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

Fluoxetine, a selective inhibitor of 5-HT uptake, was compared to dothiepin in a double-blind study of 6 weeks duration in 100 depressed patients (male and female) drawn from 8 general practices. Only those who scored at least 17 on the first 17 questions of the Hamilton Psychiatric Rating Scale for Depression (HAM-D) were selected. Both groups improved throughout the trial, though the dothiepin treated patients tended to improve quicker. However, by the end of the trial there was no statistically significant difference between the 2 groups. Subset analyses of HAM-D scores associated with anxiety and sleep revealed no statistically significant differences between the 2 treatments though improvement in anxiety scores was marginally greater for those receiving fluoxetine by the end of the trial. Other global assessments by patients and doctors confirmed the changes in HAM-D scores. Statistically significant weight changes occurred between visits 1 and 5. Whereas fluoxetine-treated patients lost weight (p less than 0.05), dothiepin-treated patients gained weight (p = 0.05) over this period. Adverse effects were reported in 27 patients given fluoxetine and 20 dothiepin. Of these, 14 fluoxetine and 7 dothiepin-treated patients withdrew before the end of the trial. The most common adverse effects were nausea, vomiting and diarrhoea in the fluoxetine group and tiredness, drowsiness and diarrhoea in the dothiepin group. There were no haematological or clinical chemistry changes.
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PMID:A double-blind comparative study of fluoxetine and dothiepin in the treatment of depression in general practice. 267 26

Clinical studies on fluoxetine have reported occasional symptoms of increased fatigue in depressed patients. On the other hand, experimental studies in healthy subjects have demonstrated evidence for fluoxetine-induced increases in cortical arousal. The present placebo-controlled study with 24 healthy subjects was designed to answer the following questions: Does fluoxetine increase measures of cortical arousal and decrease feelings of alertness, and does the 5HT2 receptor blocker ritanserin produce inverse effects to fluoxetine? Analyses of covariance revealed the following results: Fluoxetine produced a slight increase, ritanserin a marked decrease in critical flicker fusion frequency. Time perception was slightly improved by both drugs. Self-ratings on alertness and energy were significantly reduced by both fluoxetine and ritanserin as compared to placebo. Effects for fatigue were increased accordingly. Possible underlying neurophysiological mechanisms and specificity of the effects for cortical as opposed to limbic arousal will be discussed.
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PMID:Effects of changes in brain 5-HT activity on indicators of cortical arousal. 315 82

To evaluate the weight reducing effect of fluoxetine on steroid-induced obesity, we conducted an open, clinical intervention study of 20-40 mg/day fluoxetine, 24 weeks duration. Thirteen myasthenia gravis, overweight, long-term steroid-treated patients [age: 31-59, body mass index (BMI): 29-54 kg/m2] were included. Measurements of weight, BMI, and routine laboratory tests, were undertaken at baseline, 12 and 24 weeks. Muscle strength and fatigue parameters were assessed at 4 week intervals. Fluoxetine induced mean weight loss of 7.7+/-2.6 kg and 10.3+/-2.9 kg over a period of 12 and 24 weeks respectively, (P<0.05). Mean BMI decreased from 35.8 to 32.2 kg/m2 over the study period. No significant side effects were noted. We conclude that patients suffering from steroid-induced obesity respond to fluoxetine treatment of overweight by significant weight loss.
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PMID:Fluoxetine treatment for weight reduction in steroid-induced obesity: a pilot study in myasthenia gravis patients. 1008 36

Intrahepatic shunts are rarely diagnosed as a cause of neurocognitive abnormality. A complaint of fatigue led to the diagnosis of a right portal vein-hepatic vein aneurysmal communication in a 23-yr-old, otherwise healthy woman. Neuropsychological testing, imaging, and MR spectroscopy revealed changes similar to those described in patients with cirrhosis and subclinical hepatic encephalopathy. T1-weighted MRI showed a hyperintense globus pallidus, a feature seen in subjects with and without portal-encephalopathy. Portal-systemic shunting in the absence of parenchymal liver disease reproduces neurological features described in cirrhosis.
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PMID:Intrahepatic portal-hepatic venous anastomosis: a portal-systemic shunt with neurological repercussions. 1089 98

Lyndsey Bohanna, 23 years, had mild depression and was prescribed Prozac by doctors to combat insomnia and fatigue. Two months later during a routine check-up a junior doctor changed her prescription. He gave her an antidepressant, dothiepin, which is for severe depression and should not be used with Prozac. It is also an antidepressant with one of the highest chances of overdose. Nine days later she was found dead. An independent review found a host of errors during her treatment at the hospital. The junior doctor had not asked the consultant for advice and had not explained to the patient the risks associated with her new medication. He also failed to inform her GP of how many tablets should be given. What is the law?
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PMID:Accountability and medicinal products 2: civil law. 1503 21

A 75 year old patient was admitted to hospital due to painless jaundice and fatigue. Patient's history was not remarkable for chronic viral hepatitis, autoimmune hepatitis, hereditary metabolic disorders or a hepatotoxic damage. Laboratory tests revealed significant elevation of the parameters of cholestasis and aminotransferase activity, a significantly elevated titer of both antinuclear (ANA) and antimitochondrial (AMA) antibodies. Abdominal ultrasound and computertomography showed no mechanic cholestasis nor tumorous process but a situs inversus abdominalis of the abdominal parenchymatous organs. Portal and periportal inflammation, consistent with autoimmune hepatitis, was diagnosed histologically after performing laparoscopic liver biopsy. Regarding the significantly elevated cholestatic parameters and the positive AMA-autoantibodies AIH-PBC overlap syndrome was highly probable so medical treatment including both ursodeoxycholic acid and immunosuppressive therapy with corticosteroids and azathioprine was started resulting in a continous downward tendency of liver enzymes and an improvement of the patient's clinical condition. Finding the correct diagnosis and therapy of autoimmune liver disease is not always easy and unproblematic. Regarding its sometimes fatal progression and good response towards medical treatment prompt diagnosis and institution of autoimmune hepatitis--alone or combined as PBC/AIH overlap syndrome--should not be deferred. Laparoscopic liver biopsy should be the method of choice in patients's with situs inversus abdominalis regading the variable anatomy.
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PMID:[Cholestatic hepatitis in situs inversus abdominalis]. 1763 66

