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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the course of treatment by Dr. H.L. Wen's technique of acupuncture for the withdrawal symptoms of various drugs, it was noted that there was a relief of neurotic symptoms, tension, restlessness and depression. Therefore, this treatment was used on neurotic patients. Forty patients ranging in age from 22 to 61 years were treated. Case reports are given on four patients. The degree of relief from neurotic symptoms was most marked in symptoms of restlessness, tension, mental and physical fatigue, loss of appetite and irritability, in that order. Obsessional symptoms showed a poor response. It is concluded that electro-acupuncture is useful in the treatment of neurotic symptoms, that it is cheaper and safer than other methods of treatment in use at this time, and that it is a useful adjunct in the treatment of psychoneurosis.
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PMID:Electro-acupuncture treatment in psychiatry. 30 May 61

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

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

Abrupt or gradual discontinuation of tricyclic antidepressants may precipitate withdrawal symptoms. The most common of these are general somatic or gastrointestinal distress, anxiety and agitation, sleep disturbance, akathisia, parkinsonism, paradoxical behavioral activation and mania. There are very few reports of withdrawal reactions following discontinuation of clomipramine since it has not been in use in the US until recently. 2 patients with withdrawal symptoms following discontinuation of clomipramine are presented. A 45-year-old man had general somatic symptoms, including headache, myalgia, weakness, fatigue (flu-like syndrome) and nervousness and insomnia after clomipramine, 75 mg/d, had been discontinued abruptly. All symptoms disappeared without treatment after 3 days. A 47-year-old woman presented mainly with severe insomnia, anxiety, agitation, jitteriness and tension after discontinuing a low dose of 25 mg/d of clomipramine. Symptoms disappeared after she started self-treatment with 50 mg/d of the drug. It is important to differentiate withdrawal symptoms from relapse of the primary psychiatric disorder.
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PMID:[Withdrawal reactions after clomipramine]. 145 99

It is evident from the data presented above that nausea and vomiting are frequent side effects which are often persistent and distressing to patients. Evidence suggests, and intuitively it appears that avoidance of nausea and vomiting is important to the patients' ability to maintain their quality of life during the treatment period. It is of particular interest to note that in the literature reviewed in this paper standard antiemetic prescribing and practice were followed. It would, therefore, appear that available antiemetic agents are not always effective or may not be adequately employed. The toxicities associated with dopamine receptor antagonists, the current standard of antiemetic regimens, limit their usefulness in the clinical setting. In fact, the contribution of antiemetic therapy toxicities to the incidence of anxiety, fatigue, and restlessness which were commonly reported by patients in the studies reviewed should be considered. Additional effort to characterise the impact of nausea and vomiting on cancer patients' quality of life is needed. Clearly, the data available suggest that these symptoms should be included as part of the physical domain component of quality of life instruments used in cancer patients. Ideally, the instrument used should contain separate items for nausea and vomiting. Major side effects of antiemetic therapy should also be assessed since these may be as debilitating as the effects of nausea and vomiting. Increased awareness of total patient impact of emesis and antiemetic therapy will serve as an impetus for improvements in antiemetic therapy strategies and practices.
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PMID:Nausea and vomiting and cancer patients' quality of life: a discussion of Professor Selby's paper. 146 95

The pharmacokinetic and pharmacodynamic properties of raclopride, a new antipsychotic, were investigated in 16 healthy men. Single 4 mg doses were administered as intravenous infusion, oral solution and 2 extended release (ER) formulations. Total plasma clearance was about 100 ml/min (6.0 L/h), of which renal clearance accounted for 0.2 ml/min, indicating extensive metabolism. The volume of distribution was 1.5 L/kg; mean absolute bioavailability was 65 to 67% following the oral solution and the ER formulations. A transient increase in plasma prolactin levels followed both the intravenous infusion and the oral solution. The ER formulations resulted in a lower increase, which appeared later. However, the area under the prolactin level curve was similar after administration of all dosage forms. The frequency and severity of the most commonly reported side effects (tiredness and restlessness) were higher after the intravenous infusion than after the ER capsules. These findings indicate that such capsules may be advantageous for clinical antipsychotic treatment with raclopride.
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PMID:Pharmacokinetics of raclopride formulations. Influence of prolactin and tolerability in healthy male volunteers. 155 Dec 92

