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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Some chronic diseases have a favourable course and are cured spontaneously. Allergic diseases such as eczema, hay fever and asthma have a good outcome in more than 75% of cases within 7 to 25 years, depending on the kind of allergy. Migraines have also a good evolution in children and after menopause. Many symptoms due to menstruation such as dysmenorrhea, premenstrual syndrome or anemia, disappear after menopause as well as diseases due to estrogens such as uterine leiomyoma, endometriosis and prolactinoma. The risk of epilepsy relapse after a first seizure is about 40% after 2 years. The risk is lower in children. Attention deficit disorder affects 3 to 5% of children but is present in only 30% of them in adult age. The prevalence of depression decreases in women between 30 and 60 years of age. Functional somatic syndromes such as fibromyalgia, irritable bowel syndrome or dyspepsia decrease in 2/3 of cases within 5 to 10 years if there is no history of anxio-depressive symptoms. However, prognosis is reserved when initial symptoms are severe or if they are connected to sexual abuse, domestic violence or depression. Other diseases have a spontaneous favourable course such as myopia, idiopathic infertility, polycystic ovary disease or ventricular arrhythmia. The knowledge of a good prognosis enables to avoid unnecessary treatments and to reassure many patients.
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PMID:[The benefits of aging. I. Patience and cure: spontaneous beneficial course of certain diseases]. 1172 11

Depression commonly affects women, particularly during their childbearing years. Often, pharmacologic therapy is the recommended treatment. Today, medication selection generally involves the newer antidepressants, with tricyclic antidepressant and monoamine oxidase inhibitors reserved for more refractory patients. Although there is ample evidence to support the benefits of breastfeeding in the infant, the scientific literature contains little information with regard to the transfer of antidepressants from the plasma into breast milk and the subsequent effects on the developing infant. Secondary to this lack of safety data, many clinicians and mothers are reluctant to breastfeed during antidepressant treatment. This article will review the literature for reports of the newer antidepressants' use during lactation.
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PMID:Antidepressant use during lactation. 1184 91

We reviewed the log book of our university-based electroconvulsive therapy (ECT) service for the years 1981 to 1987. We identified 10 patients treated with monthly maintenance electroconvulsive therapy (ECT-M). These 10 patients received 3% of the ECT treatments given in this 7 year period. The review of their charts suggests that ECT-M is generally reserved for patients who are older (i.e., over 60 years of age), suffering from delusional depression and/or depressive pseudodementia, and have a history of poor response or tolerance to medications but good response to ECT. The patients had fewer hospitalizations in the 18 months after initiating ECT-M than during the 18 months preceding ECT-M (mean of 3.1 vs. 0.3, respectively, p < 0.001). However, this apparent efficacy of ECT-M may be confounded by the concurrent use of medication. A review of the literature reveals only descriptive studies on ECT-M and shows that our data are congruent with these published studies. The relative value of maintenance ECT and its specificity remain unknown. Its apparent impact on hospitalization rates and safety warrant controlled trials.
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PMID:A Retrospective Study of Maintenance Electroconvulsive Therapy in a University-Based Psychiatric Practice. 1194 Oct 53

The classification of depressive disorders has been changing ever since the first descriptions of mood disorders were produced some 2500 years ago. The interest in their classification has recently been revived as a result of the introduction of new types of medicaments for the treatment of the disorders belonging to the spectrum of mood disorders and of the emphasis that has been given to the diagnosis and treatment of mental disorders, and in particular depression in primary health care services. The currently used systems of classification contain a relatively large number of categories reserved for depressive disorders and it is to be hoped that the experience and information obtained by the use of these classifications, as well as the results of research into the psychopathology and the effects of treatment of mood disorders, will make it possible to arrive at a simplified and better classification of these conditions. It is likely that this improvement will be incremental, that the development of significantly better classifications will take time and the result of this developmental process will be a classification that will reflect consensus of the mental health professions based on the best available evidence. Copyright 2001 John Wiley & Sons, Ltd.
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PMID:Concepts of depression: sporadic revolutions of continuous evolution. 1240 30

