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)

To determine what patients are likely to benefit from treatment with a tricyclic antidepressant, the authors surveyed American researchers, teachers of psychiatry, general psychiatric practitioners, and foreign researchers. Areas of agreement were appreciable and can serve as an index of accepted community practice and as guidelines for teaching. Responses indicated that patients most likely to benefit from a tricyclic antidepressant are those with primary depression; early morning awakening; motor retardation; loss of appetite; weight loss; prior positive response to a tricyclic antidepressant; loss of interest in work or hobbies; sad, blue, or depressed feelings; improved mood in evening; and loss of interest in sex. Amitriptyline was preferred for agitated depressions, and imipramine was preferred for retarded depressions.
 ...
PMID:Who benefits from tricyclic antidepressants: a survey. 337 27

The efficacy of amitriptyline was evaluated in 28 patients with chronic oral-facial pain. Most of the patients had evidence of musculoskeletal pain while some had a history suggesting pain of neurogenic origin. Two patients had mixed elements of neurogenic and musculoskeletal pain. Amitriptyline was more effective than placebo in reducing pain after 4 weeks of treatment. No effect was found after only 1 week of drug administration in either dose range. When the patients were divided into depressed and non-depressed groups based on their Hamilton depression scores, amitriptyline reduced pain in the depressed and in the non-depressed groups as compared to placebo. Amitriptyline reduced the depression scores in the depressed group but had no effect on the depression scores in the non-depressed group. Thus, pain reduction was not associated with a change in mood in the non-depressed group. Amitriptyline had no effect on patients' ratings of the intensity of experimental heat stimuli. We conclude that amitriptyline is effective in the treatment of chronic oral-facial pain and that its efficacy is independent of its effects on depression. It appears that tricyclic antidepressants act in a fashion different from opiate drugs that alter the sensory discriminative component of pain.
 ...
PMID:The analgesic effect of amitriptyline on chronic facial pain. 343 80

A theory of excessive transmission of serotonin (5-HT) in depression has been previously proposed. The purpose of the present study was to test this theory further by using the model of depression in rats induced by L-5-hydroxytryptophan (5-HTP), the precursor of 5-HT. The drug effects on 5-HTP (25 mg/kg) induced behavioral depression were tested by chronic administration using methysergide which is a postsynaptic blocker of 5-HT, or by comparable clinical doses of antidepressant drugs. Methysergide (2 mg/kg) blocked 5-HTP induced depression on days 8 and 22 after initiation of medication by 70% and 83%, respectively. Among antidepressants, mianserin (2 mg/kg) was the first to produce an effect, displaying a 38% effect as early as 1 day after the start of medication and having blocking effects of 52% and 72% on days 8 and 22. Desipramine (5 mg/kg), doxepine (5 mg/kg), imipramine (5 mg/kg) and trazodone (10 mg/kg) showed no significant effect on days 1 and 8, and on day 22, 64, 36, 33 and 32% blocking, respectively. Amitriptyline had an initial effect of 41% at a dose of 10 mg/kg. Clomipramine (5 mg/kg), zimelidine (6 mg/kg) and chlorpromazine (2.5 mg/kg), which is a neuroleptic, showed no effect. Considering these results in light of recent data reported on the 5-HT synapse, it was suggested that 5-HTP induced depression may be induced by excessive transmission of 5-HT and that some antidepressant drugs may produce their effect by blocking this postsynaptic transmission. Based on these results, the mechanisms of human depression were discussed.
 ...
PMID:Action of chronically administered antidepressants on the serotonergic postsynapse in a model of depression. 349 69

Amitriptyline (AT) and the noradrenaline reuptake inhibiting antidepressant oxaprotiline (OT = hydroxymaprotiline) were compared in 59 primary depressive inpatients in a 4-week double blind parallel group design. In the Hamilton Depression Rating Scale and 2 self-rating scales AT proved to be more efficient than OT, mainly with respect to disturbances of appetite and sleep. Agitated patients receiving OT needed more additional tranquilizing medication. The number of side-effects did not differ. Both drugs increased heart rate and skin resistance level (SRL) to about the same degree and did not influence the number of spontaneous fluctuations of SRL, habituation of SRL orienting responses (OR), frequencies of respiration and blinking. Salivation was temporarily more impaired by AT. All physiological variables differed between patients and 30 healthy controls during the whole 4-week trial. Clinical outcome showed a linear relation to OT plasma levels. For AT a therapeutic window was confirmed for concentrations of AT and its metabolite nortriptyline between 125 and 200 ng/ml. Patients whose SRL-OR habituated rapidly had a better outcome than slow habituators. Urinary excretion of 3-methoxy-4-hydroxyphenylglycol was lower in patients than in controls but could not predict outcome with either drug.
 ...
PMID:Amitriptyline and oxaprotiline in the treatment of hospitalized depressive patients. Clinical aspects, psychophysiology, and drug plasma levels. 352 6

The results of dexamethasone suppression test (DST) and the effectiveness of amitriptyline and phenelzine in treating depression with melancholia after minor closed head injury in 10 patients were compared to those in 12 control patients with primary depression and melancholia. Prevalence of abnormal DST results was higher in the control group (91%) than in the closed head injury group (10%). Results of the DST corresponded with clinical improvement. Amitriptyline produced significant and consistent improvement in all control patients at the end of 4 weeks of treatment. No patient in the closed head injury group showed significant improvement with amitriptyline. The closed head injury patients were treated with phenelzine after a 3- to 7-day washout period. No statistical improvement after 4 weeks of treatment with phenelzine was seen in any of these patients. The DST may be useful as an adjunct to the diagnostic and monitoring process in primary depression with melancholia. Depression after minor closed head injury did not correlate with the DST. Amitriptyline and phenelzine have limited use (if any) in depression with melancholia after minor closed head injury.
 ...
PMID:Depression after minor closed head injury: role of dexamethasone suppression test and antidepressants. 401 22

