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Query: UMLS:C0012833 (
dizziness
)
9,689
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Approximately 20 million patients suffer from major depressive disorder each year, indicating a need for antidepressant agents that are synonymous with effectiveness, tolerability and patient compliance. The authors examined the effects of fluvoxamine, a selective serotonin reuptake inhibitor, in the treatment of outpatients meeting
DSM
-III-R criteria for major depressive disorder. A randomized, double-blind, parallel group, placebo- and imipramine-controlled single center study was conducted in 150 outpatients. Patients were randomized to receive up to 150 mg/day of fluvoxamine as a single bedtime dose, 240 mg/day of imipramine on a twice-daily (BID) schedule, or placebo for six weeks. Efficacy measurements included HAM-D, MADRS, CGI, Raskin-Covi and SCL-56 scales. The HAM-D total score indicated that both active treatment groups showed significantly (p < or = 0.05) greater therapeutic benefit than did placebo. Severely depressed patients (HAM-D > or = 30) responded better to fluvoxamine in five of six measures. Side-effects from fluvoxamine were similar to those reported for other selective serotonin reuptake inhibitors (nausea, somnolence) and were well tolerated. Imipramine was associated with anticholinergic effects such as dry mouth and
dizziness
. The pharmacokinetic properties of fluvoxamine which allow the drug to be administered as a single daily dose should aid in the maintenance of patient compliance, while offering significant clinical benefit in the improvement of depressive symptoms.
...
PMID:Fluvoxamine versus imipramine and placebo: a double-blind comparison in depressed patients. 880 49
The results of an open tolerability and exploratory efficacy study of bretazenil, a partial benzodiazepine-receptor agonist in hospitalized schizophrenic patients with an acute psychotic episode (
DSM
-III-R criteria), are presented. The duration of the study was 6 weeks, with a mandatory titration (ascending doses of 3-18 mg/day) period of 14 days. The assessment criteria for tolerability were the frequency of adverse events (including EPS), vital signs and laboratory tests. The efficacy criteria, which were only descriptively analysed, were: (a) Clinical Global Impression (CGI, percentage of "very much" and "much" improvement); and (b) change in BPRS total score (e.g. percentage of patients showing > or = 40% decrease of BPRS score at the end of the treatment). Sixty-six patients (aged 21-62 years) with acute episodes of schizophrenia of moderate to marked severity (mean BPRS score = 46.3, range 26-76) were included in the study. Of these 66 patients (68%) were reportedly non-responders (n = 10) or partial responders (n = 35) to previous neuroleptic therapy. Twenty patients (30%) terminated the trial prematurely due to therapeutic failure (no improvement or worsening after 2 weeks of treatment), 17% of patients dropped out due to other reasons (transfer to other hospitals, withdrawal of consent, intercurrent diseases) and 4.5% of patients stopped the treatment due to adverse reactions. Four patients (6%) showed early complete remission and refused to be further treated. The analysis of efficacy (intention-to-treat) revealed a sustained decrease of BPRS scores with 49% of patients showing > or = 40% BPRS score change by the end of the treatment. Forty-four per cent of patients improved "very much" or "much". Eleven patients (17%) were full responders (BPRS score decrease 75-100%) and 21 patients (32%) showed at least 40% reduction of BPRS score. The reduction of BPRS scores in completers only was 60%. All BPRS factor scores decreased in parallel and, particularly, no preferential decrease of anxiety/depression subscores was found. The analysis of tolerability showed that 59% of patients presented no complaints at all. The most frequent treatment-related adverse reactions in the remaining patients were: sedation (n = 14),
dizziness
(n = 4) and headache (n = 3). The results of this study suggest moderate antipsychotic efficacy of bretazenil in schizophrenic patients. They encourage further investigations of partial benzodiazepine-receptor agonists in this indication, particularly because of the excellent tolerability and lack of extrapyramidal side-effects.
...
PMID:Antipsychotic effects of bretazenil, a partial benzodiazepine agonist in acute schizophrenia--a study group report. 890 33
The Beck Anxiety Inventory (BAI) has become a popular measure in anxiety assessment and the BAI does not overlap in content with measures of depression. There is also some factor analytic evidence to support this distinction. However, an inspection of the BAI's content indicates that many of its items resemble, or are identical to, the symptoms of panic attacks listed in the
DSM
-IV. Further empirical support for this suspicion is provided from the results of a factor analysis of the BAI items and the individual
DSM
-IV panic symptoms contained in the Panic Attack Questionnaire, using data from a sample of 157 panic disorder patients. A three-factor model (
dizziness
related, catastrophic cognitions/fear, cardiorespiratory distress) emerged that replicated a three-factor model of panic symptoms identified in earlier work with another panic disorder sample. All but one of the BAI items loaded highly on the three panic symptom clusters and no separate BAI factor was obtained. The BAI appears to be confounded with, or actually measures, panic attacks rather than anxiety in general. Several implications of this finding are discussed.
