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)

From August 1988-June 1989, 983 physicians participated in a phase IV trial by following 7759 women using the monophasic oral contraceptive (OC), Demulen 1/35 (1 mg ethynodiol diacetate and 35 ug ethinyl estradiol) to evaluate its efficacy and safety. The total number of cycles for the study stood at 21,440. In addition, the total woman-years stood at 1787. Only 6382 patients could be evaluated for safety. 4.4% of the patients had adverse reactions to the OC, but only 1.7% of all patients stopped taking it. The leading side effects included nausea (67 cases), headache (45), amenorrhea (42), emotional changes (30), breast pain (19), dysmenorrhea (12), and 11 cases of weight gain, abdominal/pelvic pain, and bloating. Of the 280 reported adverse reactions, only 87 (31%) were considered severe. The leading serious adverse reactions were depression (10) and hypertension (6). Only 5412 patients could be used to determine efficacy. The physicians initially reported 121 (2.2%) pregnancies during the study. The researchers learned that 33 of the 84 returned 2nd questionnaires (response rate, 70%) reported that the women conceived after enrollment but before taking the OC. 36 conceived while taking it, but 8 did not take it daily. Noncompliance may have contributed to pregnancy for the remaining 28 cases. Therefore the 36 confirmed pregnancies made for a failure rate of .7%. 85.7% of the pregnancies happened in the 1st 3 months of taking the OC. Either patient noncompliance or true medication failure accounted for treatment failure. Therefore it is important for physicians to instruct patients on how to take OCs correctly.
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PMID:Efficacy and safety of ethynodiol diacetate, 1 mg, with ethinyl estradiol, 35 micrograms, with an emphasis on contraceptive efficacy. A phase IV trial. 204 81

Femovan contains 30 mcg of ethinyl estradiol and 75 mcg of gestodene. Gestodene has been used in combination oral contraceptives since 1987 in 38 countries with hardly any effect on carbohydrate and lipid metabolism or fibrinolysis. Its contraceptive reliability for menstrual cycle control and tolerance was examined. A total of 102.769 women aged 18-35 with 593.455 menstrual cycles were included in 2 phases. Most of the women were German women, but the study included women from Europe and Latin America. Although 2-8% of the women took Femovan irregularly, only 3 pregnancies occurred in 414 English women (4704 cycles), 7 in 3267 German women (36.711 cycles), and 124 in 95.906 German women (523.477) as a result of forgetfulness. The pearl index reached .16 and .22 in the 2 phases, respectively, under client failure, and .07 and .06 under method failure. Bleeding ranged from .6-2.8% of cycles, while spotting was 4.5-8.2%. The omission of menstrual bleeding occurred in less than 1% of this population. Tension in the breasts, headache, and nausea with nervousness occurred in up to 10% of the women. Nervousness, vertigo, and depression was significantly less frequent. Acne and edema occurred only in a few cases. The average increase of body weight was a maximum of .8 kg. Blood pressure was unchanged for a few cases. There were 2 and 26 cases, respectively, of thromboembolitic diseases in the 2 phases amounting to .3 and .6/1000 woman years of use which compares to .4-1.7/1000 of the Oxford-Family Planning Association cohort study results. Femovan was discontinued on medical grounds (headache, nausea, and irregular bleeding) in 10.3% of 3267 German women and in 7.5% of 95.906 German women. Femovan's acceptance rate was remarkably high, and it proved to reliable and well-tolerated.
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PMID:[Clinical experiences with femovan (Gynera)]. 209 80

Psychotropic effects have been imputed to oral contraceptives (OCs); however, studies with large populations found no depressive episodes caused by OCs. Affective disorders of women such as premenstrual syndrome and postpartum and menopausal depression are well-known. The estrogen and progesterone levels are high during pregnancy, when the risk of emotional disease declines. A study on Marvelon (containing .15 mg of desogestrel and .03 mg of ethinyl estradiol) involving 27,000 women found a history of depression in 3%, but in 90% the symptoms disappeared after OC use. Other studies corroborated the finding that OCs exerted a stabilizing effect on emotional disorders. The overwhelming majority of women without psychiatric anamnesis did not suffer any mood fluctuations under OC use. In a study, 4327 women were interviewed at 3 and 6 months of OC use, and in 45.7% their sense of well-being improved, 30.3% were in a good frame of mind, and 21.2% had a slight deterioration of their sense of well-being. Neurotic and introverted persons tended to attribute affective disorders, weakness of concentration, sleep disturbances, and the avoidance of sex to OCs. With such individuals, OC indication requires particularly strict adherence to rules. The ability of Ocs to improve acne was analyzed when 1785 questionnaires were examined from 1958 women who had used Marvelon. 60% reported improvement of their acne, and 50% of the more severe cases improved. Dysmenorrhea and menstrual cycle disorders improved similarly. Body weight increase in insignificant with modern OCs. OCs exert a positive psychotropic effect through their ability to influence these conditions.
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PMID:[Does the pill have a psychotropic effect?]. 215 6