From 1976 to 1980, there were 3,193 admissions due to acute drug overdosage at the Resuscitation Center of the Klinikum Charlottenburg of Berlin, Free University. We determined the frequency and characteristics of self-poisoning with antidepressants and some low potency neuroleptic drugs (perazine and thioridazine). These drugs were involved in 92 cases (i.e., 3%) during a 5-year period. Amitriptyline - in combination with a benzodiazepine - was the most common antidepressant taken by the patients. 10 of the patients required assisted ventilation. Complete ECG recordings were carried out in 24 patients; 21 of them had abnormalities comprising prolonged QTC and PR intervals (19, 15 and 8 patients, respectively). Sinus tachycardia was present in half of those patients. In no cases were convulsions or cardiac arrhythmias requiring special treatment described in the medical records. The percentage of patients showing ECG changes and respiratory depression was higher when other drugs such as ethanol were ingested along with antidepressants than when only antidepressants were taken. The incidence of antidepressant self-poisoning in this area was relatively low compared to the results of other studies. Possible explanations for its low frequency could be a low rate of prescription of antidepressants, a low dosage prescribed or the success of antidepressants in the treatment of depression and thereby in the prevention of attempted suicide.
 ...
PMID:Poisoning with antidepressive drugs: a five-year retrospective study. 406 78

Patients with cirrhosis were found to be extremely sensitive to tranylcypromine, and the use of this drug for the treatment of depression in such patients is contraindicated. Amitriptyline has a wider margin of safety in such patients, but caution is necessary when the higher therapeutic doses are prescribed.
 ...
PMID:Antidepressants and liver disease. 463 4

Alkalinization with NaHCO3 can effectively reverse ventricular arrhythmias caused by amitriptyline intoxication, but the mechanism is unclear. To test whether alkalinization per se is important or whether increases in extracellular Na concentration also contribute, we exposed Purkinje fibers to 500 ng/ml (1.8 microM) of amitriptyline and then superfused them with three different test solutions, viz. 1) high Na-Tyrode's, 2) high NaHCO3-Tyrode's and 3) high pH-low pCO2-Tyrode's. Amitriptyline significantly depressed action potential amplitude and Vmax without altering resting membrane potential and abbreviated action potential duration at all phases of repolarization. Effects on phase 0 were accompanied by a depression of conduction velocity. All three test solutions produced significant hyperpolarization and improvement in action potential amplitude and Vmax. However, the magnitude of improvement of phase 0 characteristics was significantly greater after high NaHCO3 and resulted in significant improvement of conduction velocity in fibers depressed by amitriptyline. The effects of amitriptyline on phase 0 were rate-dependent. Reversal of this effect by NaHCO3 was equally effective at all rates. Improvement of Vmax was partly related to a shift of the Vmax-membrane potential relationship in the depolarizing direction. NaHCO3 had minimal and variable effects on action potential duration. The results suggest that the beneficial effects of NaHCO3 are related to a reversal of drug effects on phase 0 characteristics and that this effect is due both to alkalinization and to increases in extracellular Na concentration.
 ...
PMID:Mechanism of reversal of toxic effects of amitriptyline on cardiac Purkinje fibers by sodium bicarbonate. 609 16

This is a preliminary report of an ongoing study of the relationship between unexplained infertility and depressive illness conducted by a team of two specialists: a gynecologist and a psychiatrist. Over a 3-year period, 16 cases of unexplained infertility and depressive illness were treated by the team. Nine of the cases received psychiatric treatment, consisting of pharmacotherapy with Amitriptyline and a limited number of psychotherapy sessions. The other seven cases terminated with the psychiatrist after the psychiatric evaluation. Three of the cases that received the psychiatric treatment became pregnant. Follow-up at the end of the 3-year period revealed that none of the 13 others (psychiatrically treated and untreated) had become pregnant. These preliminary data suggest that in cases of depression preceding the onset of unexplained infertility psychiatric treatment as described above increases reproductive capacity.
 ...
PMID:Infertility and depression. 613 Oct 40

Amitriptyline (Am) is a frequently prescribed tricyclic antidepressant drug associated with an increased risk of sudden death that has been presumed to be arrhythmia related. Little has been known about the effects of Am on left ventricular function. We studied i.v. Am (0.5, 1.0, and 1.5 mg/kg) in 10 conscious, resting, chronically instrumented dogs. Heart rate (HR) increased up to 70%; this increase was only partially prevented by propranolol. Left ventricular end diastolic pressure (LVEDP) decreased without, but not with, propranolol. Mean arterial pressure (MAP) increased by 10-13% transiently. The maximum rate of rise of left ventricular pressure (dP/dtmax) decreased by 16-18% without propranolol and by 14-29% with propranolol, indicating a moderate decrease in myocardial contractility. Changes in stroke volume were similar to changes in dP/dt. Thus, i.v. Am, at levels similar to therapeutic blood levels, causes a moderate depression of myocardial contractility, which is accentuated by propranolol. Tricyclic antidepressants, therefore, could have adverse effects on cardiac performance in patients with underlying myocardial dysfunction.
 ...
PMID:Effects of amitriptyline on left ventricular function in conscious dogs. 617 21


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