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)

Buspirone is an anxiolytic agent that appears to have no sedative effects. The aim of this study was to assess the effects of buspirone on breathlessness and exercise tolerance in patients with chronic airway obstruction. Sixteen patients, age 56.9 +/- 17.0; forced expiratory volume in 1 s (FEV1) 1.15 +/- 0.42 l; FEV1/forced vital capacity (FVC) 50.7 +/- 15.0%; PaCO2 42.2 +/- 5.5 mm Hg; and PaO2 57.6 +/- 10 mm Hg, underwent a 6-min walking test, an incremental cycle ergometer test, an incremental treadmill walking test with self-assessment of dyspnea on Borg's scale during exercise and an assessment of respiratory drive (P 0.1), timing [inspiration time (TI)/total breathing time (Ttot)], PaO2, PaCO2, FVC, FEV1, following oral administration for 14 days of placebo or buspirone (20 mg daily) in a double-blind, cross-over randomized way. We also used the symptom check list-90-R for the assessment of subjective complaints and symptomatic behavior. A significant improvement in anxiety, depression and obsessive symptoms and complaints was noted after buspirone treatment. The P 0.1, TI/Ttot, arterial blood gases and respiratory mechanics did not change after drug treatment. There was an improvement in exercise tolerance and in the sensation of dyspnea during the buspirone period. Thus, as given in this study, oral buspirone has therapeutic potential in the treatment of dyspnea in patients with chronic lung disease.
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PMID:Buspirone effect on breathlessness and exercise performance in patients with chronic obstructive pulmonary disease. 826 78

Psychopharmacotherapy of the elderly must take into account the effects of age-related changes in the structure and function of the brain and various organs. In general, older people are more sensitive than young people to both the therapeutic and toxic effects of psychotropic medications, necessitating lower doses and longer dosage intervals. This holds true for the treatment of 5 major types of psychiatric illness (depression, bipolar disorder, anxiety, psychotic disorders and dementia). The tricyclic antidepressants, although efficacious, inexpensive, and backed by 30 years of experience, are less well tolerated by the elderly than are newer antidepressants such as the selective serotonin uptake inhibitors. Problems with monoamine oxidase (MAO) inhibitors, including orthostatic hypotension and restrictions in diet and other medication use, have been overcome by the advent of reversible selective inhibitors of MAO-A, but the efficacy of these in the elderly has yet to be proven in clinical trials. Lithium remains the mainstay for the treatment of bipolar disorder. However, careful dosing and monitoring of plasma lithium concentrations are required in the elderly due to changes in pharmacokinetics and pharmacodynamics which make older patients very sensitive to the toxic effects of this medication. Similarly, age-related changes in the pharmacokinetics and pharmacodynamics of the benzodiazepines, the most frequently prescribed medications for anxiety in the elderly, result in recommendations for lower doses and preferential use of those agents metabolised by conjugation (e.g. oxazepam). Buspirone, a partial serotonin 5-HT1A-agonist which is better tolerated than benzodiazepines in the elderly, may be used as an alternative. The elderly are extremely sensitive to extrapyramidal adverse effects which the typical antipsychotics (neuroleptics) exhibit to varying extents. The selection of a suitable agent for the treatment of a psychotic disorder should be based upon the adverse effect profile of the drug and the specific symptoms and situation of the patient. The newer atypical antipsychotics, clozapine and risperidone, have yet to be well-studied in the elderly. Dementia, exemplified by Alzheimer's disease, is almost exclusively an illness of the elderly. Only one medication, tacrine, has been approved for its treatment, based on extensive basic research and positive results of several clinical trials. Its long-term benefits have yet to be determined and it has several adverse effects, including a tendency to increase liver enzymes to the extent that the medication has to be discontinued.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Recent advances in geriatric psychopharmacology. 853 49

The azapirones are a relatively new class of psychotherapeutic drugs with both anxiolytic and antidepressant properties and a favorable benefit-to-risk ratio. They represent a significant advance in psychotherapeutic drug development. Buspirone, the only azapirone currently in clinical use, is a partial serotonin agonist with low abuse potential, no sedative effects, no cognitive or psychomotor impairment properties and no significant withdrawal symptoms. It is well-tolerated by elderly patients. Clinical indications for which buspirone is particularly appropriate are chronic anxiety and mixed anxiety/depression states. Buspirone has demonstrated some efficacy in the treatment of a broad range of other serotonin-related disorders.
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PMID:Azapirones: an alternative to benzodiazepines for anxiety. 863 11

