Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a controlled clinical investigation based on ten patients with simple absences and ten patients with myoclonic atonic seizures, all patients who had insufficient response to conventional antiepileptic treatment received clonazepam (Rivotril [Denmark]; Clonopin, comparable US product) combined with previous antiepileptic drugs. The effects of the combined use of clonazepam and the previous antiepileptid drugs were compared with the effects of placebo combined with the same drugs. The trial was single-blind crossover with sequential analysis. In a daily dose of usually 3 to 6 mg, depending on patient age, the antiepileptic effect of clonazepam was significantly superior to placebo and was estimated as remarkably good. Side-effects of somnolence, fatigue, drowsiness, and coordination disturbances occurred in most of the patients, but subsided spontaneously or could be controlled by slow increase or slight reduction of dosage. Mental sideeffects such as agitation, confusion, and aggressiveness were more troublesome and caused discontinuation of clonazepam in two patients.
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PMID:Clonazepam in the treatment of epilepsy. A controlled clinical trial in simple absences, bilateral massive epileptic myoclonus, and atonic seizures. 81 96

A group of 27 patients with various types of epilepsy were selected for a 6-month double-blind crossover study to compare the anticonvulsant effect and toxicity of eterobarb and phenobarbital. No statistically significant differences in seizure frequency were found among the 21 patients who completed the 6-month trial, but three others, in whom status epilepticus developed during the crossover from eterobarb to phenobarbital, had to be removed from the trial. The study provided some indication that when eterobarb and phenobarbital were used in high dosage with corresponding high serum barbiturate levels (over 30 mug per milliliter), eterobarb had a superior therapeutic effect. Side effects from both drugs included tiredness, sleepiness, nystagmus, and infrequently ataxia, but serious systemic toxicity did not occur. This study showed that eterobarb is a safe and potent anticonvulsant comparable in efficacy to phenobarbital, and the superior results obtained in some patients with eterobarb therapy indicate that it is an effective alternative anticonvulsant.
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PMID:Eterobarb therapy in epilepsy. 82 67

Clonazepam or 5-(2-chlorphenyl)-1, 3-dihydro-7-nitro-2H-1,4benzodiazepin-2-one, is a close structural and pharmacological relative of nitrazepam. It has a broad spectrum of activity against the various types of epilepsy, and is effective in many patients whose condition has proved resistant to other antiepileptic drugs. Its chief uses are in status epilepticus, in which intravenous clonazepam may replace diazepam as the drug of first choice, and in the minor motor seizures of childhood, particularly petit mal absences, the Lennox-Gastaut syndrome and infantile spasms. Clonazepam is also at least as effective as current treatment in psychomotor and myoclonic epilepsies, but seems unlikely to replace phenytoin and the barbiturates in the treatment of grand mal or focal motor seizures except in patients resistant to standard therapy. Initial success with clonazepam can be followed by loss of effect, but benefit can often be restored, at least initially, by temporary interruption and re-institution of treatment. Side-effects are common with clonazepam. Most patients experience drowsiness and fatigue, which are frequent causes of withdrawal, together with lesser incidences of ataxia, dystonia, hypotonia, and hyperactivity. These effects usually disappear with continued therapy, and are minimised by gradual introduction of the drug over 2-4 weeks. Hypersalivation and excessive bronchial secretion may be a problem in children and infants.
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PMID:Clonazepam: a review of its pharmacological properties and therapeutic efficacy in epilepsy. 97 34

The possibility (based on the recognised existence of anticonvulsant osteomalacia), of an osteomalacic origin of a number of subjective symptoms in epileptics (back pain, tiredness, sleepiness, irritability, and giddiness) was tested during a controlled therapeutic trial in 226 outpatients. There was no correlation between subjective symptoms and objective pathological indices of osteomalacia, and group treated with vitamin D (2000 international units daily for 3 months) showed no amelioration of subjective symptoms above that seen in the placebo group. The findings do not support the view that all epileptic patients on anticonvulsant therapy should be treated prophylactically with vitamin D.
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PMID:Subjective symptoms in epileptic patients on anticonvulsant drugs. A controlled therapeutic trial on the effect of vitamin d. 109 58

Periodic sleep apnea may be due to repeated episodes of upper airway obstruction in patients who have a short thick neck and/or large jowls. Apnea due to complete cessation of breathing may occur to a lesser extent. Anaylsis of the sleep electroencephalogram shows that these patients rarely achieve deep sleep and have less stage 1-REM sleep than normal subjects of comparable age. They are chronically sleep-deprived, a manifestation expressed by daytime somnolence, chronic fatigue and often by personality disturbances marked by paranoia, agitated depression and hostility. The definitive diagnosis of this syndrome may be established by monitoring during sleep, the electroencephalogram, measuring abdominal excursions through a mercury-in-Silastic-strain gauge and recording air flow at the nose by means of a thermocouple. As demonstrated by other investigators, chronic hypoventilation during sleep leads to both pulmonary and systemic arterial hypertension, which may produce generalized cardiac enlargement and congestive heart failure. The abnormalities in the periodic sleep apnea syndrome are abolished by establishing a patent airway either through tracheostomy or weight reduction.
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PMID:Periodic sleep apnea: chronic sleep deprivation related to intermittent upper airway obstruction and central nervous system disturbance. 111 91

