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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eighty-one patients undergoing carotid endarterectomy were divided into two groups based on the degree of stenosis of the carotid artery. Group I, 37 patients, was defined as having severe carotid stenosis (greater than 70%). Group II, 44 patients, was defined as having mild (less than 40%) or moderate (40% to 70%) carotid artery stenosis. Both groups were evaluated for neurologic and psychologic changes in the postoperative period. Prospective analysis demonstrated no significant differences between groups I and II in the areas of cardiac disease, history of preoperative stroke, preoperative and postoperative hypertension, diabetes, or postoperative computed tomography changes. Group II had a significantly higher percentage of carotid artery ulceration (p less than 0.01). Postoperative analysis revealed 34 group I patients had 6 to 8 weeks of lethargy versus two group II patients (p less than 0.01). Eleven group I patients had headaches for the first week postoperatively versus three patients in group II (p less than 0.05). Four group I patients had paranoid ideation, and another four patients had clinical depression, but not one patient in group II (p less than 0.01) had these psychiatric disturbances. These data suggest that significant, reversible neurologic and psychologic changes can occur because of reperfusion after relief of severe stenosis of the carotid artery.
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PMID:Postoperative somnolence in patients after carotid endarterectomy. 235 8

Chronic muscle contraction headache (CMCH) and depression have many features in common. Patients with CMCH respond to antidepressants. We attempted to further elucidate this relationship through the use of the dexamethasone suppression test (DST) pattern of patients suffering from CMCH as well as their response to amitriptyline. Twenty drug-free patients suffering from CMCH of at least 6 months' duration were studied with DST and subsequently treated with amitriptyline 75 mg at bedtime. Nineteen patients completed the treatment trial and reported variable headache relief. All cortisol levels were within the expected range. We conclude CMCH patients do not display the DST pattern of endogenous depression.
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PMID:Muscle contraction headache: dexamethasone suppression test and response to amitriptyline. 279 51

The dexamethasone suppression test (DST) was administered in 48 daily chronic headache (DCH) sufferers, 37 of whom also suffered from mild to severe depression. In 14 of 48 subjects (29.2%), cortisol values at 1600h were greater than 50 ng/ml, despite normal suppression at 0800h. The escapers showed basal cortisol values and (Depression scale) scores on the Minnesota Multiphasic Personality Inventory higher than suppressors. Thus, a group of DCH sufferers appeared to share a biochemical defect often seen in endogenous depression. The escape from dexamethasone suppression could be a psychobiological indicator of vulnerability to develop depressive disorder and/or chronic pain complaints.
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PMID:Abnormal dexamethasone suppression test in daily chronic headache sufferers. 378 99

In a period of nine months, all patients referred for purely neurological assessment of headache were fully examined both neurologically and psychiatrically. In 68 of 148 patients the cardinal symptom of headache was found to be the expression of an endogenous depression (46%). This diagnosis was based on the presence of an endogenomorphic-depressive axis syndrome (as classified by Berger), follow-up observations, and the efficacy of antidepressive drug treatment. Neurological and other physical underlying illness was excluded.
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PMID:[How frequently is a headache the expression of endogenous depression?]. 395 4

Alprazolam is a triazolobenzodiazepine, a derivative of the benzodiazepines. Comparison studies of alprazolam and diazepam or chlordiazepoxide in patients suffering from clinical anxiety secondary to anxiety neurosis or chronic alcohol withdrawal suggest an equal efficacy of those agents. Studies examining the use of alprazolam for the treatment of "primary depression" suggest that it is as effective as imipramine in the treatment of exogenous (reactive) depression. Although alprazolam may be effective in patients with exogenous depression, no extrapolation can be made to the treatment of endogenous depression. Mechanisms of action have not been fully elucidated, but probably are similar to those of other benzodiazepines. Peak blood levels are reached in 0.7-1.6 hours and the elimination half-life after steady state is approximately 19 hours. Daily dosages established from clinical studies ranged from 1 to 6 mg. Clinically, alprazolam appears to be ten times more potent than diazepam. Drowsiness, headaches, lightheadedness, dry mouth, and depression appear to be the most common side effects of the drug. It is concluded that alprazolam offers no striking therapeutic advantage over currently marketed benzodiazepines.
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PMID:Alprazolam (Xanax, the Upjohn Company). 611 42