Depression is treated by a great variety of antidepressant treatments. SSRIs (such as fluoxetine) are well known: it is, however, sure that further progress is needed and the search for antidepressants with other mechanisms of action (such as tianeptine) or different efficacy is still of interest. A multinational study compared tianeptine with fluoxetine in 387 patients with Depressive Episode, or Recurrent Depressive Disorder, or Bipolar Affective Disorder (ICD-10), in a double-blind parallel group design. They were treated for six weeks. At inclusion, no significant difference between groups was shown. Final MADRS scores were 15.7 and 15.8 with tianeptine and fluoxetine, respectively (ITT population) (p = 0.944). MADRS responders were 58% and 56% with tianeptine and fluoxetine, respectively (p = 0.710). No statistical difference was observed for the other efficacy parameters. Thirty-six withdrawals occurred in each group, without any difference for the reasons of discontinuation. There was no major difference between groups for the other safety parameters. In this study, both tianeptine and fluoxetine exhibited a good efficacy and safety. Copyright 1999 Elsevier Science B. V. All rights reserved.
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PMID:Efficacy and safety of tianeptine in the treatment of depressive disorders in comparison with fluoxetine* 1240 33

Although atypical antipsychotics are on the rise, traditional treatment of psychotic (or delusional) depression mostly includes the addition of classical antipsychotics to antidepressants. As there are only few data supporting this approach compared with antidepressant monotherapy, and almost no data comparing it with antidepressants of the latest generation, we conducted a retrospective chart analysis and a prospective, randomized open study on the efficacy and tolerability of nefazodone monotherapy versus combined treatment with amitriptyline and haloperidol in psychotic depression. The results suggest that the addition of classical antipsychotics should be reserved for those with very severe psychotic symptoms, but may not be needed in milder forms.
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PMID:Nefazodone in psychotic unipolar and bipolar depression: a retrospective chart analysis and open prospective study on its efficacy and safety versus combined treatment with amitriptyline and haloperidol. 1257 31

Anorexia and weight loss represent a major cause of morbidity and mortality. At present in the United States two effective anorectic agents are commonly used, namely, megestrol acetate and dronabinol. These two agents are compared in Table 1. In persons with a large excess cytokine production. megestrol acetate should be tried at a does of 800 mg per day for no longer than 3 months. Megestrol acetate should be administered with testosterone in men. It should be avoided in persons who are bed-bound because of the risk of deep vein thrombosis. Dronabinol should be used for most anorectic patients. Dronabinol should initially be given in a low dose (2.5 mg) in the evening. The dose should be increased to 5 mg per day if no improvement in appetite is seen after 2 to 4 weeks. Dronabinol can be continued indefinitely. It seems to have a particularly good profile for persons with anorexia who are at the end of life. In persons with depression and anorexia. mirtazapine seems to be the antidepressant of choice. In addition, the use of taste enhancers can be considered in persons who complain that the food does not taste good. The appropriate use of anabolic agents in older persons with weight loss is controversial. Certainly all older men who are losing weight should have bioavailable testosterone measured and, if the testosterone level is low, should receive testosterone replacement therapy. Women who are losing weight may benefit from the use of low-dose testosterone (eg, Estratest). Anabolic agents, such as oxandrolone, should be reserved for those who have profound cachexia. An approach to the management of anorexia and weight loss in older persons is given in Fig. 1. Thomas et al have provided a more complex algorithm the management of weight loss in nursing home residents.
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PMID:Orexigenic and anabolic agents. 1260 9