Buspirone, an azaspirone serotonin (5-HT) 1A partial agonist, has been approved by the FDA as an anxiolytic. It has been tested for use in depression, panic disorder, obsessive-compulsive disorder, and schizophrenia as well. Several trials have indicated that it may prove to be a useful agent for augmentation of other psychotropic medications in these disorders. We review the literature supporting the potential use of buspirone as an augmenting agent.
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PMID:Augmentation with buspirone: a review. 864 75

This article is a practical review of the current psychopharmacological agents used in the treatment of child and adolescent psychiatric disorders. Psychostimulants such as methylphenidate, dexamphetamine and pemoline are effective in the control of symptoms associated with attention deficit hyperactivity disorder. The controlled release preparations and the adjunctive use of clonidine are helpful to extend stimulant effects and control adverse effects. Tricyclic antidepressants are helpful in individual cases of child and adolescent depression, but adverse effects may limit their use. Clomipramine has been found to be effective for childhood obsessive-compulsive disorder. Selective serotonin (5-HT) reuptake inhibitors (SSRIs) appear to be safer for depression and are also useful in obsessive-compulsive disorder. Buspirone is effective for the treatment of anxiety disorders in children. Newer atypical antipsychotics such as risperidone may have less limiting adverse effects than older antipsychotics in the treatment of psychosis and severe behaviour disorders, but the physician must be vigilant for the emergence of tardive dyskinesia. Drug treatment in children and adolescents must take into account the child's environmental influences and be part of an overall treatment plan where individual, familial and cultural issues are addressed.
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PMID:Pharmacological treatment of psychiatric disorders in children and adolescents: focus on guidelines for the primary care practitioner. 886 45

The antipsychotic drug risperidone shows high affinity for both central serotonin (5-HT)2A and dopamine (DA)-D2 receptors in vivo. By employing microdialysis in freely moving rats, the effects of acute risperidone administration on regional brain DA and 5-HT release and metabolism were compared with the corresponding effects of the atypical antipsychotic drug clozapine as well as amperozide, the selective DA-D2 receptor antagonist raclopride and the selective 5-HT2A/5-HT2C receptor antagonist ritanserin. Risperidone (0.2 or 2.0 mg/kg, SC) was found to increase DA release and metabolism to about the same extent in three major projection areas of the mesotelencephalic dopaminergic system, i.e. the nucleus accumbens (NAC), the medial prefrontal cortex (MPC) and the lateral striatum (STR). In contrast, clozapine and amperozide (both 10.0 mg/kg, SC), as well as raclopride (2.0 mg/kg, SC), were all found differentially to affect DA release and metabolism in the three projections areas. Specifically, clozapine and amperozide enhanced DA release in the MPC to a greater extent than in the NAC or the STR, whereas raclopride instead preferentially increased DA release in the NAC and the STR but not in the MPC. Ritanserin (3.0 mg/kg, SC) did not exert any major effects on DA metabolism in the three areas studied. In contrast to the regionally rather homogenous activation of brain DA systems caused by risperidone, the drug was found to enhance brain 5-HT metabolism preferentially in the MPC, as indicated by the elevated extracellular concentration of 5-hydroxyindoleacetic acid (5-HIAA) in this region. A similar elevation of the 5-HIAA level in the MPC was observed after amperozide and, to some extent, after clozapine and ritanserin administration. The risperidone-induced (2.0 mg/kg, SC) elevation of 5-HIAA concentrations in the frontal cortex was found to be paralleled by an increased 5-HT release in this brain area. Consequently, our findings demonstrate a pharmacological profile of risperidone, as reflected in brain DA metabolism, in between that of clozapine and the DA-D2 antagonists. The preferential activation of 5-HT release and metabolism in frontal cortical areas might be of particular relevance for the ameliorating effect of risperidone on negative symptoms in schizophrenia, especially when associated with depression.
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PMID:Risperidone: regional effects in vivo on release and metabolism of dopamine and serotonin in the rat brain. 893 2

