patient with recent cardiac disease: case report. 614 13

The possible predictive value of cortisol non-suppression by dexamethasone for therapeutic response to antidepressants was investigated both in "endogenous" and "neurotic" depression. Seventy-four female patients who fulfilled the RDC of Major Depressive Disorder (Study 1) and 44 female patients with the diagnosis of "Neurotic Depression" of ICD-9 (Study 2) were given DST and then treated with antidepressants, their clinical response being assessed after four weeks of drug treatment. Forty-three out of the 74 patients with Primary Major Depression were non-suppressor. The DST non-suppressors showed a significantly more frequent therapeutic response to maprotiline than to amitriptyline. DST suppressors, on the other hand, responded better to amitriptyline treatment than non-suppressors. In the neurotic depression group 23 patients were subclassified as Primary Minor Depression, and 52% of them showed non-suppressor response to DST. Twenty-one patients were diagnosed as Secondary Depression, with a history of chronic neurosis. One patient only (5%) was the non-suppressor. Patients with Primary Minor Depression showed good therapeutic response to antidepressants more frequently, than patients with Secondary Depression.
 ...
PMID:Dexamethasone suppression test as a predictor of drug treatment response. 615 43

EEG sleep recordings and two provocative neuroendocrinological tests (the DST and the GH stimulation test after desipramine) were investigated in two depressed pubertal monozygotic twin boys with Major Depressive Disorder and compared with results from one normal pubertal control boy and an adolescent girl suffering from major depression. REM latency was reduced in the adolescent depressed girl but not in the pubertal depressed twin children when compared to the normal control. Sleep continuity and sleep architecture were, however, disturbed in pubertal and adolescent depression as a function of severity of the depressive state. The results of the DST showed abnormal cortisol values in the most severely depressed twin and in the depressed adolescent. GH secretion after DMI showed a clear GH response in the less depressed twin and in the normal subject while in the depressed adolescent, the GH response was blunted. The findings suggest that REM latency disturbances in our depressed patients do not appear before adolescence, while neuroendocrine dysfunction can already be present in pubertal depression.
 ...
PMID:Electroencephalogram and neuroendocrine parameters in pubertal and adolescent depressed children. A case report study. 623 57

The DST does appear to be abnormal in a sizable subgroup of patients with major depressive disorder, particularly those characterized as "endogenomorphic" or "melancholic." At present the available data seem clear in indicating this abnormality is significantly less common in normal controls and patients without affective illness. The test holds considerable promise in helping to define new subgroups of depressed individuals for further study. In terms of its ability to predict treatment response to an adequate course of somatic therapy, the test does not appear to be of value, and the clinician should still be guided by the clinical presentation and history in initiating or choosing between various somatic treatments. With further attention to issues of diagnosis and DST methodology this strategy could help in addressing questions of differential diagnosis in potential "variants" of affective illness and providing a better understanding of the pathophysiology of depression.
 ...
PMID:The dexamethasone suppression test in depression. 634 66


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>