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)

Recent years have seen significant advances in sleep disorders medicine, including effective treatments for chronic psychophysiological insomnia and obstructive sleep apnea syndrome; greater understanding of biological rhythms and of the nature of sleep in depression, including seasonal affective disorder; and the discovery of REM behavior disorder. The author reviews selected developments in the sleep disorders field over the last three years. Developments are presented in the framework of the diagnostic classification of the American Sleep Disorders Association, with emphasis on areas relevant to the practice of psychiatry.
 ...
PMID:Sleep disorders: a selective update. 264 52

Forty-two outpatients with major depressive disorder entered a double-blind, randomized trial of either desipramine or amitriptyline for a minimum of 6 weeks. Pretreatment polysomnographic and clinical measures were used to predict response. Response was defined as a 17-item Hamilton Rating Scale for Depression score less than or equal to 9 at the end of treatment. There was a 61.1% response rate for patients treated with amitriptyline and a 66.7% response rate for patients treated with desipramine. Reduced REM latency (2-night mean less than or equal to 65.0 min) predicted a positive response to these tricyclic antidepressants. REM latency did not differentiate between desipramine or amitriptyline responders. More patients with reduced REM latency (80%) responded to treatment compared with patients with nonreduced REM latency (50%). The 80% response rate in reduced REM latency depressed patients confirms our previous findings in a mixed inpatient and outpatient sample. Contrary to our hypothesis, in this sample, endogenous depression was not associated with a good response to tricyclic medication.
 ...
PMID:Reduced REM latency predicts response to tricyclic medication in depressed outpatients. 265 19

1. Since the late 1970's, considerable progress in the description and quantification of EEG sleep changes in depression has been made. A consistent finding in the sleep of depressed patients is a shortening of the time from sleep onset to the appearance of the first REM period (short REM latency) suggesting that this finding might be used as a clinical test to differentiate depressed from nondepressed patients. 2. Sleep architecture changes in depression are described and factors influencing REM sleep are identified. The stability of REM sleep abnormalities and the specificity of these changes for depression are discussed. Methodological issues, which have been identified as possible contaminants affecting the reliability of research findings, are described before the author concludes with a summary of current obstacles to using polysomnography in the clinical assessment of depressed patients.
 ...
PMID:Sleep architecture changes in depression: interesting finding or clinically useful. 266 93

Within the last decade, the application of neurophysiological and neuroendocrine techniques has led directly to the identification of specific psychobiological correlates of depression. More recent efforts have attempted to establish linkages between mechanisms of action by antidepressants and such psychobiological factors. EEG sleep investigations, conducted with various antidepressants, have focused on the "specificity" of REM suppression or slow-wave sleep alterations. To date, results point to a greater commonality of action for REM suppression, lack of sedative effect as a necessary condition for clinical improvement, and the need for greater emphasis on slow-wave sleep research in relation to clinical recovery. The need for integrated theories of neurophysiological and neuroendocrine factors in depression is stressed.
 ...
PMID:Neurophysiological factors in depression: new perspectives. 267 May 72

In this review we discuss the symptoms, etiology and therapy of reversible organic mental disorders following surgery. Acute confusional states and delirium still pose difficult and unsolved problems in our operative wards and intensive care units. They are a major cause of morbidity and mortality following geriatric surgery. It is necessary to keep a watchful eye for signs of mild cerebral impairment. Slight disorientation, minor fear, depression or delusions can be the first step towards an aggressive or delirious restlessness. Changes in cognitive skills and a reduction in the operative level are useful guidelines. In most cases more than one etiological factor contributes to the psychopathology. The list of possible causes is long and the frequency and importance varies greatly. Preexisting dementia, unrecognized hypoxia, massive surgical procedures, extracorporeal circulation during cardiac surgery, drug and alcohol withdrawal, infections and the use of multiple medications with cerebral side effects can all interfere. A total, but reversible cerebral alteration or sometimes local damage with neurological dysfunction is thought to be part of the pathomechanism. Disorders of the blood-brain barrier, changes in transmitter turnover, disturbances in the circadian rhythm and REM sleep phases are also being considered. When attempting to make a diagnosis, one should look for signs of neurological damage, withdrawal reactions and exclude or verify major or menacing etiological factors. The therapeutic strategy consists of treatment of the underlying organic diseases, consistent and attentive care that provides orientation and support, and carefully selected medication. The change in pharmacokinetics during old age, and the anticholinergic or other confusion-inducing properties in drugs should be remembered. The administration of either minor or major tranquilizers should be in accordance with a clear treatment strategy.
 ...
PMID:[Postoperative transitory syndrome and delirium]. 268 86