This is an account of my trips to Brazil in 2001 where I worked on a series of mental health projects with Brazilian colleagues. I first got interested in Brazil after I graduated from college when I was a Peace Corps volunteer in Northeast Brazil (Bahia state). After I got out of the Peace Corps I moved to Rio de Janeiro and went to work for United Press International (UPI) in their Rio bureau. I was UPI foreign news correspondent for a year and a half. Those years in Brazil were probably the happiest years of my life. Later on, after I became ill in the U.S., my Brazilian connection played an important role in my recovery. Raised in a Victorian family in a small town in the Midwest, and schooled in a traditional boarding school for boys and then at an all men's college, Brazil's lively Latino culture served as a healthy antidote for my tendency to be reserved and often depressed. My contact with Brazilians and Brazilian culture always beckoned me on. I maintained contact with my friends in Brazil and they stuck by me through my illness years. What seemed like my emotional and intellectual "excess" to me, was easily accepted by my Brazilian friends. I felt much more myself interacting with Brazilians and connected to a larger sense of self I developed in Brazil. I traveled to Brazil at every opportunity and made friends with Brazilians I met in the States. I initiated Portuguese classes at John Carroll University in Cleveland, Ohio in the early 1990s and then was invited to teach Brazilian culture to undergraduates. These appointments and my own resilience moved me past one depression and a dysthymia condition and into the wider community. I regained my confidence as a teacher, a role I had before and during the years of my illness. From this position, I organized a club for Brazilian students studying in the Cleveland area. After this teaching stint, I felt ready to pursue full time employment and began a job search that would eventually land me in New Haven at the Connecticut Mental Health Center. Since 1997, I've spent my vacations traveling and working in Brazil as an Outside Consultant on mental health projects with colleagues in Rio and Sao Paulo. In my travels I've been befriended and supported by adherents of a social movement, not unlike the U.S. Civil Rights Movement, that has struggled for many years to close Brazil's long-term psychiatric hospitals, create community-based services and expand the rights of mental patients. Now I see my Brazilian connection as part of my ongoing recovery. I see myself as having the opportunity to be a link between the mental health worlds of the U.S. and Brazil. I believe the two countries have much to offer each other when it comes to mental health.
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PMID:Brazil's mental health adventure. 1265 51

Corticotropin-releasing factor (CRF) systems are major regulators of stress-induced endocrine, autonomic, immune and behavioral responses. Studies indicate that two high affinity CRF receptors designated CRF(1) and CRF(2) mediate the actions of CRF. Dysregulation of this CRF system, which may involve excessive secretion of the CRF peptide and/or alterations in CRF receptor functions, may facilitate the occurrence of stress-induced disorders including anxiety and depression. In the last few years, several specific CRF(1) receptor antagonists were developed and shown to be effective in reducing animal anxiety and depression-like behavior. In contrast, comparable information concerning the role of the CRF(2) receptor has not been available. However, recent preclinical studies demonstrate that CRF(2) receptors may also mediate anxiety behavior. Although the involvement of both CRF(1) and CRF(2) receptors underscores the complexity and diversity in CRF receptor systems underlying the neurobiology of anxiety, the development of CRF receptor antagonists that are capable of binding to one or both receptors may lead to novel pharmacotherapies for the treatment of psychopathology.(c) 2002 Prous Science. All rights reserved.
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PMID:CRF(2) Receptors: An Emerging Role in Anxiety. 1267 15

Since its discovery in 1983, the neuropeptide galanin has been found to be involved in a wide range of functions, including pain sensation, sexual activity, feeding, and learning and memory. Furthermore, galanin has recently been proposed to have a key role in depression, owing to its inhibition of noradrenergic cells, and in epilepsy. Three galanin receptor subtypes have been cloned and studied, though little is known about their specific contributions to behavioral processes. This article reviews galanin's role in behavior, with special attention to learning and memory. It concludes by discussing the status of the pharmacology of galanin, including nonpeptide ligands that have recently been developed with potential for therapeutic use, and the need for better receptor subtype-specific ligands. Despite the existence of many unknowns, the accumulation of basic research and the emergence of new research tools suggests we are entering an exciting period in the development of galanin pharmacology that may lead to new drugs for the treatment of cognitive decline and other neuro- and psychopathologies. (c) 2002 Prous Science. All rights reserved.
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PMID:Galanin: Involvement in Behavior and Neuropathology, and Therapeutic Potential. 1267 50


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