We examined possible predictors of traumatic deaths by means of a case-control study nested within a large ongoing cohort study of residents of a Southern California retirement community. Baseline information was collected by means of a detailed mailed health survey completed by 11,888 residents in 1981-1982. In multivariate logistic regression analysis, being widowed or divorced (RR = 6.4, P = 0.009), sleeping 9 or more hours per night (RR = 4.6, P = 0.02), and drinking more than three alcoholic beverages a day (RR = 3.5, P = 0.04) were significant predictors of suicide risk. However, the strongest predictor of suicide was a mental outlook assessment summary score calculated from responses to seven questions derived from the Zung self-rating depression scale. Individuals in the poorest summary score category were 23 times more likely to commit suicide than individuals in the best summary score category (P = 0.004). Women who regularly practiced breast self-examination were also at very low risk for suicide (RR = 0.1, P = 0.0005). The mental outlook assessment summary score was also a predictor of accidental deaths, although the relative risk estimates were lower than those for suicide and the individual questions best predicting risk were different. A history of a serious chronic disease (RR = 2.6, P = 0.01) and moderate alcohol intake of less than two drinks per day (RR = 0.3, P = 0.01) were also predictors of accidental deaths. Estrogen use in women did not predict risk of traumatic deaths.
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PMID:A prospective study of risk factors for traumatic deaths in a retirement community. 237 94

The oral contraceptive formulations in use today consist of three types. One type has a fixed dose of a combination of a synthetic estrogen and a synthetic progestin, the second has varying doses of each of these steroids, and the third consists of a fixed dose of a progestin without an estrogen. The estrogen in the older formulations contained mestranol, while all those developed since 1974 contain ethinyl estradiol. The estrogen is combined with varying dosages of nine different progestins to produce a wide variety of formulations. The major metabolic effects of the estrogen are an increase in hepatic production of globulins, some of which cause hypercoagulability, and an increase in blood pressure in certain users. By varying HDL-cholesterol, the estrogen has a beneficial effect upon lipids. Other estrogenic effects include fluid retention, depression, and breast tenderness. Most of the progestins have androgenic effects, being derived from 19-nortestosterone. These include peripheral insulin resistance, a lowering of HDL-cholesterol, nitrogen retention, and nervousness. Both the estrogen and progestins metabolic effects are dose-related and with the newer, low-dose formulations, the adverse metabolic and clinical effects are minimal. Thus the results of the epidemiologic studies performed 10 to 15 years ago, when women were using high-dose formulations, are not relevant to the oral contraceptive formulations in use today. Recent epidemiologic studies show that healthy, nonsmoking women using oral contraceptives do not have an increased risk of developing cardiovascular disease.
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PMID:The pharmacologic and metabolic effects of oral contraceptives. 257 52

As an indicator of analogous brain serotonin metabolism, and by extension of depression tendency, platelet imipramine receptors were measured in women taking the triphasic oral contraceptive Logynon. Logynon (Schering AG Berlin/Bergkamen, Germany) contains levonorgestrel 50 mcg for 6 days, 75 mcg for 5 days and 125 mcg for 10 days, followed by 7 days pill-free; ethinyl estradiol doses are 30, 40 and 30 mcg for the same periods of time. The mean imipramine binding values (Bmax), calculated from Scatchard plots of tritiated uptake by platelets, was 429 in the control cycle, 396 on Day 14 of the 1st treatment cycle, and 582 in the 2nd treatment cycle (p0.02 vs pretreatment). Control means were 412 and 411. No significant differences were seen in affinity (Kd). There were no significant differences in mean Beck Depression Inventory tests, although 1 woman became clinically depressed, with BDI scores of 22 and 33 compared to 2 before taking Logynon. Her Bmax values were 626, 630 and 796 in the pretreatment, 1st and 2nd cycles respectively. Overall, the increase in imipramine binding did not correlate with Beck depression inventory scores.
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PMID:Up-regulatory effect of triphasic oral contraceptive on platelet 3H-imipramine binding sites. 283 63

Patients with ovarian carcinoma refractory to chemotherapy received a sequential combination of ethinyl estradiol and medroxyprogesterone acetate in two dose regimens. There was no difference in therapeutic activity of the two dose regimens. Of 65 patients, nine (14%) responded to treatment and 13 (20%) had stable disease. Vascular complications occurred in three patients; hemiplegia developed in one of those. Nine patients had significant nausea and vomiting, and one experienced severe depression that required treatment withdrawal. The sequential and combined use of ethinyl estradiol and medroxyprogesterone acetate may provide an alternative treatment for certain patients with ovarian carcinoma that does not respond to optimum chemotherapy. Additional studies are required to determine if synergism exists between this treatment and other modalities of therapy. Further investigation is required into the vascular disorders that complicate therapy to determine whether appropriate preventive measures are possible.
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PMID:Ethinyl estradiol and medroxyprogesterone acetate in patients with epithelial ovarian carcinoma: a phase II study. 293 33