Effects of the antidepressant fluoxetine on stimulation-dependent synaptic vesicle exocytosis were examined in cultured primary hippocampal neurons. Synaptic vesicles were fluorescently labeled in vitro with FM1-43, washed and subsequently destained in two consecutive cycles. Exocytosis was triggered by electric field stimulation and imaged by fluorescence microscopy. In control preparations, the second staining-destaining cycle caused a significant reduction of relative fluorescence loss, number of active synapses and half-decay time (t(50)). These fatigue effects were largely prevented by short-term administration of 1 microM fluoxetine, which was present before and during the second stimulation cycle. Fluoxetine concentrations above 10 microM inhibited exocytosis almost completely but showed no other toxic effects on neurons. Stressed neurons, grown under hyperosmotic conditions, were even more fatigue-protected by fluoxetine. These observations support the idea that therapeutic concentrations of fluoxetine enhance the recovery of neurotransmission from exhausting stimuli in healthy and in hyperosmotically stressed neurons as well.
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PMID:Fluoxetine prevents stimulation-dependent fatigue of synaptic vesicle exocytosis in hippocampal neurons. 2047 41

Three neurotransmitter systems are implicated in the biological basis of depression: the serotonergic system is thought to be a major component in the development of depression and in the efficacy of antidepressant drugs, while the noradrenergic and dopaminergic systems play lesser roles, but are important in the development of antidepressant side-effects. Selective serotonin re-uptake inhibitors (SSRIs) are still the drug treatments of choice in major depressive disorder, but each has a subtly different pharmacological profile, which has implications for pharmacodynamic actions and clinical efficacy and side-effect profiles. Although the precise mechanisms responsible for specific depressive symptoms are not yet well defined, evidence is emerging that some SSRIs may be more effective in combating certain symptoms than others. Fluoxetine appears to be particularly effective in overcoming symptoms of fatigue and low energy, whereas paroxetine or sertraline may be more appropriately used for depressed patients experiencing anxiety. A growing understanding of molecular mechanisms in depression and the unique clinical consequences of each pharmacological agent brings us one step closer to being able to individualize antidepressant treatment on the basis of core presenting symptoms and the needs of the individual patient. ( Int J Psych Clin Pract 2001; 5 (Suppl 1): S19-S28).
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PMID:Antidepressants: pharmacological profile and clinical consequences. 2493 91

Cancer patients frequently suffer from fatigue, a complex syndrome associated with tiredness and depressed mood. Cancer-related fatigue (CRF) can be present at the time of diagnosis, escalates during treatment, and can persist for years after treatment. CRF negatively influences quality of life, limits functional independence, and is associated with decreased survival in patients with incurable disease. We have previously shown that increased pro-inflammatory cytokine expression in the brain contributes to depressive- and fatigue-like behaviors in a mouse model of CRF. Inflammatory cytokines increase the activity of indoleamine 2,3-dioxygenase (IDO) and kynurenine 3-monooxygenase (KMO), which competitively reduce serotonin synthesis. Reduced serotonin availability in the brain and increased production of alternative neuroactive metabolites of tryptophan are thought to contribute to the development of depression and fatigue. The purpose of this study was to determine the effects of fluoxetine, a selective serotonin reuptake inhibitor (SSRI), on brain cytokines and behavioral measures of fatigue and depression in tumor-bearing mice. Here we show that tumor growth increased brain expression of pro-inflammatory cytokines and KMO. Treatment with fluoxetine had no effect on tumor growth, muscle wasting, fatigue behavior, or cytokine expression in the brain. Fluoxetine, however, reduced depressive-like behaviors in tumor bearing mice. In conclusion, our data confirm that increased brain expression of pro-inflammatory cytokines is associated with tumor-induced fatigue- and depressive-like behaviors. However, it is possible to separate the effects of tumor growth on mood and fatigue-like behaviors using SSRIs such as fluoxetine.
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PMID:Fluoxetine prevents the development of depressive-like behavior in a mouse model of cancer related fatigue. 2555 80

Erectile dysfunction is a sexual dysfunction which is commonlycomorbid with major depression. Antidepressant treatment does notalways improve comorbid sexual dysfunctions in major depression. Infact, sexual dysfunction may worsen or get complicated following theintroduction of antidepressants. Modafinil is a drug with stimulanteffect on the central nervous system by binding to norepinephrineand dopamine transporters and consequently increasing synapticnorepinephrine and dopamine levels. Modafinil is primarily used inthe treatment of narcolepsy and chronic fatigue syndrome. In addition,it is known for its effectiveness in attention deficit hyperactivitydisorder and as an add-on option for major depression. In this paper,we report the case of a 39-year-old man with major depression whosecomorbid erectile dysfunction improved after addition of modafinilto antidepressant treatment. Fluoxetine 20 mg/day was initiatedand despite the improvement of most of the depressive symptomsand the sexual desire, his complaints of fatigue, weakness and erectiledysfunction continued. With the addition of modafinil (200 mg /day),improvement was observed not only in psychomotor symptoms but alsoin erectile dysfunction of the patient.
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PMID:[Use of Modafinil in Co-existing Major Depression and ErectileDysfunction: A Case Report]. 3148 80


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