In a double-blind comparison of 21 inpatients with endogenous depression 225 mg zimeldine demonstrated the same degree of antidepressive efficacy as 150 mg amitriptyline after 4 weeks of treatment. Only "sleep disturbances" on the Hamilton Rating Scale for Depression (HRS) showed significant (P less than 0.05) improvement with amitriptyline. Only small differences in the frequency of side effects were seen. In the zimeldine group, increased sweating and headache were more pronounced, while the amitriptyline patients more often reported dry mouth and constipation. Body weight was not significantly changed by either treatment. In the zimeldine group, treatment had to be interrupted in three patients due to hypersensitivity reactions in the form of drug fever. Three other patients in the zimeldine group showed clinically significant elevation of liver enzymes. Hypersensitivity reactions and abnormal blood chemistry were both reversible. The adverse reactions are discussed, the cause of the occurrence remaining unknown.
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PMID:Zimeldine versus amitriptyline in endogenous depression. A double-blind study with special reference to effects on liver function. 623 28

Thirty-nine (39) patients entered a double blind study conducted to compare the therapeutic efficacy and safety of Zimelidine and amitriptyline in endogenous depression. Following a 3-5 day washout period, patients were randomly allocated to Zimelidine or amitriptyline for 6 weeks period and were assessed regularly. 63% of Zimelidine and 65% of amitriptyline patients showed significant clinical improvement. Side effects recorded with amitriptyline were predominantly anticholinergic and headaches with Zimelidine. It is concluded that while Zimelidine and amitriptyline show equally efficacous antidepressant properties, zimelidine may offer a slight therapeutic advantage due to lack of anticholinergic side-effects.
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PMID:Double blind study comparing the efficacy of zimelidine and amitriptyline in endogenous depression. 623 35

Among 33 out-patients with endogenous depression, 16 were treated with bromocriptine (10-60 mg/day, mean 34) and 17 with imipramine (75-250 mg/day, mean 143). The total score on the Hamilton Rating Scale decreased during 6-week treatment from 19.9 to 7.8 in the bromocriptine group (P less than 0.001) and from 20.1 to 6.1 in the imipramine group (P less than 0.001). There was no significant difference between the two groups. The main side-effects were for bromocriptine: nausea, dizziness, and headache; for imipramine; dryness of mouth, dizziness, and sweating. This study suggests an antidepressant effect of bromocriptine although, due to the possibility of Type II error, it may not necessarily be equal to that of imipramine.
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PMID:Bromocriptine and imipramine in endogenous depression. A double-blind controlled trial in out-patients. 645 13

We present a case report of a patient with clinical features suggestive of pseudotumor cerebri (PTC), without a documented elevated measurement of intracranial pressure (ICP). Chart review was done of one patient's clinical course over a 28-month period. The patient was treated for PTC even though she never had a documented elevated ICP. Her signs and symptoms, including headache, disc edema, and visual field loss, all showed improvement with standard PTC therapy, which ultimately included optic nerve sheath fenestration (ONSF). Her presenting symptoms of clinical depression were also relieved with this treatment. PTC may present without an elevated ICP as defined by current standards. Some patients may be more susceptible to lower levels of ICP and develop this syndrome, and it may be responsive to standard PTC therapy. Further investigation may warrant that clinical depression be included as another minor symptom of PTC.
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PMID:"Normal pressure" pseudotumor cerebri. 942 85

Depression is a most common psychiatric complication of Parkinson's patients. Approximately 30% of Parkinson's patients show depressive mood changes. Loss of interest, feelings of hopelessness, marked loss of energy and psychomotor retardation are common depressive symptoms with parkinsonism. Suicidal ideations and delusions are less frequent in Parkinson's patients with depression in compared to endogenous depression. Somatic symptoms, like fatigue, constipation, headache, insomnia, loss of appetite, dizzinees and sweating are usually seen in Parkinson's patient with depression. Serotonin reuptake inhibitors and selegiline are recommended for the treatment of depression in parkinsonian patients.
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PMID:[Parkinson's disease]. 1151 61


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