...
PMID:Does the Beck Anxiety Inventory measure anything beyond panic attack symptoms? 899 May 48
Cardiovascular adverse effects are amongst the most serious observed with antidepressant drugs and are often due to effects on cardiac conduction and refractoriness. However, such electrophysiologic effects may not be evident when using conventional electrocardiographic measures. Forty patients with major depressive disorder (according to
DSM
-III-R criteria) were enrolled in a 6-week double-blind parallel group study of fluoxetine (N = 20) or doxepin (N = 20). Cardiac conduction (QRS duration) and repolarization (corrected QT interval, QTc), were measured using signal-averaged electrocardiograms and 12-lead electrocardiogram at baseline and after 2, 4, and 6 weeks of treatment. Patients taking doxepin (mean daily dosage at 6 weeks 169 +/- 42 mg) were similar to those taking fluoxetine (37 +/- 18 mg) for demographic variables and improvement in depression scores but volunteered more side effects (p = 0.011), especially dry mouth (p < 0.001) and
dizziness
/lightheadedness (p = 0.005). After 6 weeks, doxepin increased heart rate (69 +/- 12 to 81 +/- 13 beats per minute; p = 0.0003) and prolonged QTc (from 417 +/- 36 to 439 +/- 28 msec; p < 0.03); overall QRS duration was not prolonged but was correlated with serum doxepin concentrations (r = 0.78, p < 0.0001). Fluoxetine had no effect on QTc (428 +/- 24 msec at baseline vs. 430 +/- 24 msec at 6 weeks) or QRS duration (97 +/- 12 msec at baseline vs. 94 +/- 12 msec at 6 weeks). The standard 12-lead electrocardiogram showed no significant change in QRS or QTc for either drug. Using a sensitive measure of electrocardiographic effects, doxepin prolongs repolarization and may slow cardiac conduction. Fluoxetine has no measurable electrocardiographic effects, which suggests an increased safety margin for cardiac adverse effects. The ability of the signal-averaged electrocardiogram to resolve small changes in the electrocardiogram is useful in the assessment of drugs with subtle electrophysiologic effects.
...
PMID:Electrocardiographic effects of fluoxetine and doxepin in patients with major depressive disorder. 900 52
Psychogenic pain, disturbances of gait and stance, sensory symptoms,
dizziness
, and psychogenic seizures have been found to be the most common conversion symptoms in neurology clinics. A retrospective analysis of 18 patients suffering from pseudoseizure "status" is presented in this study. All of the patients fulfilled the
DSM
-III-R criteria of conversion disorder. However, 5 of them had concomitant major depression, 6 suffered from bulimia nervosa, and 7 met the criteria for substance abuse. On Axis II, 10 cases of borderline personality disorder, 2 cases of antisocial personality disorder, and 3 cases of histrionic personality disorder were diagnosed. The majority of the patients had attempted suicide and other forms of self-destructive behavior. The findings suggest that patients with pseudoseizure "status" suffer from severe affective imbalances and disturbed impulse control.
...
PMID:Pseudoseizure "status". 919 24
To date, the quantitative psychopathology of panic disorder (PD) has been less well studied than that of other psychiatric conditions such as schizophrenia or major depression. The aim of the present study was to assess the frequency and factorial grouping of symptoms in a naturalistic sample of PD patients. A total of 274 consecutive cases of PD who contacted an out-patient clinic in Barcelona, Spain were assessed by two experienced interviewers. The assessment instruments included the Structured Clinical Interview for
DSM
-III-R Upjohn version (SCID-UP-R) and an inventory of panic attack symptoms based on
DSM
-III-R. Of the patients who presented at the unit during the assessment period, 8.5% presented with PD. Palpitations, shortness of breath, fear of dying and
dizziness
were the most frequent and intense symptoms reported by the PD patients. Principal-component analysis revealed four factors which accounted for 57% of the variance, including 'cardiorespiratory' (26.1%) and 'vestibular' (15.1%) factors, and two additional factors with mixed symptoms. The frequency of presentation of symptoms was similar to that reported in other studies. However, some discrepancies were observed that may be attributed to transcultural differences as well as to terminological problems and the range of symptoms assessed. These factors may also explain some of the differences found in factor analysis groupings in previous studies. Our findings support the symptom subtyping of PD.
...