The incidence of drowsings as a cause of near traffic accidents was studied on the basis of daily recordings or near accidental events by 288 locomotive drivers during a rotation period of 2-3 weeks. Of 198 near accidents reported during 2,290 trips, 34 cases, or 1,5 cases per 100 trips, were operation missess involving drowsing or strong drowsiness. Improper operation due to drowsing occurred at a certain rate for any group of drivers, irrespective of the type of train, running sections, weather, and other operative conditions such as train delays, whereas 117 cases of danger caused by unforeseen obstacles on the track were related to site characteristics, and 47 cases of other disorders were frequent in unusual operative conditions such as arrival-departure, poor signal display, wrong instructions, or equipment failure. Thus continued driving under ordinary track conditions at a more or less constant speed was likely to induce drowsiness under the dominant influences of fatigue and time of the day; 79% of such cases occurred between midnight and 6 a.m. Most drowsings on the second night appeared during the first 2-4 hr of duty. Effects of monotony and insufficient rest were discussed in relation to recurrent fluctuation in vigilance.
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PMID:Incidence of near accidental drowsing in locomotive driving during a period of rotation. 122 12

Interferon (IFN) related neurotoxicity includes somnolence and confusion, fatigue, lethargy, psychiatric symptoms, conceptual disorganization, neurological deficits, cortical blindness, coma and, rarely, death. The neurologic syndromes seem to be more common in elderly patients, following intramuscular or intravenous administration, at higher doses of frequent injections of IFN-alpha and in primary renal cell carcinoma. The duration of the treatment was not strongly related to neurotoxicity. Computed tomography findings were non-specific and included atrophy or periventricular lucencies. Electroencephalograph studies demonstrated a generalized increase in slow wave activity which returned to normal after cessation of treatment. Behavioral and mental changes in patients treated with IFN are warning signs, and indicate the need to withdraw treatment.
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PMID:Neurotoxicity of interferon-alpha. 128 26

In adverse drug reaction studies proper control over 'Back ground noise' is to be maintained to avoid erroneous conclusions to be drawn for adverse drug effects. Healthy volunteers, not taking any medication, were surveyed by a questionnaire to obtain data on the occurrence of any symptoms, often ascribed to side effects of drugs. Only 62 subjects out of a total of 236 (26.27%) stated experiencing none of these symptoms during the previous 3 days. The remaining subjects reported some symptoms, with an median number of symptoms experienced per person being 2; the most common being fatigue; headache, inability to concentrate and excessive sleepiness.
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PMID:Background noise in healthy volunteers--a consideration in adverse drug reaction studies. 129 78

124 Rhesus monkeys (Macaca Mulatta) were caught in the Taihang Mountain region, a high incidence area of human esophageal cancer in Northern China, in January 1989. Among them, two monkeys died of esophageal carcinoma in 1990. Case 1, a male monkey about 6.5 years old and weighing 14.5 kg, had symptoms of salivation, vomiting and dysphagia in February 1990. The symptoms became gradually more serious and died in March 1990. Postmortem examination revealed a huge tumor in the distal segment of esophagus, causing severe stricture of the organ. The tumor was classified as medullary type and histopathologically diagnosed as a well differentiated squamous cell carcinoma, with metastases to mediastinum and lymph nodes of right gastric group. Case 2, a female monkey about 11-year-old and weighing 10.0 kg, showed loss of appetite, tiredness, somnolence, coughing and vomiting in September and died in December 1990. Autopsy revealed an annular tumor involving the whole circumference of lower portion of the esophagus. The tumor was of ulcerative type and diagnosed as a well differentiated squamous cell carcinoma. The symptoms and pathological changes of the two monkeys showed high similarity to esophageal cancer in humans. We believe that the present findings would provide important leads for further study to clarify the etiology and pathogenesis of human esophageal cancer in this high incidence area of esophageal cancer.
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PMID:[Esophageal cancer in rhesus monkeys from the Taihang Mountain area. A preliminary report]. 130 71

The average therapeutic effect of classical tricyclic antidepressants and antidepressants of the second and third generation varies between 60-70%. Moreover, tricycklic antidepressants are associated with undesirable effects mostly anticholinergic and "cardiotoxic", which may be a contraindication in particular in patients with multiple diseases and in older age groups. The authors compared two new alternative therapeutic procedures, represented by new highly effective benzodiazepines and anticonvulsants, as regards the therapeutic effect and side-effects. From this comparison ensues that their general therapeutic effect is on average comparable with the effect of tricyclic antidepressants, however, in the spectrum of their undesirable symptoms the anticholinergic effects are absent. Recent benzodiazepines have a better effect on depressions where anxiety and agitation are in the foreground. Their effect on depressive core symptoms is more marked, as compared with anticonvulsants. The most frequent side-effects are fatigue, somnolence and vertigo. Anticonvulsants have a balanced effect in different syndromological forms of depression. Undesirable effects are mostly gastrointestinal. In the authors' trials it did not lead to hypomania.
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PMID:[Alternative therapy in the acute phase of endogenous depression--antiepileptics and new benzodiazepines and their comparison]. 136 40


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