The syndromes of oculogyric crisis (OGC) and paroxysmal perceptual alteration (PPA) in chronic schizophrenics have been investigated. The perceptual symptoms of PPA are characterized by hypersensitivity of perception, psychedelic experience (brightening of colors, sharpening of contrast, visual distortion, etc.) and a disorder of somatic schema (one feels that one is floating, one's extremities are pulled and elongated, etc.). PPA in chronic schizophrenics occurs abruptly mainly in the evening, often precipitated by fatigue. During the attack patients also suffer from mood and thought alteration (anxiety, agitation, depressive mood and inability to distract their thought from one thing), but they are aware that symptoms of PPA are not real and apprehensive about them. The attack ceases gradually and spontaneously while the patient rests or sleeps. The syndrome of OGC occurs in a similar fashion as in PPA; the attack occurs mainly in the evening and is also associated with a variety of transient mood and thought disturbances similar to those in PPA. Four cases have been described in this study, who experienced both PPA and OGC simultaneously. Among 223 schizophrenic patients admitted to our hospital between April 1987 and September 1988, 18 cases with OGC, 5 cases with PPA, and 4 cases with both PPA and OGC were found. The mean +/- SD dose of neuroleptics (chlorpromazine equivalent) at the latest occurrence of these syndromes was 761 +/- 470 mg (N = 22, ranging from 195 to 2010 mg) for OGC and 773 +/- 587 mg (N = 9, ranging from 227 to 2010 mg) for PPA. The appearance of OGC in cases with 195 mg or more dose (chlorpromazine equivalent) of neuroleptics of OGC in cases with with 195 mg or more dose (chlorpromazine equivalent) of neuroleptics (NLP) is significantly higher (p less than 0.05) than that in cases with less than 195 mg of NLP. Similarly, the appearance of PPA in cases with 277 mg or more dose of NLP was higher (p less than 0.1) than that in cases with less than 277 mg of NLP. In paranoid schizophrenic patients the incidences of OGC and PPA were significantly lower (p less than 0.001 and p less than 0.05, respectively) than those in other types of schizophrenics. In disorganized schizophrenic patients the incidence of PPA was significantly lower (p less than 0.01) than those in undifferentiated, residual and schizoaffective types.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[The syndromes of oculogyric crisis and paroxysmal perceptual alteration in chronic schizophrenic patients--a clinical inquiry into their pathophysiology]. 167 49

The majority of persons with dementia are cared for in the home by family and friends. The goals of treatment in this setting are to maximize the quality of life of the demented person and minimize burdens on the caregiver. Behavioral problems are common with dementia and can lead to significant caregiver burden. Behaviors that are most common or most serious to caregivers include behaviors related to memory disturbances, restlessness and agitation, catastrophic reactions, day/night disturbances, delusions, wandering, and physical violence. A general method for clinicians to manage these problems involves the identification of the behavior and its antecedent and consequent events. Stressors that may cause behavioral problems include fatigue, a change of routine, excessive demands, overwhelming stimuli, and acute illness or pain. Caregivers can be taught to identify these stressors in order to prevent or alleviate troublesome behaviors. When behavioral techniques are not successful and the behaviors are particularly dangerous or burdensome, therapy with low doses of high-potency neuroleptics has been suggested. Measures such as these to help caregivers in the management of dementia at home can be instrumental in improving the quality of life for the person with dementia.
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PMID:Managing the behavioral problems of dementia in the home. 176 Jul 95

Ondansetron was compared with metoclopramide for antiemetic efficacy in a randomised double-blind trial in 122 patients with advanced breast cancer. All patients were treated with epirubicin (greater than 50 mg/m2) and cyclophosphamide (greater than 500 mg/m2). 50 patients receiving ondansetron and 60 with metoclopramide were considered evaluable. Ondansetron was at least as effective as metoclopramide in the control of vomiting and nausea. The percentage of patients with complete plus major control was 72% (59-85%) vs. 61% (48-74%) on day 1 (P = 0.230) and 79% (67-91%) vs. 66% (53-78%) on days 2-3 after chemotherapy (P = 0.122). Over the 3-day study period, nausea was absent or mild in 60% of the patients treated with ondansetron, compared to 45% given metoclopramide (P = 0.064). No major drug-related side-effects were reported. 1 patient receiving ondansetron experienced gastrointestinal disturbance and headache. Episodes of diarrhoea, fever, hyperkinetic syndrome, fatigue, restlessness and migraine with vomiting were reported by 5 patients treated with metoclopramide. None of the changes in the biochemical or haematological parameters was attributed to the antiemetic treatments.
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PMID:Double-blind randomised trial of the antiemetic efficacy and safety of ondansetron and metoclopramide in advanced breast cancer patients treated with epirubicin and cyclophosphamide. 183 24

The Geriatric Depression Scale (GDS) is commonly used to measure depression in the elderly. However, there have been no reports of the underlying structure of the GDS. To this end, the GDS was administered to 326 community-dwelling elderly subjects, and the data were subjected to a factor analysis. A five-factor solution was selected and, after a varimax rotation, the factors that emerged could be described as: (1) sad mood, (2) lack of energy, (3) positive mood, (4) agitation, and (5) social withdrawal. This solution accounted for 42.9% of the variance. Knowledge of the factor structure should aid both clinicians and researchers in the interpretation of responses on the GDS.
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PMID:Proposed factor structure of the Geriatric Depression Scale. 186 3


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