PMID:Semiology and subtyping of panic disorders. 957 Apr 87
Ginkgo biloba is a plant extract used to alleviate symptoms associated with cognitive deficits, e.g., decreased memory performance, lack of concentration, decreased alertness, tinnitus, and
dizziness
. Pharmacologic studies have shown that the therapeutic effect of ginkgo is based on several active constituents with vasoactive and free radical-scavenging properties. The use of ginkgo extract in either dementias of the Alzheimer or multi-infarct type or in the case of cerebral insufficiency, a symptom complex related to age-dependent impairment of cerebral circulation, is based mainly on positive results from good-quality placebo-controlled studies that enrolled approximately 1,200 patients with criteria established by International Classification of Diseases (9th and 10th revisions, ICD-9 and ICD-10) or the 3rd revision of the Diagnostic and Statistical Manual (
DSM
-III-R) (uncomplicated dementia). Effect on cognitive symptoms was within the range of a 25% reduction. Memory, concentration, and alertness were the first symptoms to be relieved, with tinnitus and
dizziness
improving somewhat later. A minimum of 4 to 6 weeks were needed before a pronounced effect could be expected. The pharmacologic advantage of ginkgo seems to be a very tolerable side-effect profile, with a side-effect frequency at the placebo level.
...
PMID:Clinical improvement of memory and other cognitive functions by Ginkgo biloba: review of relevant literature. 1017 38
This multicenter study compared the efficacy and safety of citalopram and placebo in a population of moderately to severely depressed patients with melancholia. This randomized, double-blind, parallel-group study compared citalopram (flexible dose; 20-80 mg/day) with placebo in 180 psychiatric outpatients with a
DSM
-III diagnosis of major depression or bipolar disorder, depressed, who also met
DSM
-III criteria for melancholia. Following a 1-week placebo washout period, patients meeting study entry criteria were randomized to 4 weeks of double-blind treatment with either citalopram or placebo. Efficacy measures included the Hamilton Rating Scale for Depression (HAM-D), the Clinical Global Impressions (CGI) Scale, and the Zung Self-Rating Depression Scale. Patients treated with citalopram showed significantly greater improvement at endpoint than placebo patients on the HAM-D, CGI, and Zung scales. On the HAM-D, citalopram patients exhibited significantly greater improvement than placebo patients after 1 week of double-blind treatment and at all subsequent study visits. Endpoint analyses of the HAM-D subscales demonstrated that citalopram produced significant improvement of the psychomotor retardation, cognitive disturbance, sleep disturbance, and melancholia symptom clusters. Nausea, dry mouth, somnolence,
dizziness
, and increased sweating were reported at higher rates by citalopram-treated patients than by placebo-treated patients, but there were no significant citalopram-placebo differences in the incidence of activation (e.g., anxiety, nervousness, insomnia) or sexual dysfunction. Analysis of electrocardiograms, vital signs, and laboratory tests did not reveal any clinically significant effects of citalopram treatment. The results of this study indicate that citalopram is safe and effective in the treatment of depressed patients with melancholia, and is associated with a favorable side effect profile and a potentially rapid onset of action.
...
PMID:Double-blind comparison of citalopram and placebo in depressed outpatients with melancholia. 1020 59
The primary objectives of this multicenter study were to determine the efficacy and safety of moclobemide, a selective reversible inhibitor of monoamino oxidase A, as drug treatment in
DSM
-III-R panic disorder with and without agoraphobia. In a comparative double-blind, randomized parallel-group design with fixed-flexible dose moclobemide 450 mg per day was compared to clomipramine 150 mg per day, as that drug was considered standard treatment of panic disorder in Europe. 135 patients were randomized and treated for a period of eight weeks. No other treatment was given. By the end of week 8, 49% of the patients treated with moclobemide and 53% of those treated with clomipramine were seen as treatment responders since they were without panic attacks. 78% of the patients in the moclobemide and 88% in the clomipramine group were considered responders according to clinical global impression of change. No significant differences were found between the two treatments at week 8. Adverse events were observed with significantly higher frequency among patients treated with clomipramine, particularly due to anticholinergic side effects. Close to 20% of those treated with moclobemide experienced headache,
dizziness
, nausea, insomnia, or dry mouth, but other adverse effects were infrequent. In conclusion, moclobemide in a dose of 450 mg per day seems to be a good drug alternative for treatment of panic disorder with and without agoraphobia.
...
PMID:The efficacy and safety of moclobemide compared to clomipramine in the treatment of panic disorder. 1036 62
In the early 1970s, a number of observers hypothesized that there had been an increase in mild depression in the United State. Interest in mild depression had increased in the world. One manifestation of that interest was the decision in previous official Nomenclatures of WHO and APA to create separate category for affective disorders in the
DSM
-III. Patients of mild depression complain mainly of physical symptom, for example, headache, lumbago, abdominal pain,
dizziness
, sleep disturbance, appetite loss. Early internal treatment of mild depression consists of three factors, rest, antidepressants and psychosocial supports. Up to date, the first choice of antidepressants in SSRI. SSRI has antidepressive effect and less side effect than TCA.
...
PMID:[Early internal treatment of mild depression]. 1151 60
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