To evaluate the safety and effectiveness of Minulet, a new low-dose combination oral contraceptive (OC) containing 75 mcg of gestodene and 30 mcg of ethinyl estradiol, a multicenter trial involving 239 women was conducted in Switzerland. Of the 239 subjects, 187 (78%) were monitored for 6 cycles of OC use and 24 (10%) were followed for 3 cycles, yielding a total of 1265 cycles for observation. No pregnancy occurred during the study period, despite the fact that 1 or more pills had been forgotten in 17.1% of cases. Cycle length and the intensity and duration of bleeding were favorably affected by Minulet use, especially in women with a prior history of prolonged, heavy bleeding. Spotting occurred in 8.2% of subjects by cycle 3, but this rate was reduced to 5.9% by cycle 6. Breakthrough bleeding alone occurred in 2.1% of the cycles. The amenorrhea rate was 1.6% after cycle 6. There were no serious side effects, and symptoms such as headache, depression, breast tenderness, acne, nervousness, and dizziness were actually reduced as a result of OC use. Most notable was the decrease in dysmenorrhea, from 40% before beginning OC use to 13% after 3 months and 8% after 6 months. No significant effects on systolic or diastolic blood pressure were recorded among study participants, nor were there significant weight changes. Of the 17 women who terminated the trial due to side effects, metrorrhagia accounted for 17% of the terminations, depression for 14%, nausea for 14%, and headache for 13%. The findings of this trial, in terms of reliability, cycle control, and tolerability, suggest that Minulet has considerable potential as a new contraceptive choice.
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PMID:Clinical experience in Switzerland with the new monophasic oral contraceptive Minulet (75 mcg gestodene, 30 mcg ethinyl oestradiol). 307 5

Female and male rats were treated with ethinyl estradiol (5.0 mg/kg daily for 5 days). Control animals were pair fed to compensate for the reduction in food intake induced by the estrogen, or were fed ad libitum. Treatment with ethinyl estradiol reduced total cholesterol and apolipoprotein A-I concentrations in the serum of female and male animals. The concentrations of serum and hepatic triacylglycerol were depressed markedly in animals of both sexes in groups treated with ethinyl estradiol, compared to the control group fed ad libitum. Compared to the pair-fed controls, however, ethinyl estradiol had only a very minor further reduction on serum triacylglycerol concentration. In male and female rats, the synthesis and secretion of triacylglycerol by the liver was, in comparison to the pair-fed controls, stimulated by estrogen, whereas the secretion of unesterified cholesterol was unaffected by any of the treatment regimens. The synthesis and secretion of total cholesteryl esters by livers from male and female rats was increased by treatment with ethinyl estradiol. The hepatic synthesis and secretion of VLDL triacylglycerol and cholesteryl ester was stimulated by ethinyl estradiol in male and female rats, and the VLDL particle was enriched with cholesteryl ester. Treatment with the high-dose estrogen increased the secretion of apolipoprotein A-I by livers from female rats. It is suggested that the depression in the serum concentrations of cholesteryl esters and apolipoprotein A-I is the result of increased rates of hepatic and/or peripheral catabolism of these components and that the hepatic production rates were increased or unaffected in animals administered high doses of ethinyl estradiol. Since the secretion of apolipoprotein A-I by livers from male rats was unaffected by treatment with ethinyl estradiol, the response to estrogen may be sex related.
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PMID:Effects of high-dose ethinyl estradiol on serum concentrations and hepatic secretion of the very-low-density lipoprotein, triacylglycerol, cholesterol, and apolipoprotein A-I in the rat. 308 18

Detailed interview information was obtained from 515 women in connection with a Swedish-Norwegian comparative investigation on possible connections between use of oral contraceptives (OCs) and premenopausal breast cancer. The Norwegian data was reviewed to ascertain the occurrence of mild side effects and how these side effects influence the use of OCs. In all, 63% of those interviewed had used OCs. Side effects were reported in 55.6% of the 629 use periods. The most frequent side effects were weight gain (17.8%), irregular menses (14.0%), nausea (8.9%) and tender breasts (8.8%). The respondents also reported depression, aggressiveness, decreased libido, headache and migraine. Differences in side effects were found for various OCs depending upon quantity of hormone and composition. Estrogen related complaints such as tender breasts and weight gain increased in relation to the estrogen dosage in the pill. Users of the minipills often reported irregular menses. Reports of psychological problems were relatively evenly distributed but users of minipills reported significantly lower rates of side effects for such complaints. Although relatively few use periods were reported for triphasic pills, these also appear to be involved with a number of side effects. 2 out of 5 women who began taking OCs reported that they had to stop because of side effects. This reduced the value of OCs as an effective and easily obtainable means of contraception.
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PMID:[Mild side-effects of oral contraceptives]. 320 63


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