In a continuation of recent work on effects of a benzodiazepine (chlordiazepoxide) and selective monoamine reuptake inhibitors (maprotiline and fluvoxamine), the current study compares effects of the 5-HT1A receptor partial agonist, buspirone (0.75-3.0 mg/kg), the 5-HT3 receptor antagonist, ondansetron (0.1-100 micrograms/kg) and the novel antidepressant, tianeptine (2.5-10.0 mg/kg). Compounds were given daily to mice for 21 days prior to testing and the subsequent behaviour of the animals during social interactions was assessed by ethopharmacological procedures. Buspirone, at 0.75 mg/kg, increased immobility and reduced occurrence of the aggressive act, "attack." At 1.5 and 3.0 mg/kg, it enhanced olfactory exploration of the sawdust substrate, but had no effect on social investigation. Ondansetron increased the duration of environmental exploration at 0.1 microgram/kg, while at 100 micrograms/kg it increased the duration of digging in the substrate. Ondansetron had no effect on the categories of behaviour and failed to induce an anxiolytic-like enhancement of social investigation. Tianeptine produced an anxiogenic-like effect at 10 mg/kg, while at 5 mg/kg it enhanced flight and immobility. The relevance of these findings is discussed in relation of the reported behavioural actions of these compounds and to current pharmacotherapy of anxiety and depression. The apparent anxiogenic effect of tianeptine is a novel finding which requires further study.
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PMID:Behavioural effects in mice of subchronic buspirone, ondansetron and tianeptine. I. Social interactions. 905 87

Anxiety disorders include generalised anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD) and social phobia. Consideration of the chronicity of these disorders reveals that anxiety disorders first occur during early adolescence or young adulthood, and can wax and wane over periods of 5 to 10 years. Thus, in considering treatment, the emphasis must be placed on long term, rather than short term, management. Comorbidity studies reveal that untreated patients with anxiety disorders are at risk of social and psychological consequences, as well as disability resulting from comorbid and secondary disorders. Comparisons between buspirone and the benzodiazepines in treating patients with generalised anxiety disorder reveal that long term use of benzodiazepines is associated with adverse effects, particularly in elderly patients. Buspirone appears to have an onset of action equivalent to that of the benzodiazepines, to be well tolerated in the long term, to lack problems of habituation and withdrawal, and to be useful in patients with masked comorbid depression. In patients with panic disorder and social phobia, buspirone has not been clearly shown to be effective in comparison with the reference standards; in those patients with OCD, there are only preliminary indications of efficacy, which merit a more adjunctive role.
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PMID:A risk-benefit assessment of buspirone in the treatment of anxiety disorders. 906 23

Many nursing home residents are candidates for antipsychotic pharmacotherapy for dementia-related behavioral disturbances that include physical agitation and aggression, verbal outbursts, anxiety, and depression. These patients are often resistant to or intolerant of standard neuroleptics and are usually receiving multiple medications for concurrent psychiatric or medical conditions. New medications must be carefully considered because they may interact with concurrent medications or aggravate concurrent medical problems. Low doses of risperidone may be better tolerated in the elderly because the drug poses little risk of extrapyramidal side effects or blood disorders. One hundred and nine patients with dementia-related behavioral disturbances were studied in 9 nursing homes; most initially received 0.25 to 0.5 mg of risperidone twice daily. Their behavior was recorded for up to 6 months on questionnaires completed by a nursing staff member at each home. Risperidone was well tolerated overall and nursing staff viewed it as helpful in 38 of 100 patients, moderately helpful in 26, slightly helpful in 17, and not helpful in 19.
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PMID:Risperidone for dementia-related disturbed behavior in nursing home residents: a clinical experience. 919 80

Behavioral effects of the antipsychotic drug risperidone were tested in rats responding for variable-interval stimulation of the ventral tegmental area (VTA). Risperidone (0-0.9 mg/kg) produced a dose-dependent depression of responding in the 60 min after injection. Self-stimulation tests delayed for 30 or 120 min after injection showed that inhibition of responding by risperidone was limited in duration, with response rates recovering to pre-injection levels in a time-dependent manner. Recovery occurred regardless of opportunity to engage in self-stimulation, and was virtually complete at a time when receptor occupancy has been shown to be almost undiminished. The atypical properties of risperidone have been ascribed to its potent antagonist activity at 5-HT2 receptors; however, spontaneous recovery from the effects of risperidone was not prevented by simultaneous administration of a selective 5-HT2 agonist (DOI), even though DOI when given alone produced a 50-70% reduction in response rates. These results show that the inhibitory effect of risperidone on operant performance may be self-limiting in a manner that is not accounted for by its pharmacokinetic properties nor by its antagonist activity at central 5-HT2 receptors.
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PMID:Rapid recovery of self-stimulation from depression produced by the atypical neuroleptic risperidone is not prevented by 5-HT2 receptor stimulation. 940 12


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