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 the light of three case histories, other personal observations and the literature, the clinical and electroencephalographical differences between absences in the limited sense and continuous LENNOX petit-mal state are described and the problems of the latter discussed. As a rule, petit-mal state is diagnosed as such in young people or adults, and practically never before the 10th year of life. In about two thirds of cases, its clinical symptomatology consists of a twilight condition lasting some hours to a few days, coupled with inertia and apathy. The remaining third of the patients usually experience milder disturbances, e.g. in the form of concentration difficulties, tiredness, and (more rarely) severe forms including lethargy. The EEG correlate of a petit-mal state is made up of continuous bilaterally synchronous, frontally marked (less frequently with exclusively frontal localization), usually irregular spike waves or poly-spike waves, which frequently occur in only rudimentary forms and register a frequency of 2 1/2-4 c/sec. For the treatment of petit-mal state, benzodiazepines and in particular clonazepam (Rivotril) (1-2 mg i.v.) are recommended. During the interval condition the same therapy as with an absence epilepsy, e.g. succinimides or dipropylacetate (Depakine) is administered. Anti-grand-mal remedies, especially hydantoins, may trigger petit-mal status.
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PMID:[The petit-mal-status]. 1 55

Clonazepam (Antelepsin) was tested on 179 patients in 8 institutions during a period of 180 days. 169 patients had been unsuccessfully treated with the usual standard medication and were additionally given Antelepsin. Typical absences and attacks of the West and Lennox syndromes yielded best to treatment with the drug, with favorable effects also being produced in cases of partial or focal epilepsy. The most important side-effect was tiredness, other collateral effects being balance disorders, sensations of dizziness, and musuclar weakness. The frequency of side-effects decreased in the course of therapy. In the electroencephalogram there was observed a significant increase in beta waves and a significant decrease in 3 Hz spike and wave complexes.
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PMID:[Treatment of epilepsy with clonazepam (Antelepsin)]. 54 53

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

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

Clonazepam was administered to 55 patients with depressive disorder (DSM-III-R) in average minimal and maximal doses of 2.40 and 6.54 mg/day for 21-28 days. Complete remission was achieved in 60% patients (Serejskij AB, drop of global HAMD and FKD score by more than 50%), in particular in case of concurrent anxiety. A marked antidepressive effectiveness of clonazepam was suggested also by a drop of the total HAMD and FKD score already after the first week of treatment. All items of the HAMD and FKD scale were significantly positively influenced with the exception of agitation, somatic anxiety, insight, paranoidity, obsession respectively hypochondriasis and paranoidity. No correlation was found between the effect of clonazepam and sex, the patients' age, duration of the depressive disorder, period of the index episode and severity of depression. As to undesirable effects, the authors recorded fatigue and sleepiness (40%) and hypotension (20% of the patients), in particular at the onset of treatment and after larger daily doses. In 3/10 bipolar patients a switch to hypomania was observed.
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PMID:[Effectiveness of clonazepam in depressive disorders]. 865 96