During depression, chronobiological disorders occur, such as disturbances in body temperature and early urinary excretion of a noradrenaline metabolite. Sleep patterns are disturbed in 90% of depressed patients; early REM sleep and shortened slow-wave sleep (stages 3 and 4), resulting in an increase in REM sleep, have been observed. Thus, an increase in REM sleep may be an indication of depression. Chronic insomnia is characterised by irregular sleep behaviour, an anxious attitude to sleep and increased cognition before sleep onset. Patients with this disorder can be divided into those with a disturbed ultradian rhythm (less than 2 REM-NREM cycles) and those with regular sleep structure (greater than 2 REM-NREM cycles). Most antidepressants reduce REM sleep, an effect evident from day 1 of administration. Trimipramine is an exception in that it has antidepressant and sedative effects without modifying REM sleep, and it possesses a different pharmacodynamic profile. Trimipramine is effective in depressed patients with chronobiological disorders such as chronic insomnia, although its mechanism of action is not fully understood.
 ...
PMID:Depression, circadian rhythms and trimipramine. 269 50

The presence of mixed symptoms of anxiety and depression are well known to every clinician. Panic, generalised anxiety and obsessive-compulsive disorder all have considerable overlap with major depressive illness. Factor analysis of anxiety and depression symptoms has sought to predict response to treatment as well as to establish a diagnosis. Sleep disturbances are important concomitants of both syndromes. The analysis of the architecture and phasing of sleep stages has been proposed as a biological marker to separate anxiety and depression. The modification of REM and delta sleep has been correlated with antidepressant action. The earliest studies of trimipramine noted antidepressant, anxiolytic and hypnotic effects. Further observations have shown this drug to have atypical effects on REM sleep. In addition, despite its structural similarity to other tricyclic antidepressants, its pharmacological profile in animals is very different: there is no synaptosomal reuptake of serotonin or noradrenaline, and no desensitisation of beta-adrenoceptors after long term administration. A series of studies was carried out on 99 patients. Admission criteria for the studies specified a minimum score of 20 on the Anxiety Status Inventory as well as the presence of moderate depression. An uncontrolled trial demonstrated the anxiolytic efficacy of trimipramine. Further controlled trials showed superior anxiolytic efficacy of trimipramine to amitriptyline and doxepin with comparable anxiolytic efficacy of trimipramine with maprotiline. All agents had equal antidepressant effects.
 ...
PMID:Trimipramine, anxiety, depression and sleep. 269 52

Patients with IPD often develop oxygen desaturation during sleep. We investigated whether or not the degree of falls in SaO2 during sleep were correlated with the daytime data of pulmonary function tests, arterial blood gas tensions, or ventilatory responses to chemical stimuli. Fourteen patients with IPD who had restrictive ventilatory impairment were studied to evaluate these relationships. The magnitude of SaO2 depression from awake to REM sleep was inversely correlated with the level of baseline SaO2. Hypercapnic ventilatory response was inversely related to the amount of maximal desaturation in both REM and NREM sleep. These results indicate that patients with IPD who have insufficient ventilatory response to hypercapnia reveal larger falls in SaO2 during sleep, particularly if they have lower baseline SaO2.
 ...
PMID:Arterial oxygen desaturation during sleep in interstitial pulmonary disease. Correlation with chemical control of breathing during wakefulness. 270 87

Brief maternal separations of young nonhuman primates have been used extensively to study the behavior and physiology of attachment, loss, and bereavement. The physiological responses to the loss of alternative attachment figures, such as peers, is less well documented in nonhuman primates. This study examined both autonomic and behavioral responses of peer-reared pigtail macaque infants to separation. Eight infants were removed from their mothers at birth and reared in four peer pairs. At 6 months of age, each monkey was implanted with a multichannel biotelemetry device which transmitted heartrate, body temperature, EEG, EMG, and EOG. Blood was collected twice weekly for immunological assessment. Behavioral and physiological data, including sleep, were collected for 1 week of baseline, 2 weeks of separation, and 1 week of reunion. Behavioral and physiological results indicated agitation but not depression following separation from their peer attachment figures. We found reduced mitogenic responses to pokeweed consequent to peer separation, suggestive of altered B-cell function. REM variables were the only sleep measures affected by the separation, and were suggestive of agitation but not depression.
 ...
PMID:Behavioral and autonomic responses to peer separation in pigtail macaque monkey infants. 278 5

The effect of a single, oral bedtime dose of the benzodiazepine hypnotics flunitrazepam (FR; 2 mg), flurazepam (FR; 30 mg), and triazolam (TR; 0.5 mg) on the sleep stages and the sleep EEG was investigated in eight healthy, young subjects. In comparison to the placebo night, all drugs reduced the percentage of stage 1 and REM sleep, increased stage 2, and decreased the number of stage shifts. For FN and FR, some of these changes persisted in the postdrug night. All-night spectral analysis of the EEG showed a reduction of low-frequency activity (0.25-10.0 Hz) in stages 2, 3 + 4 and REM sleep, changes that persisted for all three drugs in the post-drug night. In the drug nights, activity in the spindle frequency range (11-14 Hz) was enhanced particularly in stage 2 and 3 + 4, activity in the high frequency range (17-25 Hz) particularly in REM sleep and stage 1. In the first third of the drug night, the depression of low-frequency activity in stage 2 was either absent (FR) or less prominent (FN, TR) than in the following part of the night. The results demonstrate that benzodiazepine hypnotics induce specific changes in the EEG spectra which reflect the immediate and residual drug effects more sensitively than conventional sleep scores.
 ...
PMID:Effect of benzodiazepine hypnotics on all-night sleep EEG spectra. 286 73


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